Minnesota Legislature
HF 1362A
Conference Committee Report - 86th Legislature (2009 - 2010) Posted on 01/15/2013 08:25pm
KEY: stricken = removed, old language.
underscored = added, new language.
1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 1362
1.3relating to state government; establishing the health and human services budget;
1.4making changes to licensing; Minnesota family investment program, children,
1.5and adult supports; child support; the Department of Health; health care
1.6programs; making technical changes; chemical and mental health; continuing
1.7care programs; establishing the State-County Results, Accountability, and
1.8Service Delivery Redesign; public health; health-related fees; making forecast
1.9adjustments; creating work groups and pilot projects; requiring reports;
1.10decreasing provider reimbursements; increasing fees; appropriating money to
1.11various state agencies for health and human services provisions;amending
1.12Minnesota Statutes 2008, sections 62J.495; 62J.496; 62J.497, subdivisions
1.131, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 2;
1.14125A.744, subdivision 3; 144.0724, subdivisions 2, 4, 8, by adding subdivisions;
1.15144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 1a; 144.125,
1.16subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 144.9501,
1.17subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 1g, 4;
1.18144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by adding
1.19a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98,
1.20subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.073, by
1.21adding a subdivision; 144A.44, subdivision 2; 144A.46, subdivision 1; 148.108;
1.22148.6445, by adding a subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180,
1.23subdivisions 1, 2, 3, 5; 153A.17; 156.015; 157.15, by adding a subdivision;
1.24157.16; 157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470,
1.25subdivision 1; 245.4871, subdivision 27; 245.488, subdivision 1; 245.4885,
1.26subdivision 1; 245A.03, by adding a subdivision; 245A.10, subdivisions 2, 3,
1.274, 5, by adding subdivisions; 245A.11, subdivision 2a, by adding a subdivision;
1.28245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, subdivisions 1,
1.293; 245C.05, subdivision 4; 245C.08, subdivision 2; 245C.10, subdivision 3,
1.30by adding subdivisions; 245C.17, by adding a subdivision; 245C.20; 245C.21,
1.31subdivision 1a; 245C.23, subdivision 2; 246.50, subdivision 5, by adding
1.32subdivisions; 246.51, by adding subdivisions; 246.511; 246.52; 246B.01, by
1.33adding subdivisions; 252.46, by adding a subdivision; 252.50, subdivision
1.341; 254A.02, by adding a subdivision; 254A.16, by adding a subdivision;
1.35254B.03, subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision
1.361; 254B.09, subdivision 2; 256.01, subdivision 2b, by adding subdivisions;
1.37256.045, subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions
1.382, 6; 256.963, by adding a subdivision; 256.969, subdivision 3a; 256.975,
1.39subdivision 7; 256.983, subdivision 1; 256B.04, subdivision 16; 256B.055,
1.40subdivisions 7, 12; 256B.056, subdivisions 3, 3b, 3c, by adding a subdivision;
1.41256B.057, subdivisions 3, 9, by adding a subdivision; 256B.0575; 256B.0595,
1.42subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2;
2.1256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions
2.25, 8; 256B.0625, subdivisions 3c, 7, 8, 8a, 9, 13e, 17, 19a, 19c, 26, 41, 42, 47;
2.3256B.0631, subdivision 1; 256B.0641, subdivision 3; 256B.0651; 256B.0652;
2.4256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, subdivisions
2.52, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 256B.0911,
2.6subdivisions 1, 1a, 3, 3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913,
2.7subdivision 4; 256B.0915, subdivisions 3e, 3h, 5, by adding a subdivision;
2.8256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 256B.092,
2.9subdivision 8a, by adding subdivisions; 256B.0943, subdivision 1; 256B.0944,
2.10by adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision
2.111; 256B.15, subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.37,
2.12subdivisions 1, 5; 256B.434, by adding a subdivision; 256B.437, subdivision 6;
2.13256B.441, subdivisions 48, 55, by adding subdivisions; 256B.49, subdivisions
2.1412, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 4a; 256B.5011,
2.15subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, subdivision
2.161; 256B.69, subdivisions 5a, 5c, 5f; 256B.76, subdivisions 1, 4, by adding
2.17a subdivision; 256B.761; 256D.024, by adding a subdivision; 256D.03,
2.18subdivision 4; 256D.051, subdivision 2a; 256D.0515; 256D.06, subdivision
2.192; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.49, subdivision 3;
2.20256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, subdivisions 1a, 7c;
2.21256J.08, subdivision 73a; 256J.20, subdivision 3; 256J.24, subdivisions 5a,
2.2210; 256J.26, by adding a subdivision; 256J.37, subdivision 3a, by adding a
2.23subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3; 256J.49, subdivision
2.2413; 256J.575, subdivisions 3, 6, 7; 256J.621; 256J.626, subdivision 6; 256J.751,
2.25by adding a subdivision; 256J.95, subdivision 12; 256L.04, subdivision 10a,
2.26by adding a subdivision; 256L.05, subdivision 1, by adding subdivisions;
2.27256L.11, subdivisions 1, 7; 256L.12, subdivision 9; 256L.17, subdivision 3;
2.28259.67, by adding a subdivision; 270A.09, by adding a subdivision; 295.52,
2.29by adding a subdivision; 327.14, by adding a subdivision; 327.15; 327.16;
2.30327.20, subdivision 1, by adding a subdivision; 393.07, subdivision 10; 501B.89,
2.31by adding a subdivision; 518A.53, subdivisions 1, 4, 10; 519.05; 604A.33,
2.32subdivision 1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572,
2.33subdivisions 6, 13, 21; Laws 2003, First Special Session chapter 14, article
2.3413C, section 2, subdivision 1, as amended; Laws 2007, chapter 147, article
2.3519, section 3, subdivision 4, as amended; proposing coding for new law in
2.36Minnesota Statutes, chapters 62A; 62Q; 156; 246B; 254B; 256; 256B; proposing
2.37coding for new law as Minnesota Statutes, chapter 402A; repealing Minnesota
2.38Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b; 148D.180,
2.39subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, subdivision
2.407; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10,
2.4111, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 5a; 256B.19,
2.42subdivision 1d; 256B.431, subdivision 23; 256D.46; 256I.06, subdivision 9;
2.43256J.626, subdivision 7; 327.14, subdivisions 5, 6; Laws 1988, chapter 689,
2.44section 251; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts
2.451, 3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5,
2.466; 9555.6125, subpart 4, item B.
2.47May 10, 2009
2.48The Honorable Margaret Anderson Kelliher
2.49Speaker of the House of Representatives
2.50The Honorable James P. Metzen
2.51President of the Senate
2.52We, the undersigned conferees for H. F. No. 1362 report that we have agreed upon
2.53the items in dispute and recommend as follows:
3.1That the Senate recede from its amendment and that H. F. No. 1362 be further
3.2amended as follows:
3.3Delete everything after the enacting clause and insert:
3.6 Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to
3.7read:
3.8 Subd. 2. County fees for background studies and licensing inspections. (a) For
3.9purposes of family and group family child care licensing under this chapter, a county
3.10agency may charge a fee to an applicant or license holder to recover the actual cost of
3.11background studies, but in any case not to exceed $100 annually. A county agency may
3.12also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
3.13license or $100 for a two-year license.
3.14 (b) A county agency may charge a fee to a legal nonlicensed child care provider or
3.15applicant for authorization to recover the actual cost of background studies completed
3.16under section119B.125 , but in any case not to exceed $100 annually.
3.17 (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
3.18 (1) in cases of financial hardship;
3.19 (2) if the county has a shortage of providers in the county's area;
3.20 (3) for new providers; or
3.21 (4) for providers who have attained at least 16 hours of training before seeking
3.22initial licensure.
3.23 (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
3.24an installment basis for up to one year. If the provider is receiving child care assistance
3.25payments from the state, the provider may have the fees under paragraph (a) or (b)
3.26deducted from the child care assistance payments for up to one year and the state shall
3.27reimburse the county for the county fees collected in this manner.
3.28 (e) For purposes of adult foster care and child foster care licensing under this
3.29chapter, a county agency may charge a fee to a corporate applicant or corporate license
3.30holder to recoverthe actual cost of background studies. A county agency may also charge
3.31a fee to a corporate applicant or corporate license holder to recover the actual cost of
3.32licensing inspections, not to exceed $500 annually.
3.33 (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
3.34following circumstances:
3.35(1) in cases of financial hardship;
4.1(2) if the county has a shortage of providers in the county's area; or
4.2(3) for new providers.
4.3 Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
4.4 Subd. 3. Application fee for initial license or certification. (a) For fees required
4.5under subdivision 1, an applicant for an initial license or certification issued by the
4.6commissioner shall submit a $500 application fee with each new application required
4.7under this subdivision. The application fee shall not be prorated, is nonrefundable, and
4.8is in lieu of the annual license or certification fee that expires on December 31. The
4.9commissioner shall not process an application until the application fee is paid.
4.10(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license
4.11to provide services at a specific location.
4.12(1) For a license to providewaivered residential-based habilitation services to
4.13persons with developmental disabilitiesor related conditions under chapter 245B, an
4.14applicant shall submit an application for each county in which thewaivered services will
4.15be provided. Upon licensure, the license holder may provide services to persons in that
4.16county plus no more than three persons at any one time in each of up to ten additional
4.17counties. A license holder in one county may not provide services under the home and
4.18community-based waiver for persons with developmental disabilities to more than three
4.19people in a second county without holding a separate license for that second county.
4.20Applicants or licensees providing services under this clause to not more than three persons
4.21remain subject to the inspection fees established in section 245A.10, subdivision 2, for
4.22each location. The license issued by the commissioner must state the name of each
4.23additional county where services are being provided to persons with developmental
4.24disabilities. A license holder must notify the commissioner before making any changes
4.25that would alter the license information listed under section 245A.04, subdivision 7,
4.26paragraph (a), including any additional counties where persons with developmental
4.27disabilities are being served.
4.28(2) For a license to provide supported employment, crisis respite, or
4.29semi-independent living services to persons with developmental disabilitiesor related
4.30conditions under chapter 245B, an applicant shall submit a single application to provide
4.31services statewide.
4.32(3) For a license to provide independent living assistance for youth under section
4.33245A.22
, an applicant shall submit a single application to provide services statewide.
4.34 Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read:
5.1 Subd. 2a. Adult foster care license capacity. The commissioner shall issue adult
5.2foster care licenses with a maximum licensed capacity of four beds, including nonstaff
5.3roomers and boarders, except that the commissioner may issue a license with a capacity of
5.4five beds, including roomers and boarders, according to paragraphs (a) to (e).
5.5(a) An adult foster care license holder may have a maximum license capacity of five
5.6if all persons in care are age 55 or over and do not have a serious and persistent mental
5.7illness or a developmental disability.
5.8(b) The commissioner may grant variances to paragraph (a) to allow a foster care
5.9provider with a licensed capacity of five persons to admit an individual under the age of 55
5.10if the variance complies with section245A.04, subdivision 9 , and approval of the variance
5.11is recommended by the county in which the licensed foster care provider is located.
5.12(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth
5.13bed for emergency crisis services for a person with serious and persistent mental illness
5.14or a developmental disability, regardless of age, if the variance complies with section
5.15245A.04, subdivision 9
, and approval of the variance is recommended by the county in
5.16which the licensed foster care provider is located.
5.17(d)Notwithstanding paragraph (a), If the 2009 legislature adopts a rate reduction
5.18that impacts providers of adult foster care services, the commissioner may issue an adult
5.19foster care license with a capacity of five adults if the fifth bed does not increase the
5.20overall statewide capacity of licensed adult foster care beds in homes that are not the
5.21primary residence of the license holder, over the licensed capacity in such homes on July
5.221, 2009, as identified in a plan submitted to the commissioner by the county, when the
5.23capacity is recommended by the county licensing agency of the county in which the
5.24facility is located and if the recommendation verifies that:
5.25(1) the facility meets the physical environment requirements in the adult foster
5.26care licensing rule;
5.27(2) the five-bed living arrangement is specified for each resident in the resident's:
5.28(i) individualized plan of care;
5.29(ii) individual service plan under section256B.092, subdivision 1b , if required; or
5.30(iii) individual resident placement agreement under Minnesota Rules, part
5.319555.5105, subpart 19, if required;
5.32(3) the license holder obtains written and signed informed consent from each
5.33resident or resident's legal representative documenting the resident's informed choice to
5.34living in the home and that the resident's refusal to consent would not have resulted in
5.35service termination; and
5.36(4) the facility was licensed for adult foster care before March 1,2003 2009.
6.1(e) The commissioner shall not issue a new adult foster care license under paragraph
6.2(d) after June 30,2005 2011. The commissioner shall allow a facility with an adult foster
6.3care license issued under paragraph (d) before June 30,2005 2011, to continue with a
6.4capacity of five adults if the license holder continues to comply with the requirements in
6.5paragraph (d).
6.6EFFECTIVE DATE.This section is effective July 1, 2009.
6.7 Sec. 4. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
6.8to read:
6.9 Subd. 7a. Alternate overnight supervision technology; adult foster care license.
6.10 (a) The commissioner may grant an applicant or license holder an adult foster care license
6.11for a residence that does not have a caregiver in the residence during normal sleeping
6.12hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
6.13monitoring technology to alert the license holder when an incident occurs that may
6.14jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
6.15holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
6.16to 9555.6265, and the requirements under this subdivision. The license printed by the
6.17commissioner must state in bold and large font:
6.18 (1) that the facility is under electronic monitoring; and
6.19 (2) the telephone number of the county's common entry point for making reports of
6.20suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
6.21(b) Applications for a license under this section must be submitted directly to
6.22the Department of Human Services licensing division. The licensing division must
6.23immediately notify the host county and lead county contract agency and the host county
6.24licensing agency. The licensing division must collaborate with the county licensing
6.25agency in the review of the application and the licensing of the program.
6.26 (c) Before a license is issued by the commissioner, and for the duration of the
6.27license, the applicant or license holder must establish, maintain, and document the
6.28implementation of written policies and procedures addressing the requirements in
6.29paragraphs (d) through (f).
6.30 (d) The applicant or license holder must have policies and procedures that:
6.31 (1) establish characteristics of target populations that will be admitted into the home,
6.32and characteristics of populations that will not be accepted into the home;
6.33 (2) explain the discharge process when a foster care recipient requires overnight
6.34supervision or other services that cannot be provided by the license holder due to the
6.35limited hours that the license holder is on-site;
7.1 (3) describe the types of events to which the program will respond with a physical
7.2presence when those events occur in the home during time when staff are not on-site, and
7.3how the license holder's response plan meets the requirements in paragraph (e), clause
7.4(1) or (2);
7.5 (4) establish a process for documenting a review of the implementation and
7.6effectiveness of the response protocol for the response required under paragraph (e),
7.7clause (1) or (2). The documentation must include:
7.8 (i) a description of the triggering incident;
7.9 (ii) the date and time of the triggering incident;
7.10 (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
7.11 (iv) whether the response met the resident's needs;
7.12 (v) whether the existing policies and response protocols were followed; and
7.13 (vi) whether the existing policies and protocols are adequate or need modification.
7.14 When no physical presence response is completed for a three-month period, the
7.15license holder's written policies and procedures must require a physical presence response
7.16drill be to conducted for which the effectiveness of the response protocol under paragraph
7.17(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
7.18 (5) establish that emergency and nonemergency phone numbers are posted in a
7.19prominent location in a common area of the home where they can be easily observed by a
7.20person responding to an incident who is not otherwise affiliated with the home.
7.21 (e) The license holder must document and include in the license application which
7.22response alternative under clause (1) or (2) is in place for responding to situations that
7.23present a serious risk to the health, safety, or rights of people receiving foster care services
7.24in the home:
7.25 (1) response alternative (1) requires only the technology to provide an electronic
7.26notification or alert to the license holder that an event is underway that requires a response.
7.27Under this alternative, no more than ten minutes will pass before the license holder will be
7.28physically present on-site to respond to the situation; or
7.29 (2) response alternative (2) requires the electronic notification and alert system
7.30under alternative (1), but more than ten minutes may pass before the license holder is
7.31present on-site to respond to the situation. Under alternative (2), all of the following
7.32conditions are met:
7.33 (i) the license holder has a written description of the interactive technological
7.34applications that will assist the licenser holder in communicating with and assessing the
7.35needs related to care, health, and safety of the foster care recipients. This interactive
7.36technology must permit the license holder to remotely assess the well being of the foster
8.1care recipient without requiring the initiation of the foster care recipient. Requiring the
8.2foster care recipient to initiate a telephone call does not meet this requirement;
8.3(ii) the license holder documents how the remote license holder is qualified and
8.4capable of meeting the needs of the foster care recipients and assessing foster care
8.5recipients' needs under item (i) during the absence of the license holder on-site;
8.6(iii) the license holder maintains written procedures to dispatch emergency response
8.7personnel to the site in the event of an identified emergency; and
8.8 (iv) each foster care recipient's individualized plan of care, individual service plan
8.9under section 256B.092, subdivision 1b, if required, or individual resident placement
8.10agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
8.11maximum response time, which may be greater than ten minutes, for the license holder
8.12to be on-site for that foster care recipient.
8.13 (f) All placement agreements, individual service agreements, and plans applicable
8.14to the foster care recipient must clearly state that the adult foster care license category is
8.15a program without the presence of a caregiver in the residence during normal sleeping
8.16hours; the protocols in place for responding to situations that present a serious risk to
8.17health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a
8.18signed informed consent from each foster care recipient or the person's legal representative
8.19documenting the person's or legal representative's agreement with placement in the
8.20program. If electronic monitoring technology is used in the home, the informed consent
8.21form must also explain the following:
8.22 (1) how any electronic monitoring is incorporated into the alternative supervision
8.23system;
8.24 (2) the backup system for any electronic monitoring in times of electrical outages or
8.25other equipment malfunctions;
8.26 (3) how the license holder is trained on the use of the technology;
8.27 (4) the event types and license holder response times established under paragraph (e);
8.28 (5) how the license holder protects the foster care recipient's privacy related to
8.29electronic monitoring and related to any electronically recorded data generated by the
8.30monitoring system. A foster care recipient may not be removed from a program under
8.31this subdivision for failure to consent to electronic monitoring. The consent form must
8.32explain where and how the electronically recorded data is stored, with whom it will be
8.33shared, and how long it is retained; and
8.34 (6) the risks and benefits of the alternative overnight supervision system.
9.1 The written explanations under clauses (1) to (6) may be accomplished through
9.2cross-references to other policies and procedures as long as they are explained to the
9.3person giving consent, and the person giving consent is offered a copy.
9.4(g) Nothing in this section requires the applicant or license holder to develop or
9.5maintain separate or duplicative polices, procedures, documentation, consent forms, or
9.6individual plans that may be required for other licensing standards, if the requirements of
9.7this section are incorporated into those documents.
9.8(h) The commissioner may grant variances to the requirements of this section
9.9according to section 245A.04, subdivision 9.
9.10(i) For the purposes of paragraphs (d) through (h), license holder has the meaning
9.11under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
9.12contractors affiliated with the license holder.
9.13(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
9.14remotely determine what action the license holder needs to take to protect the well-being
9.15of the foster care recipient.
9.16 Sec. 5. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
9.17to read:
9.18 Subd. 8b. Adult foster care data privacy and security. (a) An adult foster
9.19care license holder who creates, collects, records, maintains, stores, or discloses any
9.20individually identifiable recipient data, whether in an electronic or any other format,
9.21must comply with the privacy and security provisions of applicable privacy laws and
9.22regulations, including:
9.23(1) the federal Health Insurance Portability and Accountability Act of 1996
9.24(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
9.25title 45, part 160, and subparts A and E of part 164; and
9.26(2) the Minnesota Government Data Practices Act as codified in chapter 13.
9.27(b) For purposes of licensure, the license holder shall be monitored for compliance
9.28with the following data privacy and security provisions:
9.29(1) the license holder must control access to data on foster care recipients according
9.30to the definitions of public and private data on individuals under section 13.02;
9.31classification of the data on individuals as private under section 13.46, subdivision 2;
9.32and control over the collection, storage, use, access, protection, and contracting related
9.33to data according to section 13.05, in which the license holder is assigned the duties
9.34of a government entity;
10.1(2) the license holder must provide each foster care recipient with a notice that
10.2meets the requirements under section 13.04, in which the license holder is assigned the
10.3duties of the government entity, and that meets the requirements of Code of Federal
10.4Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of
10.5the data, and to whom and why it may be disclosed pursuant to law. The notice must
10.6inform the recipient that the license holder uses electronic monitoring and, if applicable,
10.7that recording technology is used;
10.8(3) the license holder must not install monitoring cameras in bathrooms;
10.9(4) electronic monitoring cameras must not be concealed from the foster care
10.10recipients; and
10.11(5) electronic video and audio recordings of foster care recipients shall not be stored
10.12by the license holder for more than five days.
10.13(c) The commissioner shall develop, and make available to license holders and
10.14county licensing workers, a checklist of the data privacy provisions to be monitored
10.15for purposes of licensure.
10.16 Sec. 6. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:
10.17 Subdivision 1. Delegation of authority to agencies. (a) County agencies and
10.18private agencies that have been designated or licensed by the commissioner to perform
10.19licensing functions and activities under section245A.04 and background studies for
10.20adult foster care, family adult day services, and family child care, under chapter 245C; to
10.21recommend denial of applicants under section245A.05 ; to issue correction orders, to issue
10.22variances, and recommend a conditional license under section245A.06 , or to recommend
10.23suspending or revoking a license or issuing a fine under section245A.07 , shall comply
10.24with rules and directives of the commissioner governing those functions and with this
10.25section. The following variances are excluded from the delegation of variance authority
10.26and may be issued only by the commissioner:
10.27 (1) dual licensure of family child care and child foster care, dual licensure of child
10.28and adult foster care, and adult foster care and family child care;
10.29 (2) adult foster care maximum capacity;
10.30 (3) adult foster care minimum age requirement;
10.31 (4) child foster care maximum age requirement;
10.32 (5) variances regarding disqualified individuals except that county agencies may
10.33issue variances under section245C.30 regarding disqualified individuals when the county
10.34is responsible for conducting a consolidated reconsideration according to sections245C.25
11.1and245C.27, subdivision 2 , clauses (a) and (b), of a county maltreatment determination
11.2and a disqualification based on serious or recurring maltreatment; and
11.3 (6) the required presence of a caregiver in the adult foster care residence during
11.4normal sleeping hours.
11.5 (b) County agencies must report information about disqualification reconsiderations
11.6under sections245C.25 and
245C.27, subdivision 2 , paragraphs (a) and (b), and variances
11.7granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
11.8prescribed by the commissioner.
11.9 (c) For family day care programs, the commissioner may authorize licensing reviews
11.10every two years after a licensee has had at least one annual review.
11.11 (d) For family adult day services programs, the commissioner may authorize
11.12licensing reviews every two years after a licensee has had at least one annual review.
11.13 (e) A license issued under this section may be issued for up to two years.
11.14 Sec. 7. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:
11.15 Subd. 3. Recommendations to commissioner. The county or private agency
11.16shall not make recommendations to the commissioner regarding licensure without first
11.17conducting an inspection, and foradult foster care, family adult day services, and family
11.18child care, a background study of the applicant under chapter 245C. The county or private
11.19agency must forward its recommendation to the commissioner regarding the appropriate
11.20licensing action within 20 working days of receipt of a completed application.
11.21 Sec. 8. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
11.22 Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
11.23background study of an individual required to be studied under section245C.03,
11.24subdivision 1 , at least upon application for initial license for all license types.
11.25 (b) The commissioner shall conduct a background study of an individual required to
11.26be studied under section245C.03, subdivision 1 , at reapplication for a license for adult
11.27foster care, family adult day services, and family child care.
11.28 (c) The commissioner is not required to conduct a study of an individual at the time
11.29of reapplication for a license if the individual's background study was completed by the
11.30commissioner of human services for an adult foster care license holder that is also:
11.31 (1) registered under chapter 144D; or
11.32 (2) licensed to provide home and community-based services to people with
11.33disabilities at the foster care location and the license holder does not reside in the foster
11.34care residence; and
12.1 (3) the following conditions are met:
12.2 (i) a study of the individual was conducted either at the time of initial licensure or
12.3when the individual became affiliated with the license holder;
12.4 (ii) the individual has been continuously affiliated with the license holder since
12.5the last study was conducted; and
12.6 (iii) the last study of the individual was conducted on or after October 1, 1995.
12.7 (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
12.8conduct a study of an individual required to be studied under section245C.03 , at the
12.9time of reapplication for a child foster care license. The county or private agency shall
12.10collect and forward to the commissioner the information required under section245C.05 ,
12.11subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
12.12study conducted by the commissioner of human services under this paragraph must
12.13include a review of the information required under section245C.08, subdivisions 1 ,
12.14paragraph (a), clauses (1) to (5), 3, and 4.
12.15 (e) The commissioner of human services shall conduct a background study of an
12.16individual specified under section245C.03, subdivision 1 , paragraph (a), clauses (2)
12.17to (6), who is newly affiliated with a child foster care license holder. The county or
12.18private agency shall collect and forward to the commissioner the information required
12.19under section245C.05, subdivisions 1 and 5. The background study conducted by the
12.20commissioner of human services under this paragraph must include a review of the
12.21information required under section245C.08, subdivisions 1 , 3, and 4.
12.22 (f) From January 1, 2010, to December 31, 2012, unless otherwise specified in
12.23paragraph (c), the commissioner shall conduct a study of an individual required to be
12.24studied under section 245C.03 at the time of reapplication for an adult foster care or family
12.25adult day services license: (1) the county shall collect and forward to the commissioner
12.26the information required under section 245C.05, subdivision 1, paragraphs (a) and (b),
12.27and subdivision 5, paragraphs (a) and (b), for background studies conducted by the
12.28commissioner for adult foster care and family adult day services when the license holder
12.29resides in the adult foster care or family adult day services residence; (2) the license
12.30holder shall collect and forward to the commissioner the information required under
12.31section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) and (b),
12.32for background studies conducted by the commissioner for adult foster care when the
12.33license holder does not reside in the adult foster care residence; and (3) the background
12.34study conducted by the commissioner under this paragraph must include a review of the
12.35information required under section 245C.08, subdivision 1, paragraph (a), clauses (1)
12.36to (5), and subdivisions 3 and 4.
13.1(g) The commissioner shall conduct a background study of an individual specified
13.2under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
13.3affiliated with an adult foster care or family adult day services license holder: (1) the
13.4county shall collect and forward to the commissioner the information required under
13.5section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
13.6and (b), for background studies conducted by the commissioner for adult foster care
13.7and family adult day services when the license holder resides in the adult foster care or
13.8family adult day services residence; (2) the license holder shall collect and forward to the
13.9commissioner the information required under section 245C.05, subdivisions 1, paragraphs
13.10(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the
13.11commissioner for adult foster care when the license holder does not reside in the adult
13.12foster care residence; and (3) the background study conducted by the commissioner under
13.13this paragraph must include a review of the information required under section 245C.08,
13.14subdivision 1, paragraph (a), and subdivisions 3 and 4.
13.15 (h) Applicants for licensure, license holders, and other entities as provided in this
13.16chapter must submit completed background study forms to the commissioner before
13.17individuals specified in section245C.03, subdivision 1 , begin positions allowing direct
13.18contact in any licensed program.
13.19(g) (i) For purposes of this section, a physician licensed under chapter 147 is
13.20considered to be continuously affiliated upon the license holder's receipt from the
13.21commissioner of health or human services of the physician's background study results.
13.22 Sec. 9. Minnesota Statutes 2008, section 245C.05, is amended by adding a subdivision
13.23to read:
13.24 Subd. 2b. County agency to collect and forward information to the
13.25commissioner. For background studies related to adult foster care and family adult
13.26day services when the license holder resides in the adult foster care or family adult
13.27day services residence, the county agency must collect the information required under
13.28subdivision 1 and forward it to the commissioner.
13.29 Sec. 10. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:
13.30 Subd. 4. Electronic transmission. For background studies conducted by the
13.31Department of Human Services, the commissioner shall implement a system for the
13.32electronic transmission of:
13.33 (1) background study information to the commissioner;
13.34 (2) background study results to the license holder;and
14.1 (3) background study results to county and private agencies for background studies
14.2conducted by the commissioner for child foster care; and
14.3(4) background study results to county agencies for background studies conducted
14.4by the commissioner for adult foster care and family adult day services.
14.5 Sec. 11. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:
14.6 Subd. 2. Background studies conducted by a county agency. (a) For a background
14.7study conducted by a county agency foradult foster care, family adult day services, and
14.8family child care services, the commissioner shall review:
14.9 (1) information from the county agency's record of substantiated maltreatment
14.10of adults and the maltreatment of minors;
14.11 (2) information from juvenile courts as required in subdivision 4 for individuals
14.12listed in section245C.03, subdivision 1 , clauses (2), (5), and (6); and
14.13 (3) information from the Bureau of Criminal Apprehension.
14.14 (b) If the individual has resided in the county for less than five years, the study shall
14.15include the records specified under paragraph (a) for the previous county or counties of
14.16residence for the past five years.
14.17 (c) Notwithstanding expungement by a court, the county agency may consider
14.18information obtained under paragraph (a), clause (3), unless the commissioner received
14.19notice of the petition for expungement and the court order for expungement is directed
14.20specifically to the commissioner.
14.21 Sec. 12. Minnesota Statutes 2008, section 245C.10, is amended by adding a
14.22subdivision to read:
14.23 Subd. 5. Adult foster care services. The commissioner shall recover the cost of
14.24background studies required under section 245C.03, subdivision 1, for the purposes of
14.25adult foster care and family adult day services licensing, through a fee of no more than
14.26$20 per study charged to the license holder. The fees collected under this subdivision are
14.27appropriated to the commissioner for the purpose of conducting background studies.
14.28 Sec. 13. Minnesota Statutes 2008, section 245C.10, is amended by adding a
14.29subdivision to read:
14.30 Subd. 8. Private agencies. The commissioner shall recover the cost of conducting
14.31background studies under section 245C.33 for studies initiated by private agencies for the
14.32purpose of adoption through a fee of no more than $70 per study charged to the private
15.1agency. The fees collected under this subdivision are appropriated to the commissioner for
15.2the purpose of conducting background studies.
15.3 Sec. 14. Minnesota Statutes 2008, section 245C.17, is amended by adding a
15.4subdivision to read:
15.5 Subd. 6. Notice to county agency. For studies on individuals related to a license
15.6to provide adult foster care and family adult day services, the commissioner shall also
15.7provide a notice of the background study results to the county agency that initiated the
15.8background study.
15.9 Sec. 15. Minnesota Statutes 2008, section 245C.20, is amended to read:
15.10245C.20 LICENSE HOLDER RECORD KEEPING.
15.11A licensed program shall document the date the program initiates a background
15.12study under this chapter in the program's personnel files. When a background study is
15.13completed under this chapter, a licensed program shall maintain a notice that the study
15.14was undertaken and completed in the program's personnel files. Except when background
15.15studies are initiated through the commissioner's online system, if a licensed program
15.16has not received a response from the commissioner under section245C.17 within 45
15.17days of initiation of the background study request, the licensed program must contact the
15.18commissioner human services licensing division to inquire about the status of the study. If
15.19a license holder initiates a background study under the commissioner's online system, but
15.20the background study subject's name does not appear in the list of active or recent studies
15.21initiated by that license holder, the license holder must either contact the human services
15.22licensing division or resubmit the background study information online for that individual.
15.23 Sec. 16. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:
15.24 Subd. 1a. Submission of reconsideration requestto county or private agency. (a)
15.25For disqualifications related to studies conducted by county agencies for family child care,
15.26and for disqualifications related to studies conducted by the commissioner for child foster
15.27care, adult foster care, and family adult day services, the individual shall submit the request
15.28for reconsideration to the countyor private agency that initiated the background study.
15.29 (b) For disqualifications related to studies conducted by the commissioner for child
15.30foster care, the individual shall submit the request for reconsideration to the private agency
15.31that initiated the background study.
16.1(c) A reconsideration request shall be submitted within 30 days of the individual's
16.2receipt of the disqualification notice or the time frames specified in subdivision 2,
16.3whichever time frame is shorter.
16.4(c) (d) The county or private agency shall forward the individual's request for
16.5reconsideration and provide the commissioner with a recommendation whether to set aside
16.6the individual's disqualification.
16.7 Sec. 17. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:
16.8 Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
16.9commissioner shall notify the license holder of the disqualification and order the license
16.10holder to immediately remove the individual from any position allowing direct contact
16.11with persons receiving services from the license holder if:
16.12 (1) the individual studied does not submit a timely request for reconsideration
16.13under section245C.21 ;
16.14 (2) the individual submits a timely request for reconsideration, but the commissioner
16.15does not set aside the disqualification for that license holder under section245C.22 ;
16.16 (3) an individual who has a right to request a hearing under sections245C.27 and
16.17256.045
, or
245C.28 and chapter 14 for a disqualification that has not been set aside, does
16.18not request a hearing within the specified time; or
16.19 (4) an individual submitted a timely request for a hearing under sections245C.27
16.20and256.045 , or
245C.28 and chapter 14, but the commissioner does not set aside the
16.21disqualification under section245A.08, subdivision 5 , or
256.045 .
16.22 (b) If the commissioner does not set aside the disqualification under section245C.22 ,
16.23and the license holder was previously ordered under section245C.17 to immediately
16.24remove the disqualified individual from direct contact with persons receiving services or
16.25to ensure that the individual is under continuous, direct supervision when providing direct
16.26contact services, the order remains in effect pending the outcome of a hearing under
16.27sections245C.27 and
256.045 , or
245C.28 and chapter 14.
16.28 (c) For background studies related to child foster care, the commissioner shall
16.29also notify the county or private agency that initiated the study of the results of the
16.30reconsideration.
16.31(d) For background studies related to adult foster care and family adult day services,
16.32the commissioner shall also notify the county that initiated the study of the results of
16.33the reconsideration.
17.1 Sec. 18. Minnesota Statutes 2008, section 256B.092, is amended by adding a
17.2subdivision to read:
17.3 Subd. 5b. Revised per diem based on legislated rate reduction. Notwithstanding
17.4section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction
17.5that impacts payment to providers of adult foster care services, the commissioner may
17.6issue adult foster care licenses that permit a capacity of five adults. The application for a
17.7five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to
17.8admission of the fifth recipient of adult foster care services, the county must negotiate a
17.9revised per diem rate for room and board and waiver services that reflects the legislated
17.10rate reduction and results in an overall average per diem reduction for all foster care
17.11recipients in that home. The revised per diem must allow the provider to maintain, as
17.12much as possible, the level of services or enhanced services provided in the residence,
17.13while mitigating the losses of the legislated rate reduction.
17.14EFFECTIVE DATE.This section is effective July 1, 2009.
17.15 Sec. 19. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
17.16 Subd. 17. Cost of services and supports. (a) The commissioner shall ensure
17.17that the average per capita expenditures estimated in any fiscal year for home and
17.18community-based waiver recipients does not exceed the average per capita expenditures
17.19that would have been made to provide institutional services for recipients in the absence
17.20of the waiver.
17.21(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
17.22need-based methods for allocating to local agencies the home and community-based
17.23waivered service resources available to support recipients with disabilities in need of
17.24the level of care provided in a nursing facility or a hospital. The commissioner shall
17.25allocate resources to single counties and county partnerships in a manner that reflects
17.26consideration of:
17.27(1) an incentive-based payment process for achieving outcomes;
17.28(2) the need for a state-level risk pool;
17.29(3) the need for retention of management responsibility at the state agency level; and
17.30(4) a phase-in strategy as appropriate.
17.31(c) Until the allocation methods described in paragraph (b) are implemented, the
17.32annual allowable reimbursement level of home and community-based waiver services
17.33shall be the greater of:
18.1(1) the statewide average payment amount which the recipient is assigned under the
18.2waiver reimbursement system in place on June 30, 2001, modified by the percentage of
18.3any provider rate increase appropriated for home and community-based services; or
18.4(2) an amount approved by the commissioner based on the recipient's extraordinary
18.5needs that cannot be met within the current allowable reimbursement level. The
18.6increased reimbursement level must be necessary to allow the recipient to be discharged
18.7from an institution or to prevent imminent placement in an institution. The additional
18.8reimbursement may be used to secure environmental modifications; assistive technology
18.9and equipment; and increased costs for supervision, training, and support services
18.10necessary to address the recipient's extraordinary needs. The commissioner may approve
18.11an increased reimbursement level for up to one year of the recipient's relocation from an
18.12institution or up to six months of a determination that a current waiver recipient is at
18.13imminent risk of being placed in an institution.
18.14(d) Beginning July 1, 2001, medically necessary private duty nursing services will be
18.15authorized under this section as complex and regular care according to sections256B.0651
18.16and256B.0653 to
256B.0656 . The rate established by the commissioner for registered
18.17nurse or licensed practical nurse services under any home and community-based waiver as
18.18of January 1, 2001, shall not be reduced.
18.19(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009
18.20legislature adopts a rate reduction that impacts payment to providers of adult foster care
18.21services, the commissioner may issue adult foster care licenses that permit a capacity of
18.22five adults. The application for a five-bed license must meet the requirements of section
18.23245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care
18.24services, the county must negotiate a revised per diem rate for room and board and waiver
18.25services that reflects the legislated rate reduction and results in an overall average per
18.26diem reduction for all foster care recipients in that home. The revised per diem must allow
18.27the provider to maintain, as much as possible, the level of services or enhanced services
18.28provided in the residence, while mitigating the losses of the legislated rate reduction.
18.29EFFECTIVE DATE.This section is effective July 1, 2009.
18.30 Sec. 20. WAIVER.
18.31By December 1, 2009, the commissioner shall request all federal approvals and
18.32waiver amendments to the disability home and community-based waivers to allow properly
18.33licensed adult foster care homes to provide residential services for up to five individuals.
18.34EFFECTIVE DATE.This section is effective July 1, 2009.
19.1 Sec. 21. REPEALER.
19.2(a) Minnesota Statutes 2008, section 245C.11, subdivisions 1 and 2, are repealed.
19.3(b) Minnesota Statutes 2008, section 256B.092, subdivision 5a, is repealed effective
19.4July 1, 2009.
19.5(c) Minnesota Rules, part 9555.6125, subpart 4, item B, is repealed.
19.8 Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:
19.9 Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child
19.10care assistance under this chapter is the later of the date the application was signed; the
19.11beginning date of employment, education, or training; the date the infant is born for
19.12applicants to the at-home infant care program; or the date a determination has been made
19.13that the applicant is a participant in employment and training services under Minnesota
19.14Rules, part 3400.0080, or chapter 256J.
19.15 (b) Payment ceases for a family under the at-home infant child care program when a
19.16family has used a total of 12 months of assistance as specified under section119B.035 .
19.17Payment of child care assistance for employed persons on MFIP is effective the date of
19.18employment or the date of MFIP eligibility, whichever is later. Payment of child care
19.19assistance for MFIP or DWP participants in employment and training services is effective
19.20the date of commencement of the services or the date of MFIP or DWP eligibility,
19.21whichever is later. Payment of child care assistance for transition year child care must be
19.22made retroactive to the date of eligibility for transition year child care.
19.23(c) Notwithstanding paragraph (b), payment of child care assistance for participants
19.24eligible under section 119B.05 may only be made retroactive for a maximum of six
19.25months from the date of application for child care assistance.
19.26EFFECTIVE DATE.This section is effective October 1, 2009.
19.27 Sec. 2. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:
19.28 Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments
19.29to the child care provider or pay the parent directly for eligible child care expenses.
19.30(b) If payments for child care assistance are made to providers, the provider shall
19.31bill the county for services provided within ten days of the end of the service period. If
19.32bills are submitted within ten days of the end of the service period, a county or the state
19.33shall issue payment to the provider of child care under the child care fund within 30 days
20.1of receiving a bill from the provider. Counties or the state may establish policies that
20.2make payments on a more frequent basis.
20.3(c)All bills If a provider has received an authorization of care and been issued a
20.4billing form for an eligible family, the bill must be submitted within 60 days of the last
20.5date of service on the bill. A county may pay a bill submitted more than 60 days after
20.6the last date of service if the provider shows good cause why the bill was not submitted
20.7within 60 days. Good cause must be defined in the county's child care fund plan under
20.8section119B.08, subdivision 3 , and the definition of good cause must include county
20.9error. A county may not pay any bill submitted more than a year after the last date of
20.10service on the bill.
20.11(d) If a provider provided care for a time period without receiving an authorization
20.12of care and a billing form for an eligible family, payment of child care assistance may only
20.13be made retroactively for a maximum of six months from the date the provider is issued
20.14an authorization of care and billing form.
20.15(e) A county may stop payment issued to a provider or may refuse to pay a bill
20.16submitted by a provider if:
20.17(1) the provider admits to intentionally giving the county materially false information
20.18on the provider's billing forms; or
20.19(2) a county finds by a preponderance of the evidence that the provider intentionally
20.20gave the county materially false information on the provider's billing forms.
20.21(e) (f) A county's payment policies must be included in the county's child care plan
20.22under section119B.08, subdivision 3 . If payments are made by the state, in addition to
20.23being in compliance with this subdivision, the payments must be made in compliance
20.24with section16A.124 .
20.25EFFECTIVE DATE.This section is effective October 1, 2009.
20.26 Sec. 3. Minnesota Statutes 2008, section 119B.21, subdivision 5, is amended to read:
20.27 Subd. 5. Child care services grants. (a) A child care resource and referral program
20.28designated under section119B.19, subdivision 1a , may award child care services grants
20.29for:
20.30 (1) creating new licensed child care facilities and expanding existing facilities,
20.31including, but not limited to, supplies, equipment, facility renovation, and remodeling;
20.32 (2) improving licensed child care facility programs;
20.33 (3) staff training and development services including, but not limited to, in-service
20.34training, curriculum development, accreditation, certification, consulting, resource
21.1centers, program and resource materials, supporting effective teacher-child interactions,
21.2child-focused teaching, and content-driven classroom instruction;
21.3 (4) interim financing;
21.4 (5) capacity building through the purchase of appropriate technology to create,
21.5enhance, and maintain business management systems;
21.6 (6) emergency assistance for child care programs;
21.7 (7) new programs or projects for the creation, expansion, or improvement of
21.8programs that serve ethnic immigrant and refugee communities; and
21.9 (8) targeted recruitment initiatives to expand and build the capacity of the child
21.10care system and to improve the quality of care provided by legal nonlicensed child care
21.11providers.
21.12 (b) A child care resource and referral program designated under section119B.19,
21.13subdivision 1a , may award child care services grants to:
21.14 (1) licensed providers;
21.15 (2) providers in the process of being licensed;
21.16 (3) corporations or public agencies that develop or provide child care services;
21.17 (4) school-age care programs;
21.18 (5) legal nonlicensed or family, friend, and neighbor care providers; or
21.19 (6) any combination of clauses (1) to (5).
21.20 (c) A recipient of a child care services grant for facility improvements, interim
21.21financing, or staff training and development must provide a 25 percent local match.
21.22(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly
21.23awarded for activities that improve provider quality, including activities under paragraph
21.24(a), clauses (1) to (3) and (7).
21.25 Sec. 4. Minnesota Statutes 2008, section 119B.21, subdivision 10, is amended to read:
21.26 Subd. 10. Family child care technical assistance grants. (a) A child care resource
21.27and referral organization designated under section119B.19, subdivision 1a , may award
21.28technical assistance grants of up to $1,000. These grants may be used for:
21.29 (1) facility improvements, including, but not limited to, improvements to meet
21.30licensing requirements;
21.31 (2) improvements to expand a child care facility or program;
21.32 (3) toys, materials, and equipment to improve the learning environment;
21.33 (4) technology and software to create, enhance, and maintain business management
21.34systems;
21.35 (5) start-up costs;
22.1 (6) staff training and development; and
22.2 (7) other uses approved by the commissioner.
22.3 (b) A child care resource and referral program may award family child care technical
22.4assistance grants to:
22.5 (1) licensed family child care providers;
22.6 (2) child care providers in the process of becoming licensed; or
22.7 (3) legal nonlicensed or family, friend, and neighbor care providers.
22.8 (c) A local match is not required for a family child care technical assistance grant.
22.9(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly
22.10awarded for activities that improve provider quality, including activities under paragraph
22.11(a), clauses (1), (3), and (6).
22.12 Sec. 5. Minnesota Statutes 2008, section 119B.231, subdivision 2, is amended to read:
22.13 Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall
22.14apply to the commissioner or have been chosen as an SRSA provider prior to June 30,
22.152009, and have complied with all requirements of the SRSA agreement. Priority for funds
22.16is given to providers who had agreements prior to June 30, 2009. If sufficient funds are
22.17available, the commissioner shall make applications available to additional providers. To
22.18be eligible to apply for an SRSA, a provider shall:
22.19 (1) be eligible for child care assistance payments under chapter 119B;
22.20 (2) have at least 25 percent of the children enrolled with the provider subsidized
22.21through the child care assistance program;
22.22 (3) provide full-time, full-year child care services; and
22.23 (4)serve at least one child who is subsidized through the child care assistance
22.24program and who is expected to enter kindergarten within the following 30 months have
22.25obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system.
22.26 (b) The commissioner may waive the 25 percent requirement in paragraph (a),
22.27clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity
22.28of types of care provided by SRSA providers.
22.29 (c) An eligible provider who would like to enter into an SRSA with the commissioner
22.30shall submit an SRSA application. To determine whether to enter into an SRSA with a
22.31provider, the commissioner shall evaluate the following factors:
22.32 (1) thequalifications of the provider and the provider's staff provider's Parent
22.33Aware rating score;
22.34(2) the provider's staff-child ratios;
22.35(3) the provider's curriculum;
23.1(4) the provider's current or planned parent education activities;
23.2(5) (2) the provider's current or planned social service and employment linkages;
23.3(6) the provider's child development assessment plan;
23.4(7) (3) the geographic distribution needed for SRSA providers;
23.5(8) (4) the inclusion of a variety of child care delivery models; and
23.6(9) (5) other related factors determined by the commissioner.
23.7 Sec. 6. Minnesota Statutes 2008, section 119B.231, subdivision 3, is amended to read:
23.8 Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA
23.9provider for their children shall:
23.10 (1) be eligible to receive child care assistance under any provision in chapter 119B
23.11except section119B.035 ;
23.12 (2) be in an authorized activity for an average of at least 35 hours per week when
23.13initial eligibility is determined; and
23.14 (3) include a child who has not yet entered kindergarten.
23.15 (b) A family who is determined to be eligible to choose an SRSA provider remains
23.16eligible to be paid at a higher rate through the SRSA provider when the following
23.17conditions exist:
23.18 (1) the child attends child care with the SRSA provider a minimum of 25 hours per
23.19week, on average;
23.20 (2) the family has a child who has not yet entered kindergarten; and
23.21 (3) the family maintains eligibility under chapter 119B except section119B.035 .
23.22 (c)For the 12 months After initial eligibility has been determined, a decrease in the
23.23family's authorized activities to an average of less than 35 hours per week does not result
23.24in ineligibility for the SRSA rate. A family must continue to maintain eligibility under this
23.25chapter and be in an authorized activity.
23.26 (d) A family that moves between counties but continues to use the same SRSA
23.27provider shall continue to receive SRSA funding for the increased payments.
23.28 Sec. 7. Minnesota Statutes 2008, section 119B.231, subdivision 4, is amended to read:
23.29 Subd. 4. Requirements of providers. An SRSA must include assessment,
23.30evaluation, and reporting requirements that promote the goals of improved school
23.31readiness and movement toward appropriate child development milestones. A provider
23.32who enters into an SRSA shall comply with all SRSA requirements, including the
23.33assessment, evaluation, and reporting requirements in the SRSA. Providers who have been
23.34selected previously for SRSAs must begin the process to obtain a rating using Parent
24.1Aware according to timelines established by the commissioner. If the initial Parent Aware
24.2rating is less than three stars, the provider must submit a plan to improve the rating. If
24.3a 3 or 4 star rating is not obtained within established timelines, the commissioner may
24.4consider continuation of the agreement, depending upon the progress made and other
24.5factors. Providers who apply and are selected for a new SRSA agreement on or after July
24.61, 2009, must have a level 3 or 4 star rating under the voluntary Parent Aware quality
24.7rating system at the time the SRSA agreement is signed.
24.8 Sec. 8. Minnesota Statutes 2008, section 145A.17, is amended by adding a subdivision
24.9to read:
24.10 Subd. 4a. Home visitors as MFIP employment and training service providers.
24.11The county social service agency and the local public health department may mutually
24.12agree to utilize home visitors under this section as MFIP employment and training service
24.13providers under section 256J.49, subdivision 4, for MFIP participants who are: (1) ill or
24.14incapacitated under section 256J.425, subdivision 2; or (2) minor caregivers under section
24.15256J.54. The county social service agency and the local public health department may
24.16also mutually agree to utilize home visitors to provide outreach to MFIP families who are
24.17being sanctioned or who have been terminated from MFIP due to the 60-month time limit.
24.18 Sec. 9. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:
24.19 Subd. 3. State agency hearings. (a) State agency hearings are available for the
24.20following:
24.21 (1) any person applying for, receiving or having received public assistance, medical
24.22care, or a program of social services granted by the state agency or a county agency or
24.23the federal Food Stamp Act whose application for assistance is denied, not acted upon
24.24with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
24.25claimed to have been incorrectly paid;
24.26 (2) any patient or relative aggrieved by an order of the commissioner under section
24.27252.27
;
24.28 (3) a party aggrieved by a ruling of a prepaid health plan;
24.29 (4) except as provided under chapter 245C, any individual or facility determined by
24.30a lead agency to have maltreated a vulnerable adult under section626.557 after they have
24.31exercised their right to administrative reconsideration under section626.557 ;
24.32 (5) any person whose claim for foster care payment according to a placement of the
24.33child resulting from a child protection assessment under section626.556 is denied or not
24.34acted upon with reasonable promptness, regardless of funding source;
25.1 (6) any person to whom a right of appeal according to this section is given by other
25.2provision of law;
25.3 (7) an applicant aggrieved by an adverse decision to an application for a hardship
25.4waiver under section256B.15 ;
25.5 (8) an applicant aggrieved by an adverse decision to an application or redetermination
25.6for a Medicare Part D prescription drug subsidy under section256B.04, subdivision 4a ;
25.7 (9) except as provided under chapter 245A, an individual or facility determined
25.8to have maltreated a minor under section626.556 , after the individual or facility has
25.9exercised the right to administrative reconsideration under section626.556 ; or
25.10 (10) except as provided under chapter 245C, an individual disqualified under sections
25.11245C.14
and
245C.15 , on the basis of serious or recurring maltreatment; a preponderance
25.12of the evidence that the individual has committed an act or acts that meet the definition
25.13of any of the crimes listed in section245C.15, subdivisions 1 to 4 ; or for failing to make
25.14reports required under section626.556, subdivision 3 , or
626.557, subdivision 3 . Hearings
25.15regarding a maltreatment determination under clause (4) or (9) and a disqualification under
25.16this clause in which the basis for a disqualification is serious or recurring maltreatment,
25.17which has not been set aside under sections245C.22 and
245C.23 , shall be consolidated
25.18into a single fair hearing. In such cases, the scope of review by the human services referee
25.19shall include both the maltreatment determination and the disqualification. The failure to
25.20exercise the right to an administrative reconsideration shall not be a bar to a hearing under
25.21this section if federal law provides an individual the right to a hearing to dispute a finding
25.22of maltreatment. Individuals and organizations specified in this section may contest the
25.23specified action, decision, or final disposition before the state agency by submitting a
25.24written request for a hearing to the state agency within 30 days after receiving written
25.25notice of the action, decision, or final disposition, or within 90 days of such written notice
25.26if the applicant, recipient, patient, or relative shows good cause why the request was not
25.27submitted within the 30-day time limit.; or
25.28 (11) any person with an outstanding debt resulting from receipt of public assistance,
25.29medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
25.30Department of Human Services or a county agency. The scope of the appeal is the validity
25.31of the claimant agency's intention to request a setoff of a refund under chapter 270A
25.32against the debt.
25.33 (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
25.34(10), is the only administrative appeal to the final agency determination specifically,
25.35including a challenge to the accuracy and completeness of data under section13.04 .
25.36Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
26.1that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
26.2homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
26.3contested case proceeding under the provisions of chapter 14. Hearings requested under
26.4paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
26.5July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
26.6only available when there is no juvenile court or adult criminal action pending. If such
26.7action is filed in either court while an administrative review is pending, the administrative
26.8review must be suspended until the judicial actions are completed. If the juvenile court
26.9action or criminal charge is dismissed or the criminal action overturned, the matter may be
26.10considered in an administrative hearing.
26.11 (c) For purposes of this section, bargaining unit grievance procedures are not an
26.12administrative appeal.
26.13 (d) The scope of hearings involving claims to foster care payments under paragraph
26.14(a), clause (5), shall be limited to the issue of whether the county is legally responsible
26.15for a child's placement under court order or voluntary placement agreement and, if so,
26.16the correct amount of foster care payment to be made on the child's behalf and shall not
26.17include review of the propriety of the county's child protection determination or child
26.18placement decision.
26.19 (e) A vendor of medical care as defined in section256B.02, subdivision 7 , or a
26.20vendor under contract with a county agency to provide social services is not a party and
26.21may not request a hearing under this section, except if assisting a recipient as provided in
26.22subdivision 4.
26.23 (f) An applicant or recipient is not entitled to receive social services beyond the
26.24services prescribed under chapter 256M or other social services the person is eligible
26.25for under state law.
26.26 (g) The commissioner may summarily affirm the county or state agency's proposed
26.27action without a hearing when the sole issue is an automatic change due to a change in
26.28state or federal law.
26.29 Sec. 10. Minnesota Statutes 2008, section 256.983, subdivision 1, is amended to read:
26.30 Subdivision 1. Programs established. Within the limits of available appropriations,
26.31the commissioner of human services shall require the maintenance of budget neutral
26.32fraud prevention investigation programs in the counties participating in the fraud
26.33prevention investigation project established under this section. If funds are sufficient,
26.34the commissioner may also extend fraud prevention investigation programs to other
26.35counties provided the expansion is budget neutral to the state. Under any expansion, the
27.1commissioner has the final authority in decisions regarding the creation and realignment
27.2of individual county or regional operations.
27.3 Sec. 11. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:
27.4 Subd. 7. Countable income. "Countable income" means all income received by an
27.5applicant or recipient less any applicable exclusions or disregards. For a recipient of any
27.6cash benefit from the SSI program, countable income means the SSI benefit limit in effect
27.7at the time the person is in a GRHsetting less $20, less the medical assistance personal
27.8needs allowance. If the SSI limit has been reduced for a person due to events occurring
27.9prior to the persons entering the GRH setting, countable income means actual income less
27.10any applicable exclusions and disregards.
27.11EFFECTIVE DATE.This section is effective April 1, 2010.
27.12 Sec. 12. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read:
27.13 Subd. 7c. Demonstration project. The commissioner is authorized to pursue the
27.14expansion of a demonstration project under federal food stamp regulation for the purpose
27.15of gaining additional federal reimbursement of food and nutritional costs currently paid by
27.16the state group residential housing program. The commissioner shall seek approval no
27.17later thanJanuary 1, 2004 October 1, 2009. Any reimbursement received is nondedicated
27.18revenue to the general fund.
27.19 Sec. 13. Minnesota Statutes 2008, section 256J.24, subdivision 5, is amended to read:
27.20 Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
27.21on the number of persons in the assistance unit eligible for both food and cash assistance
27.22unless the restrictions in subdivision 6 on the birth of a child apply. The following table
27.23represents the transitional standards effectiveOctober 1, 2007 April 1, 2009.
28.7 The commissioner shall annually publish in the State Register the transitional
28.8standard for an assistance unit sizes 1 to 10 including a breakdown of the cash and food
28.9portions.
28.10EFFECTIVE DATE.This section is effective retroactively from April 1, 2009.
28.11 Sec. 14. Minnesota Statutes 2008, section 256J.425, subdivision 2, is amended to read:
28.12 Subd. 2. Ill or incapacitated. (a) An assistance unit subject to the time limit in
28.13section256J.42, subdivision 1 , is eligible to receive months of assistance under a hardship
28.14extension if the participant who reached the time limit belongs to any of the following
28.15groups:
28.16(1) participants who are suffering from an illness, injury, or incapacity which
28.17has been certified by a qualified professional when the illness, injury, or incapacity is
28.18expected to continue for more than 30 days andprevents the person from obtaining or
28.19retaining employment severely limits the person's ability to obtain or maintain suitable
28.20employment. These participants must follow the treatment recommendations of the
28.21qualified professional certifying the illness, injury, or incapacity;
28.22(2) participants whose presence in the home is required as a caregiver because of
28.23the illness, injury, or incapacity of another member in the assistance unit, a relative in the
28.24household, or a foster child in the household when the illness or incapacity and the need
28.25for a person to provide assistance in the home has been certified by a qualified professional
28.26and is expected to continue for more than 30 days; or
28.27(3) caregivers with a child or an adult in the household who meets the disability or
28.28medical criteria for home care services under section256B.0651, subdivision 1 , paragraph
28.29(c), or a home and community-based waiver services program under chapter 256B, or
28.30meets the criteria for severe emotional disturbance under section245.4871, subdivision
28.316 , or for serious and persistent mental illness under section
245.462, subdivision 20 ,
28.32paragraph (c). Caregivers in this category are presumed to be prevented from obtaining
28.33or retaining employment.
29.1(b) An assistance unit receiving assistance under a hardship extension under this
29.2subdivision may continue to receive assistance as long as the participant meets the criteria
29.3in paragraph (a), clause (1), (2), or (3).
29.4 Sec. 15. Minnesota Statutes 2008, section 256J.425, subdivision 3, is amended to read:
29.5 Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time
29.6limit in section256J.42, subdivision 1 , is eligible to receive months of assistance under
29.7a hardship extension if the participant who reached the time limit belongs to any of the
29.8following groups:
29.9(1) a person who is diagnosed by a licensed physician, psychological practitioner,
29.10or other qualified professional, as developmentally disabled or mentally ill, andthat
29.11condition prevents the person from obtaining or retaining unsubsidized employment the
29.12condition severely limits the person's ability to obtain or maintain suitable employment;
29.13(2) a person who:
29.14(i) has been assessed by a vocational specialist or the county agency to be
29.15unemployable for purposes of this subdivision; or
29.16(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
29.17agency to be employable, butnot at a level that makes the participant eligible for an
29.18extension under subdivision 4 the condition severely limits the person's ability to obtain or
29.19maintain suitable employment. The determination of IQ level must be made by a qualified
29.20professional. In the case of a non-English-speaking person: (A) the determination must
29.21be made by a qualified professional with experience conducting culturally appropriate
29.22assessments, whenever possible; (B) the county may accept reports that identify an
29.23IQ range as opposed to a specific score; (C) these reports must include a statement of
29.24confidence in the results;
29.25(3) a person who is determined by a qualified professional to be learning disabled,
29.26and thedisability condition severely limits the person's ability to obtain, perform, or
29.27maintain suitable employment. For purposes of the initial approval of a learning disability
29.28extension, the determination must have been made or confirmed within the previous 12
29.29months. In the case of a non-English-speaking person: (i) the determination must be made
29.30by a qualified professional with experience conducting culturally appropriate assessments,
29.31whenever possible; and (ii) these reports must include a statement of confidence in the
29.32results. If a rehabilitation plan for a participant extended as learning disabled is developed
29.33or approved by the county agency, the plan must be incorporated into the employment
29.34plan. However, a rehabilitation plan does not replace the requirement to develop and
29.35comply with an employment plan under section256J.521 ; or
30.1(4) a person who has been granted a family violence waiver, and who is complying
30.2with an employment plan under section256J.521, subdivision 3 .
30.3(b) For purposes of this section, "severely limits the person's ability to obtain or
30.4maintain suitable employment" means that a qualified professional has determined that the
30.5person's condition prevents the person from working 20 or more hours per week.
30.6 Sec. 16. Minnesota Statutes 2008, section 256J.49, subdivision 1, is amended to read:
30.7 Subdivision 1. Scope. The terms used in sections256J.50256J.72 have
30.8the meanings given them in this section.
30.9 Sec. 17. Minnesota Statutes 2008, section 256J.49, subdivision 4, is amended to read:
30.10 Subd. 4. Employment and training service provider. "Employment and training
30.11service provider" means:
30.12(1) a public, private, or nonprofit agency with which a county has contracted to
30.13provide employment and training services and which is included in the county's service
30.14agreement submitted under section256J.626, subdivision 4 ; or
30.15(2) a county agency, if the county has opted to provide employment and training
30.16services and the county has indicated that fact in the service agreement submitted under
30.17section256J.626, subdivision 4 ; or
30.18(3) a local public health department under section 145A.17, subdivision 3a, that a
30.19county has designated to provide employment and training services and is included in the
30.20county's service agreement submitted under section 256J.626, subdivision 4.
30.21Notwithstanding section116L.871 , an employment and training services provider
30.22meeting this definition may deliver employment and training services under this chapter.
30.23 Sec. 18. Minnesota Statutes 2008, section 256J.521, subdivision 2, is amended to read:
30.24 Subd. 2. Employment plan; contents. (a) Based on the assessment under
30.25subdivision 1, the job counselor and the participant must develop an employment plan
30.26that includes participation in activities and hours that meet the requirements of section
30.27256J.55, subdivision 1
. The purpose of the employment plan is to identify for each
30.28participant the most direct path to unsubsidized employment and any subsequent steps that
30.29support long-term economic stability. The employment plan should be developed using
30.30the highest level of activity appropriate for the participant. Activities must be chosen from
30.31clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
30.32preference for activities, priority must be given for activities related to a family violence
30.33waiver when developing the employment plan. The employment plan must also list the
31.1specific steps the participant will take to obtain employment, including steps necessary
31.2for the participant to progress from one level of activity to another, and a timetable for
31.3completion of each step. Levels of activity include:
31.4 (1) unsubsidized employment;
31.5 (2) job search;
31.6 (3) subsidized employment or unpaid work experience;
31.7 (4) unsubsidized employment and job readiness education or job skills training;
31.8 (5) unsubsidized employment or unpaid work experience and activities related to
31.9a family violence waiver or preemployment needs; and
31.10 (6) activities related to a family violence waiver or preemployment needs.
31.11 (b) Participants who are determined to possess sufficient skills such that the
31.12participant is likely to succeed in obtaining unsubsidized employment must job search at
31.13least 30 hours per week for up to six weeks and accept any offer of suitable employment.
31.14The remaining hours necessary to meet the requirements of section256J.55, subdivision
31.151 , may be met through participation in other work activities under section
256J.49,
31.16subdivision 13 . The participant's employment plan must specify, at a minimum: (1)
31.17whether the job search is supervised or unsupervised; (2) support services that will
31.18be provided; and (3) how frequently the participant must report to the job counselor.
31.19Participants who are unable to find suitable employment after six weeks must meet
31.20with the job counselor to determine whether other activities in paragraph (a) should be
31.21incorporated into the employment plan. Job search activities which are continued after six
31.22weeks must be structured and supervised.
31.23 (c) Beginning July 1, 2004, activities and hourly requirements in the employment
31.24plan may be adjusted as necessary to accommodate the personal and family circumstances
31.25of participants identified under section
256J.561, subdivision 2, paragraph (d). Participants
31.26who no longer meet the provisions of section
256J.561, subdivision 2, paragraph (d),
31.27must meet with the job counselor within ten days of the determination to revise the
31.28employment plan.
31.29(d) Participants who are determined to have barriers to obtaining or retaining
31.30employment that will not be overcome during six weeks of job search under paragraph (b)
31.31must work with the job counselor to develop an employment plan that addresses those
31.32barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6).
31.33The employment plan must include enough hours to meet the participation requirements
31.34in section256J.55, subdivision 1 , unless a compelling reason to require fewer hours
31.35is noted in the participant's file.
32.1(e) (d) The job counselor and the participant must sign the employment plan to
32.2indicate agreement on the contents.
32.3(f) (e) Except as provided under paragraph (g) (f), failure to develop or comply with
32.4activities in the plan, or voluntarily quitting suitable employment without good cause, will
32.5result in the imposition of a sanction under section256J.46 .
32.6(g) (f) When a participant fails to meet the agreed upon hours of participation in paid
32.7employment because the participant is not eligible for holiday pay and the participant's
32.8place of employment is closed for a holiday, the job counselor shall not impose a sanction
32.9or increase the hours of participation in any other activity, including paid employment, to
32.10offset the hours that were missed due to the holiday.
32.11(h) (g) Employment plans must be reviewed at least every three months to determine
32.12whether activities and hourly requirements should be revised. The job counselor is
32.13encouraged to allow participants who are participating in at least 20 hours of work
32.14activities to also participate in education and training activities in order to meet the federal
32.15hourly participation rates.
32.16 Sec. 19. Minnesota Statutes 2008, section 256J.545, is amended to read:
32.17256J.545 FAMILY VIOLENCE WAIVER CRITERIA.
32.18 (a) In order to qualify for a family violence waiver, an individual must provide
32.19documentation of past or current family violence which may prevent the individual from
32.20participating in certain employment activities.
32.21 (b) The following items may be considered acceptable documentation or verification
32.22of family violence:
32.23 (1) police, government agency, or court records;
32.24 (2) a statement from a battered women's shelter staff with knowledge of the
32.25circumstancesor credible evidence that supports the sworn statement;
32.26 (3) a statement from a sexual assault or domestic violence advocate with knowledge
32.27of the circumstancesor credible evidence that supports the sworn statement; or
32.28 (4) a statement from professionals from whom the applicant or recipient has sought
32.29assistance for the abuse.
32.30 (c) A claim of family violence may also be documented by a sworn statement from
32.31the applicant or participant and a sworn statement from any other person with knowledge
32.32of the circumstances or credible evidence that supports the client's statement.
32.33 Sec. 20. Minnesota Statutes 2008, section 256J.561, subdivision 2, is amended to read:
33.1 Subd. 2. Participation requirements. (a) All MFIP caregivers, except caregivers
33.2who meet the criteria in subdivision 3, mustparticipate in employment services develop an
33.3individualized employment plan that identifies the activities the participant is required to
33.4participate in and the required hours of participation.Except as specified in paragraphs (b)
33.5to (d), the employment plan must meet the requirements of section
256J.521, subdivision
33.62
, contain allowable work activities, as defined in section
256J.49, subdivision 13, and,
33.7include at a minimum, the number of participation hours required under section
256J.55,
33.8subdivision 1
.
33.9(b) Minor caregivers and caregivers who are less than age 20 who have not
33.10completed high school or obtained a GED are required to comply with section
256J.54.
33.11(c) A participant who has a family violence waiver shall develop and comply with
33.12an employment plan under section
256J.521, subdivision 3.
33.13(d) As specified in section
256J.521, subdivision 2, paragraph (c), a participant who
33.14meets any one of the following criteria may work with the job counselor to develop an
33.15employment plan that contains less than the number of participation hours under section
33.16256J.55, subdivision 1. Employment plans for participants covered under this paragraph
33.17must be tailored to recognize the special circumstances of caregivers and families
33.18including limitations due to illness or disability and caregiving needs:
33.19(1) a participant who is age 60 or older;
33.20(2) a participant who has been diagnosed by a qualified professional as suffering
33.21from an illness or incapacity that is expected to last for 30 days or more, including a
33.22pregnant participant who is determined to be unable to obtain or retain employment due
33.23to the pregnancy; or
33.24(3) a participant who is determined by a qualified professional as being needed in
33.25the home to care for an ill or incapacitated family member, including caregivers with a
33.26child or an adult in the household who meets the disability or medical criteria for home
33.27care services under section
256B.0651, subdivision 1, paragraph (c), or a home and
33.28community-based waiver services program under chapter 256B, or meets the criteria for
33.29severe emotional disturbance under section
245.4871, subdivision 6, or for serious and
33.30persistent mental illness under section
245.462, subdivision 20, paragraph (c).
33.31(e) For participants covered under paragraphs (c) and (d), the county shall review
33.32the participant's employment services status every three months to determine whether
33.33conditions have changed. When it is determined that the participant's status is no longer
33.34covered under paragraph (c) or (d), the county shall notify the participant that a new or
33.35revised employment plan is needed. The participant and job counselor shall meet within
33.36ten days of the determination to revise the employment plan.
34.1(b) Participants who meet the eligibility requirements in section 256J.575,
34.2subdivision 3, must develop a family stabilization services plan that meets the
34.3requirements in section 256J.575, subdivision 5.
34.4(c) Minor caregivers and caregivers who are less than age 20 who have not
34.5completed high school or obtained a GED must develop an education plan that meets the
34.6requirements in section 256J.54.
34.7(d) Participants with a family violence waiver must develop an employment plan
34.8that meets the requirements in section 256J.521, which cover the provisions in section
34.9256J.575, subdivision 5.
34.10(e) All other participants must develop an employment plan that meets the
34.11requirements of section256J.521, subdivision 2 , and contains allowable work activities,
34.12as defined in section256J.49, subdivision 13 . The employment plan must include, at a
34.13minimum, the number of participation hours required under section256J.55, subdivision 1 .
34.14 Sec. 21. Minnesota Statutes 2008, section 256J.561, subdivision 3, is amended to read:
34.15 Subd. 3. Child under 12weeks months of age. (a) A participant who has a
34.16natural born child who is less than 12weeks months of age who meets the criteria in this
34.17subdivision is not required to participate in employment services until the child reaches
34.1812weeks months of age. To be eligible for this provision, the assistance unit must not
34.19have already used this provision or the previously allowed child under age one exemption.
34.20However, an assistance unit that has an approved child under age one exemption at the
34.21time this provision becomes effective may continue to use that exemption until the child
34.22reaches one year of age.
34.23(b) The provision in paragraph (a) ends the first full month after the child reaches
34.2412weeks months of age. This provision is available only once in a caregiver's lifetime.
34.25In a two-parent household, only one parent shall be allowed to use this provision. The
34.26participant and job counselor must meet within ten days after the child reaches 12weeks
34.27months of age to revise the participant's employment plan.
34.28EFFECTIVE DATE.This section is effective March 1, 2010.
34.29 Sec. 22. Minnesota Statutes 2008, section 256J.57, subdivision 1, is amended to read:
34.30 Subdivision 1. Good cause for failure to comply. The county agency shall not
34.31impose the sanction under section256J.46 if it determines that the participant has good
34.32cause for failing to comply with the requirements of sections256J.515 to
256J.57 . Good
34.33cause exists when:
34.34(1) appropriate child care is not available;
35.1(2) the job does not meet the definition of suitable employment;
35.2(3) the participant is ill or injured;
35.3(4) a member of the assistance unit, a relative in the household, or a foster child in
35.4the household is ill and needs care by the participant that prevents the participant from
35.5complying with the employment plan;
35.6(5) the participant is unable to secure necessary transportation;
35.7(6) the participant is in an emergency situation that prevents compliance with the
35.8employment plan;
35.9(7) the schedule of compliance with the employment plan conflicts with judicial
35.10proceedings;
35.11(8) a mandatory MFIP meeting is scheduled during a time that conflicts with a
35.12judicial proceeding or a meeting related to a juvenile court matter, or a participant's work
35.13schedule;
35.14(9) the participant is already participating in acceptable work activities;
35.15(10) the employment plan requires an educational program for a caregiver under age
35.1620, but the educational program is not available;
35.17(11) activities identified in the employment plan are not available;
35.18(12) the participant is willing to accept suitable employment, but suitable
35.19employment is not available;or
35.20(13) the participant documents other verifiable impediments to compliance with the
35.21employment plan beyond the participant's control; or
35.22(14) the documentation needed to determine if a participant is eligible for family
35.23stabilization services is not available, but there is information that the participant may
35.24qualify and the participant is cooperating with the county or employment service provider's
35.25efforts to obtain the documentation necessary to determine eligibility.
35.26The job counselor shall work with the participant to reschedule mandatory meetings
35.27for individuals who fall under clauses (1), (3), (4), (5), (6), (7), and (8).
35.28 Sec. 23. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:
35.29 Subd. 3. Eligibility. (a) The following MFIPor diversionary work program (DWP)
35.30participants are eligible for the services under this section:
35.31 (1) a participant who meets the requirements for or has been granted a hardship
35.32extension under section256J.425, subdivision 2 or 3, except that it is not necessary for
35.33the participant to have reached or be approaching 60 months of eligibility for this section
35.34to apply;
36.1 (2) a participant who is applying for Supplemental Security Income or Social
36.2Security disability insurance;and
36.3 (3) a participant who is a noncitizen who has been in the United States for 12 or
36.4fewer months; and
36.5(4) a participant who is age 60 or older.
36.6 (b) Families must meet all other eligibility requirements for MFIP established in
36.7this chapter. Families are eligible for financial assistance to the same extent as if they
36.8were participating in MFIP.
36.9 (c) A participant under paragraph (a), clause (3), must be provided with English as a
36.10second language opportunities and skills training for up to 12 months. After 12 months,
36.11the case manager and participant must determine whether the participant should continue
36.12with English as a second language classes or skills training, or both, and continue to
36.13receive family stabilization services.
36.14(d) If a county agency or employment services provider has information that
36.15an MFIP participant may meet the eligibility criteria set forth in this subdivision, the
36.16county agency or employment services provider must assist the participant in obtaining
36.17the documentation necessary to determine eligibility. Until necessary documentation is
36.18obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.
36.19EFFECTIVE DATE.This section is effective July 1, 2009, except the amendment
36.20to paragraph (a) striking "or diversionary work program (DWP)" is effective March 1,
36.212010.
36.22 Sec. 24. Minnesota Statutes 2008, section 256J.575, subdivision 4, is amended to read:
36.23 Subd. 4. Universal participation. All caregivers must participate in family
36.24stabilization services as defined in subdivision 2, except for caregivers exempt under
36.25section 256J.561, subdivision 3.
36.26EFFECTIVE DATE.This section is effective March 1, 2010.
36.27 Sec. 25. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read:
36.28 Subd. 6. Cooperation with services requirements. (a)To be eligible, A participant
36.29who is eligible for family stabilization services under this section shall comply with
36.30paragraphs (b) to (d).
36.31 (b) Participants shall engage in family stabilization plan services for the appropriate
36.32number of hours per week that the activities are scheduled and available, unless good
36.33cause exists for not doing so, as defined in section256J.57, subdivision 1 . The appropriate
36.34number of hours must be based on the participant's plan.
37.1 (c) The case manager shall review the participant's progress toward the goals in the
37.2family stabilization plan every six months to determine whether conditions have changed,
37.3including whether revisions to the plan are needed.
37.4 (d) A participant's requirement to comply with any or all family stabilization plan
37.5requirements under this subdivision is excused when the case management services,
37.6training and educational services, or family support services identified in the participant's
37.7family stabilization plan are unavailable for reasons beyond the control of the participant,
37.8including when money appropriated is not sufficient to provide the services.
37.9 Sec. 26. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read:
37.10 Subd. 7. Sanctions. (a) The county agency or employment services provider must
37.11follow the requirements of this subdivision at the time the county agency or employment
37.12services provider has information that an MFIP recipient may meet the eligibility criteria
37.13in subdivision 3.
37.14(b) The financial assistance grant of a participating family is reduced according to
37.15section256J.46 , if a participating adult fails without good cause to comply or continue
37.16to comply with the family stabilization plan requirements in this subdivision, unless
37.17compliance has been excused under subdivision 6, paragraph (d).
37.18(b) (c) Given the purpose of the family stabilization services in this section and the
37.19nature of the underlying family circumstances that act as barriers to both employment and
37.20full compliance with program requirements, there must be a review by the county agency
37.21prior to imposing a sanction to determine whether the plan was appropriated to the needs
37.22of the participant and family, and. There must be a current assessment by a behavioral
37.23health or medical professional confirming that the participant in all ways had the ability to
37.24comply with the plan, as confirmed by a behavioral health or medical professional.
37.25(c) (d) Prior to the imposition of a sanction, the county agency or employment
37.26services provider shall review the participant's case to determine if the family stabilization
37.27plan is still appropriate and meet with the participant face-to-face.The participant may
37.28bring an advocate The county agency or employment services provider must inform the
37.29participant of the right to bring an advocate to the face-to-face meeting.
37.30 During the face-to-face meeting, the county agency shall:
37.31 (1) determine whether the continued noncompliance can be explained and mitigated
37.32by providing a needed family stabilization service, as defined in subdivision 2, paragraph
37.33(d);
37.34 (2) determine whether the participant qualifies for a good cause exception under
37.35section256J.57 , or if the sanction is for noncooperation with child support requirements,
38.1determine if the participant qualifies for a good cause exemption under section256.741 ,
38.2subdivision 10;
38.3 (3) determine whether activities in the family stabilization plan are appropriate
38.4based on the family's circumstances;
38.5 (4) explain the consequences of continuing noncompliance;
38.6 (5) identify other resources that may be available to the participant to meet the
38.7needs of the family; and
38.8 (6) inform the participant of the right to appeal under section256J.40 .
38.9 If the lack of an identified activity or service can explain the noncompliance, the
38.10county shall work with the participant to provide the identified activity.
38.11 (d) If the participant fails to come to the face-to-face meeting, the case manager or a
38.12designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
38.13the county agency shall send the participant a written notice that includes the information
38.14under paragraph (c).
38.15 (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
38.16of a sanction, the county agency shall provide a notice of intent to sanction under section
38.17256J.57, subdivision 2
, and, when applicable, a notice of adverse action under section
38.18256J.31
.
38.19 (f) Section256J.57 applies to this section except to the extent that it is modified
38.20by this subdivision.
38.21 Sec. 27. Minnesota Statutes 2008, section 256J.621, is amended to read:
38.22256J.621 WORK PARTICIPATION CASH BENEFITS.
38.23 (a) Effective October 1, 2009, upon exiting the diversionary work program (DWP)
38.24or upon terminating the Minnesota family investment program with earnings, a participant
38.25who is employed may be eligible for work participation cash benefits of$75 $50 per
38.26month to assist in meeting the family's basic needs as the participant continues to move
38.27toward self-sufficiency.
38.28 (b) To be eligible for work participation cash benefits, the participant shall not
38.29receive MFIP or diversionary work program assistance during the month and the
38.30participant or participants must meet the following work requirements:
38.31 (1) if the participant is a single caregiver and has a child under six years of age, the
38.32participant must be employed at least 87 hours per month;
38.33 (2) if the participant is a single caregiver and does not have a child under six years of
38.34age, the participant must be employed at least 130 hours per month; or
39.1 (3) if the household is a two-parent family, at least one of the parents must be
39.2employed an average of at least 130 hours per month.
39.3 Whenever a participant exits the diversionary work program or is terminated from
39.4MFIP and meets the other criteria in this section, work participation cash benefits are
39.5available for up to 24 consecutive months.
39.6 (c) Expenditures on the program are maintenance of effort state funds under
39.7a separate state program for participants under paragraph (b), clauses (1) and (2).
39.8Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
39.9funds. Months in which a participant receives work participation cash benefits under this
39.10section do not count toward the participant's MFIP 60-month time limit.
39.11 Sec. 28. Minnesota Statutes 2008, section 256J.626, subdivision 7, is amended to read:
39.12 Subd. 7. Performance base funds. (a) For the purpose of this section, the following
39.13terms have the meanings given.
39.14(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
39.15TANF and separate state program caseload has fallen relative to federal fiscal year 2005
39.16based on caseload data from October 1 to September 30.
39.17(2) "TANF participation rate target" means a 50 percent participation rate reduced by
39.18the CRC for the previous year.
39.19(b) For calendar year2009 2010 and yearly thereafter, each county and tribe will be
39.20allocated 95 percent of their initial calendar year allocation. Counties and tribes will be
39.21allocated additional funds based on performance as follows:
39.22 (1) a county or tribe that achievesa 50 percent the TANF participation rate target
39.23or a five percentage point improvement over the previous year's TANF participation rate
39.24under section256J.751, subdivision 2 , clause (7), as averaged across 12 consecutive
39.25months for the most recent year for which the measurements are available, will receive an
39.26additional allocation equal to 2.5 percent of its initial allocation;and
39.27 (2) a county or tribe that performs within or above its range of expected performance
39.28on the annualized three-year self-support index under section256J.751, subdivision 2 ,
39.29clause (6), will receive an additional allocation equal to 2.5 percent of its initial allocation;
39.30and
39.31 (3) a county or tribe that does not achievea 50 percent the TANF participation rate
39.32target or a five percentage point improvement over the previous year's TANF participation
39.33rate under section256J.751, subdivision 2 , clause (7), as averaged across 12 consecutive
39.34months for the most recent year for which the measurements are available, will not
40.1receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
40.2improvement plan with the commissioner; or
40.3 (4) a county or tribe that does not perform within or above its range of expected
40.4performance on the annualized three-year self-support index under section256J.751,
40.5subdivision 2 , clause (6), will not receive an additional allocation equal to 2.5 percent
40.6of its initial allocation until after negotiating a multiyear improvement plan with the
40.7commissioner.
40.8(b) (c) For calendar year 2009 and yearly thereafter, performance-based funds for
40.9a federally approved tribal TANF program in which the state and tribe have in place
40.10a contract under section256.01 , addressing consolidated funding, will be allocated as
40.11follows:
40.12 (1) a tribe that achieves the participation rate approved in its federal TANF plan
40.13using the average of 12 consecutive months for the most recent year for which the
40.14measurements are available, will receive an additional allocation equal to 2.5 percent of
40.15its initial allocation; and
40.16 (2) a tribe that performs within or above its range of expected performance on the
40.17annualized three-year self-support index under section256J.751, subdivision 2 , clause (6),
40.18will receive an additional allocation equal to 2.5 percent of its initial allocation; or
40.19 (3) a tribe that does not achieve the participation rate approved in its federal TANF
40.20plan using the average of 12 consecutive months for the most recent year for which the
40.21measurements are available, will not receive an additional allocation equal to 2.5 percent
40.22of its initial allocation until after negotiating a multiyear improvement plan with the
40.23commissioner; or
40.24 (4) a tribe that does not perform within or above its range of expected performance
40.25on the annualized three-year self-support index under section256J.751, subdivision
40.262 , clause (6), will not receive an additional allocation equal to 2.5 percent until after
40.27negotiating a multiyear improvement plan with the commissioner.
40.28(c) (d) Funds remaining unallocated after the performance-based allocations
40.29in paragraph(a) (b) are available to the commissioner for innovation projects under
40.30subdivision 5.
40.31(d) (1) If available funds are insufficient to meet county and tribal allocations under
40.32paragraph(a) (b), the commissioner may make available for allocation funds that are
40.33unobligated and available from the innovation projects through the end of the current
40.34biennium.
40.35 (2) If after the application of clause (1) funds remain insufficient to meet county
40.36and tribal allocations under paragraph(a) (b), the commissioner must proportionally
41.1reduce the allocation of each county and tribe with respect to their maximum allocation
41.2available under paragraph(a) (b).
41.3 Sec. 29. Minnesota Statutes 2008, section 256J.95, subdivision 3, is amended to read:
41.4 Subd. 3. Eligibility for diversionary work program. (a) Except for the categories
41.5of family units listed below, all family units who apply for cash benefits and who
41.6meet MFIP eligibility as required in sections256J.11 to
256J.15 are eligible and must
41.7participate in the diversionary work program. Family units that are not eligible for the
41.8diversionary work program include:
41.9 (1) child only cases;
41.10 (2) a single-parent family unit that includes a child under 12weeks months of age.
41.11A parent is eligible for this exception once in a parent's lifetime and is not eligible if
41.12the parent has already used the previously allowed child under age one exemption from
41.13MFIP employment services;
41.14 (3) a minor parent without a high school diploma or its equivalent;
41.15 (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
41.16who chooses to have an employment plan with an education option;
41.17 (5) a caregiver age 60 or over;
41.18 (6) family units with a caregiver who received DWP benefits in the 12 months prior
41.19to the month the family applied for DWP, except as provided in paragraph (c);
41.20 (7) family units with a caregiver who received MFIP within the 12 months prior to
41.21the month the family unit applied for DWP;
41.22 (8) a family unit with a caregiver who received 60 or more months of TANF
41.23assistance;
41.24 (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
41.25fraud; and
41.26 (10) refugees and asylees as defined in Code of Federal Regulations, title 45, part
41.27400, subpart d, section400.43 , who arrived in the United States in the 12 months prior to
41.28the date of application for family cash assistance.
41.29 (b) A two-parent family must participate in DWP unless both caregivers meet the
41.30criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
41.31includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), (9), or (10).
41.32 (c) Once DWP eligibility is determined, the four months run consecutively. If a
41.33participant leaves the program for any reason and reapplies during the four-month period,
41.34the county must redetermine eligibility for DWP.
41.35EFFECTIVE DATE.This section is effective March 1, 2010.
42.1 Sec. 30. Minnesota Statutes 2008, section 256J.95, subdivision 11, is amended to read:
42.2 Subd. 11. Universal participation required. (a) All DWP caregivers, except
42.3caregivers who meet the criteria in paragraph (d), are required to participate in DWP
42.4employment services. Except as specified in paragraphs (b) and (c), employment plans
42.5under DWP must, at a minimum, meet the requirements in section256J.55, subdivision 1 .
42.6(b) A caregiver who is a member of a two-parent family that is required to participate
42.7in DWP who would otherwise be ineligible for DWP under subdivision 3 may be allowed
42.8to develop an employment plan under section256J.521, subdivision 2 , paragraph (c), that
42.9may contain alternate activities and reduced hours.
42.10(c) A participant who is a victim of family violence shall be allowed to develop an
42.11employment plan under section256J.521, subdivision 3 . A claim of family violence must
42.12be documented by the applicant or participant by providing a sworn statement which is
42.13supported by collateral documentation in section256J.545, paragraph (b) .
42.14(d) One parent in a two-parent family unit that has a natural born child under 12
42.15weeks months of age is not required to have an employment plan until the child reaches 12
42.16weeks months of age unless the family unit has already used the exclusion under section
42.17256J.561, subdivision 3
, or the previously allowed child under age one exemption under
42.18section256J.56, paragraph (a) , clause (5).
42.19(e) The provision in paragraph (d) ends the first full month after the child reaches 12
42.20weeks months of age. This provision is allowable only once in a caregiver's lifetime. In a
42.21two-parent household, only one parent shall be allowed to use this category.
42.22(f) The participant and job counselor must meet within ten working days after the
42.23child reaches 12weeks months of age to revise the participant's employment plan. The
42.24employment plan for a family unit that has a child under 12weeks months of age that has
42.25already used the exclusion in section256J.561 or the previously allowed child under
42.26age one exemption under section256J.56, paragraph (a) , clause (5), must be tailored to
42.27recognize the caregiving needs of the parent.
42.28EFFECTIVE DATE.This section is effective March 1, 2010.
42.29 Sec. 31. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:
42.30 Subd. 12. Conversion or referral to MFIP. (a) If at any time during the DWP
42.31application process or during the four-month DWP eligibility period, it is determined that
42.32a participant is unlikely to benefit from the diversionary work program, the county shall
42.33convert or refer the participant to MFIP as specified in paragraph (d). Participants who are
42.34determined to be unlikely to benefit from the diversionary work program must develop
42.35and sign an employment plan.Participants who meet any one of the criteria in paragraph
43.1(b) shall be considered to be unlikely to benefit from DWP, provided the necessary
43.2documentation is available to support the determination.
43.3(b) A participant who: meets the eligibility requirements under section 256J.575,
43.4subdivision 3, must be considered to be unlikely to benefit from DWP, provided the
43.5necessary documentation is available to support the determination.
43.6(1) has been determined by a qualified professional as being unable to obtain or retain
43.7employment due to an illness, injury, or incapacity that is expected to last at least 60 days;
43.8(2) is required in the home as a caregiver because of the illness, injury, or incapacity,
43.9of a family member, or a relative in the household, or a foster child, and the illness, injury,
43.10or incapacity and the need for a person to provide assistance in the home has been certified
43.11by a qualified professional and is expected to continue more than 60 days;
43.12(3) is determined by a qualified professional as being needed in the home to care for
43.13a child or adult meeting the special medical criteria in section
256J.561, subdivision 2,
43.14paragraph (d), clause (3);
43.15(4) is pregnant and is determined by a qualified professional as being unable to
43.16obtain or retain employment due to the pregnancy; or
43.17(5) has applied for SSI or SSDI.
43.18(c) In a two-parent family unit,both parents must be if one parent is determined
43.19to be unlikely to benefit from the diversionary work programbefore, the family unit
43.20can must be converted or referred to MFIP.
43.21(d) A participant who is determined to be unlikely to benefit from the diversionary
43.22work program shall be converted to MFIP and, if the determination was made within 30
43.23days of the initial application for benefits, no additional application form is required.
43.24A participant who is determined to be unlikely to benefit from the diversionary work
43.25program shall be referred to MFIP and, if the determination is made more than 30
43.26days after the initial application, the participant must submit a program change request
43.27form. The county agency shall process the program change request form by the first of
43.28the following month to ensure that no gap in benefits is due to delayed action by the
43.29county agency. In processing the program change request form, the county must follow
43.30section256J.32, subdivision 1 , except that the county agency shall not require additional
43.31verification of the information in the case file from the DWP application unless the
43.32information in the case file is inaccurate, questionable, or no longer current.
43.33(e) The county shall not request a combined application form for a participant who
43.34has exhausted the four months of the diversionary work program, has continued need for
43.35cash and food assistance, and has completed, signed, and submitted a program change
43.36request form within 30 days of the fourth month of the diversionary work program. The
44.1county must process the program change request according to section256J.32, subdivision
44.21 , except that the county agency shall not require additional verification of information
44.3in the case file unless the information is inaccurate, questionable, or no longer current.
44.4When a participant does not request MFIP within 30 days of the diversionary work
44.5program benefits being exhausted, a new combined application form must be completed
44.6for any subsequent request for MFIP.
44.7EFFECTIVE DATE.This section is effective March 1, 2010.
44.8 Sec. 32. Minnesota Statutes 2008, section 256J.95, subdivision 13, is amended to read:
44.9 Subd. 13. Immediate referral to employment services. Within one working day of
44.10determination that the applicant is eligible for the diversionary work program, but before
44.11benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to
44.12employment services. The referral to the DWP employment services must be in writing
44.13and must contain the following information:
44.14(1) notification that, as part of the application process, applicants are required to
44.15develop an employment plan or the DWP application will be denied;
44.16(2) the employment services provider name and phone number;
44.17(3) the date, time, and location of the scheduled employment services interview;
44.18(4) the immediate availability of supportive services, including, but not limited to,
44.19child care, transportation, and other work-related aid; and
44.20(5) (4) the rights, responsibilities, and obligations of participants in the program,
44.21including, but not limited to, the grounds for good cause, the consequences of refusing or
44.22failing to participate fully with program requirements, and the appeal process.
44.23 Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
44.24to read:
44.25 Subd. 3b. Extension; adoption finalized after age 16. A child who has attained the
44.26age of 16 prior to finalization of their adoption is eligible for extension of the adoption
44.27assistance agreement to the date the child attains age 21 if the child is:
44.28 (1) completing a secondary education program or a program leading to an equivalent
44.29credential;
44.30 (2) enrolled in an institution which provides postsecondary or vocational education;
44.31 (3) participating in a program or activity designed to promote or remove barriers to
44.32employment;
44.33 (4) employed for at least 80 hours per month; or
45.1 (5) incapable of doing any of the activities described in clauses (1) to (4) due to a
45.2medical condition which incapability is supported by regularly updated information in
45.3the case plan of the child.
45.4EFFECTIVE DATE.This section is effective October 1, 2010.
45.5 Sec. 34. Minnesota Statutes 2008, section 270A.09, is amended by adding a
45.6subdivision to read:
45.7 Subd. 1b. Department of Human Services claims. Notwithstanding subdivision 1,
45.8any debtor contesting a setoff claim by the Department of Human Services or a county
45.9agency whose claim relates to a debt resulting from receipt of public assistance, medical
45.10care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as
45.11an appeal under sections 256.045 and 256.0451.
45.12 Sec. 35. AMERICAN INDIAN CHILD WELFARE PROJECTS.
45.13Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human
45.14services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010
45.15to tribes participating in the American Indian child welfare projects under Minnesota
45.16Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe
45.17participating in the Indian child welfare projects under Minnesota Statutes, section 256.01,
45.18subdivision 14b, must be granted according to the commissioner's authority under
45.19Minnesota Statutes, section 16A.28.
45.20 Sec. 36. REPEALER.
45.21Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.
45.24 Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:
45.25 Subd. 5. Cost of care. "Cost of care" means the commissioner's charge for services
45.26provided to any person admitted to a state facility.
45.27For purposes of this subdivision, "charge for services" means thecost of services,
45.28treatment, maintenance, bonds issued for capital improvements, depreciation of buildings
45.29and equipment, and indirect costs related to the operation of state facilities. The
45.30commissioner may determine the charge for services on an anticipated average per diem
45.31basis as an all inclusive charge per facility, per disability group, or per treatment program.
45.32The commissioner may determine a charge per service, using a method that includes direct
46.1and indirect costs usual and customary fee charged for services provided to clients. The
46.2usual and customary fee shall be established in a manner required to appropriately bill
46.3services to all payers and shall include the costs related to the operations of any program
46.4offered by the state.
46.5 Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
46.6to read:
46.7 Subd. 10. State-operated community-based program. "State-operated
46.8community-based program" means any program operated in the community including
46.9community behavioral health hospitals, crisis centers, residential facilities, outpatient
46.10services, and other community-based services developed and operated by the state and
46.11under the commissioner's control.
46.12 Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
46.13to read:
46.14 Subd. 11. Health plan company. "Health plan company" has the meaning given it
46.15in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in
46.16section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating
46.17in county-based purchasing according to section 256B.692, and a children's mental health
46.18collaborative under contract to provide medical assistance for individuals enrolled in
46.19the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to
46.20245.495.
46.21 Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
46.22to read:
46.23 Subd. 1a. Clients in state-operated community-based programs; determination.
46.24The commissioner shall determine available health plan coverage from a health plan
46.25company for services provided to clients admitted to a state-operated community-based
46.26program. If the health plan coverage requires a co-pay or deductible, or if there is no
46.27available health plan coverage, the commissioner shall determine or redetermine, what
46.28part of the noncovered cost of care, if any, the client is able to pay. If the client is unable to
46.29pay the uncovered cost of care, the commissioner shall determine the client's relatives'
46.30ability to pay. The client and relatives shall provide to the commissioner documents and
46.31proof necessary to determine the client and relatives' ability to pay. Failure to provide the
46.32commissioner with sufficient information to determine ability to pay may make the client
46.33or relatives liable for the full cost of care until the time when sufficient information is
47.1provided. If it is determined that the responsible party does not have the ability to pay,
47.2the commissioner shall waive payment of the portion that exceeds ability to pay under
47.3the determination.
47.4 Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
47.5to read:
47.6 Subd. 1b. Clients served by regional treatment centers or nursing homes;
47.7determination. The commissioner shall determine or redetermine, if necessary, what part
47.8of the cost of care, if any, a client served in regional treatment centers or nursing homes
47.9operated by state-operated services, is able to pay. If the client is unable to pay the full cost
47.10of care, the commissioner shall determine if the client's relatives have the ability to pay.
47.11The client and relatives shall provide to the commissioner documents and proof necessary
47.12to determine the client and relatives' ability to pay. Failure to provide the commissioner
47.13with sufficient information to determine ability to pay may make the client or relatives
47.14liable for the full cost of care until the time when sufficient information is provided. No
47.15parent shall be liable for the cost of care given a client at a regional treatment center after
47.16the client has reached the age of 18 years.
47.17 Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:
47.18246.511 RELATIVE RESPONSIBILITY.
47.19Except for chemical dependency services paid for with funds provided under chapter
47.20254B, a client's relatives shall not, pursuant to the commissioner's authority under section
47.21246.51
, be ordered to pay more than ten percent of the cost of the following: (1) for
47.22services provided in a community-based service, the noncovered cost of care as determined
47.23under the ability to pay determination; and (2) for services provided at a regional treatment
47.24center operated by state-operated services, 20 percent of the cost of care, unless they
47.25reside outside the state. Parents of children in state facilities shall have their responsibility
47.26to pay determined according to section252.27, subdivision 2 , or in rules adopted under
47.27chapter 254B if the cost of care is paid under chapter 254B. The commissioner may
47.28accept voluntary payments in excess often 20 percent. The commissioner may require
47.29full payment of the full per capita cost of care in state facilities for clients whose parent,
47.30parents, spouse, guardian, or conservator do not reside in Minnesota.
47.31 Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:
47.32246.52 PAYMENT FOR CARE; ORDER; ACTION.
48.1The commissioner shall issue an order to the client or the guardian of the estate, if
48.2there be one, and relatives determined able to pay requiring them to paymonthly to the
48.3state of Minnesota the amounts so determined the total of which shall not exceed the full
48.4cost of care. Such order shall specifically state the commissioner's determination and shall
48.5be conclusive unless appealed from as herein provided. When a client or relative fails to
48.6pay the amount due hereunder the attorney general, upon request of the commissioner,
48.7may institute, or direct the appropriate county attorney to institute, civil action to recover
48.8such amount.
48.9 Sec. 8. Minnesota Statutes 2008, section 246.54, subdivision 2, is amended to read:
48.10 Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
48.11Minnesota Security Hospital, the Minnesota sex offender program, or the Minnesota
48.12extended treatment options program. For services at these facilities, a county's payment
48.13shall be made from the county's own sources of revenue and payments shall be paid as
48.14follows: payments to the state from the county shall equal ten percent of the cost of care,
48.15as determined by the commissioner, for each day, or the portion thereof, that the client
48.16spends at the facility. If payments received by the state under sections246.50 to
246.53
48.17exceed 90 percent of the cost of care, the county shall be responsible for paying the state
48.18only the remaining amount. The county shall not be entitled to reimbursement from the
48.19client, the client's estate, or from the client's relatives, except as provided in section246.53 .
48.20 (b) Regardless of the facility to which the client is committed, subdivision 1 does
48.21not apply to the following individuals:
48.22 (1) clients who are committed as mentally ill and dangerous under section253B.02 ,
48.23subdivision 17;
48.24 (2) clients who are committed as sexual psychopathic personalities under section
48.25253B.02, subdivision 18b
; and
48.26 (3) clients who are committed as sexually dangerous persons under section253B.02 ,
48.27subdivision 18c.
48.28 For each of the individuals in clauses (1) to (3), the payment by the county to the state
48.29shall equal ten percent of the cost of care for each day as determined by the commissioner.
48.30 Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
48.31to read:
48.32 Subd. 1a. Client. "Client" means a person who is admitted to the Minnesota sex
48.33offender program or subject to a court hold order under section 253B.185 for the purpose
49.1of assessment, diagnosis, care, treatment, supervision, or other services provided by the
49.2Minnesota sex offender program.
49.3 Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a
49.4subdivision to read:
49.5 Subd. 1b. Client's county. "Client's county" means the county of the client's
49.6legal settlement for poor relief purposes at the time of commitment. If the client has no
49.7legal settlement for poor relief in this state, it means the county of commitment, except
49.8that when a client with no legal settlement for poor relief is committed while serving a
49.9sentence at a penal institution, it means the county from which the client was sentenced.
49.10 Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
49.11to read:
49.12 Subd. 2a. Cost of care. "Cost of care" means the commissioner's charge for housing
49.13and treatment services provided to any person admitted to the Minnesota sex offender
49.14program.
49.15For purposes of this subdivision, "charge for housing and treatment services" means
49.16the cost of services, treatment, maintenance, bonds issued for capital improvements,
49.17depreciation of buildings and equipment, and indirect costs related to the operation of
49.18state facilities. The commissioner may determine the charge for services on an anticipated
49.19average per diem basis as an all-inclusive charge per facility.
49.20 Sec. 12. Minnesota Statutes 2008, section 246B.01, is amended by adding a
49.21subdivision to read:
49.22 Subd. 2b. Local social services agency. "Local social services agency" means the
49.23local social services agency of the client's county as defined in subdivision 1b and of the
49.24county of commitment, and any other local social services agency possessing information
49.25regarding, or requested by the commissioner to investigate, the financial circumstances
49.26of a client.
49.27 Sec. 13. [246B.07] PAYMENT FOR CARE AND TREATMENT:
49.28DETERMINATION.
49.29 Subdivision 1. Procedures. The commissioner shall determine or redetermine, if
49.30necessary, what amount of the cost of care, if any, the client is able to pay. The client shall
49.31provide to the commissioner documents and proof necessary to determine the ability to
49.32pay. Failure to provide the commissioner with sufficient information to determine ability
50.1to pay may make the client liable for the full cost of care until the time when sufficient
50.2information is provided.
50.3 Subd. 2. Rules. The commissioner shall use the standards in section 246.51,
50.4subdivision 2, to determine the client's liability for the care provided by the Minnesota sex
50.5offender program.
50.6 Subd. 3. Applicability. The commissioner may recover, under sections 246B.07 to
50.7246B.10, the cost of any care provided by the Minnesota sex offender program.
50.8 Sec. 14. [246B.08] PAYMENT FOR CARE; ORDER; ACTION.
50.9The commissioner shall issue an order to the client or the guardian of the estate, if
50.10there is one, requiring the client or guardian to pay to the state the amounts determined, the
50.11total of which must not exceed the full cost of care. The order must specifically state the
50.12commissioner's determination and must be conclusive, unless appealed. If a client fails to
50.13pay the amount due, the attorney general, upon request of the commissioner, may institute,
50.14or direct the appropriate county attorney to institute a civil action to recover the amount.
50.15 Sec. 15. [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
50.16 Subdivision 1. Client's estate. Upon the death of a client, or a former client, the
50.17total cost of care provided to the client, less the amount actually paid toward the cost of
50.18care by the client, must be filed by the commissioner as a claim against the estate of the
50.19client with the court having jurisdiction to probate the estate, and all proceeds collected
50.20by the state in the case must be divided between the state and county in proportion to
50.21the cost of care each has borne.
50.22 Subd. 2. Preferred status. An estate claim in subdivision 1 must be considered an
50.23expense of the last illness for purposes of section 524.3-805.
50.24If the commissioner determines that the property or estate of a client is not more
50.25than needed to care for and maintain the spouse and minor or dependent children of a
50.26deceased client, the commissioner has the power to compromise the claim of the state in a
50.27manner deemed just and proper.
50.28 Subd. 3. Exception from statute of limitations. Any statute of limitations that
50.29limits the commissioner in recovering the cost of care obligation incurred by a client or
50.30former client must not apply to any claim against an estate made under this section to
50.31recover cost of care.
50.32 Sec. 16. [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.
51.1The client's county shall pay to the state a portion of the cost of care provided in
51.2the Minnesota sex offender program to a client who has legally settled in that county. A
51.3county's payment must be made from the county's own sources of revenue and payments
51.4must equal ten percent of the cost of care, as determined by the commissioner, for each
51.5day or portion of a day, that the client spends at the facility. If payments received by the
51.6state under this chapter exceed 90 percent of the cost of care, the county is responsible
51.7for paying the state the remaining amount. The county is not entitled to reimbursement
51.8from the client, the client's estate, or from the client's relatives, except as provided in
51.9section 246B.07.
51.10 Sec. 17. Minnesota Statutes 2008, section 252.025, subdivision 7, is amended to read:
51.11 Subd. 7. Minnesota extended treatment options. The commissioner shall develop
51.12by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have
51.13developmental disabilities and exhibit severe behaviors which present a risk to public
51.14safety. This program is statewide and must provide specialized residential services in
51.15Cambridge and an array ofcommunity support community-based services statewide with
51.16sufficient levels of care and a sufficient number of specialists to ensure that individuals
51.17referred to the program receive the appropriate care. The individuals working in the
51.18community-based services under this section are state employees supervised by the
51.19commissioner of human services. No layoffs shall occur as a result of restructuring
51.20under this section.
51.21 Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
51.22MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
51.23ANOKA-METRO REGIONAL TREATMENT CENTER.
51.24In consultation with community partners, the commissioner of human services
51.25shall develop an array of community-based services to transform the current services
51.26now provided to patients at the Anoka-Metro Regional Treatment Center. The
51.27community-based services may be provided in facilities with 16 or fewer beds, and must
51.28provide the appropriate level of care for the patients being admitted to the facilities. The
51.29planning for this transition must be completed by October 1, 2009, with an initial report
51.30to the committee chairs of health and human services by November 30, 2009, and a
51.31semiannual report on progress until the transition is completed. The commissioner of
51.32human services shall solicit interest from stakeholders and potential community partners.
51.33The individuals working in the community-based services facilities under this section are
52.1state employees supervised by the commissioner of human services. No layoffs shall
52.2occur as a result of restructuring under this section.
52.3 Sec. 19. REPEALER.
52.4Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision
52.53, are repealed.
52.8 Section 1. Minnesota Statutes 2008, section 62J.495, is amended to read:
52.962J.495 HEALTH INFORMATION TECHNOLOGY AND
52.10INFRASTRUCTURE.
52.11 Subdivision 1. Implementation. By January 1, 2015, all hospitals and health care
52.12providers must have in place an interoperable electronic health records system within their
52.13hospital system or clinical practice setting. The commissioner of health, in consultation
52.14with the e-HealthInformation Technology and Infrastructure Advisory Committee,
52.15shall develop a statewide plan to meet this goal, including uniform standards to be used
52.16for the interoperable system for sharing and synchronizing patient data across systems.
52.17The standards must be compatible with federal efforts. The uniform standards must be
52.18developed by January 1, 2009,with a status report on the development of these standards
52.19submitted to the legislature by January 15, 2008 and updated on an ongoing basis. The
52.20commissioner shall include an update on standards development as part of an annual
52.21report to the legislature.
52.22 Subd. 1a. Definitions. (a) "Certified electronic health record technology" means an
52.23electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH
52.24Act to meet the standards and implementation specifications adopted under section 3004
52.25as applicable.
52.26(b) "Commissioner" means the commissioner of health.
52.27(c) "Pharmaceutical electronic data intermediary" means any entity that provides
52.28the infrastructure to connect computer systems or other electronic devices utilized
52.29by prescribing practitioners with those used by pharmacies, health plans, third party
52.30administrators, and pharmacy benefit manager in order to facilitate the secure transmission
52.31of electronic prescriptions, refill authorization requests, communications, and other
52.32prescription-related information between such entities.
52.33(d) "HITECH Act" means the Health Information Technology for Economic and
52.34Clinical Health Act in division A, title XIII and division B, title IV of the American
53.1Recovery and Reinvestment Act of 2009, including federal regulations adopted under
53.2that act.
53.3(e) "Interoperable electronic health record" means an electronic health record that
53.4securely exchanges health information with another electronic health record system that
53.5meets national requirements for certification under the HITECH Act.
53.6(f) "Qualified electronic health record" means an electronic record of health-related
53.7information on an individual that includes patient demographic and clinical health
53.8information and has the capacity to:
53.9(1) provide clinical decision support;
53.10(2) support physician order entry;
53.11(3) capture and query information relevant to health care quality; and
53.12(4) exchange electronic health information with, and integrate such information
53.13from, other sources.
53.14 Subd. 2. E-HealthInformation Technology and Infrastructure Advisory
53.15Committee. (a) The commissioner shall establisha an e-Health Information Technology
53.16and Infrastructure Advisory Committee governed by section
15.059 to advise the
53.17commissioner on the following matters:
53.18 (1) assessment of the adoption and effective use of health information technology by
53.19the state, licensed health care providers and facilities, and local public health agencies;
53.20 (2) recommendations for implementing a statewide interoperable health information
53.21infrastructure, to include estimates of necessary resources, and for determining standards
53.22foradministrative clinical data exchange, clinical support programs, patient privacy
53.23requirements, and maintenance of the security and confidentiality of individual patient
53.24data;
53.25 (3) recommendations for encouraging use of innovative health care applications
53.26using information technology and systems to improve patient care and reduce the cost
53.27of care, including applications relating to disease management and personal health
53.28management that enable remote monitoring of patients' conditions, especially those with
53.29chronic conditions; and
53.30 (4) other related issues as requested by the commissioner.
53.31 (b) The members of the e-HealthInformation Technology and Infrastructure
53.32Advisory Committee shall include the commissioners, or commissioners' designees, of
53.33health, human services, administration, and commerce and additional members to be
53.34appointed by the commissioner to include persons representing Minnesota's local public
53.35health agencies, licensed hospitals and other licensed facilities and providers, private
53.36purchasers, the medical and nursing professions, health insurers and health plans, the
54.1state quality improvement organization, academic and research institutions, consumer
54.2advisory organizations with an interest and expertise in health information technology, and
54.3other stakeholders as identified by theHealth Information Technology and Infrastructure
54.4Advisory Committee commissioner to fulfill the requirements of section 3013, paragraph
54.5(g) of the HITECH Act.
54.6 (c) The commissioner shall prepare and issue an annual report not later than January
54.730 of each year outlining progress to date in implementing a statewide health information
54.8infrastructure and recommendingfuture projects action on policy and necessary resources
54.9to continue the promotion of adoption and effective use of health information technology.
54.10(d) Notwithstanding section15.059 , this subdivision expires June 30, 2015.
54.11 Subd. 3. Interoperable electronic health record requirements.(a) To meet the
54.12requirements of subdivision 1, hospitals and health care providers must meet the following
54.13criteria when implementing an interoperable electronic health records system within their
54.14hospital system or clinical practice setting.
54.15(a) The electronic health record must be a qualified electronic health record.
54.16 (b) The electronic health record must be certified by theCertification Commission
54.17for Healthcare Information Technology, or its successor Office of the National Coordinator
54.18pursuant to the HITECH Act. This criterion only applies to hospitals and health care
54.19providerswhose practice setting is a practice setting covered by the Certification
54.20Commission for Healthcare Information Technology certifications only if a certified
54.21electronic health record product for the provider's particular practice setting is available.
54.22This criterion shall be considered met if a hospital or health care provider is using an
54.23electronic health records system that has been certified within the last three years, even if a
54.24more current version of the system has been certified within the three-year period.
54.25(c) The electronic health record must meet the standards established according to
54.26section 3004 of the HITECH Act as applicable.
54.27(d) The electronic health record must have the ability to generate information on
54.28clinical quality measures and other measures reported under sections 4101, 4102, and
54.294201 of the HITECH Act.
54.30(c) (e) A health care provider who is a prescriber or dispenser of controlled
54.31substances legend drugs must have an electronic health record system that meets the
54.32requirements of section62J.497 .
54.33 Subd. 4. Coordination with national HIT activities. (a) The commissioner,
54.34in consultation with the e-Health Advisory Committee, shall update the statewide
54.35implementation plan required under subdivision 2 and released June 2008, to be consistent
54.36with the updated Federal HIT Strategic Plan released by the Office of the National
55.1Coordinator in accordance with section 3001 of the HITECH Act. The statewide plan
55.2shall meet the requirements for a plan required under section 3013 of the HITECH Act.
55.3(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
55.4work to ensure coordination between state, regional, and national efforts to support and
55.5accelerate efforts to effectively use health information technology to improve the quality
55.6and coordination of health care and continuity of patient care among health care providers,
55.7to reduce medical errors, to improve population health, to reduce health disparities, and
55.8to reduce chronic disease. The commissioner's coordination efforts shall include but not
55.9be limited to:
55.10(1) assisting in the development and support of health information technology
55.11regional extension centers established under section 3012(c) of the HITECH Act to
55.12provide technical assistance and disseminate best practices; and
55.13(2) providing supplemental information to the best practices gathered by regional
55.14centers to ensure that the information is relayed in a meaningful way to the Minnesota
55.15health care community.
55.16(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
55.17monitor national activity related to health information technology and shall coordinate
55.18statewide input on policy development. The commissioner shall coordinate statewide
55.19responses to proposed federal health information technology regulations in order to ensure
55.20that the needs of the Minnesota health care community are adequately and efficiently
55.21addressed in the proposed regulations. The commissioner's responses may include, but
55.22are not limited to:
55.23(1) reviewing and evaluating any standard, implementation specification, or
55.24certification criteria proposed by the national HIT standards committee;
55.25(2) reviewing and evaluating policy proposed by the national HIT policy
55.26committee relating to the implementation of a nationwide health information technology
55.27infrastructure;
55.28(3) monitoring and responding to activity related to the development of quality
55.29measures and other measures as required by section 4101 of the HITECH Act. Any
55.30response related to quality measures shall consider and address the quality efforts required
55.31under chapter 62U; and
55.32(4) monitoring and responding to national activity related to privacy, security, and
55.33data stewardship of electronic health information and individually identifiable health
55.34information.
55.35(d) To the extent that the state is either required or allowed to apply, or designate an
55.36entity to apply for or carry out activities and programs under section 3013 of the HITECH
56.1Act, the commissioner of health, in consultation with the e-Health Advisory Committee
56.2and the commissioner of human services, shall be the lead applicant or sole designating
56.3authority. The commissioner shall make such designations consistent with the goals and
56.4objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.
56.5(e) The commissioner of human services shall apply for funding necessary to
56.6administer the incentive payments to providers authorized under title IV of the American
56.7Recovery and Reinvestment Act.
56.8(f) The commissioner shall include in the report to the legislature information on the
56.9activities of this subdivision and provide recommendations on any relevant policy changes
56.10that should be considered in Minnesota.
56.11 Subd. 5. Collection of data for assessment and eligibility determination. (a)
56.12The commissioner of health, in consultation with the commissioner of human services,
56.13may require providers, dispensers, group purchasers, and pharmaceutical electronic data
56.14intermediaries to submit data in a form and manner specified by the commissioner to
56.15assess the status of adoption, effective use, and interoperability of electronic health
56.16records for the purpose of:
56.17(1) demonstrating Minnesota's progress on goals established by the Office of the
56.18National Coordinator to accelerate the adoption and effective use of health information
56.19technology established under the HITECH Act;
56.20(2) assisting the Center for Medicare and Medicaid Services and Department of
56.21Human Services in determining eligibility of health care professionals and hospitals
56.22to receive federal incentives for the adoption and effective use of health information
56.23technology under the HITECH Act or other federal incentive programs;
56.24(3) assisting the Office of the National Coordinator in completing required
56.25assessments of the impact of the implementation and effective use of health information
56.26technology in achieving goals identified in the national strategic plan, and completing
56.27studies required by the HITECH Act;
56.28(4) providing the data necessary to assist the Office of the National Coordinator in
56.29conducting evaluations of regional extension centers as required by the HITECH Act; and
56.30(5) other purposes as necessary to support the implementation of the HITECH Act.
56.31(b) The commissioner shall coordinate with the commissioner of human services
56.32and other state agencies in the collection of data required under this section to:
56.33(1) avoid duplicative reporting requirements;
56.34(2) maximize efficiencies in the development of reports on state activities as
56.35required by HITECH; and
57.1(3) determine health professional and hospital eligibility for incentives available
57.2under the HITECH Act.
57.3(c) The commissioner must not collect data or publish analyses that identify, or could
57.4potentially identify, individual patients. The commissioner must not collect individual
57.5data in identified or de-identified form.
57.6 Sec. 2. Minnesota Statutes 2008, section 62J.496, is amended to read:
57.762J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
57.8ACCOUNT AND LOAN PROGRAM.
57.9 Subdivision 1. Account establishment. (a) An account is established to:provide
57.10loans to eligible borrowers to assist in financing the installation or support of an
57.11interoperable health record system. The system must provide for the interoperable
57.12exchange of health care information between the applicant and, at a minimum, a hospital
57.13system, pharmacy, and a health care clinic or other physician group.
57.14(1) finance the purchase of certified electronic health records or qualified electronic
57.15health records as defined in section 62J.495, subdivision 1a;
57.16(2) enhance the utilization of electronic health record technology, which may include
57.17costs associated with upgrading the technology to meet the criteria necessary to be a
57.18certified electronic health record or a qualified electronic health record;
57.19(3) train personnel in the use of electronic health record technology; and
57.20(4) improve the secure electronic exchange of health information.
57.21(b) Amounts deposited in the account, including any grant funds obtained through
57.22federal or other sources, loan repayments, and interest earned on the amounts shall be
57.23used only for awarding loans or loan guarantees, as a source of reserve and security for
57.24leveraged loans, or for the administration of the account.
57.25(c) The commissioner may accept contributions to the account from private sector
57.26entities subject to the following provisions:
57.27(1) the contributing entity may not specify the recipient or recipients of any loan
57.28issued under this subdivision;
57.29(2) the commissioner shall make public the identity of any private contributor to the
57.30loan fund, as well as the amount of the contribution provided; and
57.31(3) the commissioner may issue letters of commendation or make other awards that
57.32have no financial value to any such entity.
57.33A contributing entity may not specify that the recipient or recipients of any loan use
57.34specific products or services, nor may the contributing entity imply that a contribution is
57.35an endorsement of any specific product or service.
58.1(d) The commissioner may use the loan funds to reimburse private sector entities
58.2for any contribution made to the loan fund. Reimbursement to private entities may not
58.3exceed the principle amount contributed to the loan fund.
58.4(e) The commissioner may use funds deposited in the account to guarantee, or
58.5purchase insurance for, a local obligation if the guarantee or purchase would improve
58.6credit market access or reduce the interest rate applicable to the obligation involved.
58.7(f) The commissioner may use funds deposited in the account as a source of revenue
58.8or security for the payment of principal and interest on revenue or bonds issued by the
58.9state if the proceeds of the sale of the bonds will be deposited into the loan fund.
58.10 Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
58.11(1) federally qualified health centers;
58.12(1) (2) community clinics, as defined under section
145.9268 ;
58.13(2) (3) nonprofit or local unit of government hospitals eligible for rural hospital
58.14capital improvement grants, as defined in section
144.148
58.15to 144.56;
58.16(3) physician clinics located in a community with a population of less than 50,000
58.17according to United States Census Bureau statistics and outside the seven-county
58.18metropolitan area;
58.19(4) individual or small group physician practices that are focused primarily on
58.20primary care;
58.21(4) (5) nursing facilities licensed under sections
144A.01 to
144A.27 ; and
58.22(6) local public health departments as defined in chapter 145A; and
58.23(5) (7) other providers of health or health care services approved by the
58.24commissioner for which interoperable electronic health record capability would improve
58.25quality of care, patient safety, or community health.
58.26 (b) The commissioner shall administer the loan fund to prioritize support and
58.27assistance to:
58.28(1) critical access hospitals;
58.29(2) federally qualified health centers;
58.30(3) entities that serve uninsured, underinsured, and medically underserved
58.31individuals, regardless of whether such area is urban or rural; and
58.32(4) individual or small group practices that are primarily focused on primary care.
58.33(b) To be eligible for a loan under this section, the (c) An eligible applicant must
58.34submit a loan application to the commissioner of health on forms prescribed by the
58.35commissioner. The application must include, at a minimum:
59.1 (1) the amount of the loan requested and a description of the purpose or project
59.2for which the loan proceeds will be used;
59.3 (2) a quote from a vendor;
59.4 (3) a description of the health care entities and other groups participating in the
59.5project;
59.6 (4) evidence of financial stability and a demonstrated ability to repay the loan; and
59.7 (5) a description of how the system to be financedinterconnects interoperates or
59.8plans in the future tointerconnect interoperate with other health care entities and provider
59.9groups located in the same geographical area;
59.10(6) a plan on how the certified electronic health record technology will be maintained
59.11and supported over time; and
59.12(7) any other requirements for applications included or developed pursuant to
59.13section 3014 of the HITECH Act.
59.14 Subd. 3. Loans. (a) The commissioner of health may make a no interest loan or
59.15low interest loan to a provider or provider group who is eligible under subdivision 2
59.16on a first-come, first-served basis provided that the applicant is able to comply with this
59.17section consistent with the priorities established in subdivision 2. The total accumulative
59.18loan principal must not exceed$1,500,000 $3,000,000 per loan. The interest rate for each
59.19loan, if imposed, shall not exceed the current market interest rate. The commissioner of
59.20health has discretion over the size, interest rate, and number of loans made. Nothing in
59.21this section shall require the commissioner to make a loan to an eligible borrower under
59.22subdivision 2.
59.23 (b) The commissioner of health may prescribe forms and establish an application
59.24process and, notwithstanding section16A.1283 , may impose a reasonable nonrefundable
59.25application fee to cover the cost of administering the loan program. Any application
59.26fees imposed and collected under the electronic health records system revolving account
59.27and loan program in this section are appropriated to the commissioner of health for the
59.28duration of the loan program. The commissioner may apply for and use all federal funds
59.29available through the HITECH Act to administer the loan program.
59.30 (c) For loans approved prior to July 1, 2009, the borrower must begin repaying the
59.31principal no later than two years from the date of the loan. Loans must be amortized no
59.32later than six years from the date of the loan.
59.33(d) For loans granted on January 1, 2010, or thereafter, the borrower must begin
59.34repaying the principle no later than one year from the date of the loan. Loans must be
59.35amortized no later than six years after the date of the loan.
60.1(d) Repayments (e) All repayments and interest paid on each loan must be credited
60.2to the account.
60.3(f) The loan agreement shall include the assurances that borrower meets requirements
60.4included or developed pursuant to section 3014 of the HITECH Act. The requirements
60.5shall include, but are not limited to:
60.6(1) submitting reports on quality measures in compliance with regulations adopted
60.7by the federal government;
60.8(2) demonstrating that any certified electronic health record technology purchased,
60.9improved, or otherwise financially supported by this loan program is used to exchange
60.10health information in a manner that, in accordance with law and standards applicable to
60.11the exchange of information, improves the quality of health care;
60.12(3) including a plan on how the borrower intends to maintain and support the
60.13certified electronic health record technology over time and the resources expected to be
60.14used to maintain and support the technology purchased with the loan; and
60.15(4) complying with other requirements the secretary may require to use loans funds
60.16under the HITECH Act.
60.17 Subd. 4. Data classification. Data collected by the commissioner of health on the
60.18application to determine eligibility under subdivision 2 and to monitor borrowers' default
60.19risk or collect payments owed under subdivision 3 are (1) private data on individuals as
60.20defined in section13.02, subdivision 12 ; and (2) nonpublic data as defined in section
60.2113.02, subdivision 9
. The names of borrowers and the amounts of the loans granted
60.22are public data.
60.23 Sec. 3. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read:
60.24 Subdivision 1. Definitions. For the purposes of this section, the following terms
60.25have the meanings given.
60.26(a) "Backward compatible" means that the newer version of a data transmission
60.27standard would retain, at a minimum, the full functionality of the versions previously
60.28adopted, and would permit the successful completion of the applicable transactions with
60.29entities that continue to use the older versions.
60.30(a) (b) "Dispense" or "dispensing" has the meaning given in section
151.01,
60.31subdivision 30. Dispensing does not include the direct administering of a controlled
60.32substance to a patient by a licensed health care professional.
60.33(b) (c) "Dispenser" means a person authorized by law to dispense a controlled
60.34substance, pursuant to a valid prescription.
61.1(c) (d) "Electronic media" has the meaning given under Code of Federal Regulations,
61.2title 45, part160.103 .
61.3(d) (e) "E-prescribing" means the transmission using electronic media of prescription
61.4or prescription-related information between a prescriber, dispenser, pharmacy benefit
61.5manager, or group purchaser, either directly or through an intermediary, including
61.6an e-prescribing network. E-prescribing includes, but is not limited to, two-way
61.7transmissions between the point of care and the dispenser and two-way transmissions
61.8related to eligibility, formulary, and medication history information.
61.9(e) (f) "Electronic prescription drug program" means a program that provides for
61.10e-prescribing.
61.11(f) (g) "Group purchaser" has the meaning given in section
62J.03, subdivision 6 .
61.12(g) (h) "HL7 messages" means a standard approved by the standards development
61.13organization known as Health Level Seven.
61.14(h) (i) "National Provider Identifier" or "NPI" means the identifier described under
61.15Code of Federal Regulations, title 45, part162.406 .
61.16(i) (j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
61.17(j) (k) "NCPDP Formulary and Benefits Standard" means the National Council for
61.18Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide,
61.19Version 1, Release 0, October 2005.
61.20(k) (l) "NCPDP SCRIPT Standard" means the National Council for Prescription
61.21Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation
61.22Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent standard
61.23adopted by the Centers for Medicare and Medicaid Services for e-prescribing under
61.24Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and
61.25regulations adopted under it. The standards shall be implemented according to the Centers
61.26for Medicare and Medicaid Services schedule for compliance. Subsequently released
61.27versions of the NCPDP SCRIPT Standard may be used, provided that the new version
61.28of the standard is backward compatible to the current version adopted by the Centers for
61.29Medicare and Medicaid Services.
61.30(l) (m) "Pharmacy" has the meaning given in section
151.01, subdivision 2 .
61.31(m) (n) "Prescriber" means a licensed health care professional who is authorized to
61.32prescribe a controlled substance under section
152.12, subdivision 1. practitioner, other
61.33than a veterinarian, as defined in section 151.01, subdivision 23.
61.34(n) (o) "Prescription-related information" means information regarding eligibility for
61.35drug benefits, medication history, or related health or drug information.
62.1(o) (p) "Provider" or "health care provider" has the meaning given in section
62J.03 ,
62.2subdivision 8.
62.3 Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read:
62.4 Subd. 2. Requirements for electronic prescribing. (a) Effective January 1, 2011,
62.5all providers, group purchasers, prescribers, and dispensers must establishand, maintain,
62.6and use an electronic prescription drug programthat complies. This program must comply
62.7with the applicable standards in this section for transmitting, directly or through an
62.8intermediary, prescriptions and prescription-related information using electronic media.
62.9 (b)Nothing in this section requires providers, group purchasers, prescribers, or
62.10dispensers to conduct the transactions described in this section. If transactions described in
62.11this section are conducted, they must be done electronically using the standards described
62.12in this section. Nothing in this section requires providers, group purchasers, prescribers,
62.13or dispensers to electronically conduct transactions that are expressly prohibited by other
62.14sections or federal law.
62.15 (c) Providers, group purchasers, prescribers, and dispensers must use either HL7
62.16messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related
62.17information internally when the sender and the recipient are part of the same legal entity. If
62.18an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard
62.19or other applicable standards required by this section. Any pharmacy within an entity
62.20must be able to receive electronic prescription transmittals from outside the entity using
62.21the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health
62.22Insurance Portability and Accountability Act (HIPAA) requirement that may require the
62.23use of a HIPAA transaction standard within an organization.
62.24(d) Entities transmitting prescriptions or prescription-related information where the
62.25prescriber is required by law to issue a prescription for a patient to a nonprescribing
62.26provider that in turn forwards the prescription to a dispenser are exempt from the
62.27requirement to use the NCPDP SCRIPT Standard when transmitting prescriptions or
62.28prescription-related information.
62.29 Sec. 5. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision
62.30to read:
62.31 Subd. 4. Development and use of uniform formulary exception form. (a) The
62.32commissioner of health, in consultation with the Minnesota Administrative Uniformity
62.33Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision,
62.34whichever is later, a uniform formulary exception form that allows health care providers
63.1to request exceptions from group purchaser formularies using a uniform form. Upon
63.2development of the form, all health care providers must submit requests for formulary
63.3exceptions using the uniform form, and all group purchasers must accept this form from
63.4health care providers.
63.5 (b) No later than January 1, 2011, the uniform formulary exception form must be
63.6accessible and submitted by health care providers, and accepted and processed by group
63.7purchasers, through secure electronic transmissions. Facsimile shall not be considered
63.8secure electronic transmissions.
63.9 Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision
63.10to read:
63.11 Subd. 5. Electronic drug prior authorization standardization and transmission.
63.12 (a) The commissioner of health, in consultation with the Minnesota e-Health Advisory
63.13Committee and the Minnesota Administrative Uniformity Committee, shall, by February
63.1415, 2010, identify an outline on how best to standardize drug prior authorization request
63.15transactions between providers and group purchasers with the goal of maximizing
63.16administrative simplification and efficiency in preparation for electronic transmissions.
63.17 (b) No later than January 1, 2011, drug prior authorization requests must be
63.18accessible and submitted by health care providers, and accepted and processed by group
63.19purchasers, electronically through secure electronic transmissions. Facsimile shall not be
63.20considered electronic transmission.
63.21 Sec. 7. [62Q.676] MEDICATION THERAPY MANAGEMENT.
63.22 A pharmacy benefit manager that provides prescription drug services must make
63.23available medication therapy management services for enrollees taking four or more
63.24prescriptions to treat or prevent two or more chronic medical conditions. For purposes
63.25of this section, "medication therapy management" means the provision of the following
63.26pharmaceutical care services by, or under the supervision of, a licensed pharmacist to
63.27optimize the therapeutic outcomes of the patient's medications:
63.28 (1) performing a comprehensive medication review to identify, resolve, and prevent
63.29medication-related problems, including adverse drug events;
63.30 (2) communicating essential information to the patient's other primary care
63.31providers; and
63.32 (3) providing verbal education and training designed to enhance patient
63.33understanding and appropriate use of the patient's medications.
64.1 Nothing in this section shall be construed to expand or modify the scope of practice
64.2of the pharmacist as defined in section 151.01, subdivision 27.
64.3 Sec. 8. Minnesota Statutes 2008, section 144.122, is amended to read:
64.4144.122 LICENSE, PERMIT, AND SURVEY FEES.
64.5 (a) The state commissioner of health, by rule, may prescribe procedures and fees
64.6for filing with the commissioner as prescribed by statute and for the issuance of original
64.7and renewal permits, licenses, registrations, and certifications issued under authority of
64.8the commissioner. The expiration dates of the various licenses, permits, registrations,
64.9and certifications as prescribed by the rules shall be plainly marked thereon. Fees may
64.10include application and examination fees and a penalty fee for renewal applications
64.11submitted after the expiration date of the previously issued permit, license, registration,
64.12and certification. The commissioner may also prescribe, by rule, reduced fees for permits,
64.13licenses, registrations, and certifications when the application therefor is submitted
64.14during the last three months of the permit, license, registration, or certification period.
64.15Fees proposed to be prescribed in the rules shall be first approved by the Department of
64.16Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
64.17in an amount so that the total fees collected by the commissioner will, where practical,
64.18approximate the cost to the commissioner in administering the program. All fees collected
64.19shall be deposited in the state treasury and credited to the state government special revenue
64.20fund unless otherwise specifically appropriated by law for specific purposes.
64.21 (b) The commissioner may charge a fee for voluntary certification of medical
64.22laboratories and environmental laboratories, and for environmental and medical laboratory
64.23services provided by the department, without complying with paragraph (a) or chapter 14.
64.24Fees charged for environment and medical laboratory services provided by the department
64.25must be approximately equal to the costs of providing the services.
64.26 (c) The commissioner may develop a schedule of fees for diagnostic evaluations
64.27conducted at clinics held by the services for children with disabilities program. All
64.28receipts generated by the program are annually appropriated to the commissioner for use
64.29in the maternal and child health program.
64.30 (d) The commissioner shall set license fees for hospitals and nursing homes that are
64.31not boarding care homes at the following levels:
65.7 The commissioner shall set license fees for outpatient surgical centers, boarding care
65.8homes, and supervised living facilities at the following levels:
65.12 (e) Unless prohibited by federal law, the commissioner of health shall charge
65.13applicants the following fees to cover the cost of any initial certification surveys required
65.14to determine a provider's eligibility to participate in the Medicare or Medicaid program:
66.1 These fees shall be submitted at the time of the application for federal certification
66.2and shall not be refunded. All fees collected after the date that the imposition of fees is not
66.3prohibited by federal law shall be deposited in the state treasury and credited to the state
66.4government special revenue fund.
66.5 Sec. 9. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:
66.6 Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
66.7subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified
66.8birth, stillbirth, or death record, and for a certification that the record cannot be found.
66.9The local or state registrar shall forward this amount to the commissioner of finance to
66.10be deposited into the state government special revenue fund. This surcharge shall not be
66.11charged under those circumstances in which no fee for a birth, stillbirth, or death record is
66.12permitted under subdivision 1, paragraph (a).
66.13(b) Effective August 1, 2005,to June 30, 2009, the surcharge in paragraph (a) shall
66.14be is $4.
66.15 Sec. 10. Minnesota Statutes 2008, section 148.6445, is amended by adding a
66.16subdivision to read:
66.17 Subd. 2a. Duplicate license fee. The fee for a duplicate license is $25.
66.20 Section 1. Minnesota Statutes 2008, section 60A.092, subdivision 2, is amended to
66.21read:
66.22 Subd. 2. Licensed assuming insurer. Reinsurance is ceded to an assuming insurer
66.23if the assuming insurer is licensed to transact insurance or reinsurance in this state. For
66.24purposes of reinsuring any health risk, an insurer is defined under section 62A.63.
66.25 Sec. 2. Minnesota Statutes 2008, section 62D.03, subdivision 4, is amended to read:
66.26 Subd. 4. Application requirements. Each application for a certificate of authority
66.27shall be verified by an officer or authorized representative of the applicant, and shall be
66.28in a form prescribed by the commissioner of health. Each application shall include the
66.29following:
66.30(a) a copy of the basic organizational document, if any, of the applicant and of
66.31each major participating entity; such as the articles of incorporation, or other applicable
66.32documents, and all amendments thereto;
67.1(b) a copy of the bylaws, rules and regulations, or similar document, if any, and all
67.2amendments thereto which regulate the conduct of the affairs of the applicant and of
67.3each major participating entity;
67.4(c) a list of the names, addresses, and official positions of the following:
67.5(1) all members of the board of directors, or governing body of the local government
67.6unit, and the principal officers and shareholders of the applicant organization; and
67.7(2) all members of the board of directors, or governing body of the local government
67.8unit, and the principal officers of the major participating entity and each shareholder
67.9beneficially owning more than ten percent of any voting stock of the major participating
67.10entity;
67.11The commissioner may by rule identify persons included in the term "principal
67.12officers";
67.13(d) a full disclosure of the extent and nature of any contract or financial arrangements
67.14between the following:
67.15(1) the health maintenance organization and the persons listed in clause (c)(1);
67.16(2) the health maintenance organization and the persons listed in clause (c)(2);
67.17(3) each major participating entity and the persons listed in clause (c)(1) concerning
67.18any financial relationship with the health maintenance organization; and
67.19(4) each major participating entity and the persons listed in clause (c)(2) concerning
67.20any financial relationship with the health maintenance organization;
67.21(e) the name and address of each participating entity and the agreed upon duration of
67.22each contract or agreement;
67.23(f) a copy of the form of each contract binding the participating entities and the
67.24health maintenance organization. Contractual provisions shall be consistent with the
67.25purposes of sections62D.01 to
62D.30 , in regard to the services to be performed under the
67.26contract, the manner in which payment for services is determined, the nature and extent
67.27of responsibilities to be retained by the health maintenance organization, the nature and
67.28extent of risk sharing permissible, and contractual termination provisions;
67.29(g) a copy of each contract binding major participating entities and the health
67.30maintenance organization. Contract information filed with the commissioner shall be
67.31confidential and subject to the provisions of section13.37, subdivision 1 , clause (b), upon
67.32the request of the health maintenance organization.
67.33Upon initial filing of each contract, the health maintenance organization shall file
67.34a separate document detailing the projected annual expenses to the major participating
67.35entity in performing the contract and the projected annual revenues received by the entity
67.36from the health maintenance organization for such performance. The commissioner
68.1shall disapprove any contract with a major participating entity if the contract will result
68.2in an unreasonable expense under section62D.19 . The commissioner shall approve or
68.3disapprove a contract within 30 days of filing.
68.4Within 120 days of the anniversary of the implementation of each contract, the
68.5health maintenance organization shall file a document detailing the actual expenses
68.6incurred and reported by the major participating entity in performing the contract in the
68.7preceding year and the actual revenues received from the health maintenance organization
68.8by the entity in payment for the performance;
68.9(h) a statement generally describing the health maintenance organization, its health
68.10maintenance contracts and separate health service contracts, facilities, and personnel,
68.11including a statement describing the manner in which the applicant proposes to provide
68.12enrollees with comprehensive health maintenance services and separate health services;
68.13(i) a copy of the form of each evidence of coverage to be issued to the enrollees;
68.14(j) a copy of the form of each individual or group health maintenance contract
68.15and each separate health service contract which is to be issued to enrollees or their
68.16representatives;
68.17(k) financial statements showing the applicant's assets, liabilities, and sources of
68.18financial support. If the applicant's financial affairs are audited by independent certified
68.19public accountants, a copy of the applicant's most recent certified financial statement
68.20may be deemed to satisfy this requirement;
68.21(l) a description of the proposed method of marketing the plan, a schedule of
68.22proposed charges, and a financial plan which includes a three-year projection of the
68.23expenses and income and other sources of future capital;
68.24(m) a statement reasonably describing the geographic area or areas to be served and
68.25the type or types of enrollees to be served;
68.26(n) a description of the complaint procedures to be utilized as required under section
68.2762D.11
;
68.28(o) a description of the procedures and programs to be implemented to meet the
68.29requirements of section62D.04, subdivision 1 , clauses (b) and (c) and to monitor the
68.30quality of health care provided to enrollees;
68.31(p) a description of the mechanism by which enrollees will be afforded an
68.32opportunity to participate in matters of policy and operation under section62D.06 ;
68.33(q) a copy of any agreement between the health maintenance organization and
68.34an insureror, including any nonprofit health service corporation or another health
68.35maintenance organization, regarding reinsurance, stop-loss coverage, insolvency
69.1coverage, or any other type of coverage for potential costs of health services, as authorized
69.2in sections62D.04, subdivision 1 , clause (f),
62D.05, subdivision 3 , and
62D.13 ;
69.3(r) a copy of the conflict of interest policy which applies to all members of the board
69.4of directors and the principal officers of the health maintenance organization, as described
69.5in section62D.04, subdivision 1 , paragraph (g). All currently licensed health maintenance
69.6organizations shall also file a conflict of interest policy with the commissioner within 60
69.7days after August 1, 1990, or at a later date if approved by the commissioner;
69.8(s) a copy of the statement that describes the health maintenance organization's prior
69.9authorization administrative procedures; and
69.10(t) other information as the commissioner of health may reasonably require to be
69.11provided.
69.12 Sec. 3. Minnesota Statutes 2008, section 62D.05, subdivision 3, is amended to read:
69.13 Subd. 3. Contracts; health services. A health maintenance organization may
69.14contract with providers of health care services to render the services the health maintenance
69.15organization has promised to provide under the terms of its health maintenance contracts,
69.16may, subject to section62D.12, subdivision 11 , enter into separate prepaid dental contracts,
69.17or other separate health service contracts, may, subject to the limitations of section
69.1862D.04, subdivision 1
, clause (f), contract with insurance companies and, including
69.19 nonprofit health service plan corporations or other health maintenance organizations,
69.20for insurance, indemnity or reimbursement of its cost of providing health care services
69.21for enrollees or against the risks incurred by the health maintenance organization, may
69.22contract with insurance companies and nonprofit health service plan corporations for
69.23insolvency insurance coverage, and may contract with insurance companies and nonprofit
69.24health service plan corporations to insure or cover the enrollees' costs and expenses in the
69.25health maintenance organization, including the customary prepayment amount and any
69.26co-payment obligations, and may contract to provide reinsurance or insolvency insurance
69.27coverage to health insurers or nonprofit health service plan corporations.
69.28 Sec. 4. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:
69.29 Subd. 7. Transfers from the commissioner of human services.(a) The amount
69.30transferred according to section
256B.69, subdivision 5c, paragraph (a), clause (1), shall
69.31be distributed by the commissioner annually to clinical medical education programs that
69.32meet the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph
69.33(a) Of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a),
69.34clauses (1) to (4), $21,714,000 shall be distributed as follows:
70.1(1) $2,157,000 shall be distributed by the commissioner to the University of
70.2Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
70.3(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
70.4Medical Center for clinical medical education;
70.5(3) $17,400,000 shall be distributed by the commissioner to the University of
70.6Minnesota Board of Regents for purposes of medial education;
70.7(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
70.8dental innovation grants in accordance with subdivision 7a; and
70.9(5) the remainder of the amount transferred according to section 256B.69,
70.10subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
70.11clinical medical education programs that meet the qualifications of subdivision 3 based on
70.12the formula in subdivision 4, paragraph (a).
70.13(b) Fifty percent of the amount transferred according to section
256B.69, subdivision
70.145c
, paragraph (a), clause (2), shall be distributed by the commissioner to the University of
70.15Minnesota Board of Regents for the purposes described in sections
137.38 to
137.40. Of
70.16the remaining amount transferred according to section
256B.69, subdivision 5c, paragraph
70.17(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to
70.18the Hennepin County Medical Center for clinical medical education. The remaining 26
70.19percent of the amount transferred shall be distributed by the commissioner in accordance
70.20with subdivision 7a. If the federal approval is not obtained for the matching funds under
70.21section
256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount
70.22transferred under this paragraph shall be distributed by the commissioner to the University
70.23of Minnesota Board of Regents for the purposes described in sections
137.38 to
137.40.
70.24(c) The amount transferred according to section
256B.69, subdivision 5c, paragraph
70.25(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the
70.26University of Minnesota Board of Regents for the purposes of clinical graduate medical
70.27education.
70.28 Sec. 5. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:
70.29 Subd. 2b. Performance payments.(a) The commissioner shall develop and
70.30implement a pay-for-performance system to provide performance payments to eligible
70.31medical groups and clinics that demonstrate optimum care in serving individuals
70.32with chronic diseases who are enrolled in health care programs administered by the
70.33commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any
70.34federal matching money that is made available through the medical assistance program
70.35for managed care oversight contracted through vendors, including consumer surveys,
71.1studies, and external quality reviews as required by the federal Balanced Budget Act of
71.21997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
71.3quality review. Any federal money received for managed care oversight is appropriated
71.4to the commissioner for this purpose. The commissioner may expend the federal money
71.5received in either year of the biennium.
71.6(b) Effective July 1, 2008, or upon federal approval, whichever is later, the
71.7commissioner shall develop and implement a patient incentive health program to provide
71.8incentives and rewards to patients who are enrolled in health care programs administered
71.9by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and
71.10have met personal health goals established with the patients' primary care providers to
71.11manage a chronic disease or condition, including but not limited to diabetes, high blood
71.12pressure, and coronary artery disease.
71.13 Sec. 6. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
71.14to read:
71.15 Subd. 18a. Public Assistance Reporting Information System. (a) Effective
71.16October 1, 2009, the commissioner shall comply with the federal requirements in Public
71.17Law 110-379 in implementing the Public Assistance Reporting Information System
71.18(PARIS) to determine eligibility for all individuals applying for:
71.19(1) health care benefits under chapters 256B, 256D, and 256L; and
71.20(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition
71.21assistance program.
71.22(b) The commissioner shall determine eligibility under paragraph (a) by performing
71.23data matches, including matching with medical assistance, cash, child care, and
71.24supplemental assistance programs operated by other states.
71.25EFFECTIVE DATE.This section is effective October 1, 2009.
71.26 Sec. 7. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
71.27to read:
71.28 Subd. 18b. Protections for American Indians. Effective February 18, 2009, the
71.29commissioner shall comply with the federal requirements in the American Recovery and
71.30Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding American Indians.
71.31 Sec. 8. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read:
72.1 Subd. 2. Outreach grants. (a) The commissioner shall award grants to public and
72.2private organizations, regional collaboratives, and regional health care outreach centers
72.3for outreach activities, including, but not limited to:
72.4 (1) providing information, applications, and assistance in obtaining coverage
72.5through Minnesota public health care programs;
72.6 (2) collaborating with public and private entities such as hospitals, providers, health
72.7plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
72.8develop outreach activities and partnerships to ensure the distribution of information
72.9and applications and provide assistance in obtaining coverage through Minnesota health
72.10care programs;and
72.11 (3) providing or collaborating with public and private entities to provide multilingual
72.12and culturally specific information and assistance to applicants in areas of high
72.13uninsurance in the state or populations with high rates of uninsurance; and
72.14(4) targeting geographic areas with high rates of (i) eligible but unenrolled children,
72.15including children who reside in rural areas, or (ii) racial and ethnic minorities and health
72.16disparity populations.
72.17 (b) The commissioner shall ensure that all outreach materials are available in
72.18languages other than English.
72.19 (c) The commissioner shall establish an outreach trainer program to provide
72.20training to designated individuals from the community and public and private entities on
72.21application assistance in order for these individuals to provide training to others in the
72.22community on an as-needed basis.
72.23 Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:
72.24 Subd. 6. School districts and charter schools. (a) At the beginning of each school
72.25year, a school district or charter school shall provide information to each student on the
72.26availability of health care coverage through the Minnesota health care programs and how
72.27to obtain an application for the Minnesota health care programs.
72.28 (b)For each child who is determined to be eligible for the free and reduced-price
72.29school lunch program, the district shall provide the child's family with information on how
72.30to obtain an application for the Minnesota health care programs and application assistance.
72.31(c) A school district or charter school shall also ensure that applications and
72.32information on application assistance are available at early childhood education sites and
72.33public schools located within the district's jurisdiction.
72.34(d) (c) Each district shall designate an enrollment specialist to provide application
72.35assistance and follow-up services with families who have indicated an interest in receiving
73.1information or an application for the Minnesota health care program. A district is eligible
73.2for the application assistance bonus described in subdivision 5.
73.3(e) Each (d) If a school district or charter school maintains a district Web site, the
73.4school district or charter school shall provide ontheir its Web site a link to information on
73.5how to obtain an application and application assistance.
73.6 Sec. 10. [256.964] DENTAL CARE PILOT PROJECTS.
73.7The commissioner shall authorize pilot projects to reduce the total cost to the state
73.8for dental services provided to enrollees of the state public health care programs by
73.9reducing hospital emergency room costs for preventable or nonemergency dental services.
73.10As part of the project, a community dental clinic or dental provider, in collaboration with a
73.11hospital emergency room, shall provide urgent care dental services as an alternative to the
73.12hospital emergency room for nonemergency dental care. The project participants shall
73.13establish a process to divert a patient presenting at the emergency room for nonemergency
73.14dental care to the dental community clinic or to an appropriate dental provider. The
73.15commissioner may establish special payment rates for urgent care services provided and
73.16may change or waive existing payment policies in order to adequately reimburse providers
73.17for providing cost-effective alternative services in an outpatient or urgent care setting.
73.18The commissioner may establish a project in conjunction with the initiative authorized
73.19under section 256.963.
73.20 Sec. 11. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:
73.21 Subd. 2b. Operating payment rates. In determining operating payment rates for
73.22admissions occurring on or after the rate year beginning January 1, 1991, and every two
73.23years after, or more frequently as determined by the commissioner, the commissioner
73.24shall obtain operating data from an updated base year and establish operating payment
73.25rates per admission for each hospital based on the cost-finding methods and allowable
73.26costs of the Medicare program in effect during the base year. Rates under the general
73.27assistance medical care, medical assistance, and MinnesotaCare programs shall not be
73.28rebased to more current data on January 1, 1997, January 1, 2005,and for the first 24
73.29months of the rebased period beginning January 1, 2009, and for the first three months of
73.30the rebased period beginning January 1, 2011. From April 1, 2011, to March 31, 2012,
73.31rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
73.32Effective April 1, 2012, rates shall be rebased at full value. The base year operating
73.33payment rate per admission is standardized by the case mix index and adjusted by the
73.34hospital cost index, relative values, and disproportionate population adjustment. The
74.1cost and charge data used to establish operating rates shall only reflect inpatient services
74.2covered by medical assistance and shall not include property cost information and costs
74.3recognized in outlier payments.
74.4 Sec. 12. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
74.5 Subd. 3a. Payments. (a) Acute care hospital billings under the medical
74.6assistance program must not be submitted until the recipient is discharged. However,
74.7the commissioner shall establish monthly interim payments for inpatient hospitals that
74.8have individual patient lengths of stay over 30 days regardless of diagnostic category.
74.9Except as provided in section256.9693 , medical assistance reimbursement for treatment
74.10of mental illness shall be reimbursed based on diagnostic classifications. Individual
74.11hospital payments established under this section and sections256.9685 ,
256.9686 , and
74.12256.9695
, in addition to third party and recipient liability, for discharges occurring during
74.13the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
74.14inpatient services paid for the same period of time to the hospital. This payment limitation
74.15shall be calculated separately for medical assistance and general assistance medical
74.16care services. The limitation on general assistance medical care shall be effective for
74.17admissions occurring on or after July 1, 1991. Services that have rates established under
74.18subdivision 11 or 12, must be limited separately from other services. After consulting with
74.19the affected hospitals, the commissioner may consider related hospitals one entity and
74.20may merge the payment rates while maintaining separate provider numbers. The operating
74.21and property base rates per admission or per day shall be derived from the best Medicare
74.22and claims data available when rates are established. The commissioner shall determine
74.23the best Medicare and claims data, taking into consideration variables of recency of the
74.24data, audit disposition, settlement status, and the ability to set rates in a timely manner.
74.25The commissioner shall notify hospitals of payment rates by December 1 of the year
74.26preceding the rate year. The rate setting data must reflect the admissions data used to
74.27establish relative values. Base year changes from 1981 to the base year established for the
74.28rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
74.29to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
74.301. The commissioner may adjust base year cost, relative value, and case mix index data
74.31to exclude the costs of services that have been discontinued by the October 1 of the year
74.32preceding the rate year or that are paid separately from inpatient services. Inpatient stays
74.33that encompass portions of two or more rate years shall have payments established based
74.34on payment rates in effect at the time of admission unless the date of admission preceded
74.35the rate year in effect by six months or more. In this case, operating payment rates for
75.1services rendered during the rate year in effect and established based on the date of
75.2admission shall be adjusted to the rate year in effect by the hospital cost index.
75.3 (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
75.4payment, before third-party liability and spenddown, made to hospitals for inpatient
75.5services is reduced by .5 percent from the current statutory rates.
75.6 (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
75.7admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
75.8before third-party liability and spenddown, is reduced five percent from the current
75.9statutory rates. Mental health services within diagnosis related groups 424 to 432, and
75.10facilities defined under subdivision 16 are excluded from this paragraph.
75.11 (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
75.12fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
75.13inpatient services before third-party liability and spenddown, is reduced 6.0 percent
75.14from the current statutory rates. Mental health services within diagnosis related groups
75.15424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
75.16Notwithstanding section256.9686, subdivision 7 , for purposes of this paragraph, medical
75.17assistance does not include general assistance medical care. Payments made to managed
75.18care plans shall be reduced for services provided on or after January 1, 2006, to reflect
75.19this reduction.
75.20 (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
75.21fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
75.22to hospitals for inpatient services before third-party liability and spenddown, is reduced
75.233.46 percent from the current statutory rates. Mental health services with diagnosis related
75.24groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
75.25paragraph. Payments made to managed care plans shall be reduced for services provided
75.26on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
75.27 (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
75.28fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
75.29to hospitals for inpatient services before third-party liability and spenddown, is reduced
75.301.9 percent from the current statutory rates. Mental health services with diagnosis related
75.31groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
75.32paragraph. Payments made to managed care plans shall be reduced for services provided
75.33on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
75.34 (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
75.35for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
75.36inpatient services before third-party liability and spenddown, is reduced 1.79 percent
76.1from the current statutory rates. Mental health services with diagnosis related groups
76.2424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
76.3Payments made to managed care plans shall be reduced for services provided on or after
76.4July 1, 2010, to reflect this reduction.
76.5(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
76.6payment for fee-for-service admissions occurring on or after July 1, 2009, made to
76.7hospitals for inpatient services before third-party liability and spenddown, is reduced
76.8one percent from the current statutory rates. Facilities defined under subdivision 16 are
76.9excluded from this paragraph. Payments made to managed care plans shall be reduced for
76.10services provided on or after October 1, 2009, to reflect this reduction.
76.11 Sec. 13. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
76.12to read:
76.13 Subd. 3b. Nonpayment for hospital-acquired conditions and for certain
76.14treatments. (a) The commissioner must not make medical assistance payments to a
76.15hospital for any costs of care that result from a condition listed in paragraph (c), if the
76.16condition was hospital acquired.
76.17 (b) For purposes of this subdivision, a condition is hospital acquired if it is not
76.18identified by the hospital as present on admission. For purposes of this subdivision,
76.19medical assistance includes general assistance medical care and MinnesotaCare.
76.20(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired
76.21condition listed in this paragraph that is represented by an ICD-9-CM diagnosis code and
76.22is designated as a complicating condition or a major complicating condition:
76.23(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);
76.24(2) air embolism (ICD-9-CM code 999.1);
76.25(3) blood incompatibility (ICD-9-CM code 999.6);
76.26(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);
76.27(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing
76.28injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating
76.29condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929;
76.30940-949; and 991-994);
76.31(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);
76.32(7) vascular catheter-associated infection (ICD-9-CM code 999.31);
76.33(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11;
76.34249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and
76.35251.0);
77.1(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain
77.2orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07;
77.381.08; 81.23; 81.24; 81.31; 81.32; 81.33; 81.34; 81.35; 81.36; 81.37; 81.38; 81.83; and
77.481.85);
77.5(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery
77.6(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity
77.7(ICD-9-CM code 278.01);
77.8(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary
77.9artery bypass graft (procedure codes 36.10 to 36.19); and
77.10(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary
77.11embolism (ICD-9-CM codes 415.11 or 415.91) following total knee replacement
77.12(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51
77.13to 81.52).
77.14(d) The prohibition in paragraph (a) applies to any additional payments that result
77.15from a hospital-acquired condition listed in paragraph (c), including, but not limited to,
77.16additional treatment or procedures, readmission to the facility after discharge, increased
77.17length of stay, change to a higher diagnostic category, or transfer to another hospital. In
77.18the event of a transfer to another hospital, the hospital where the condition listed under
77.19paragraph (c) was acquired is responsible for any costs incurred at the hospital to which
77.20the patient is transferred.
77.21(e) A hospital shall not bill a recipient of services for any payment disallowed under
77.22this subdivision.
77.23 Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
77.24to read:
77.25 Subd. 28. Temporary rate increase for qualifying hospitals. For the period
77.26from April 1, 2009, to September 30, 2010, for each hospital with a medical assistance
77.27utilization rate equal to or greater than 25 percent during the base year, the commissioner
77.28shall provide an equal percentage rate increase for each medical assistance admission. The
77.29commissioner shall estimate the percentage rate increase using as the state share of the
77.30increase the amount available under section 256B.199, paragraph (d). The commissioner
77.31shall settle up payments to qualifying hospitals based on actual payments under that
77.32section and actual hospital admissions.
77.33EFFECTIVE DATE.This section is effective the day following final enactment.
78.1 Sec. 15. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
78.2to read:
78.3 Subd. 29. Reimbursement for the fee increase for the early hearing detection
78.4and intervention program. For services provided on or after July 1, 2010, in addition to
78.5any other payment under this section, the commissioner shall reimburse hospitals for the
78.6increase in the fee for the early hearing detection and intervention program described in
78.7section 144.125, subdivision 1, paid by the hospital for public program recipients.
78.8 Sec. 16. [256B.032] ELIGIBLE VENDORS OF MEDICAL CARE.
78.9(a) Effective January 1, 2011, the commissioner shall establish performance
78.10thresholds for health care providers included in the provider peer grouping system
78.11developed by the commissioner of health under section 62U.04. The thresholds shall be
78.12set at the 10th percentile of the combined cost and quality measure used for provider peer
78.13grouping, and separate thresholds shall be set for hospital and physician services.
78.14(b) Beginning January 1, 2012, any health care provider with a combined cost and
78.15quality score below the threshold set in paragraph (a) shall be prohibited from enrolling
78.16as a vendor of medical care in the medical assistance, general assistance medical care,
78.17or MinnesotaCare programs, and shall not be eligible for direct payments under those
78.18programs or for payments made by managed care plans under their contracts with the
78.19commissioner under section 256B.69 or 256L.12. A health care provider that is prohibited
78.20from enrolling as a vendor or receiving payments under this paragraph may reenroll
78.21effective January 1 of any subsequent year if the provider's most recent combined cost and
78.22quality score exceeds the threshold established in paragraph (a).
78.23(c) Notwithstanding paragraph (b), a provider may continue to participate as a vendor
78.24or as part of a managed care plan provider network if the commissioner determines that a
78.25contract with the provider is necessary to ensure adequate access to health care services.
78.26(d) By January 15, 2013, the commissioner shall report to the legislature on the
78.27impact of this section. The commissioner's report shall include information on:
78.28(1) the providers falling below the thresholds as of January 1, 2012;
78.29(2) the volume of services and cost of care provided to enrollees in the medical
78.30assistance, general assistance medical care, or MinnesotaCare programs in the 12 months
78.31prior to January 1, 2012, by providers falling below the thresholds;
78.32(3) providers who fell below the thresholds but continued to be eligible vendors
78.33under paragraph (c);
78.34(4) the estimated cost savings achieved by not contracting with providers who do
78.35not meet the performance thresholds; and
79.1(5) recommendations for increasing the threshold levels of performance over time.
79.2 Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to
79.3read:
79.4 Subd. 3c. Asset limitations for families and children. A household of two or more
79.5persons must not own more than $20,000 in total net assets, and a household of one
79.6person must not own more than $10,000 in total net assets. In addition to these maximum
79.7amounts, an eligible individual or family may accrue interest on these amounts, but they
79.8must be reduced to the maximum at the time of an eligibility redetermination. The value of
79.9assets that are not considered in determining eligibility for medical assistance for families
79.10and children is the value of those assets excluded under the AFDC state plan as of July 16,
79.111996, as required by the Personal Responsibility and Work Opportunity Reconciliation
79.12Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:
79.13(1) household goods and personal effects are not considered;
79.14(2) capital and operating assets of a trade or business up to $200,000 are not
79.15considered, except that a bank account that contains personal income or assets, or is used to
79.16pay personal expenses, is not considered a capital or operating asset of a trade or business;
79.17(3) one motor vehicle is excluded for each person of legal driving age who is
79.18employed or seeking employment;
79.19(4) one burial plot and all other burial expenses equal to the supplemental security
79.20income program asset limit are not considered for each individual;
79.21(5) court-ordered settlements up to $10,000 are not considered;
79.22(6) individual retirement accounts and funds are not considered; and
79.23(7) assets owned by children are not considered.
79.24The assets specified in clause (2) must be disclosed to the local agency at the time of
79.25application and at the time of an eligibility redetermination, and must be verified upon
79.26request of the local agency.
79.27EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
79.28approval, whichever is later.
79.29 Sec. 18. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to
79.30read:
79.31 Subd. 3d. Reduction of excess assets. Assets in excess of the limits in subdivisions
79.323 to 3c may be reduced to allowable limits as follows:
79.33(a) Assets may be reduced in any of the three calendar months before the month
79.34of application in which the applicant seeks coverage by:
80.1(1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible
80.2dependent child; and
80.3(2) paying health service bills for health services that are incurred in the retroactive
80.4period for which the applicant seeks eligibility, starting with the oldest bill. After assets
80.5are reduced to allowable limits, eligibility begins with the next dollar of MA-covered
80.6health services incurred in the retroactive period. Applicants reducing assets under this
80.7subdivision who also have excess income shall first spend excess assets to pay health
80.8service bills and may meet the income spenddown on remaining bills.
80.9(b) Assets may be reduced beginning the month of application by:
80.10(1) paying bills for health services that are incurred during the period specified in
80.11Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical
80.12assistance; and. After assets are reduced to allowable limits, eligibility begins with the
80.13next dollar of medical assistance covered health services incurred in the period. Applicants
80.14reducing assets under this subdivision who also have excess income shall first spend excess
80.15assets to pay health service bills and may meet the income spenddown on remaining bills.
80.16(2) using any means other than a transfer of assets for less than fair market value as
80.17defined in section
256B.0595, subdivision 1, paragraph (b).
80.18EFFECTIVE DATE.This section is effective January 1, 2011.
80.19 Sec. 19. Minnesota Statutes 2008, section 256B.057, is amended by adding a
80.20subdivision to read:
80.21 Subd. 11. Treatment for colorectal cancer. (a) Medical assistance shall be paid for
80.22an individual who:
80.23(1) has been screened for colorectal cancer by the colorectal cancer prevention
80.24demonstration project;
80.25(2) according to the individual's treating health professional, needs treatment for
80.26colorectal cancer;
80.27(3) meets income eligibility guidelines for the colorectal cancer prevention
80.28demonstration project;
80.29(4) is under the age of 65; and
80.30(5) is not otherwise eligible for medical assistance or covered under creditable
80.31coverage as defined under United States Code, title 42, section 300gg(a).
80.32(b) Medical assistance provided under this subdivision shall be limited to services
80.33provided during the period that the individual receives treatment for colorectal cancer.
81.1(c) An individual meeting the criteria in paragraph (a) is eligible for medical
81.2assistance without meeting the eligibility criteria relating to income and assets in section
81.3256B.056, subdivisions 1a to 5b.
81.4(d) This subdivision expires December 31, 2010.
81.5 Sec. 20. Minnesota Statutes 2008, section 256B.0575, is amended to read:
81.6256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
81.7PERSONS.
81.8 Subdivision 1. Income deductions. When an institutionalized person is determined
81.9eligible for medical assistance, the income that exceeds the deductions in paragraphs (a)
81.10and (b) must be applied to the cost of institutional care.
81.11(a) The following amounts must be deducted from the institutionalized person's
81.12income in the following order:
81.13(1) the personal needs allowance under section256B.35 or, for a veteran who
81.14does not have a spouse or child, or a surviving spouse of a veteran having no child, the
81.15amount of an improved pension received from the veteran's administration not exceeding
81.16$90 per month;
81.17(2) the personal allowance for disabled individuals under section256B.36 ;
81.18(3) if the institutionalized person has a legally appointed guardian or conservator,
81.19five percent of the recipient's gross monthly income up to $100 as reimbursement for
81.20guardianship or conservatorship services;
81.21(4) a monthly income allowance determined under section256B.058, subdivision
81.222 , but only to the extent income of the institutionalized spouse is made available to the
81.23community spouse;
81.24(5) a monthly allowance for children under age 18 which, together with the net
81.25income of the children, would provide income equal to the medical assistance standard
81.26for families and children according to section256B.056, subdivision 4 , for a family size
81.27that includes only the minor children. This deduction applies only if the children do not
81.28live with the community spouse and only to the extent that the deduction is not included
81.29in the personal needs allowance under section256B.35, subdivision 1 , as child support
81.30garnished under a court order;
81.31(6) a monthly family allowance for other family members, equal to one-third of the
81.32difference between 122 percent of the federal poverty guidelines and the monthly income
81.33for that family member;
82.1(7) reparations payments made by the Federal Republic of Germany and reparations
82.2payments made by the Netherlands for victims of Nazi persecution between 1940 and
82.31945;
82.4(8) all other exclusions from income for institutionalized persons as mandated by
82.5federal law; and
82.6(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for
82.7necessary medical or remedial care for the institutionalized person that are recognized
82.8under state law, not medical assistance covered expenses, andthat are not subject to
82.9payment by a third party.
82.10Reasonable expenses are limited to expenses that have not been previously used as a
82.11deduction from income and are incurred during the enrollee's current period of eligibility,
82.12including retroactive months associated with the current period of eligibility, for medical
82.13assistance payment of long-term care services.
82.14For purposes of clause (6), "other family member" means a person who resides
82.15with the community spouse and who is a minor or dependent child, dependent parent, or
82.16dependent sibling of either spouse. "Dependent" means a person who could be claimed as
82.17a dependent for federal income tax purposes under the Internal Revenue Code.
82.18(b) Income shall be allocated to an institutionalized person for a period of up to three
82.19calendar months, in an amount equal to the medical assistance standard for a family
82.20size of one if:
82.21(1) a physician certifies that the person is expected to reside in the long-term care
82.22facility for three calendar months or less;
82.23(2) if the person has expenses of maintaining a residence in the community; and
82.24(3) if one of the following circumstances apply:
82.25(i) the person was not living together with a spouse or a family member as defined in
82.26paragraph (a) when the person entered a long-term care facility; or
82.27(ii) the person and the person's spouse become institutionalized on the same date, in
82.28which case the allocation shall be applied to the income of one of the spouses.
82.29For purposes of this paragraph, a person is determined to be residing in a licensed nursing
82.30home, regional treatment center, or medical institution if the person is expected to remain
82.31for a period of one full calendar month or more.
82.32 Subd. 2. Reasonable expenses. For the purposes of subdivision 1, paragraph (a),
82.33clause (9), reasonable expenses are limited to expenses that have not been previously used
82.34as a deduction from income and were not:
82.35 (1) for long-term care expenses incurred during a period of ineligibility as defined in
82.36section 256B.0595, subdivision 2;
83.1 (2) incurred more than three months before the month of application associated with
83.2the current period of eligibility;
83.3 (3) for expenses incurred by a recipient that are duplicative of services that are
83.4covered under chapter 256B; or
83.5 (4) nursing facility expenses incurred without a timely assessment as required under
83.6section 256B.0911.
83.7 Sec. 21. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to
83.8read:
83.9 Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before
83.10August 10, 1993, if an institutionalized person or the institutionalized person's spouse has
83.11given away, sold, or disposed of, for less than fair market value, any asset or interest
83.12therein, except assets other than the homestead that are excluded under the supplemental
83.13security program, within 30 months before or any time after the date of institutionalization
83.14if the person has been determined eligible for medical assistance, or within 30 months
83.15before or any time after the date of the first approved application for medical assistance
83.16if the person has not yet been determined eligible for medical assistance, the person is
83.17ineligible for long-term care services for the period of time determined under subdivision
83.182.
83.19 (b) Effective for transfers made after August 10, 1993, an institutionalized person, an
83.20institutionalized person's spouse, or any person, court, or administrative body with legal
83.21authority to act in place of, on behalf of, at the direction of, or upon the request of the
83.22institutionalized person or institutionalized person's spouse, may not give away, sell, or
83.23dispose of, for less than fair market value, any asset or interest therein, except assets other
83.24than the homestead that are excluded under the Supplemental Security Income program,
83.25for the purpose of establishing or maintaining medical assistance eligibility. This applies
83.26to all transfers, including those made by a community spouse after the month in which
83.27the institutionalized spouse is determined eligible for medical assistance. For purposes of
83.28determining eligibility for long-term care services, any transfer of such assets within 36
83.29months before or any time after an institutionalized person requests medical assistance
83.30payment of long-term care services, or 36 months before or any time after a medical
83.31assistance recipient becomes an institutionalized person, for less than fair market value
83.32may be considered. Any such transfer is presumed to have been made for the purpose
83.33of establishing or maintaining medical assistance eligibility and the institutionalized
83.34person is ineligible for long-term care services for the period of time determined under
83.35subdivision 2, unless the institutionalized person furnishes convincing evidence to
84.1establish that the transaction was exclusively for another purpose, or unless the transfer is
84.2permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a
84.3trust that are considered transfers of assets under federal law, or in the case of any other
84.4disposal of assets made on or after February 8, 2006, any transfers made within 60 months
84.5before or any time after an institutionalized person requests medical assistance payment of
84.6long-term care services and within 60 months before or any time after a medical assistance
84.7recipient becomes an institutionalized person, may be considered.
84.8 (c) This section applies to transfers, for less than fair market value, of income
84.9or assets, including assets that are considered income in the month received, such as
84.10inheritances, court settlements, and retroactive benefit payments or income to which the
84.11institutionalized person or the institutionalized person's spouse is entitled but does not
84.12receive due to action by the institutionalized person, the institutionalized person's spouse,
84.13or any person, court, or administrative body with legal authority to act in place of, on
84.14behalf of, at the direction of, or upon the request of the institutionalized person or the
84.15institutionalized person's spouse.
84.16 (d) This section applies to payments for care or personal services provided by a
84.17relative, unless the compensation was stipulated in a notarized, written agreement which
84.18was in existence when the service was performed, the care or services directly benefited
84.19the person, and the payments made represented reasonable compensation for the care
84.20or services provided. A notarized written agreement is not required if payment for the
84.21services was made within 60 days after the service was provided.
84.22 (e) This section applies to the portion of any asset or interest that an institutionalized
84.23person, an institutionalized person's spouse, or any person, court, or administrative body
84.24with legal authority to act in place of, on behalf of, at the direction of, or upon the request
84.25of the institutionalized person or the institutionalized person's spouse, transfers to any
84.26annuity that exceeds the value of the benefit likely to be returned to the institutionalized
84.27person or institutionalized person's spouse while alive, based on estimated life expectancy
84.28as determined according to the current actuarial tables published by the Office of the
84.29Chief Actuary of the Social Security Administration. The commissioner may adopt rules
84.30reducing life expectancies based on the need for long-term care. This section applies to an
84.31annuity purchased on or after March 1, 2002, that:
84.32 (1) is not purchased from an insurance company or financial institution that is
84.33subject to licensing or regulation by the Minnesota Department of Commerce or a similar
84.34regulatory agency of another state;
84.35 (2) does not pay out principal and interest in equal monthly installments; or
84.36 (3) does not begin payment at the earliest possible date after annuitization.
85.1 (f) Effective for transactions, including the purchase of an annuity, occurring on or
85.2after February 8, 2006, by or on behalf of an institutionalized person who has applied for
85.3or is receiving long-term care services or the institutionalized person's spouse shall be
85.4treated as the disposal of an asset for less than fair market value unless the department is
85.5named a preferred remainder beneficiary as described in section256B.056, subdivision
85.611 . Any subsequent change to the designation of the department as a preferred remainder
85.7beneficiary shall result in the annuity being treated as a disposal of assets for less than
85.8fair market value. The amount of such transfer shall be the maximum amount the
85.9institutionalized person or the institutionalized person's spouse could receive from the
85.10annuity or similar financial instrument. Any change in the amount of the income or
85.11principal being withdrawn from the annuity or other similar financial instrument at the
85.12time of the most recent disclosure shall be deemed to be a transfer of assets for less than
85.13fair market value unless the institutionalized person or the institutionalized person's spouse
85.14demonstrates that the transaction was for fair market value. In the event a distribution
85.15of income or principal has been improperly distributed or disbursed from an annuity or
85.16other retirement planning instrument of an institutionalized person or the institutionalized
85.17person's spouse, a cause of action exists against the individual receiving the improper
85.18distribution for the cost of medical assistance services provided or the amount of the
85.19improper distribution, whichever is less.
85.20 (g) Effective for transactions, including the purchase of an annuity, occurring on
85.21or after February 8, 2006, by or on behalf of an institutionalized person applying for or
85.22receiving long-term care services shall be treated as a disposal of assets for less than fair
85.23market value unless it is:
85.24 (i) an annuity described in subsection (b) or (q) of section 408 of the Internal
85.25Revenue Code of 1986; or
85.26 (ii) purchased with proceeds from:
85.27 (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
85.28Internal Revenue Code;
85.29 (B) a simplified employee pension within the meaning of section 408(k) of the
85.30Internal Revenue Code; or
85.31 (C) a Roth IRA described in section 408A of the Internal Revenue Code; or
85.32 (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
85.33determined in accordance with actuarial publications of the Office of the Chief Actuary of
85.34the Social Security Administration; and provides for payments in equal amounts during
85.35the term of the annuity, with no deferral and no balloon payments made.
86.1 (h) For purposes of this section, long-term care services include services in a nursing
86.2facility, services that are eligible for payment according to section256B.0625, subdivision
86.32 , because they are provided in a swing bed, intermediate care facility for persons with
86.4developmental disabilities, and home and community-based services provided pursuant
86.5to sections256B.0915 ,
256B.092 , and
256B.49 . For purposes of this subdivision and
86.6subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient
86.7in a nursing facility or in a swing bed, or intermediate care facility for persons with
86.8developmental disabilities or who is receiving home and community-based services under
86.9sections256B.0915 ,
256B.092 , and
256B.49 .
86.10 (i) This section applies to funds used to purchase a promissory note, loan, or
86.11mortgage unless the note, loan, or mortgage:
86.12 (1) has a repayment term that is actuarially sound;
86.13 (2) provides for payments to be made in equal amounts during the term of the loan,
86.14with no deferral and no balloon payments made; and
86.15 (3) prohibits the cancellation of the balance upon the death of the lender.
86.16 In the case of a promissory note, loan, or mortgage that does not meet an exception
86.17in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
86.18balance due as of the date of the institutionalized person's request for medical assistance
86.19payment of long-term care services.
86.20 (j) This section applies to the purchase of a life estate interest in another person's
86.21home unless the purchaser resides in the home for a period of at least one year after the
86.22date of purchase.
86.23(k) This section applies to transfers into a pooled trust that qualifies under United
86.24States Code, title 42, section 1396p(d)(4)(C), by:
86.25(1) a person age 65 or older or the person's spouse; or
86.26(2) any person, court, or administrative body with legal authority to act in place
86.27of, on behalf of, at the direction of, or upon the request of a person age 65 or older or
86.28the person's spouse.
86.29 Sec. 22. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to
86.30read:
86.31 Subd. 2. Period of ineligibility for long-term care services. (a) For any
86.32uncompensated transfer occurring on or before August 10, 1993, the number of months
86.33of ineligibility for long-term care services shall be the lesser of 30 months, or the
86.34uncompensated transfer amount divided by the average medical assistance rate for nursing
86.35facility services in the state in effect on the date of application. The amount used to
87.1calculate the average medical assistance payment rate shall be adjusted each July 1 to
87.2reflect payment rates for the previous calendar year. The period of ineligibility begins
87.3with the month in which the assets were transferred. If the transfer was not reported to
87.4the local agency at the time of application, and the applicant received long-term care
87.5services during what would have been the period of ineligibility if the transfer had been
87.6reported, a cause of action exists against the transferee for the cost of long-term care
87.7services provided during the period of ineligibility, or for the uncompensated amount of
87.8the transfer, whichever is less. The uncompensated transfer amount is the fair market
87.9value of the asset at the time it was given away, sold, or disposed of, less the amount of
87.10compensation received.
87.11 (b) For uncompensated transfers made after August 10, 1993, the number of months
87.12of ineligibility for long-term care services shall be the total uncompensated value of the
87.13resources transferred divided by the average medical assistance rate for nursing facility
87.14services in the state in effect on the date of application. The amount used to calculate
87.15the average medical assistance payment rate shall be adjusted each July 1 to reflect
87.16payment rates for the previous calendar year. The period of ineligibility begins with the
87.17first day of the month after the month in which the assets were transferred except that
87.18if one or more uncompensated transfers are made during a period of ineligibility, the
87.19total assets transferred during the ineligibility period shall be combined and a penalty
87.20period calculated to begin on the first day of the month after the month in which the first
87.21uncompensated transfer was made. If the transfer was reported to the local agency after
87.22the date that advance notice of a period of ineligibility that affects the next month could
87.23be provided to the recipient and the recipient received medical assistance services or the
87.24transfer was not reported to the local agency, and the applicant or recipient received
87.25medical assistance services during what would have been the period of ineligibility if
87.26the transfer had been reported, a cause of action exists against the transferee for that
87.27portion of long-term care services provided during the period of ineligibility, or for the
87.28uncompensated amount of the transfer, whichever is less. The uncompensated transfer
87.29amount is the fair market value of the asset at the time it was given away, sold, or disposed
87.30of, less the amount of compensation received. Effective for transfers made on or after
87.31March 1, 1996, involving persons who apply for medical assistance on or after April 13,
87.321996, no cause of action exists for a transfer unless:
87.33 (1) the transferee knew or should have known that the transfer was being made by a
87.34person who was a resident of a long-term care facility or was receiving that level of care in
87.35the community at the time of the transfer;
88.1 (2) the transferee knew or should have known that the transfer was being made to
88.2assist the person to qualify for or retain medical assistance eligibility; or
88.3 (3) the transferee actively solicited the transfer with intent to assist the person to
88.4qualify for or retain eligibility for medical assistance.
88.5 (c) For uncompensated transfers made on or after February 8, 2006, the period
88.6of ineligibility:
88.7 (1) for uncompensated transfers by or on behalf of individuals receiving medical
88.8assistance payment of long-term care services, begins the first day of the month following
88.9advance notice of thepenalty period of ineligibility, but no later than the first day of the
88.10month that follows three full calendar months from the date of the report or discovery
88.11of the transfer; or
88.12 (2) for uncompensated transfers by individuals requesting medical assistance
88.13payment of long-term care services, begins the date on which the individual is eligible
88.14for medical assistance under the Medicaid state plan and would otherwise be receiving
88.15long-term care services based on an approved application for such care but for the
88.16application of the penalty period of ineligibility resulting from the uncompensated
88.17transfer; and
88.18 (3) cannot begin during any other period of ineligibility.
88.19 (d) If a calculation of apenalty period of ineligibility results in a partial month,
88.20payments for long-term care services shall be reduced in an amount equal to the fraction.
88.21 (e) In the case of multiple fractional transfers of assets in more than one month for
88.22less than fair market value on or after February 8, 2006, the period of ineligibility is
88.23calculated by treating the total, cumulative, uncompensated value of all assets transferred
88.24during all months on or after February 8, 2006, as one transfer.
88.25 (f) A period of ineligibility established under paragraph (c) may be eliminated if
88.26all of the assets transferred for less than fair market value used to calculate the period of
88.27ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned
88.28within 12 months after the date the period of ineligibility began. A period of ineligibility
88.29must not be adjusted if less than the full amount of the transferred assets or the full cash
88.30value of the transferred assets are returned.
88.31EFFECTIVE DATE.This section is effective for periods of ineligibility established
88.32on or after January 1, 2011.
88.33 Sec. 23. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read:
88.34 Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
88.35to citizens of the United States, qualified noncitizens as defined in this subdivision, and
89.1other persons residing lawfully in the United States. Citizens or nationals of the United
89.2States must cooperate in obtaining satisfactory documentary evidence of citizenship or
89.3nationality according to the requirements of the federal Deficit Reduction Act of 2005,
89.4Public Law 109-171.
89.5(b) "Qualified noncitizen" means a person who meets one of the following
89.6immigration criteria:
89.7(1) admitted for lawful permanent residence according to United States Code, title 8;
89.8(2) admitted to the United States as a refugee according to United States Code,
89.9title 8, section 1157;
89.10(3) granted asylum according to United States Code, title 8, section 1158;
89.11(4) granted withholding of deportation according to United States Code, title 8,
89.12section 1253(h);
89.13(5) paroled for a period of at least one year according to United States Code, title 8,
89.14section 1182(d)(5);
89.15(6) granted conditional entrant status according to United States Code, title 8,
89.16section 1153(a)(7);
89.17(7) determined to be a battered noncitizen by the United States Attorney General
89.18according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
89.19title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
89.20(8) is a child of a noncitizen determined to be a battered noncitizen by the United
89.21States Attorney General according to the Illegal Immigration Reform and Immigrant
89.22Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
89.23Public Law 104-200; or
89.24(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
89.25Law 96-422, the Refugee Education Assistance Act of 1980.
89.26(c) All qualified noncitizens who were residing in the United States before August
89.2722, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
89.28medical assistance with federal financial participation.
89.29(d) All qualified noncitizens who entered the United States on or after August 22,
89.301996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
89.31medical assistance with federal financial participation through November 30, 1996.
89.32Beginning December 1, 1996, qualified noncitizens who entered the United States
89.33on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
89.34chapter are eligible for medical assistance with federal participation for five years if they
89.35meet one of the following criteria:
90.1(i) refugees admitted to the United States according to United States Code, title 8,
90.2section 1157;
90.3(ii) persons granted asylum according to United States Code, title 8, section 1158;
90.4(iii) persons granted withholding of deportation according to United States Code,
90.5title 8, section 1253(h);
90.6(iv) veterans of the United States armed forces with an honorable discharge for
90.7a reason other than noncitizen status, their spouses and unmarried minor dependent
90.8children; or
90.9(v) persons on active duty in the United States armed forces, other than for training,
90.10their spouses and unmarried minor dependent children.
90.11Beginning December 1, 1996, qualified noncitizens who do not meet one of the
90.12criteria in items (i) to (v) are eligible for medical assistance without federal financial
90.13participation as described in paragraph (j).
90.14Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant
90.15women who are qualified noncitizens, as described in paragraph (b), are eligible for
90.16medical assistance with federal financial participation as provided by the federal Children's
90.17Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
90.18(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
90.19are lawfully present in the United States, as defined in Code of Federal Regulations, title
90.208, section103.12 , and who otherwise meet the eligibility requirements of this chapter, are
90.21eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
90.22with the United States Citizenship and Immigration Services to pursue any applicable
90.23immigration status, including citizenship, that would qualify them for medical assistance
90.24with federal financial participation.
90.25(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
90.26for medical assistance with federal financial participation through December 31, 1996.
90.27(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
90.28medical assistance without federal financial participation as described in paragraph (j).
90.29(3) Beginning December 1, 1996, persons residing in the United States prior to
90.30August 22, 1996, who were not receiving medical assistance and persons who arrived on
90.31or after August 22, 1996, are eligible for medical assistance without federal financial
90.32participation as described in paragraph (j).
90.33(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
90.34are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this
90.35subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
90.36Code, title 8, section 1101(a)(15).
91.1(g) Payment shall also be made for care and services that are furnished to noncitizens,
91.2regardless of immigration status, who otherwise meet the eligibility requirements of
91.3this chapter, if such care and services are necessary for the treatment of an emergency
91.4medical condition, except for organ transplants and related care and services and routine
91.5prenatal care.
91.6(h) For purposes of this subdivision, the term "emergency medical condition" means
91.7a medical condition that meets the requirements of United States Code, title 42, section
91.81396b(v).
91.9(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
91.10nonimmigrants, oreligible for medical assistance as described in paragraph (j), lawfully
91.11present as designated in paragraph (e) and who are not covered by a group health plan
91.12or health insurance coverage according to Code of Federal Regulations, title 42, section
91.13457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible
91.14for medical assistance through the period of pregnancy, including labor and delivery,
91.15and 60 days postpartum, to the extent federal funds are available under title XXI of the
91.16Social Security Act, and the state children's health insurance program, followed by 60
91.17days postpartum without federal financial participation.
91.18(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
91.19lawfully residing in the United States as described in paragraph (e), who are ineligible
91.20for medical assistance with federal financial participation and who otherwise meet the
91.21eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
91.22assistance without federal financial participation. Qualified noncitizens as described
91.23in paragraph (d) are only eligible for medical assistance without federal financial
91.24participation for five years from their date of entry into the United States.
91.25(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation
91.26services from a nonprofit center established to serve victims of torture and are otherwise
91.27ineligible for medical assistance under this chapter are eligible for medical assistance
91.28without federal financial participation. These individuals are eligible only for the period
91.29during which they are receiving services from the center. Individuals eligible under this
91.30paragraph shall not be required to participate in prepaid medical assistance.
91.31EFFECTIVE DATE.This section is effective July 1, 2009.
91.32 Sec. 24. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read:
91.33 Subd. 5. Deeming of sponsor income and resources. When determining eligibility
91.34for any federal or state funded medical assistance under this section, the income
91.35and resources of all noncitizens shall be deemed to include their sponsors' income
92.1and resources as required under the Personal Responsibility and Work Opportunity
92.2Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
92.3subsequently set out in federal rules. This section is effective May 1, 1997. Beginning
92.4July 1, 2010, sponsor deeming does not apply to pregnant women and children who are
92.5qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b).
92.6EFFECTIVE DATE.This section is effective July 1, 2010.
92.7 Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to
92.8read:
92.9 Subd. 3. Physicians' services. (a) Medical assistance covers physicians' services.
92.10(b) Rates paid for anesthesiology services provided by physicians shall be according
92.11to the formula utilized in the Medicare program and shall use a conversion factor "at
92.12percentile of calendar year set by legislature.," except that rates paid to physicians for the
92.13medical direction of a certified registered nurse anesthetist shall be the same as the rate
92.14paid to the certified registered nurse anesthetist under medical direction.
92.15 Sec. 26. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to
92.16read:
92.17 Subd. 3c. Health Services Policy Committee. (a) The commissioner, after
92.18receiving recommendations from professional physician associations, professional
92.19associations representing licensed nonphysician health care professionals, and consumer
92.20groups, shall establish a 13-member Health Services Policy Committee, which consists of
92.2112 voting members and one nonvoting member. The Health Services Policy Committee
92.22shall advise the commissioner regarding health services pertaining to the administration
92.23of health care benefits covered under the medical assistance, general assistance medical
92.24care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at
92.25least quarterly. The Health Services Policy Committee shall annually elect a physician
92.26chair from among its members, who shall work directly with the commissioner's medical
92.27director, to establish the agenda for each meeting. The Health Services Policy Committee
92.28shall also recommend criteria for verifying centers of excellence for specific aspects of
92.29medical care where a specific set of combined services, a volume of patients necessary to
92.30maintain a high level of competency, or a specific level of technical capacity is associated
92.31with improved health outcomes.
92.32(b) The commissioner shall establish a dental subcommittee to operate under the
92.33Health Services Policy Committee. The dental subcommittee consists of general dentists,
92.34dental specialists, safety net providers, dental hygienists, health plan company and
93.1county and public health representatives, health researchers, consumers, and a designee
93.2of the commissioner of health. The dental subcommittee shall advise the commissioner
93.3regarding:
93.4(1) the critical access dental program under section 256B.76, subdivision 4, including
93.5but not limited to criteria for designating and terminating critical access dental providers;
93.6(2) any changes to the critical access dental provider program necessary to comply
93.7with program expenditure limits;
93.8(3) dental coverage policy based on evidence, quality, continuity of care, and best
93.9practices;
93.10(4) the development of dental delivery models; and
93.11(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
93.12(c) The Health Services Policy Committee shall study approaches to making
93.13provider reimbursement under the medical assistance, MinnesotaCare, and general
93.14assistance medical care programs contingent on patient participation in a patient-centered
93.15decision-making process, and shall evaluate the impact of these approaches on health
93.16care quality, patient satisfaction, and health care costs. The committee shall present
93.17findings and recommendations to the commissioner and the legislative committees with
93.18jurisdiction over health care by January 15, 2010.
93.19(d) The Health Services Policy Committee shall monitor and track the practice
93.20patterns of physicians providing services to medical assistance, MinnesotaCare, and
93.21general assistance medical care enrollees under fee-for-service, managed care, and
93.22county-based purchasing. The committee shall focus on services or specialties for which
93.23there is a high variation in utilization across physicians, or which are associated with
93.24high medical costs. The commissioner, based upon the findings of the committee, shall
93.25regularly notify physicians whose practice patterns indicate higher than average utilization
93.26or costs. Managed care and county-based purchasing plans shall provide the committee
93.27with utilization and cost data necessary to implement this paragraph.
93.28 (e) The Health Services Policy Committee shall review caesarean section rates
93.29for the fee-for-service medical assistance population. The committee may develop best
93.30practices policies related to the minimization of caesarean sections, including but not
93.31limited to standards and guidelines for health care providers and health care facilities.
93.32 Sec. 27. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to
93.33read:
94.1 Subd. 9. Dental services. (a) Medical assistance covers dental services.Dental
94.2services include, with prior authorization, fixed bridges that are cost-effective for persons
94.3who cannot use removable dentures because of their medical condition.
94.4(b) Medical assistance dental coverage for nonpregnant adults is limited to the
94.5following services:
94.6(1) comprehensive exams, limited to once every five years;
94.7(2) periodic exams, limited to one per year;
94.8(3) limited exams;
94.9(4) bitewing x-rays, limited to one per year;
94.10(5) periapical x-rays;
94.11(6) panoramic x-rays, limited to one every five years, and only if provided in
94.12conjunction with a posterior extraction or scheduled outpatient facility procedure, or as
94.13medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology
94.14and trauma. Panoramic x-rays may be taken once every two years for patients who cannot
94.15cooperate for intraoral film due to a developmental disability or medical condition that
94.16does not allow for intraoral film placement;
94.17(7) prophylaxis, limited to one per year;
94.18(8) application of fluoride varnish, limited to one per year;
94.19(9) posterior fillings, all at the amalgam rate;
94.20(10) anterior fillings;
94.21(11) endodontics, limited to root canals on the anterior and premolars only;
94.22(12) removable prostheses, each dental arch limited to one every six years;
94.23(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
94.24abscesses;
94.25(14) palliative treatment and sedative fillings for relief of pain; and
94.26(15) full-mouth debridement, limited to one every five years.
94.27(c) In addition to the services specified in paragraph (b), medical assistance
94.28covers the following services for adults, if provided in an outpatient hospital setting or
94.29freestanding ambulatory surgical center as part of outpatient dental surgery:
94.30(1) periodontics, limited to periodontal scaling and root planing once every two
94.31years;
94.32(2) general anesthesia; and
94.33(3) full-mouth survey once every five years.
94.34(d) Medical assistance covers dental services for children that are medically
94.35necessary. The following guidelines apply:
94.36(1) posterior fillings are paid at the amalgam rate;
95.1(2) application of sealants once every five years per permanent molar; and
95.2(3) application of fluoride varnish once every six months.
95.3EFFECTIVE DATE.This section is effective January 1, 2010.
95.4 Sec. 28. Minnesota Statutes 2008, section 256B.0625, subdivision 11, is amended to
95.5read:
95.6 Subd. 11. Nurse anesthetist services. Medical assistance covers nurse anesthetist
95.7services. Rates paid for anesthesiology services provided by a certified registered nurse
95.8anesthetists anesthetist under the direction of a physician shall be according to the formula
95.9utilized in the Medicare program and shall use the conversion factor that is used by
95.10the Medicare program. Rates paid for anesthesiology services provided by a certified
95.11registered nurse anesthetist who is not directed by a physician shall be the same rate as
95.12paid under subdivision 3, paragraph (b).
95.13 Sec. 29. Minnesota Statutes 2008, section 256B.0625, subdivision 13, is amended to
95.14read:
95.15 Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs
95.16when specifically used to enhance fertility, if prescribed by a licensed practitioner and
95.17dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance
95.18program as a dispensing physician, or by a physician, physician assistant, or a nurse
95.19practitioner employed by or under contract with a community health board as defined in
95.20section145A.02, subdivision 5 , for the purposes of communicable disease control.
95.21(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
95.22unless authorized by the commissioner.
95.23(c) Medical assistance covers the following over-the-counter drugs when prescribed
95.24by a licensed practitioner or by a licensed pharmacist who meets standards established by
95.25the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen,
95.26family planning products, aspirin, insulin, products for the treatment of lice, vitamins for
95.27adults with documented vitamin deficiencies, vitamins for children under the age of seven
95.28and pregnant or nursing women, and any other over-the-counter drug identified by the
95.29commissioner, in consultation with the formulary committee, as necessary, appropriate,
95.30and cost-effective for the treatment of certain specified chronic diseases, conditions,
95.31or disorders, and this determination shall not be subject to the requirements of chapter
95.3214. A pharmacist may prescribe over-the-counter medications as provided under this
95.33paragraph for purposes of receiving reimbursement under Medicaid. When prescribing
95.34over-the-counter drugs under this paragraph, licensed pharmacists must consult with the
96.1recipient to determine necessity, provide drug counseling, review drug therapy for potential
96.2adverse interactions, and make referrals as needed to other health care professionals.
96.3(d) Effective January 1, 2006, medical assistance shall not cover drugs that
96.4are coverable under Medicare Part D as defined in the Medicare Prescription Drug,
96.5Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e),
96.6for individuals eligible for drug coverage as defined in the Medicare Prescription
96.7Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section
96.81860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the
96.9drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this
96.10subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code,
96.11title 42, section 1396r-8(d)(2)(E), shall not be covered.
96.12 Sec. 30. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to
96.13read:
96.14 Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
96.15shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
96.16the maximum allowable cost set by the federal government or by the commissioner plus
96.17the fixed dispensing fee; or the usual and customary price charged to the public. The
96.18amount of payment basis must be reduced to reflect all discount amounts applied to the
96.19charge by any provider/insurer agreement or contract for submitted charges to medical
96.20assistance programs. The net submitted charge may not be greater than the patient liability
96.21for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
96.22for intravenous solutions which must be compounded by the pharmacist shall be $8 per
96.23bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
96.24nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
96.25nutritional products dispensed in quantities greater than one liter. Actual acquisition
96.26cost includes quantity and other special discounts except time and cash discounts.
96.27Effective July 1,2008 2009, the actual acquisition cost of a drug shall be estimated by the
96.28commissioner, at average wholesale price minus14 15 percent. The actual acquisition
96.29cost of antihemophilic factor drugs shall be estimated at the average wholesale price
96.30minus 30 percent. The maximum allowable cost of a multisource drug may be set by the
96.31commissioner and it shall be comparable to, but no higher than, the maximum amount
96.32paid by other third-party payors in this state who have maximum allowable cost programs.
96.33Establishment of the amount of payment for drugs shall not be subject to the requirements
96.34of the Administrative Procedure Act.
97.1 (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
97.2to pharmacists for legend drug prescriptions dispensed to residents of long-term care
97.3facilities when a unit dose blister card system, approved by the department, is used. Under
97.4this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
97.5The National Drug Code (NDC) from the drug container used to fill the blister card must
97.6be identified on the claim to the department. The unit dose blister card containing the
97.7drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
97.8that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
97.9will be required to credit the department for the actual acquisition cost of all unused
97.10drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
97.11manufacturer's unopened package. The commissioner may permit the drug clozapine to be
97.12dispensed in a quantity that is less than a 30-day supply.
97.13 (c) Whenever a generically equivalent product is available, payment shall be on the
97.14basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost
97.15established by the commissioner.
97.16 (d) The basis for determining the amount of payment for drugs administered in an
97.17outpatient setting shall be the lower of the usual and customary cost submitted by the
97.18provider or the amount established for Medicare by the United States Department of
97.19Health and Human Services pursuant to title XVIII, section 1847a of the federal Social
97.20Security Act.
97.21 (e) The commissioner may negotiate lower reimbursement rates for specialty
97.22pharmacy products than the rates specified in paragraph (a). The commissioner may
97.23require individuals enrolled in the health care programs administered by the department
97.24to obtain specialty pharmacy products from providers with whom the commissioner has
97.25negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
97.26used by a small number of recipients or recipients with complex and chronic diseases
97.27that require expensive and challenging drug regimens. Examples of these conditions
97.28include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
97.29C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
97.30of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
97.31biotechnology drugs, high-cost therapies, and therapies that require complex care. The
97.32commissioner shall consult with the formulary committee to develop a list of specialty
97.33pharmacy products subject to this paragraph. In consulting with the formulary committee
97.34in developing this list, the commissioner shall take into consideration the population
97.35served by specialty pharmacy products, the current delivery system and standard of care in
98.1the state, and access to care issues. The commissioner shall have the discretion to adjust
98.2the reimbursement rate to prevent access to care issues.
98.3 Sec. 31. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, is amended to
98.4read:
98.5 Subd. 13h. Medication therapy management services. (a) Medical assistance
98.6and general assistance medical care cover medication therapy management services for
98.7a recipient taking four or more prescriptions to treat or prevent two or more chronic
98.8medical conditions, or a recipient with a drug therapy problem that is identified or prior
98.9authorized by the commissioner that has resulted or is likely to result in significant
98.10nondrug program costs. The commissioner may cover medical therapy management
98.11services under MinnesotaCare if the commissioner determines this is cost-effective. For
98.12purposes of this subdivision, "medication therapy management" means the provision
98.13of the following pharmaceutical care services by a licensed pharmacist to optimize the
98.14therapeutic outcomes of the patient's medications:
98.15 (1) performing or obtaining necessary assessments of the patient's health status;
98.16 (2) formulating a medication treatment plan;
98.17 (3) monitoring and evaluating the patient's response to therapy, including safety
98.18and effectiveness;
98.19 (4) performing a comprehensive medication review to identify, resolve, and prevent
98.20medication-related problems, including adverse drug events;
98.21 (5) documenting the care delivered and communicating essential information to
98.22the patient's other primary care providers;
98.23 (6) providing verbal education and training designed to enhance patient
98.24understanding and appropriate use of the patient's medications;
98.25 (7) providing information, support services, and resources designed to enhance
98.26patient adherence with the patient's therapeutic regimens; and
98.27 (8) coordinating and integrating medication therapy management services within the
98.28broader health care management services being provided to the patient.
98.29Nothing in this subdivision shall be construed to expand or modify the scope of practice of
98.30the pharmacist as defined in section151.01, subdivision 27 .
98.31 (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
98.32must meet the following requirements:
98.33 (1) have a valid license issued under chapter 151;
98.34 (2) have graduated from an accredited college of pharmacy on or after May 1996, or
98.35completed a structured and comprehensive education program approved by the Board of
99.1Pharmacy and the American Council of Pharmaceutical Education for the provision and
99.2documentation of pharmaceutical care management services that has both clinical and
99.3didactic elements;
99.4 (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
99.5have developed a structured patient care process that is offered in a private or semiprivate
99.6patient care area that is separate from the commercial business that also occurs in the
99.7setting, or in home settings, excluding long-term care and group homes, if the service is
99.8ordered by the provider-directed care coordination team; and
99.9 (4) make use of an electronic patient record system that meets state standards.
99.10 (c) For purposes of reimbursement for medication therapy management services,
99.11the commissioner may enroll individual pharmacists as medical assistance and general
99.12assistance medical care providers. The commissioner may also establish contact
99.13requirements between the pharmacist and recipient, including limiting the number of
99.14reimbursable consultations per recipient.
99.15(d) The commissioner, after receiving recommendations from professional medical
99.16associations, professional pharmacy associations, and consumer groups, shall convene
99.17an 11-member Medication Therapy Management Advisory Committee to advise
99.18the commissioner on the implementation and administration of medication therapy
99.19management services. The committee shall be comprised of: two licensed physicians;
99.20two licensed pharmacists; two consumer representatives; two health plan company
99.21representatives; and three members with expertise in the area of medication therapy
99.22management, who may be licensed physicians or licensed pharmacists. The committee is
99.23governed by section
15.059, except that committee members do not receive compensation
99.24or reimbursement for expenses. The advisory committee expires on June 30, 2007.
99.25(e) The commissioner shall evaluate the effect of medication therapy management
99.26on quality of care, patient outcomes, and program costs, and shall include a description
99.27of any savings generated in the medical assistance and general assistance medical care
99.28programs that can be attributable to this coverage. The evaluation shall be submitted to
99.29the legislature by December 15, 2007. The commissioner may contract with a vendor
99.30or an academic institution that has expertise in evaluating health care outcomes for the
99.31purpose of completing the evaluation.
99.32(d) The commissioner shall establish a pilot project for an intensive medication
99.33therapy management program for patients identified by the commissioner with multiple
99.34chronic conditions and a high number of medications who are at high risk of preventable
99.35hospitalizations, emergency room use, medication complications, and suboptimal
99.36treatment outcomes due to medication-related problems. For purposes of the pilot
100.1project, medication therapy management services may be provided in a patient's home
100.2or community setting, in addition to other authorized settings. The commissioner may
100.3waive existing payment policies and establish special payment rates for the pilot project.
100.4The pilot project must be designed to produce a net savings to the state compared to the
100.5estimated costs that would otherwise be incurred for similar patients without the program.
100.6 Sec. 32. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to
100.7read:
100.8 Subd. 17. Transportation costs. (a) Medical assistance covers medical
100.9transportation costs incurred solely for obtaining emergency medical care or transportation
100.10costs incurred by eligible persons in obtaining emergency or nonemergency medical
100.11care when paid directly to an ambulance company, common carrier, or other recognized
100.12providers of transportation services. Medical transportation must be provided by:
100.13(1) an ambulance, as defined in section 144E.001, subdivision 2;
100.14(2) special transportation; or
100.15(3) common carrier including, but not limited to, bus, taxicab, other commercial
100.16carrier, or private automobile.
100.17(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
100.18part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
100.19would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
100.20transportation, or private automobile.
100.21The commissioner may use an order by the recipient's attending physician to certify that
100.22the recipient requires special transportation services. Special transportationincludes
100.23providers shall perform driver-assistedservice to services for eligible individuals.
100.24Driver-assisted service includes passenger pickup at and return to the individual's
100.25residence or place of business, assistance with admittance of the individual to the medical
100.26facility, and assistance in passenger securement or in securing of wheelchairs or stretchers
100.27in the vehicle. Special transportation providers must obtain written documentation
100.28from the health care service provider who is serving the recipient being transported,
100.29identifying the time that the recipient arrived. Special transportation providers may not
100.30bill for separate base rates for the continuation of a trip beyond the original destination.
100.31Special transportation providers must take recipients to the nearest appropriate health
100.32care provider, using the most direct routeavailable. The maximum minimum medical
100.33assistance reimbursement rates for special transportation services are:
100.34(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
100.35eligible persons who need a wheelchair-accessible van;
101.1(2) (ii) $11.50 for the base rate and $1.30 per mile for special transportation services
101.2to eligible persons who do not need a wheelchair-accessible van; and
101.3(3) (iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip,
101.4for special transportation services to eligible persons who need a stretcher-accessible
101.5vehicle;
101.6(2) the base rates for special transportation services in areas defined under RUCA
101.7to be super rural shall be equal to the reimbursement rate established in clause (1) plus
101.811.3 percent; and
101.9(3) for special transportation services in areas defined under RUCA to be rural
101.10or super rural areas:
101.11(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
101.12percent of the respective mileage rate in clause (1); and
101.13(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
101.14112.5 percent of the respective mileage rate in clause (1).
101.15(c) For purposes of reimbursement rates for special transportation services under
101.16paragraph (b), the zip code of the recipient's place of residence shall determine whether
101.17the urban, rural, or super rural reimbursement rate applies.
101.18(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
101.19means a census-tract based classification system under which a geographical area is
101.20determined to be urban, rural, or super rural.
101.21 Sec. 33. Minnesota Statutes 2008, section 256B.0625, subdivision 17a, is amended to
101.22read:
101.23 Subd. 17a. Payment for ambulance services. Medical assistance covers
101.24ambulance services. Providers shall bill ambulance services according to Medicare
101.25criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
101.26for services rendered on or after July 1, 2001, medical assistance payments for ambulance
101.27services shall be paid at the Medicare reimbursement rate or at the medical assistance
101.28payment rate in effect on July 1, 2000, whichever is greater.
101.29 Sec. 34. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
101.30subdivision to read:
101.31 Subd. 18b. Broker dispatching prohibition. The commissioner shall not use a
101.32broker or coordinator for any purpose related to transportation services under subdivision
101.3318.
102.1 Sec. 35. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
102.2subdivision to read:
102.3 Subd. 25a. Prior authorization of diagnostic imaging services. (a) Effective
102.4January 1, 2010, the commissioner shall require prior authorization or decision support
102.5for the ordering providers at the time the service is ordered for the following outpatient
102.6diagnostic imaging services: computerized tomography (CT), magnetic resonance
102.7imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography
102.8(PET), cardiac imaging and ultrasound diagnostic imaging.
102.9(b) Prior authorization under this subdivision is not required for diagnostic imaging
102.10services performed as part of a hospital emergency room visit, inpatient hospitalization, or
102.11if concurrent with or on the same day as an urgent care facility visit.
102.12(c) This subdivision does not apply to services provided to recipients who are
102.13enrolled in Medicare, the prepaid medical assistance program, the prepaid general
102.14assistance medical care program, or the MinnesotaCare program.
102.15(d) The commissioner may contract with a private entity to provide the prior
102.16authorization or decision support required under this subdivision. The contracting entity
102.17must incorporate clinical guidelines that are based on evidence-based medical literature, if
102.18available. By January 1, 2012, the contracting entity shall report to the commissioner the
102.19results of prior authorization or decision support.
102.20 Sec. 36. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to
102.21read:
102.22 Subd. 26. Special education services. (a) Medical assistance covers medical
102.23services identified in a recipient's individualized education plan and covered under the
102.24medical assistance state plan. Covered services include occupational therapy, physical
102.25therapy, speech-language therapy, clinical psychological services, nursing services,
102.26school psychological services, school social work services, personal care assistants
102.27serving as management aides, assistive technology devices, transportation services,
102.28health assessments, and other services covered under the medical assistance state plan.
102.29Mental health services eligible for medical assistance reimbursement must be provided or
102.30coordinated through a children's mental health collaborative where a collaborative exists if
102.31the child is included in the collaborative operational target population. The provision or
102.32coordination of services does not require that the individual education plan be developed
102.33by the collaborative.
102.34The services may be provided by a Minnesota school district that is enrolled as a
102.35medical assistance provider or its subcontractor, and only if the services meet all the
103.1requirements otherwise applicable if the service had been provided by a provider other
103.2than a school district, in the following areas: medical necessity, physician's orders,
103.3documentation, personnel qualifications, and prior authorization requirements. The
103.4nonfederal share of costs for services provided under this subdivision is the responsibility
103.5of the local school district as provided in section125A.74 . Services listed in a child's
103.6individual education plan are eligible for medical assistance reimbursement only if those
103.7services meet criteria for federal financial participation under the Medicaid program.
103.8(b) Approval of health-related services for inclusion in the individual education plan
103.9does not require prior authorization for purposes of reimbursement under this chapter.
103.10The commissioner may require physician review and approval of the plan not more than
103.11once annually or upon any modification of the individual education plan that reflects a
103.12change in health-related services.
103.13(c) Services of a speech-language pathologist provided under this section are covered
103.14notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
103.15(1) holds a masters degree in speech-language pathology;
103.16(2) is licensed by the Minnesota Board of Teaching as an educational
103.17speech-language pathologist; and
103.18(3) either has a certificate of clinical competence from the American Speech and
103.19Hearing Association, has completed the equivalent educational requirements and work
103.20experience necessary for the certificate or has completed the academic program and is
103.21acquiring supervised work experience to qualify for the certificate.
103.22(d) Medical assistance coverage for medically necessary services provided under
103.23other subdivisions in this section may not be denied solely on the basis that the same or
103.24similar services are covered under this subdivision.
103.25(e) The commissioner shall develop and implement package rates, bundled rates, or
103.26per diem rates for special education services under which separately covered services are
103.27grouped together and billed as a unit in order to reduce administrative complexity.
103.28(f) The commissioner shall develop a cost-based payment structure for payment
103.29of these services. The commissioner shall reimburse claims submitted based on an
103.30interim rate, and shall settle at a final rate once the department has determined it. The
103.31commissioner shall notify the school district of the final rate. The school district has 60
103.32days to appeal the final rate. To appeal the final rate, the school district shall file a written
103.33appeal request to the commissioner within 60 days of the date the final rate determination
103.34was mailed. The appeal request shall specify (1) the disputed items and (2) the name and
103.35address of the person to contact regarding the appeal.
104.1(g) Effective July 1, 2000, medical assistance services provided under an individual
104.2education plan or an individual family service plan by local school districts shall not count
104.3against medical assistance authorization thresholds for that child.
104.4(h) Nursing services as defined in section148.171, subdivision 15 , and provided
104.5as an individual education plan health-related service, are eligible for medical assistance
104.6payment if they are otherwise a covered service under the medical assistance program.
104.7Medical assistance covers the administration of prescription medications by a licensed
104.8nurse who is employed by or under contract with a school district when the administration
104.9of medications is identified in the child's individualized education plan. The simple
104.10administration of medications alone is not covered under medical assistance when
104.11administered by a provider other than a school district or when it is not identified in the
104.12child's individualized education plan.
104.13 Sec. 37. Minnesota Statutes 2008, section 256B.08, is amended by adding a
104.14subdivision to read:
104.15 Subd. 4. Data from Social Security. The commissioner shall accept data from the
104.16Social Security Administration in accordance with United States Code, title 42, section
104.171396U-5(a).
104.18EFFECTIVE DATE.This section is effective January 1, 2010.
104.19 Sec. 38. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read:
104.20 Subdivision 1. Policy and applicability. (a) It is the policy of this state that
104.21individuals or couples, either or both of whom participate in the medical assistance
104.22program, use their own assets to pay their share of the total cost of their care during or
104.23after their enrollment in the program according to applicable federal law and the laws of
104.24this state. The following provisions apply:
104.25 (1) subdivisions 1c to 1k shall not apply to claims arising under this section which
104.26are presented under section525.313 ;
104.27 (2) the provisions of subdivisions 1c to 1k expanding the interests included in an
104.28estate for purposes of recovery under this section give effect to the provisions of United
104.29States Code, title 42, section 1396p, governing recoveries, but do not give rise to any
104.30express or implied liens in favor of any other parties not named in these provisions;
104.31 (3) the continuation of a recipient's life estate or joint tenancy interest in real
104.32property after the recipient's death for the purpose of recovering medical assistance under
104.33this section modifies common law principles holding that these interests terminate on
104.34the death of the holder;
105.1 (4) all laws, rules, and regulations governing or involved with a recovery of medical
105.2assistance shall be liberally construed to accomplish their intended purposes;
105.3 (5) a deceased recipient's life estate and joint tenancy interests continued under this
105.4section shall be owned by the remaindermen or surviving joint tenants as their interests
105.5may appear on the date of the recipient's death. They shall not be merged into the
105.6remainder interest or the interests of the surviving joint tenants by reason of ownership.
105.7They shall be subject to the provisions of this section. Any conveyance, transfer, sale,
105.8assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs,
105.9successors, and assigns shall be deemed to include all of their interest in the deceased
105.10recipient's life estate or joint tenancy interest continued under this section; and
105.11 (6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy
105.12interests in real property after the recipient's death do not apply to a homestead owned
105.13of record, on the date the recipient dies, by the recipient and the recipient's spouse as
105.14joint tenants with a right of survivorship. Homestead means the real property occupied
105.15by the surviving joint tenant spouse as their sole residence on the date the recipient dies
105.16and classified and taxed to the recipient and surviving joint tenant spouse as homestead
105.17property for property tax purposes in the calendar year in which the recipient dies. For
105.18purposes of this exemption, real property the recipient and their surviving joint tenant
105.19spouse purchase solely with the proceeds from the sale of their prior homestead, own
105.20of record as joint tenants, and qualify as homestead property under section273.124 in
105.21the calendar year in which the recipient dies and prior to the recipient's death shall be
105.22deemed to be real property classified and taxed to the recipient and their surviving joint
105.23tenant spouse as homestead property in the calendar year in which the recipient dies.
105.24The surviving spouse, or any person with personal knowledge of the facts, may provide
105.25an affidavit describing the homestead property affected by this clause and stating facts
105.26showing compliance with this clause. The affidavit shall be prima facie evidence of the
105.27facts it states.
105.28 (b) For purposes of this section, "medical assistance" includes the medical assistance
105.29program under this chapter and the general assistance medical care program under chapter
105.30256D and alternative care for nonmedical assistance recipients under section256B.0913 .
105.31 (c) For purposes of this section, beginning January 1, 2010, "medical assistance"
105.32does not include Medicare cost-sharing benefits in accordance with United States Code,
105.33title 42, section 1396p.
105.34 (d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j,
105.35related to the continuation of a recipient's life estate or joint tenancy interests in real
105.36property after the recipient's death for the purpose of recovering medical assistance, are
106.1effective only for life estates and joint tenancy interests established on or after August 1,
106.22003. For purposes of this paragraph, medical assistance does not include alternative care.
106.3 Sec. 39. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
106.4 Subd. 1a. Estates subject to claims. (a) If a person receives any medical assistance
106.5hereunder, on the person's death, if single, or on the death of the survivor of a married
106.6couple, either or both of whom received medical assistance, or as otherwise provided
106.7for in this section, the total amount paid for medical assistance rendered for the person
106.8and spouse shall be filed as a claim against the estate of the person or the estate of the
106.9surviving spouse in the court having jurisdiction to probate the estate or to issue a decree
106.10of descent according to sections525.31 to
525.313 .
106.11(b) For the purposes of this section, the person's estate must consist of:
106.12(1) the person's probate estate;
106.13(2) all of the person's interests or proceeds of those interests in real property the
106.14person owned as a life tenant or as a joint tenant with a right of survivorship at the time of
106.15the person's death;
106.16(3) all of the person's interests or proceeds of those interests in securities the person
106.17owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time
106.18of the person's death, to the extent the interests or proceeds of those interests become part
106.19of the probate estate under section 524.6-307;
106.20(4) all of the person's interests in joint accounts, multiple-party accounts, and
106.21pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of
106.22those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the
106.23person's death to the extent the interests become part of the probate estate under section
106.24524.6-207; and
106.25(5) assets conveyed to a survivor, heir, or assign of the person through survivorship,
106.26living trust, or other arrangements.
106.27(c) For the purpose of this section and recovery in a surviving spouse's estate for
106.28medical assistance paid for a predeceased spouse, the estate must consist of all of the legal
106.29title and interests the deceased individual's predeceased spouse had in jointly owned or
106.30marital property at the time of the spouse's death, as defined in subdivision 2b, and the
106.31proceeds of those interests, that passed to the deceased individual or another individual, a
106.32survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy
106.33in common, survivorship, life estate, living trust, or other arrangement. A deceased
106.34recipient who, at death, owned the property jointly with the surviving spouse shall have
106.35an interest in the entire property.
107.1(d) For the purpose of recovery in a single person's estate or the estate of a survivor
107.2of a married couple, "other arrangement" includes any other means by which title to all or
107.3any part of the jointly owned or marital property or interest passed from the predeceased
107.4spouse to another including, but not limited to, transfers between spouses which are
107.5permitted, prohibited, or penalized for purposes of medical assistance.
107.6(e) A claim shall be filed if medical assistance was rendered for either or both
107.7persons under one of the following circumstances:
107.8(a) (1) the person was over 55 years of age, and received services under this chapter;
107.9(b) (2) the person resided in a medical institution for six months or longer, received
107.10services under this chapter, and, at the time of institutionalization or application for
107.11medical assistance, whichever is later, the person could not have reasonably been expected
107.12to be discharged and returned home, as certified in writing by the person's treating
107.13physician. For purposes of this section only, a "medical institution" means a skilled
107.14nursing facility, intermediate care facility, intermediate care facility for persons with
107.15developmental disabilities, nursing facility, or inpatient hospital; or
107.16(c) (3) the person received general assistance medical care services under chapter
107.17256D.
107.18(f) The claim shall be considered an expense of the last illness of the decedent for the
107.19purpose of section524.3-805 . Notwithstanding any law or rule to the contrary, a state or
107.20county agency with a claim under this section must be a creditor under section 524.6-307.
107.21Any statute of limitations that purports to limit any county agency or the state agency,
107.22or both, to recover for medical assistance granted hereunder shall not apply to any claim
107.23made hereunder for reimbursement for any medical assistance granted hereunder. Notice
107.24of the claim shall be given to all heirs and devisees of the decedent whose identity can be
107.25ascertained with reasonable diligence. The notice must include procedures and instructions
107.26for making an application for a hardship waiver under subdivision 5; time frames for
107.27submitting an application and determination; and information regarding appeal rights and
107.28procedures. Counties are entitled to one-half of the nonfederal share of medical assistance
107.29collections from estates that are directly attributable to county effort. Counties are entitled
107.30to ten percent of the collections for alternative care directly attributable to county effort.
107.31 Sec. 40. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
107.32 Subd. 1h. Estates of specific persons receiving medical assistance. (a) For
107.33purposes of this section, paragraphs (b) to(k) (j) apply if a person received medical
107.34assistance for which a claim may be filed under this section and died single, or the
108.1surviving spouse of the couple and was not survived by any of the persons described
108.2in subdivisions 3 and 4.
108.3(b) For purposes of this section, the person's estate consists of: (1) the person's
108.4probate estate; (2) all of the person's interests or proceeds of those interests in real property
108.5the person owned as a life tenant or as a joint tenant with a right of survivorship at the
108.6time of the person's death; (3) all of the person's interests or proceeds of those interests in
108.7securities the person owned in beneficiary form as provided under sections
524.6-301 to
108.8524.6-311 at the time of the person's death, to the extent they become part of the probate
108.9estate under section
524.6-307; (4) all of the person's interests in joint accounts, multiple
108.10party accounts, and pay on death accounts, or the proceeds of those accounts, as provided
108.11under sections
524.6-201 to
524.6-214 at the time of the person's death to the extent
108.12they become part of the probate estate under section
524.6-207; and (5) the person's
108.13legal title or interest at the time of the person's death in real property transferred under
108.14a transfer on death deed under section
507.071, or in the proceeds from the subsequent
108.15sale of the person's interest in the real property. Notwithstanding any law or rule to the
108.16contrary, a state or county agency with a claim under this section shall be a creditor under
108.17section
524.6-307.
108.18(c) (b) Notwithstanding any law or rule to the contrary, the person's life estate or joint
108.19tenancy interest in real property not subject to a medical assistance lien under sections
108.20514.980
to
514.985 on the date of the person's death shall not end upon the person's death
108.21and shall continue as provided in this subdivision. The life estate in the person's estate
108.22shall be that portion of the interest in the real property subject to the life estate that is equal
108.23to the life estate percentage factor for the life estate as listed in the Life Estate Mortality
108.24Table of the health care program's manual for a person who was the age of the medical
108.25assistance recipient on the date of the person's death. The joint tenancy interest in real
108.26property in the estate shall be equal to the fractional interest the person would have owned
108.27in the jointly held interest in the property had they and the other owners held title to the
108.28property as tenants in common on the date the person died.
108.29(d) (c) The court upon its own motion, or upon motion by the personal representative
108.30or any interested party, may enter an order directing the remaindermen or surviving joint
108.31tenants and their spouses, if any, to sign all documents, take all actions, and otherwise
108.32fully cooperate with the personal representative and the court to liquidate the decedent's
108.33life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of
108.34those interests to the personal representative and provide for any legal and equitable
108.35sanctions as the court deems appropriate to enforce and carry out the order, including an
108.36award of reasonable attorney fees.
109.1(e) (d) The personal representative may make, execute, and deliver any conveyances
109.2or other documents necessary to convey the decedent's life estate or joint tenancy interest
109.3in the estate that are necessary to liquidate and reduce to cash the decedent's interest or
109.4for any other purposes.
109.5(f) (e) Subject to administration, all costs, including reasonable attorney fees,
109.6directly and immediately related to liquidating the decedent's life estate or joint tenancy
109.7interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation
109.8allocable to the decedent's interest and the net proceeds shall be turned over to the personal
109.9representative and applied to payment of the claim presented under this section.
109.10(g) (f) The personal representative shall bring a motion in the district court in which
109.11the estate is being probated to compel the remaindermen or surviving joint tenants to
109.12account for and deliver to the personal representative all or any part of the proceeds of any
109.13sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the
109.14decedent's life estate or joint tenancy interest in the decedent's estate, and do everything
109.15necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of
109.16the sale or other disposition over to the personal representative. The court may grant any
109.17legal or equitable relief including, but not limited to, ordering a partition of real estate
109.18under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy
109.19interest available to the estate for payment of a claim under this section.
109.20(h) (g) Subject to administration, the personal representative shall use all of the cash
109.21or proceeds of interests to pay an allowable claim under this section. The remaindermen
109.22or surviving joint tenants and their spouses, if any, may enter into a written agreement
109.23with the personal representative or the claimant to settle and satisfy obligations imposed at
109.24any time before or after a claim is filed.
109.25(i) (h) The personal representative may, at their discretion, provide any or all of the
109.26other owners, remaindermen, or surviving joint tenants with an affidavit terminating the
109.27decedent's estate's interest in real property the decedent owned as a life tenant or as a joint
109.28tenant with others, if the personal representative determines in good faith that neither the
109.29decedent nor any of the decedent's predeceased spouses received any medical assistance
109.30for which a claim could be filed under this section, or if the personal representative has
109.31filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as
109.32presented, or if there is a written agreement under paragraph(h) (g), or if the claim, as
109.33allowed, has been paid in full or to the full extent of the assets the estate has available
109.34to pay it. The affidavit may be recorded in the office of the county recorder or filed in
109.35the Office of the Registrar of Titles for the county in which the real property is located.
109.36Except as provided in section514.981, subdivision 6 , when recorded or filed, the affidavit
110.1shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a
110.2joint tenant with others. The affidavit shall:
110.3(1) be signed by the personal representative;
110.4(2) identify the decedent and the interest being terminated;
110.5(3) give recording information sufficient to identify the instrument that created the
110.6interest in real property being terminated;
110.7(4) legally describe the affected real property;
110.8(5) state that the personal representative has determined that neither the decedent
110.9nor any of the decedent's predeceased spouses received any medical assistance for which
110.10a claim could be filed under this section;
110.11(6) state that the decedent's estate has other assets sufficient to pay the claim, as
110.12presented, or that there is a written agreement between the personal representative and
110.13the claimant and the other owners or remaindermen or other joint tenants to satisfy the
110.14obligations imposed under this subdivision; and
110.15(7) state that the affidavit is being given to terminate the estate's interest under this
110.16subdivision, and any other contents as may be appropriate.
110.17The recorder or registrar of titles shall accept the affidavit for recording or filing. The
110.18affidavit shall be effective as provided in this section and shall constitute notice even if it
110.19does not include recording information sufficient to identify the instrument creating the
110.20interest it terminates. The affidavit shall be conclusive evidence of the stated facts.
110.21(j) (i) The holder of a lien arising under subdivision 1c shall release the lien at
110.22the holder's expense against an interest terminated under paragraph(h) (g) to the extent
110.23of the termination.
110.24(k) (j) If a lien arising under subdivision 1c is not released under paragraph (j) (i),
110.25prior to closing the estate, the personal representative shall deed the interest subject to the
110.26lien to the remaindermen or surviving joint tenants as their interests may appear. Upon
110.27recording or filing, the deed shall work a merger of the recipient's life estate or joint
110.28tenancy interest, subject to the lien, into the remainder interest or interest the decedent and
110.29others owned jointly. The lien shall attach to and run with the property to the extent of
110.30the decedent's interest at the time of the decedent's death.
110.31 Sec. 41. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:
110.32 Subd. 2. Limitations on claims. The claim shall include only the total amount
110.33of medical assistance rendered after age 55 or during a period of institutionalization
110.34described in subdivision 1a,clause (b) paragraph (e), and the total amount of general
110.35assistance medical care rendered, and shall not include interest. Claims that have been
111.1allowed but not paid shall bear interest according to section524.3-806, paragraph (d) . A
111.2claim against the estate of a surviving spouse who did not receive medical assistance, for
111.3medical assistance rendered for the predeceased spouse, shall be payable from the full
111.4value of all of the predeceased spouse's assets and interests which are part of the surviving
111.5spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in
111.6the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate
111.7that were marital property or jointly owned property at any time during the marriage. The
111.8claim is not payable from the value of assets or proceeds of assets in the estate attributable
111.9to a predeceased spouse whom the individual married after the death of the predeceased
111.10recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the
111.11estate which the nonrecipient decedent spouse acquired with assets which were not marital
111.12property or jointly owned property after the death of the predeceased recipient spouse.
111.13Claims for alternative care shall be net of all premiums paid under section256B.0913,
111.14subdivision 12 , on or after July 1, 2003, and shall be limited to services provided on or
111.15after July 1, 2003. Claims against marital property shall be limited to claims against
111.16recipients who died on or after July 1, 2009.
111.17 Sec. 42. Minnesota Statutes 2008, section 256B.15, is amended by adding a
111.18subdivision to read:
111.19 Subd. 2b. Controlling provisions. (a) For purposes of this subdivision and
111.20subdivisions 1a and 2, paragraphs (b) to (d) apply.
111.21(b) At the time of death of a recipient spouse and solely for purpose of recovery of
111.22medical assistance benefits received, a predeceased recipient spouse shall have a legal
111.23title or interest in the undivided whole of all of the property which the recipient and the
111.24recipient's surviving spouse owned jointly or which was marital property at any time
111.25during their marriage regardless of the form of ownership and regardless of whether
111.26it was owned or titled in the names of one or both the recipient and the recipient's
111.27spouse. Title and interest in the property of a predeceased recipient spouse shall not end
111.28or extinguish upon the person's death and shall continue for the purpose of allowing
111.29recovery of medical assistance in the estate of the surviving spouse. Upon the death of
111.30the predeceased recipient spouse, title and interest in the predeceased spouse's property
111.31shall vest in the surviving spouse by operation of law and without the necessity for any
111.32probate or decree of descent proceedings and shall continue to exist after the death of the
111.33predeceased spouse and the surviving spouse to permit recovery of medical assistance.
111.34The recipient spouse and the surviving spouse of a deceased recipient spouse shall not
112.1encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of
112.2these interests before or upon death.
112.3(c) For purposes of this section, "marital property" includes any and all real or
112.4personal property of any kind or interests in such property the predeceased recipient
112.5spouse and their spouse, or either of them, owned at the time of their marriage to each
112.6other or acquired during their marriage regardless of whether it was owned or titled in
112.7the names of one or both of them. If either or both spouses of a married couple received
112.8medical assistance, all property owned during the marriage or which either or both spouses
112.9acquired during their marriage shall be presumed to be marital property for purposes of
112.10recovering medical assistance unless there is clear and convincing evidence to the contrary.
112.11(d) The agency responsible for the claim for medical assistance for a recipient spouse
112.12may, at its discretion, release specific real and personal property from the provisions of
112.13this section. The release shall extinguish the interest created under paragraph (b) in the
112.14land it describes upon filing or recording. The release need not be attested, certified, or
112.15acknowledged as a condition of filing or recording and shall be filed or recorded in the
112.16office of the county recorder or registrar of titles, as appropriate, in the county where the
112.17real property is located. The party to whom the release is given shall be responsible for
112.18paying all fees and costs necessary to record and file the release. If the property described
112.19in the release is registered property, the registrar of titles shall accept it for recording and
112.20shall record it on the certificate of title for each parcel of property described in the release.
112.21If the property described in the release is abstract property, the recorder shall accept it
112.22for filing and file it in the county's grantor-grantee indexes and any tract index the county
112.23maintains for each parcel of property described in the release.
112.24 Sec. 43. Minnesota Statutes 2008, section 256B.15, is amended by adding a
112.25subdivision to read:
112.26 Subd. 9. Commissioner's intervention. The commissioner shall be permitted to
112.27intervene as a party in any proceeding involving recovery of medical assistance upon
112.28filing a notice of intervention and serving such notice on the other parties.
112.29 Sec. 44. [256B.196] INTERGOVERNMENTAL TRANSFERS; HOSPITAL
112.30PAYMENTS.
112.31 Subdivision 1. Federal approval required. This section is contingent on federal
112.32approval of the intergovernmental transfers and payments authorized under this section.
112.33This section is also contingent on current payment by the government entities of the
112.34intergovernmental transfers under this section.
113.1 Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
113.2subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
113.3services upper payment limit for nonstate government hospitals. The commissioner shall
113.4then determine the amount of a supplemental payment to Hennepin County Medical
113.5Center and Regions Hospital for these services that would increase medical assistance
113.6spending in this category to the aggregate upper payment limit for all nonstate government
113.7hospitals in Minnesota. In making this determination, the commissioner shall allot the
113.8available increases between Hennepin County Medical Center and Regions Hospital
113.9based on the ratio of medical assistance fee-for-service outpatient hospital payments to
113.10the two facilities. The commissioner shall adjust this allotment as necessary based on
113.11federal approvals, the amount of intergovernmental transfers received from Hennepin and
113.12Ramsey Counties, and other factors, in order to maximize the additional total payments.
113.13The commissioner shall inform Hennepin County and Ramsey County of the periodic
113.14intergovernmental transfers necessary to match federal Medicaid payments available
113.15under this subdivision in order to make supplementary medical assistance payments to
113.16Hennepin County Medical Center and Regions Hospital equal to an amount that when
113.17combined with existing medical assistance payments to nonstate governmental hospitals
113.18would increase total payments to hospitals in this category for outpatient services to
113.19the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
113.20receipt of these periodic transfers, the commissioner shall make supplementary payments
113.21to Hennepin County Medical Center and Regions Hospital.
113.22(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
113.23determine an upper payment limit for physicians affiliated with Hennepin County Medical
113.24Center and with Regions Hospital. The upper payment limit shall be based on the average
113.25commercial rate or be determined using another method acceptable to the Centers for
113.26Medicare and Medicaid Services. The commissioner shall inform Hennepin County and
113.27Ramsey County of the periodic intergovernmental transfers necessary to match the federal
113.28Medicaid payments available under this subdivision in order to make supplementary
113.29payments to physicians affiliated with Hennepin County Medical Center and Regions
113.30Hospital equal to the difference between the established medical assistance payment for
113.31physician services and the upper payment limit. Upon receipt of these periodic transfers,
113.32the commissioner shall make supplementary payments to physicians of Hennepin Faculty
113.33Associates and HealthPartners.
113.34(c) Beginning January 1, 2010, Hennepin County and Ramsey County shall make
113.35monthly intergovernmental transfers to the commissioner in the following amounts:
113.36$133,333 by Hennepin County and $100,000 by Ramsey County. The commissioner shall
114.1increase the medical assistance capitation payments to Metropolitan Health Plan and
114.2HealthPartners by an amount equal to the annual value of the monthly transfers plus
114.3federal financial participation.
114.4(d) The commissioner shall inform Hennepin County and Ramsey County on an
114.5ongoing basis of the need for any changes needed in the intergovernmental transfers
114.6in order to continue the payments under paragraphs (a) to (c), at their maximum level,
114.7including increases in upper payment limits, changes in the federal Medicaid match, and
114.8other factors.
114.9(e) The payments in paragraphs (a) to (c) shall be implemented independently of
114.10each other, subject to federal approval and to the receipt of transfers under subdivision 3.
114.11 Subd. 3. Intergovernmental transfers. Based on the determination by the
114.12commissioner under subdivision 2, Hennepin County and Ramsey County shall make
114.13periodic intergovernmental transfers to the commissioner for the purposes of subdivision
114.142, paragraphs (a) to (c). All of the intergovernmental transfers made by Hennepin County
114.15shall be used to match federal payments to Hennepin County Medical Center under
114.16subdivision 2, paragraph (a); to physicians affiliated with Hennepin Faculty Associates
114.17under subdivision 2, paragraph (b); and to Metropolitan Health Plan under subdivision
114.182, paragraph (c). All of the intergovernmental transfers made by Ramsey County shall
114.19be used to match federal payments to Regions Hospital under subdivision 2, paragraph
114.20(a); to physicians affiliated with HealthPartners under subdivision 2, paragraph (b); and to
114.21HealthPartners under subdivision 2, paragraph (c).
114.22 Subd. 4. Adjustments permitted. (a) The commissioner may adjust the
114.23intergovernmental transfers under subdivision 3 and the payments under subdivision
114.242, based on the commissioner's determination of Medicare upper payment limits,
114.25hospital-specific charge limits, hospital-specific limitations on disproportionate share
114.26payments, medical inflation, actuarial certification, and cost-effectiveness for purposes
114.27of federal waivers. Any adjustments must be made on a proportional basis. The
114.28commissioner may make adjustments under this subdivision only after consultation
114.29with the affected counties and hospitals. All payments under subdivision 2 and all
114.30intergovernmental transfers under subdivision 3 are limited to amounts available after all
114.31other base rates, adjustments, and supplemental payments in chapter 256B are calculated.
114.32(b) The ratio of medical assistance payments specified in subdivision 2 to the
114.33voluntary intergovernmental transfers specified in subdivision 3 shall not be reduced
114.34except as provided under paragraph (a).
115.1 Subd. 5. Recession period. Each type of intergovernmental transfer in subdivision
115.22, paragraphs (a) to (d), for payment periods from October 1, 2008, through December
115.331, 2010, is voluntary on the part of Hennepin and Ramsey Counties, meaning that the
115.4transfer must be agreed to, in writing, by the counties prior to any payments being issued.
115.5One agreement on each type of transfer shall cover the entire recession period.
115.6 Sec. 45. Minnesota Statutes 2008, section 256B.199, is amended to read:
115.7256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
115.8 (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
115.9for the expenditures in paragraphs (b) and (c).
115.10 (b) The commissioner shall apply for federal matching funds for certified public
115.11expenditures as follows:
115.12 (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions
115.13Hospital, the University of Minnesota, and Fairview-University Medical Center shall
115.14report quarterly to the commissioner beginning June 1, 2007, payments made during the
115.15second previous quarter that may qualify for reimbursement under federal law;
115.16 (2) based on these reports, the commissioner shall apply for federal matching
115.17funds. These funds are appropriated to the commissioner for the payments under section
115.18256.969, subdivision 27
; and
115.19 (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
115.20the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
115.21hospital payment money expected to be available in the current federal fiscal year.
115.22 (c) The commissioner shall apply for federal matching funds for general assistance
115.23medical care expenditures as follows:
115.24 (1) for hospital services occurring on or after July 1, 2007, general assistance medical
115.25care expenditures for fee-for-service inpatient and outpatient hospital payments made by
115.26the department shall be used to apply for federal matching funds, except as limited below:
115.27 (i) only those general assistance medical care expenditures made to an individual
115.28hospital that would not cause the hospital to exceed its individual hospital limits under
115.29section 1923 of the Social Security Act may be considered; and
115.30 (ii) general assistance medical care expenditures may be considered only to the extent
115.31of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
115.32 (2) all hospitals must provide any necessary expenditure, cost, and revenue
115.33information required by the commissioner as necessary for purposes of obtaining federal
115.34Medicaid matching funds for general assistance medical care expenditures.
116.1(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall
116.2apply for additional federal matching funds available as disproportionate share hospital
116.3payments under the American Recovery and Reinvestment Act of 2009. These funds shall
116.4be made available as the state share of payments under section 256.969, subdivision 28.
116.5The entities required to report certified public expenditures under paragraph (b), clause
116.6(1), shall report additional certified public expenditures as necessary under this paragraph.
116.7EFFECTIVE DATE.This section is effective the day following final enactment.
116.8 Sec. 46. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
116.9 Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
116.10and sections256L.12 and
256D.03 , shall be entered into or renewed on a calendar year
116.11basis beginning January 1, 1996. Managed care contracts which were in effect on June
116.1230, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
116.13through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
116.14commissioner may issue separate contracts with requirements specific to services to
116.15medical assistance recipients age 65 and older.
116.16 (b) A prepaid health plan providing covered health services for eligible persons
116.17pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
116.18of its contract with the commissioner. Requirements applicable to managed care programs
116.19under chapters 256B, 256D, and 256L, established after the effective date of a contract
116.20with the commissioner take effect when the contract is next issued or renewed.
116.21 (c) Effective for services rendered on or after January 1, 2003, the commissioner shall
116.22withhold five percent of managed care plan payments under this section and county-based
116.23purchasing plan's payment rate under section 256B.692 for the prepaid medical assistance
116.24and general assistance medical care programs pending completion of performance targets.
116.25Each performance target must be quantifiable, objective, measurable, and reasonably
116.26attainable, except in the case of a performance target based on a federal or state law or rule.
116.27Criteria for assessment of each performance target must be outlined in writing prior to the
116.28contract effective date. The managed care plan must demonstrate, to the commissioner's
116.29satisfaction, that the data submitted regarding attainment of the performance target is
116.30accurate. The commissioner shall periodically change the administrative measures used
116.31as performance targets in order to improve plan performance across a broader range of
116.32administrative services. The performance targets must include measurement of plan
116.33efforts to contain spending on health care services and administrative activities. The
116.34commissioner may adopt plan-specific performance targets that take into account factors
116.35affecting only one plan, including characteristics of the plan's enrollee population. The
117.1withheld funds must be returned no sooner than July of the following year if performance
117.2targets in the contract are achieved. The commissioner may exclude special demonstration
117.3projects under subdivision 23.A managed care plan or a county-based purchasing plan
117.4under section
256B.692 may include as admitted assets under section
62D.044 any amount
117.5withheld under this paragraph that is reasonably expected to be returned.
117.6 (d)(1) Effective for services rendered on or after January 1, 2009, through December
117.731, 2009, the commissioner shall withhold three percent of managed care plan payments
117.8under this section and county-based purchasing plan payments under section 256B.692 for
117.9the prepaid medical assistance and general assistance medical care programs. The withheld
117.10funds must be returned no sooner than July 1 and no later than July 31 of the following
117.11year. The commissioner may exclude special demonstration projects under subdivision 23.
117.12(2) A managed care plan or a county-based purchasing plan under section
256B.692
117.13may include as admitted assets under section
62D.044 any amount withheld under
117.14this paragraph. The return of the withhold under this paragraph is not subject to the
117.15requirements of paragraph (c).
117.16(e) Effective for services rendered on or after January 1, 2010, through December
117.1731, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments
117.18under this section and county-based purchasing plan payments under section 256B.692
117.19for the prepaid medical assistance program. The withheld funds must be returned no
117.20sooner than July 1 and no later than July 31 of the following year. The commissioner may
117.21exclude special demonstration projects under subdivision 23.
117.22(f) Effective for services rendered on or after January 1, 2011, through December 31,
117.232011, the commissioner shall withhold four percent of managed care plan payments under
117.24this section and county-based purchasing plan payments under section 256B.692 for the
117.25prepaid medical assistance program. The withheld funds must be returned no sooner than
117.26July 1 and no later than July 31 of the following year. The commissioner may exclude
117.27special demonstration projects under subdivision 23.
117.28(g) Effective for services rendered on or after January 1, 2012, through December
117.2931, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
117.30under this section and county-based purchasing plan payments under section 256B.692
117.31for the prepaid medical assistance program. The withheld funds must be returned no
117.32sooner than July 1 and no later than July 31 of the following year. The commissioner may
117.33exclude special demonstration projects under subdivision 23.
117.34(h) Effective for services rendered on or after January 1, 2013, through December
117.3531, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
117.36under this section and county-based purchasing plan payments under section 256B.692
118.1for the prepaid medical assistance program. The withheld funds must be returned no
118.2sooner than July 1 and no later than July 31 of the following year. The commissioner may
118.3exclude special demonstration projects under subdivision 23.
118.4(i) Effective for services rendered on or after January 1, 2014, the commissioner
118.5shall withhold three percent of managed care plan payments under this section and
118.6county-based purchasing plan payments under section 256B.692 for the prepaid medical
118.7assistance and prepaid general assistance medical care programs. The withheld funds must
118.8be returned no sooner than July 1 and no later than July 31 of the following year. The
118.9commissioner may exclude special demonstration projects under subdivision 23.
118.10(j) A managed care plan or a county-based purchasing plan under section 256B.692
118.11may include as admitted assets under section 62D.044 any amount withheld under this
118.12section that is reasonably expected to be returned.
118.13 Sec. 47. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:
118.14 Subd. 5c. Medical education and research fund. (a) Except as provided in
118.15paragraph (c), the commissioner of human services shall transfer each year to the medical
118.16education and research fund established under section62J.692 , the following:
118.17(1) an amount equal to the reduction in the prepaid medical assistance and prepaid
118.18general assistance medical care payments as specified in this clause. Until January 1,
118.192002, the county medical assistance and general assistance medical care capitation base
118.20rate prior to plan specific adjustments and after the regional rate adjustments under section
118.21256B.69, subdivision 5b
, is reduced 6.3 percent for Hennepin County, two percent for
118.22the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota
118.23counties; and after January 1, 2002, the county medical assistance and general assistance
118.24medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent
118.25for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent
118.26for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments
118.27and demonstration project payments operating under subdivision 23 are excluded from
118.28this reduction. The amount calculated under this clause shall not be adjusted for periods
118.29already paid due to subsequent changes to the capitation payments;
118.30(2) beginning July 1, 2003,$2,157,000 $4,314,000 from the capitation rates paid
118.31under this sectionplus any federal matching funds on this amount;
118.32(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
118.33paid under this section; and
118.34(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
118.35under this section.
119.1(b) This subdivision shall be effective upon approval of a federal waiver which
119.2allows federal financial participation in the medical education and research fund. Effective
119.3July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4),
119.4shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first
119.5reduce the amounts otherwise required to be transferred under paragraph (a), clauses
119.6(2) to (4). Any excess following this reduction shall proportionally reduce the transfers
119.7under paragraph (a), clause (1).
119.8(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance
119.9medical care payments under paragraph (a), clause (1), shall be transferred to the general
119.10fund.
119.11(d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall
119.12transfer $21,714,000 each fiscal year to the medical education and research fund. The
119.13balance of the transfers under paragraph (a) shall be transferred to the medical education
119.14and research fund no earlier than July 1 of the following fiscal year.
119.15 Sec. 48. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
119.16 Subd. 5f. Capitation rates. (a) Beginning July 1, 2002, the capitation rates paid
119.17under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the
119.18capitation rates paid under this section are increased by $4,700,000 per year.
119.19(b) Beginning July 1, 2009, the capitation rates paid under this section are increased
119.20each year by the lesser of $21,714,000 or an amount equal to the difference between the
119.21estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1),
119.22and the amount of the limit described in subdivision 5c, paragraph (b).
119.23 Sec. 49. Minnesota Statutes 2008, section 256B.69, subdivision 23, is amended to read:
119.24 Subd. 23. Alternative services; elderly and disabled persons. (a) The
119.25commissioner may implement demonstration projects to create alternative integrated
119.26delivery systems for acute and long-term care services to elderly persons and persons
119.27with disabilities as defined in section256B.77, subdivision 7a , that provide increased
119.28coordination, improve access to quality services, and mitigate future cost increases.
119.29The commissioner may seek federal authority to combine Medicare and Medicaid
119.30capitation payments for the purpose of such demonstrations and may contract with
119.31Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
119.32services shall be administered according to the terms and conditions of the federal contract
119.33and demonstration provisions. For the purpose of administering medical assistance funds,
119.34demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
120.1of Minnesota Rules, parts9500.1450 to
9500.1464 , apply to these demonstrations,
120.2with the exceptions of parts9500.1452 , subpart 2, item B; and
9500.1457 , subpart 1,
120.3items B and C, which do not apply to persons enrolling in demonstrations under this
120.4section. An initial open enrollment period may be provided. Persons who disenroll from
120.5demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
120.6to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
120.7the health plan's participation is subsequently terminated for any reason, the person shall
120.8be provided an opportunity to select a new health plan and shall have the right to change
120.9health plans within the first 60 days of enrollment in the second health plan. Persons
120.10required to participate in health plans under this section who fail to make a choice of
120.11health plan shall not be randomly assigned to health plans under these demonstrations.
120.12Notwithstanding section256L.12, subdivision 5 , and Minnesota Rules, part
9505.5220 ,
120.13subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
120.14the commissioner may contract with managed care organizations, including counties, to
120.15serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
120.16disabled persons only. For persons with a primary diagnosis of developmental disability,
120.17serious and persistent mental illness, or serious emotional disturbance, the commissioner
120.18must ensure that the county authority has approved the demonstration and contracting
120.19design. Enrollment in these projects for persons with disabilities shall be voluntary. The
120.20commissioner shall not implement any demonstration project under this subdivision for
120.21persons with a primary diagnosis of developmental disabilities, serious and persistent
120.22mental illness, or serious emotional disturbance, without approval of the county board of
120.23the county in which the demonstration is being implemented.
120.24 (b) Notwithstanding chapter 245B, sections252.40 to
252.46 ,
256B.092 ,
256B.501
120.25to256B.5015 , and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
120.269525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
120.27under this section projects for persons with developmental disabilities. The commissioner
120.28may capitate payments for ICF/MR services, waivered services for developmental
120.29disabilities, including case management services, day training and habilitation and
120.30alternative active treatment services, and other services as approved by the state and by the
120.31federal government. Case management and active treatment must be individualized and
120.32developed in accordance with a person-centered plan. Costs under these projects may not
120.33exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
120.34and until four years after the pilot project implementation date, subcontractor participation
120.35in the long-term care developmental disability pilot is limited to a nonprofit long-term
120.36care system providing ICF/MR services, home and community-based waiver services,
121.1and in-home services to no more than 120 consumers with developmental disabilities in
121.2Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
121.3prior to expansion of the developmental disability pilot project. This paragraph expires
121.4four years after the implementation date of the pilot project.
121.5 (c) Before implementation of a demonstration project for disabled persons, the
121.6commissioner must provide information to appropriate committees of the house of
121.7representatives and senate and must involve representatives of affected disability groups
121.8in the design of the demonstration projects.
121.9 (d) A nursing facility reimbursed under the alternative reimbursement methodology
121.10in section256B.434 may, in collaboration with a hospital, clinic, or other health care entity
121.11provide services under paragraph (a). The commissioner shall amend the state plan and
121.12seek any federal waivers necessary to implement this paragraph.
121.13 (e) The commissioner, in consultation with the commissioners of commerce and
121.14health, may approve and implement programs for all-inclusive care for the elderly (PACE)
121.15according to federal laws and regulations governing that program and state laws or rules
121.16applicable to participating providers. The process for approval of these programs shall
121.17begin only after the commissioner receives grant money in an amount sufficient to cover
121.18the state share of the administrative and actuarial costs to implement the programs during
121.19state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
121.20account in the special revenue fund and are appropriated to the commissioner to be used
121.21solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
121.22not required to be licensed or certified as a health plan company as defined in section
121.2362Q.01, subdivision 4
. Persons age 55 and older who have been screened by the county
121.24and found to be eligible for services under the elderly waiver or community alternatives
121.25for disabled individuals or who are already eligible for Medicaid but meet level of
121.26care criteria for receipt of waiver services may choose to enroll in the PACE program.
121.27Medicare and Medicaid services will be provided according to this subdivision and
121.28federal Medicare and Medicaid requirements governing PACE providers and programs.
121.29PACE enrollees will receive Medicaid home and community-based services through the
121.30PACE provider as an alternative to services for which they would otherwise be eligible
121.31through home and community-based waiver programs and Medicaid State Plan Services.
121.32The commissioner shall establish Medicaid rates for PACE providers that do not exceed
121.33costs that would have been incurred under fee-for-service or other relevant managed care
121.34programs operated by the state.
121.35 (f) The commissioner shall seek federal approval to expand the Minnesota disability
121.36health options (MnDHO) program established under this subdivision in stages, first to
122.1regional population centers outside the seven-county metro area and then to all areas of
122.2the state. Until July 1, 2009, expansion for MnDHO projects that include home and
122.3community-based services is limited to the two projects and service areas in effect on
122.4March 1, 2006. Enrollment in integrated MnDHO programs that include home and
122.5community-based services shall remain voluntary. Costs for home and community-based
122.6services included under MnDHO must not exceed costs that would have been incurred
122.7under the fee-for-service program. Notwithstanding whether expansion occurs under
122.8this paragraph, in determining MnDHO payment rates and risk adjustment methods for
122.9contract years starting in 2012, the commissioner must consider the methods used to
122.10determine county allocations for home and community-based program participants. If
122.11necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
122.12for home and community-based services, the commissioner shall achieve the reduction by
122.13maintaining the base rate for contract years 2010 and 2011 for services provided under the
122.14community alternatives for disabled individuals waiver at the same level as for contract
122.15year 2009. The commissioner may apply other reductions to MnDHO rates to implement
122.16decreases in provider payment rates required by state law. In developing program
122.17specifications for expansion of integrated programs, the commissioner shall involve and
122.18consult the state-level stakeholder group established in subdivision 28, paragraph (d),
122.19including consultation on whether and how to include home and community-based waiver
122.20programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
122.21of the house of representatives and senate committees with jurisdiction over health and
122.22human services policy and finance by February 1, 2007.
122.23 (g) Notwithstanding section256B.0261 , health plans providing services under this
122.24section are responsible for home care targeted case management and relocation targeted
122.25case management. Services must be provided according to the terms of the waivers and
122.26contracts approved by the federal government.
122.27 Sec. 50. [256B.756] REIMBURSEMENT RATES FOR BIRTHS.
122.28 Subdivision 1. Facility rate. (a) Notwithstanding section 256.969, effective for
122.29services provided on or after October 1, 2009, the facility payment rate for the following
122.30diagnosis-related groups, as they fall within the diagnostic categories: (1) 371 cesarean
122.31section without complicating diagnosis; (2) 372 vaginal delivery with complicating
122.32diagnosis; and (3) 373 vaginal delivery without complicating diagnosis, shall be calculated
122.33as provided in paragraph (b).
122.34(b) The commissioner shall calculate a single rate for all of the diagnostic related
122.35groups specified in paragraph (a) consistent with an increase in the proportion of births
123.1by vaginal delivery and a reduction in the percentage of births by cesarean section. The
123.2calculated single rate must be based on an expected increase in the number of vaginal
123.3births and expected reduction in the number of cesarean section such that the reduction
123.4in cesarean sections is less than or equal to one standard deviation below the average in
123.5the frequency of cesarean births for Minnesota health care program clients at hospitals
123.6performing greater than 50 deliveries per year.
123.7(c) The rates described in this subdivision do not include newborn care.
123.8 Subd. 2. Provider rate. Notwithstanding section 256B.76, effective for services
123.9provided on or after October 1, 2009, the payment rate for professional services related
123.10to labor, delivery, and antepartum and postpartum care when provided for any of the
123.11diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using
123.12the methodology specified in subdivision 1, paragraph (b).
123.13 Subd. 3. Health plans. Payments to managed care and county-based purchasing
123.14plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services
123.15provided on or after October 1, 2009, to reflect the adjustments in subdivisions 1 and 2.
123.16 Subd. 4. Prior authorization. Prior authorization shall not be required before
123.17reimbursement is paid for a cesarean section delivery.
123.18 Sec. 51. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read:
123.19 Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
123.20or after October 1, 1992, the commissioner shall make payments for physician services
123.21as follows:
123.22 (1) payment for level one Centers for Medicare and Medicaid Services' common
123.23procedural coding system codes titled "office and other outpatient services," "preventive
123.24medicine new and established patient," "delivery, antepartum, and postpartum care,"
123.25"critical care," cesarean delivery and pharmacologic management provided to psychiatric
123.26patients, and level three codes for enhanced services for prenatal high risk, shall be paid
123.27at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
123.2830, 1992. If the rate on any procedure code within these categories is different than the
123.29rate that would have been paid under the methodology in section256B.74, subdivision 2 ,
123.30then the larger rate shall be paid;
123.31 (2) payments for all other services shall be paid at the lower of (i) submitted charges,
123.32or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
123.33 (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
123.34percentile of 1989, less the percent in aggregate necessary to equal the above increases
124.1except that payment rates for home health agency services shall be the rates in effect
124.2on September 30, 1992.
124.3 (b) Effective for services rendered on or after January 1, 2000, payment rates for
124.4physician and professional services shall be increased by three percent over the rates
124.5in effect on December 31, 1999, except for home health agency and family planning
124.6agency services. The increases in this paragraph shall be implemented January 1, 2000,
124.7for managed care.
124.8(c) Effective for services rendered on or after July 1, 2009, payment rates for
124.9physician and professional services shall be reduced by five percent over the rates in effect
124.10on June 30, 2009. This reduction does not apply to office or other outpatient services
124.11(procedure codes 99201 to 99215), preventive medicine services (procedure codes 99381
124.12to 99412) and family planning services billed by the following primary care specialties:
124.13general practice, internal medicine, pediatrics, geriatrics, family practice, or by an
124.14advanced practice registered nurse or physician assistant practicing in pediatrics, geriatrics,
124.15or family practice. This reduction does not apply to federally qualified health centers,
124.16rural health centers, and Indian health services. Effective October 1, 2009, payments
124.17made to managed care plans and county-based purchasing plans under sections 256B.69,
124.18256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
124.19 Sec. 52. [256B.766] REIMBURSEMENT FOR BASIC CARE SERVICES.
124.20(a) Effective for services provided on or after July 1, 2009, total payments for basic
124.21care services, shall be reduced by three percent, prior to third-party liability and spenddown
124.22calculation. Payments made to managed care plans and county-based purchasing plans
124.23shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.
124.24(b) This section does not apply to physician and professional services, inpatient
124.25hospital services, family planning services, mental health services, dental services,
124.26prescription drugs, and medical transportation.
124.27 Sec. 53. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:
124.28 Subd. 4. General assistance medical care; services. (a)(i) For a person who is
124.29eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
124.30care covers, except as provided in paragraph (c):
124.31 (1) inpatient hospital services;
124.32 (2) outpatient hospital services;
124.33 (3) services provided by Medicare certified rehabilitation agencies;
125.1 (4) prescription drugs and other products recommended through the process
125.2established in section256B.0625, subdivision 13 ;
125.3 (5) equipment necessary to administer insulin and diagnostic supplies and equipment
125.4for diabetics to monitor blood sugar level;
125.5 (6) eyeglasses and eye examinations provided by a physician or optometrist;
125.6 (7) hearing aids;
125.7 (8) prosthetic devices;
125.8 (9) laboratory and X-ray services;
125.9 (10) physician's services;
125.10 (11) medical transportation except special transportation;
125.11 (12) chiropractic services as covered under the medical assistance program;
125.12 (13) podiatric services;
125.13 (14) dental services as covered under the medical assistance program;
125.14 (15) mental health services covered under chapter 256B;
125.15 (16) prescribed medications for persons who have been diagnosed as mentally ill as
125.16necessary to prevent more restrictive institutionalization;
125.17 (17) medical supplies and equipment, and Medicare premiums, coinsurance and
125.18deductible payments;
125.19 (18) medical equipment not specifically listed in this paragraph when the use of
125.20the equipment will prevent the need for costlier services that are reimbursable under
125.21this subdivision;
125.22 (19) services performed by a certified pediatric nurse practitioner, a certified family
125.23nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
125.24nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
125.25practitioner in independent practice, if (1) the service is otherwise covered under this
125.26chapter as a physician service, (2) the service provided on an inpatient basis is not included
125.27as part of the cost for inpatient services included in the operating payment rate, and (3) the
125.28service is within the scope of practice of the nurse practitioner's license as a registered
125.29nurse, as defined in section148.171 ;
125.30 (20) services of a certified public health nurse or a registered nurse practicing in
125.31a public health nursing clinic that is a department of, or that operates under the direct
125.32authority of, a unit of government, if the service is within the scope of practice of the
125.33public health nurse's license as a registered nurse, as defined in section148.171 ;
125.34 (21) telemedicine consultations, to the extent they are covered under section
125.35256B.0625, subdivision 3b
;
126.1 (22) care coordination and patient education services provided by a community
126.2health worker according to section256B.0625, subdivision 49 ; and
126.3 (23) regardless of the number of employees that an enrolled health care provider
126.4may have, sign language interpreter services when provided by an enrolled health care
126.5provider during the course of providing a direct, person-to-person covered health care
126.6service to an enrolled recipient who has a hearing loss and uses interpreting services.
126.7 (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
126.8paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
126.9to inpatient hospital services, including physician services provided during the inpatient
126.10hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
126.11 (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
126.12subdivision.
126.13 (c) In order to contain costs, the commissioner of human services shall select
126.14vendors of medical care who can provide the most economical care consistent with high
126.15medical standards and shall where possible contract with organizations on a prepaid
126.16capitation basis to provide these services. The commissioner shall consider proposals by
126.17counties and vendors for prepaid health plans, competitive bidding programs, block grants,
126.18or other vendor payment mechanisms designed to provide services in an economical
126.19manner or to control utilization, with safeguards to ensure that necessary services are
126.20provided. Before implementing prepaid programs in counties with a county operated or
126.21affiliated public teaching hospital or a hospital or clinic operated by the University of
126.22Minnesota, the commissioner shall consider the risks the prepaid program creates for the
126.23hospital and allow the county or hospital the opportunity to participate in the program in a
126.24manner that reflects the risk of adverse selection and the nature of the patients served by
126.25the hospital, provided the terms of participation in the program are competitive with the
126.26terms of other participants considering the nature of the population served. Payment for
126.27services provided pursuant to this subdivision shall be as provided to medical assistance
126.28vendors of these services under sections256B.02, subdivision 8 , and
256B.0625 . For
126.29payments made during fiscal year 1990 and later years, the commissioner shall consult
126.30with an independent actuary in establishing prepayment rates, but shall retain final control
126.31over the rate methodology.
126.32 (d) Effective January 1, 2008, drug coverage under general assistance medical
126.33care is limited to prescription drugs that:
126.34 (i) are covered under the medical assistance program as described in section
126.35256B.0625, subdivisions 13
and 13d; and
127.1 (ii) are provided by manufacturers that have fully executed general assistance
127.2medical care rebate agreements with the commissioner and comply with the agreements.
127.3Prescription drug coverage under general assistance medical care must conform to
127.4coverage under the medical assistance program according to section256B.0625 ,
127.5subdivisions 13 to 13g.
127.6 (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
127.7co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
127.8 (1) $25 for eyeglasses;
127.9 (2) $25 for nonemergency visits to a hospital-based emergency room;
127.10 (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
127.11subject to a $12 per month maximum for prescription drug co-payments. No co-payments
127.12shall apply to antipsychotic drugs when used for the treatment of mental illness; and
127.13 (4) 50 percent coinsurance on restorative dental services.
127.14 (f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
127.15co-payments for services provided on or after January 1, 2009:
127.16 (1) $25 for nonemergency visits to a hospital-based emergency room; and
127.17 (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
127.18subject to a $7 per month maximum for prescription drug co-payments. No co-payments
127.19shall apply to antipsychotic drugs when used for the treatment of mental illness.
127.20 (g) MS 2007 Supp [Expired]
127.21 (h) Effective January 1, 2009, co-payments shall be limited to one per day per
127.22provider for nonemergency visits to a hospital-based emergency room. Recipients of
127.23general assistance medical care are responsible for all co-payments in this subdivision.
127.24The general assistance medical care reimbursement to the provider shall be reduced by the
127.25amount of the co-payment, except that reimbursement for prescription drugs shall not be
127.26reduced once a recipient has reached the $7 per month maximum for prescription drug
127.27co-payments. The provider collects the co-payment from the recipient. Providers may not
127.28deny services to recipients who are unable to pay the co-payment.
127.29 (i) General assistance medical care reimbursement to fee-for-service providers
127.30and payments to managed care plans shall not be increased as a result of the removal of
127.31the co-payments effective January 1, 2009.
127.32 (j) Any county may, from its own resources, provide medical payments for which
127.33state payments are not made.
127.34 (k) Chemical dependency services that are reimbursed under chapter 254B must not
127.35be reimbursed under general assistance medical care.
128.1 (l) The maximum payment for new vendors enrolled in the general assistance
128.2medical care program after the base year shall be determined from the average usual and
128.3customary charge of the same vendor type enrolled in the base year.
128.4 (m) The conditions of payment for services under this subdivision are the same
128.5as the conditions specified in rules adopted under chapter 256B governing the medical
128.6assistance program, unless otherwise provided by statute or rule.
128.7 (n) Inpatient and outpatient payments shall be reduced by five percent, effective July
128.81, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
128.9and incorporated by reference in paragraph (l).
128.10 (o) Payments for all other health services except inpatient, outpatient, and pharmacy
128.11services shall be reduced by five percent, effective July 1, 2003.
128.12 (p) Payments to managed care plans shall be reduced by five percent for services
128.13provided on or after October 1, 2003.
128.14 (q) A hospital receiving a reduced payment as a result of this section may apply the
128.15unpaid balance toward satisfaction of the hospital's bad debts.
128.16 (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for
128.17services provided on or after January 1, 2006. For purposes of this subdivision, a visit
128.18means an episode of service which is required because of a recipient's symptoms,
128.19diagnosis, or established illness, and which is delivered in an ambulatory setting by
128.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
128.21audiologist, optician, or optometrist.
128.22 (s) Payments to managed care plans shall not be increased as a result of the removal
128.23of the $3 nonpreventive visit co-payment effective January 1, 2006.
128.24 (t) Payments for mental health services added as covered benefits after December
128.2531, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
128.26(u) Effective for services provided on or after July 1, 2009, total payment rates for
128.27basic care services shall be reduced by three percent, in accordance with section 256B.766.
128.28Payments made to managed care plans shall be reduced for services provided on or after
128.29October 1, 2009, to reflect this reduction.
128.30(v) Effective for services provided on or after July 1, 2009, payment rates for
128.31physician and professional services shall be reduced as described under section 256B.76,
128.32subdivision 1, paragraph (c). Payments made to managed care plans shall be reduced for
128.33services provided on or after October 1, 2009, to reflect this reduction.
128.34 Sec. 54. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision
128.35to read:
129.1 Subd. 3b. Chiropractic services. MinnesotaCare covers the following chiropractic
129.2services: medically necessary exams, manual manipulation of the spine, and x-rays.
129.3EFFECTIVE DATE.This section is effective January 1, 2010.
129.4 Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:
129.5 Subdivision 1. Families with children. (a) Families with children with family
129.6income equal to or less than 275 percent of the federal poverty guidelines for the
129.7applicable family size shall be eligible for MinnesotaCare according to this section. All
129.8other provisions of sections256L.01 to
256L.18 , including the insurance-related barriers
129.9to enrollment under section256L.07 , shall apply unless otherwise specified.
129.10 (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
129.11if the children are eligible. Children may be enrolled separately without enrollment by
129.12parents. However, if one parent in the household enrolls, both parents must enroll, unless
129.13other insurance is available. If one child from a family is enrolled, all children must
129.14be enrolled, unless other insurance is available. If one spouse in a household enrolls,
129.15the other spouse in the household must also enroll, unless other insurance is available.
129.16Families cannot choose to enroll only certain uninsured members.
129.17 (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
129.18to the MinnesotaCare program. These persons are no longer counted in the parental
129.19household and may apply as a separate household.
129.20 (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
129.21not eligible for MinnesotaCare if their gross income exceeds $57,500.
129.22 (e) Children formerly enrolled in medical assistance and automatically deemed
129.23eligible for MinnesotaCare according to section256B.057, subdivision 2c , are exempt
129.24from the requirements of this section until renewal.
129.25(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
129.268, are exempt from the eligibility requirements of this subdivision.
129.27 Sec. 56. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision
129.28to read:
129.29 Subd. 1b. Children with family income greater than 275 percent of federal
129.30poverty guidelines. Children with family income greater than 275 percent of federal
129.31poverty guidelines for the applicable family size shall be eligible for MinnesotaCare. All
129.32other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
129.33to enrollment under section 256L.07, shall apply unless otherwise specified.
130.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
130.2approval, whichever is later.
130.3 Sec. 57. Minnesota Statutes 2008, section 256L.04, subdivision 7a, is amended to read:
130.4 Subd. 7a. Ineligibility.Applicants Adults whose income is greater than the limits
130.5established under this section may not enroll in the MinnesotaCare program.
130.6EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
130.7approval, whichever is later.
130.8 Sec. 58. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to
130.9read:
130.10 Subd. 10a. Sponsor's income and resources deemed available; documentation.
130.11When determining eligibility for any federal or state benefits under sections256L.01 to
130.12256L.18
, the income and resources of all noncitizens whose sponsor signed an affidavit of
130.13support as defined under United States Code, title 8, section 1183a, shall be deemed to
130.14include their sponsors' income and resources as defined in the Personal Responsibility
130.15and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections
130.16421 and 422, and subsequently set out in federal rules. To be eligible for the program,
130.17noncitizens must provide documentation of their immigration status. Beginning July
130.181, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply
130.19to pregnant women and children who are qualified noncitizens, as described in section
130.20256B.06, subdivision 4, paragraph (b).
130.21EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
130.22approval, whichever is later. The commissioner shall notify the revisor of statutes when
130.23federal approval has been obtained.
130.24 Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read:
130.25 Subdivision 1. Application assistance and information availability. (a)
130.26Applications and application assistance must be made available at provider offices, local
130.27human services agencies, school districts, public and private elementary schools in which
130.2825 percent or more of the students receive free or reduced price lunches, community health
130.29offices, Women, Infants and Children (WIC) program sites, Head Start program sites,
130.30public housing councils, crisis nurseries, child care centers, early childhood education
130.31and preschool program sites, legal aid offices, and libraries. These sites may accept
130.32applications and forward the forms to the commissioner or local county human services
131.1agencies that choose to participate as an enrollment site. Otherwise, applicants may apply
131.2directly to the commissioner or to participating local county human services agencies.
131.3(b) Application assistance must be available for applicants choosing to file an
131.4online application.
131.5 Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision
131.6to read:
131.7 Subd. 1c. Open enrollment and streamlined application and enrollment
131.8process. (a) The commissioner and local agencies working in partnership must develop a
131.9streamlined and efficient application and enrollment process for medical assistance and
131.10MinnesotaCare enrollees that meets the criteria specified in this subdivision.
131.11(b) The commissioners of human services and education shall provide
131.12recommendations to the legislature by January 15, 2010, on the creation of an open
131.13enrollment process for medical assistance and MinnesotaCare that is coordinated with
131.14the public education system. The recommendations must:
131.15(1) be developed in consultation with medical assistance and MinnesotaCare
131.16enrollees and representatives from organizations that advocate on behalf of children and
131.17families, low-income persons and minority populations, counties, school administrators
131.18and nurses, health plans, and health care providers;
131.19 (2) be based on enrollment and renewal procedures best practices, including express
131.20lane eligibility as required under subdivision 1d;
131.21(3) simplify the enrollment and renewal processes wherever possible; and
131.22(4) establish a process:
131.23(i) to disseminate information on medical assistance and MinnesotaCare to all
131.24children in the public education system, including prekindergarten programs; and
131.25(ii) for the commissioner of human services to enroll children and other household
131.26members who are eligible.
131.27The commissioner of human services in coordination with the commissioner of
131.28education shall implement an open enrollment process by August 1, 2010, to be effective
131.29beginning with the 2010-2011 school year.
131.30(c) The commissioner and local agencies shall develop an online application process
131.31for medical assistance and MinnesotaCare.
131.32(d) The commissioner shall develop an application that is easily understandable
131.33and does not exceed four pages in length.
132.1(e) The commissioner of human services shall present to the legislature, by January
132.215, 2010, an implementation plan for the open enrollment period and online application
132.3process.
132.4EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
132.5approval, which must be requested by the commissioner, whichever is later.
132.6 Sec. 61. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
132.7 Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
132.8first day of the month following the month in which eligibility is approved and the first
132.9premium payment has been received. As provided in section256B.057 , coverage for
132.10newborns is automatic from the date of birth and must be coordinated with other health
132.11coverage. The effective date of coverage for eligible newly adoptive children added to a
132.12family receiving covered health services is the month of placement. The effective date
132.13of coverage for other new members added to the family is the first day of the month
132.14following the month in which the change is reported. All eligibility criteria must be met
132.15by the family at the time the new family member is added. The income of the new family
132.16member is included with the family's gross income and the adjusted premium begins in
132.17the month the new family member is added.
132.18(b) The initial premium must be received by the last working day of the month for
132.19coverage to begin the first day of the following month.
132.20(c) Benefits are not available until the day following discharge if an enrollee is
132.21hospitalized on the first day of coverage.
132.22(d) Notwithstanding any other law to the contrary, benefits under sections256L.01 to
132.23256L.18
are secondary to a plan of insurance or benefit program under which an eligible
132.24person may have coverage and the commissioner shall use cost avoidance techniques to
132.25ensure coordination of any other health coverage for eligible persons. The commissioner
132.26shall identify eligible persons who may have coverage or benefits under other plans of
132.27insurance or who become eligible for medical assistance.
132.28(e) The effective date of coverage for single adults and households with no children
132.29formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
132.30according to section256D.03, subdivision 3 , is the first day of the month following the
132.31last day of general assistance medical care coverage.
132.32(f) The effective date of coverage for children eligible under section 256L.07,
132.33subdivision 8, is the first day of the month following the date of termination from foster
132.34care or release from a juvenile residential correctional facility.
133.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
133.2approval, whichever is later.
133.3 Sec. 62. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:
133.4 Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility
133.5must be renewed every 12 months. The 12-month period begins in the month after the
133.6month the application is approved.
133.7 (b) Each new period of eligibility must take into account any changes in
133.8circumstances that impact eligibility and premium amount. An enrollee must provide all
133.9the information needed to redetermine eligibility by the first day of the month that ends
133.10the eligibility period. If there is no change in circumstances, the enrollee may renew
133.11eligibility at designated locations that include community clinics and health care providers'
133.12offices. The designated sites shall forward the renewal forms to the commissioner. The
133.13commissioner may establish criteria and timelines for sites to forward applications to the
133.14commissioner or county agencies. The premium for the new period of eligibility must be
133.15received as provided in section256L.06 in order for eligibility to continue.
133.16 (c) For single adults and households with no children formerly enrolled in general
133.17assistance medical care and enrolled in MinnesotaCare according to section256D.03,
133.18subdivision 3 , the first period of eligibility begins the month the enrollee submitted the
133.19application or renewal for general assistance medical care.
133.20 (d)An enrollee Notwithstanding paragraph (e), an enrollee who fails to submit
133.21renewal forms and related documentation necessary for verification of continued eligibility
133.22in a timely manner shall remain eligible for one additional month beyond the end of the
133.23current eligibility period before being disenrolled. The enrollee remains responsible for
133.24MinnesotaCare premiums for the additional month.
133.25(e) Children in families with family income equal to or below 275 percent of federal
133.26poverty guidelines who fail to submit renewal forms and related documentation necessary
133.27for verification of continued eligibility in a timely manner shall remain eligible for the
133.28program. The commissioner shall use the means described in subdivision 2 or any other
133.29means available to verify family income. If the commissioner determines that there has
133.30been a change in income in which premium payment is required to remain enrolled, the
133.31commissioner shall notify the family of the premium payment, and that the children
133.32will be disenrolled if the premium payment is not received effective the first day of the
133.33calendar month following the calendar month for which the premium is due.
133.34(f) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, the
133.35first period of renewal begins the month the enrollee turns 21 years of age.
134.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
134.2approval, whichever is later.
134.3 Sec. 63. Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:
134.4 Subdivision 1. General requirements. (a) Children enrolled in the original
134.5children's health plan as of September 30, 1992, children who enrolled in the
134.6MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
134.7article 4, section 17, and children who have family gross incomes that are equal to or
134.8less than150 200 percent of the federal poverty guidelines are eligible without meeting
134.9the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
134.10long as they maintain continuous coverage in the MinnesotaCare program or medical
134.11assistance.Children who apply for MinnesotaCare on or after the implementation date
134.12of the employer-subsidized health coverage program as described in Laws 1998, chapter
134.13407, article 5, section 45, who have family gross incomes that are equal to or less than 150
134.14percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
134.15be eligible for MinnesotaCare.
134.16Families Parents enrolled in MinnesotaCare under section
256L.04, subdivision 1 ,
134.17whose income increases above 275 percent of the federal poverty guidelines, are no longer
134.18eligible for the program and shall be disenrolled by the commissioner. Beginning January
134.191, 2008, individuals enrolled in MinnesotaCare under section256L.04, subdivision
134.207 , whose income increases above 200 percent of the federal poverty guidelines or 250
134.21percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
134.22the program and shall be disenrolled by the commissioner. For persons disenrolled under
134.23this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
134.24following the month in which the commissioner determines that the income of a family or
134.25individual exceeds program income limits.
134.26 (b)Notwithstanding paragraph (a), Children may remain enrolled in MinnesotaCare
134.27iften percent of their gross individual or gross family income as defined in section
134.28256L.01, subdivision 4
, is less than the annual premium for a policy with a $500
134.29deductible available through the Minnesota Comprehensive Health Association. Children
134.30who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
134.31notice period from the date that ineligibility is determined before disenrollment greater
134.32than 275 percent of federal poverty guidelines. The premium for children remaining
134.33eligible under thisclause paragraph shall be the maximum premium determined under
134.34section256L.15, subdivision 2 , paragraph (b).
135.1 (c) Notwithstandingparagraphs paragraph (a) and (b), parents are not eligible for
135.2MinnesotaCare if gross household income exceeds $57,500 for the 12-month period
135.3of eligibility.
135.4EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
135.5approval, whichever is later.
135.6 Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:
135.7 Subd. 2. Must not have access to employer-subsidized coverage. (a) To be
135.8eligible, a family or individual must not have access to subsidized health coverage through
135.9an employer and must not have had access to employer-subsidized coverage through
135.10a current employer for 18 months prior to application or reapplication. A family or
135.11individual whose employer-subsidized coverage is lost due to an employer terminating
135.12health care coverage as an employee benefit during the previous 18 months is not eligible.
135.13(b) This subdivision does not apply to a family or individual who was enrolled
135.14in MinnesotaCare within six months or less of reapplication and who no longer has
135.15employer-subsidized coverage due to the employer terminating health care coverage as an
135.16employee benefit. This subdivision does not apply to children with family gross incomes
135.17that are equal to or less than 200 percent of federal poverty guidelines.
135.18(c) For purposes of this requirement, subsidized health coverage means health
135.19coverage for which the employer pays at least 50 percent of the cost of coverage for
135.20the employee or dependent, or a higher percentage as specified by the commissioner.
135.21Children are eligible for employer-subsidized coverage through either parent, including
135.22the noncustodial parent. The commissioner must treat employer contributions to Internal
135.23Revenue Code Section 125 plans and any other employer benefits intended to pay
135.24health care costs as qualified employer subsidies toward the cost of health coverage for
135.25employees for purposes of this subdivision.
135.26EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
135.27approval, whichever is later.
135.28 Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:
135.29 Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
135.30MinnesotaCare program must have no health coverage while enrolledor for at least four
135.31months prior to application and renewal. Children with family gross incomes equal to or
135.32greater than 200 percent of federal poverty guidelines, and adults, must have had no health
135.33coverage for at least four months prior to application and renewal. Children enrolled in the
135.34original children's health plan and children in families with income equal to or less than
136.1150 200 percent of the federal poverty guidelines, who have other health insurance, are
136.2eligible if the coverage:
136.3(1) lacks two or more of the following:
136.4(i) basic hospital insurance;
136.5(ii) medical-surgical insurance;
136.6(iii) prescription drug coverage;
136.7(iv) dental coverage; or
136.8(v) vision coverage;
136.9(2) requires a deductible of $100 or more per person per year; or
136.10(3) lacks coverage because the child has exceeded the maximum coverage for a
136.11particular diagnosis or the policy excludes a particular diagnosis.
136.12The commissioner may change this eligibility criterion for sliding scale premiums
136.13in order to remain within the limits of available appropriations. The requirement of no
136.14health coverage does not apply to newborns.
136.15(b) Medical assistance, general assistance medical care, and the Civilian Health and
136.16Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under
136.17United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or
136.18health coverage for purposes of the four-month requirement described in this subdivision.
136.19(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
136.20Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
136.21Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
136.22have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
136.23Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
136.24for MinnesotaCare.
136.25(d) Applicants who were recipients of medical assistance or general assistance
136.26medical care within one month of application must meet the provisions of this subdivision
136.27and subdivision 2.
136.28(e) Cost-effective health insurance that was paid for by medical assistance is not
136.29considered health coverage for purposes of the four-month requirement under this
136.30section, except if the insurance continued after medical assistance no longer considered it
136.31cost-effective or after medical assistance closed.
136.32EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
136.33approval, whichever is later.
136.34 Sec. 66. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
136.35to read:
137.1 Subd. 8. Automatic eligibility for certain children. Any child who was residing
137.2in foster care or a juvenile residential correctional facility on the child's 18th birthday is
137.3automatically deemed eligible for MinnesotaCare upon termination or release until the
137.4child reaches the age of 21, and is exempt from the requirements of this section and
137.5section 256L.15. To be enrolled under this section, a child must complete an initial
137.6application for MinnesotaCare. The commissioner shall contact individuals enrolled
137.7under this section annually to ensure the individual continues to reside in the state and is
137.8interested in continuing MinnesotaCare coverage.
137.9EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
137.10approval, whichever is later.
137.11 Sec. 67. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:
137.12 Subdivision 1. Medical assistance rate to be used. (a) Payment to providers under
137.13sections256L.01 to
256L.11 shall be at the same rates and conditions established for
137.14medical assistance, except as provided in subdivisions 2 to 6.
137.15(b) Effective for services provided on or after July 1, 2009, total payments for basic
137.16care services shall be reduced by three percent, in accordance with section 256B.766.
137.17Payments made to managed care plans shall be reduced for services provided on or after
137.18October 1, 2009, to reflect this reduction.
137.19 Sec. 68. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:
137.20 Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
137.21commissioner shall establish a sliding fee scale to determine the percentage of monthly
137.22gross individual or family income that households at different income levels must pay to
137.23obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
137.24on the enrollee's monthly gross individual or family income. The sliding fee scale must
137.25contain separate tables based on enrollment of one, two, or three or more persons. Until
137.26June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
137.27individual or family income for individuals or families with incomes below the limits for
137.28the medical assistance program for families and children in effect on January 1, 1999, and
137.29proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
137.308.8 percent. These percentages are matched to evenly spaced income steps ranging from
137.31the medical assistance income limit for families and children in effect on January 1, 1999,
137.32to 275 percent of the federal poverty guidelines for the applicable family size, up to a
137.33family size of five. The sliding fee scale for a family of five must be used for families of
137.34more than five. The sliding fee scale and percentages are not subject to the provisions of
138.1chapter 14. If a family or individual reports increased income after enrollment, premiums
138.2shall be adjusted at the time the change in income is reported.
138.3 (b) Children in families whose gross income is above 275 percent of the federal
138.4poverty guidelines shall pay the maximum premium. The maximum premium is defined
138.5as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
138.6cases paid the maximum premium, the total revenue would equal the total cost of
138.7MinnesotaCare medical coverage and administration. In this calculation, administrative
138.8costs shall be assumed to equal ten percent of the total. The costs of medical coverage
138.9for pregnant women and children under age two and the enrollees in these groups shall
138.10be excluded from the total. The maximum premium for two enrollees shall be twice the
138.11maximum premium for one, and the maximum premium for three or more enrollees shall
138.12be three times the maximum premium for one.
138.13 (c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according
138.14to the premium scale specified in paragraph (d) with the exception that children in families
138.15with income at or below150 200 percent of the federal poverty guidelines shall pay
138.16a monthly premium of $4 no premiums. For purposes of paragraph (d), "minimum"
138.17means a monthly premium of $4.
138.18 (d) The following premium scale is established for individuals and families with
138.19gross family incomes of 300 percent of the federal poverty guidelines or less:
139.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
139.2approval, whichever is later.
139.3 Sec. 69. Minnesota Statutes 2008, section 256L.15, subdivision 3, is amended to read:
139.4 Subd. 3. Exceptions to sliding scale. Children in families with income at or below
139.5150 200 percent of the federal poverty guidelines shall pay a no monthly premium of
139.6$4 premiums.
139.7EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
139.8approval, whichever is later.
139.9 Sec. 70. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read:
139.10 Subd. 3. Documentation. (a) The commissioner of human services shall require
139.11individuals and families, at the time of application or renewal, to indicate on acheckoff
139.12form developed by the commissioner whether they satisfy the MinnesotaCare asset
139.13requirement.
139.14 (b) The commissioner may require individuals and families to provide any
139.15information the commissioner determines necessary to verify compliance with the asset
139.16requirement, if the commissioner determines that there is reason to believe that an
139.17individual or family has assets that exceed the program limit.
139.18 Sec. 71. Minnesota Statutes 2008, section 256L.17, subdivision 5, is amended to read:
139.19 Subd. 5. Exemption. This section does not apply to pregnant women or children.
139.20For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
139.21 Sec. 72. Minnesota Statutes 2008, section 501B.89, is amended by adding a
139.22subdivision to read:
139.23 Subd. 4. Annual filing requirement for supplemental needs trusts. (a) A trustee
139.24of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or
139.25(C), shall submit to the commissioner of human services, at the time of a beneficiary's
139.26request for medical assistance, the following information about the trust:
139.27(1) a copy of the trust instrument; and
139.28(2) an inventory of the beneficiary's trust account assets and the value of those assets.
139.29(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section
139.301396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the
139.31commissioner of human services at least annually until the trust, or the beneficiary's
139.32interest in the trust, terminates. Accountings are due on the anniversary of the execution
140.1date of the trust unless another annual date is established by the terms of the trust. The
140.2accounting must include the following information for the accounting period:
140.3(1) an inventory of trust assets and the value of those assets at the beginning of the
140.4accounting period;
140.5(2) additions to the trust during the accounting period and the source of those
140.6additions;
140.7(3) itemized distributions from the trust during the accounting period, including the
140.8purpose of the distributions and to whom the distributions were made;
140.9(4) an inventory of trust assets and the value of those assets at the end of the
140.10accounting period; and
140.11(5) changes to the trust instrument during the accounting period.
140.12(c) For the purpose of paragraph (b), an accounting period is 12 months unless an
140.13accounting period of a different length is permitted by the commissioner.
140.14EFFECTIVE DATE.This section is effective for applications for medical
140.15assistance and renewals of medical assistance submitted on or after July 1, 2009.
140.16 Sec. 73. Minnesota Statutes 2008, section 519.05, is amended to read:
140.17519.05 LIABILITY OF HUSBAND AND WIFE.
140.18(a) A spouse is not liable to a creditor for any debts of the other spouse. Where
140.19husband and wife are living together, they shall be jointly and severally liable for
140.20necessary medical services that have been furnished to either spouse, including any claims
140.21arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household
140.22articles and supplies furnished to and used by the family. Notwithstanding this paragraph,
140.23in a proceeding under chapter 518 the court may apportion such debt between the spouses.
140.24(b) Either spouse may close a credit card account or other unsecured consumer line
140.25of credit on which both spouses are contractually liable, by giving written notice to the
140.26creditor.
140.27 Sec. 74. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision
140.281, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:
141.6Federal Contingency Appropriation. (a)
141.7Federal Medicaid funds made available
141.8under title IV of the federal Jobs and Growth
141.9Tax Relief Reconciliation Act of 2003
141.10are appropriated to the commissioner of
141.11human services for use in the state's medical
141.12assistance and MinnesotaCare programs.
141.13The commissioners of human services and
141.14finance shall report to the legislative advisory
141.15committee on the additional federal Medicaid
141.16matching funds that will be available to the
141.17state.
141.18(b) Because of the availability of these funds,
141.19the following policies shall become effective:
141.20(1) medical assistance and MinnesotaCare
141.21eligibility and local financial participation
141.22changes provided for in this act may be
141.23implemented prior to September 2, 2003, or
141.24may be delayed as necessary to maximize
141.25the use of federal funds received under
141.26title IV of the Jobs and Growth Tax Relief
141.27Reconciliation Act of 2003;
141.28(2) the aggregate cap on the services
141.29identified in Minnesota Statutes, section
141.30256L.035
, paragraph (a), clause (3), shall
141.31be increased from $2,000 to $5,000. This
141.32increase shall expire at the end of fiscal year
141.332007. Funds may be transferred from the
142.1general fund to the health care access fund as
142.2necessary to implement this provision; and
142.3(3) the following payment shifts shall not be
142.4implemented:
142.5(i) MFIP payment shift found in subdivision
142.611;
142.7(ii) the county payment shift found in
142.8subdivision 1; and
142.9(iii) the delay in medical assistance
142.10and general assistance medical care
142.11fee-for-service payments found in
142.12subdivision 6.
142.13(c) Notwithstanding section 14, paragraphs
142.14(a) and (b) shall expire June 30, 2007.
142.15Receipts for Systems Projects.
142.16Appropriations and federal receipts for
142.17information system projects for MAXIS,
142.18PRISM, MMIS, and SSIS must be deposited
142.19in the state system account authorized in
142.20Minnesota Statutes, section256.014 . Money
142.21appropriated for computer projects approved
142.22by the Minnesota office of technology,
142.23funded by the legislature, and approved
142.24by the commissioner of finance may be
142.25transferred from one project to another
142.26and from development to operations as the
142.27commissioner of human services considers
142.28necessary. Any unexpended balance in
142.29the appropriation for these projects does
142.30not cancel but is available for ongoing
142.31development and operations.
142.32Gifts. Notwithstanding Minnesota Statutes,
142.33chapter 7, the commissioner may accept
142.34on behalf of the state additional funding
143.1from sources other than state funds for the
143.2purpose of financing the cost of assistance
143.3program grants or nongrant administration.
143.4All additional funding is appropriated to the
143.5commissioner for use as designated by the
143.6grantor of funding.
143.7Systems Continuity. In the event of
143.8disruption of technical systems or computer
143.9operations, the commissioner may use
143.10available grant appropriations to ensure
143.11continuity of payments for maintaining the
143.12health, safety, and well-being of clients
143.13served by programs administered by the
143.14department of human services. Grant funds
143.15must be used in a manner consistent with the
143.16original intent of the appropriation.
143.17Nonfederal Share Transfers. The
143.18nonfederal share of activities for which
143.19federal administrative reimbursement is
143.20appropriated to the commissioner may be
143.21transferred to the special revenue fund.
143.22TANF Funds Appropriated to Other
143.23Entities. Any expenditures from the TANF
143.24block grant shall be expended in accordance
143.25with the requirements and limitations of part
143.26A of title IV of the Social Security Act, as
143.27amended, and any other applicable federal
143.28requirement or limitation. Prior to any
143.29expenditure of these funds, the commissioner
143.30shall assure that funds are expended in
143.31compliance with the requirements and
143.32limitations of federal law and that any
143.33reporting requirements of federal law are
143.34met. It shall be the responsibility of any entity
143.35to which these funds are appropriated to
144.1implement a memorandum of understanding
144.2with the commissioner that provides the
144.3necessary assurance of compliance prior to
144.4any expenditure of funds. The commissioner
144.5shall receipt TANF funds appropriated
144.6to other state agencies and coordinate all
144.7related interagency accounting transactions
144.8necessary to implement these appropriations.
144.9Unexpended TANF funds appropriated to
144.10any state, local, or nonprofit entity cancel
144.11at the end of the state fiscal year unless
144.12appropriating language permits otherwise.
144.13TANF Funds Transferred to Other Federal
144.14Grants. The commissioner must authorize
144.15transfers from TANF to other federal block
144.16grants so that funds are available to meet the
144.17annual expenditure needs as appropriated.
144.18Transfers may be authorized prior to the
144.19expenditure year with the agreement of the
144.20receiving entity. Transferred funds must be
144.21expended in the year for which the funds
144.22were appropriated unless appropriation
144.23language permits otherwise. In accelerating
144.24transfer authorizations, the commissioner
144.25must aim to preserve the future potential
144.26transfer capacity from TANF to other block
144.27grants.
144.28TANF Maintenance of Effort. (a) In
144.29order to meet the basic maintenance of
144.30effort (MOE) requirements of the TANF
144.31block grant specified under Code of Federal
144.32Regulations, title 45, section263.1 , the
144.33commissioner may only report nonfederal
144.34money expended for allowable activities
144.35listed in the following clauses as TANF/MOE
144.36expenditures:
145.1(1) MFIP cash, diversionary work program,
145.2and food assistance benefits under Minnesota
145.3Statutes, chapter 256J;
145.4(2) the child care assistance programs
145.5under Minnesota Statutes, sections119B.03
145.6and119B.05 , and county child care
145.7administrative costs under Minnesota
145.8Statutes, section119B.15 ;
145.9(3) state and county MFIP administrative
145.10costs under Minnesota Statutes, chapters
145.11256J and 256K;
145.12(4) state, county, and tribal MFIP
145.13employment services under Minnesota
145.14Statutes, chapters 256J and 256K;
145.15(5) expenditures made on behalf of
145.16noncitizen MFIP recipients who qualify
145.17for the medical assistance without federal
145.18financial participation program under
145.19Minnesota Statutes, section256B.06,
145.20subdivision 4 , paragraphs (d), (e), and (j);
145.21and
145.22(6) qualifying working family credit
145.23expenditures under Minnesota Statutes,
145.24section290.0671 .
145.25(b) The commissioner shall ensure that
145.26sufficient qualified nonfederal expenditures
145.27are made each year to meet the state's
145.28TANF/MOE requirements. For the activities
145.29listed in paragraph (a), clauses (2) to
145.30(6), the commissioner may only report
145.31expenditures that are excluded from the
145.32definition of assistance under Code of
145.33Federal Regulations, title 45, section260.31 .
146.1(c) By August 31 of each year, the
146.2commissioner shall make a preliminary
146.3calculation to determine the likelihood
146.4that the state will meet its annual federal
146.5work participation requirement under Code
146.6of Federal Regulations, title 45, sections
146.7261.21
and
261.23 , after adjustment for any
146.8caseload reduction credit under Code of
146.9Federal Regulations, title 45, section261.41 .
146.10If the commissioner determines that the
146.11state will meet its federal work participation
146.12rate for the federal fiscal year ending that
146.13September, the commissioner may reduce the
146.14expenditure under paragraph (a), clause (1),
146.15to the extent allowed under Code of Federal
146.16Regulations, title 45, section 263.1(a)(2).
146.17(d) For fiscal years beginning with state
146.18fiscal year 2003, the commissioner shall
146.19assure that the maintenance of effort used
146.20by the commissioner of finance for the
146.21February and November forecasts required
146.22under Minnesota Statutes, section16A.103 ,
146.23contains expenditures under paragraph (a),
146.24clause (1), equal to at least 25 percent of
146.25the total required under Code of Federal
146.26Regulations, title 45, section263.1 .
146.27(e) If nonfederal expenditures for the
146.28programs and purposes listed in paragraph
146.29(a) are insufficient to meet the state's
146.30TANF/MOE requirements, the commissioner
146.31shall recommend additional allowable
146.32sources of nonfederal expenditures to the
146.33legislature, if the legislature is or will be in
146.34session to take action to specify additional
146.35sources of nonfederal expenditures for
146.36TANF/MOE before a federal penalty is
147.1imposed. The commissioner shall otherwise
147.2provide notice to the legislative commission
147.3on planning and fiscal policy under paragraph
147.4(g).
147.5(f) If the commissioner uses authority
147.6granted under section 11, or similar authority
147.7granted by a subsequent legislature, to
147.8meet the state's TANF/MOE requirement
147.9in a reporting period, the commissioner
147.10shall inform the chairs of the appropriate
147.11legislative committees about all transfers
147.12made under that authority for this purpose.
147.13(g) If the commissioner determines that
147.14nonfederal expenditures under paragraph
147.15(a) are insufficient to meet TANF/MOE
147.16expenditure requirements, and if the
147.17legislature is not or will not be in
147.18session to take timely action to avoid a
147.19federal penalty, the commissioner may
147.20report nonfederal expenditures from
147.21other allowable sources as TANF/MOE
147.22expenditures after the requirements of this
147.23paragraph are met. The commissioner
147.24may report nonfederal expenditures
147.25in addition to those specified under
147.26paragraph (a) as nonfederal TANF/MOE
147.27expenditures, but only ten days after the
147.28commissioner of finance has first submitted
147.29the commissioner's recommendations for
147.30additional allowable sources of nonfederal
147.31TANF/MOE expenditures to the members of
147.32the legislative commission on planning and
147.33fiscal policy for their review.
147.34(h) The commissioner of finance shall not
147.35incorporate any changes in federal TANF
148.1expenditures or nonfederal expenditures for
148.2TANF/MOE that may result from reporting
148.3additional allowable sources of nonfederal
148.4TANF/MOE expenditures under the interim
148.5procedures in paragraph (g) into the February
148.6or November forecasts required under
148.7Minnesota Statutes, section16A.103 , unless
148.8the commissioner of finance has approved
148.9the additional sources of expenditures under
148.10paragraph (g).
148.11(i) Minnesota Statutes, section256.011,
148.12subdivision 3 , which requires that federal
148.13grants or aids secured or obtained under that
148.14subdivision be used to reduce any direct
148.15appropriations provided by law, do not apply
148.16if the grants or aids are federal TANF funds.
148.17(j) Notwithstanding section 14, paragraph
148.18(a), clauses (1) to (6), and paragraphs (b) to
148.19(j) expire June 30, 2007.
148.20Working Family Credit Expenditures as
148.21TANF MOE. The commissioner may claim
148.22as TANF maintenance of effort up to the
148.23following amounts of working family credit
148.24expenditures for the following fiscal years:
148.25(1) fiscal year 2004, $7,013,000;
148.26(2) fiscal year 2005, $25,133,000;
148.27(3) fiscal year 2006, $6,942,000; and
148.28(4) fiscal year 2007, $6,707,000.
148.29Fiscal Year 2003 Appropriations
148.30Carryforward. Effective the day following
148.31final enactment, notwithstanding Minnesota
148.32Statutes, section16A.28 , or any other law to
148.33the contrary, state agencies and constitutional
148.34offices may carry forward unexpended
149.1and unencumbered nongrant operating
149.2balances from fiscal year 2003 general fund
149.3appropriations into fiscal year 2004 to offset
149.4general budget reductions.
149.5Transfer of Grant Balances. Effective
149.6the day following final enactment, the
149.7commissioner of human services, with
149.8the approval of the commissioner of
149.9finance and after notification of the chair
149.10of the senate health, human services and
149.11corrections budget division and the chair
149.12of the house of representatives health
149.13and human services finance committee,
149.14may transfer unencumbered appropriation
149.15balances for the biennium ending June 30,
149.162003, in fiscal year 2003 among the MFIP,
149.17MFIP child care assistance under Minnesota
149.18Statutes, section119B.05 , general assistance,
149.19general assistance medical care, medical
149.20assistance, Minnesota supplemental aid,
149.21and group residential housing programs,
149.22and the entitlement portion of the chemical
149.23dependency consolidated treatment fund, and
149.24between fiscal years of the biennium.
149.25TANF Appropriation Cancellation.
149.26Notwithstanding the provisions of Laws
149.272000, chapter 488, article 1, section 16,
149.28any prior appropriations of TANF funds
149.29to the department of trade and economic
149.30development or to the job skills partnership
149.31board or any transfers of TANF funds from
149.32another agency to the department of trade
149.33and economic development or to the job
149.34skills partnership board are not available
149.35until expended, and if unobligated as of June
150.130, 2003, these appropriations or transfers
150.2shall cancel to the TANF fund.
150.3Shift County Payment. The commissioner
150.4shall make up to 100 percent of the
150.5calendar year 2005 payments to counties for
150.6developmental disabilities semi-independent
150.7living services grants, developmental
150.8disabilities family support grants, and
150.9adult mental health grants from fiscal year
150.102006 appropriations. This is a onetime
150.11payment shift. Calendar year 2006 and future
150.12payments for these grants are not affected by
150.13this shift. This provision expires June 30,
150.142006.
150.15Capitation Rate Increase. Of the health care
150.16access fund appropriations to the University
150.17of Minnesota in the higher education
150.18omnibus appropriation bill,$2,157,000 in
150.19fiscal year 2004 and $2,157,000 in fiscal year
150.202005 are to be used to increase the capitation
150.21payments under for fiscal years beginning
150.22July 1, 2003, and thereafter, $2,157,000 each
150.23year shall be transferred to the commissioner
150.24for purposes of Minnesota Statutes, section
150.25256B.69
. Notwithstanding the provisions of
150.26section 14, this provision shall not expire.
150.27 Sec. 75. ASTHMA COVERAGE DEMONSTRATION PROJECT.
150.28 Subdivision 1. Medical assistance coverage. The commissioner of human services
150.29shall establish a demonstration project to provide additional medical assistance coverage
150.30for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth
150.31who are burdened by health disparities associated with the cumulative health impact of
150.32toxic environmental exposures. Under this demonstration project, the additional medical
150.33assistance coverage for this population must include, but is not limited to, the following
150.34durable medical equipment: high efficiency particulate air (HEPA) cleaners, HEPA
150.35vacuum cleaners, allergy bed and pillow encasements, high filtration filters for forced air
151.1gas furnaces, and dehumidifiers with medical tubing to connect the appliance to a floor
151.2drain, if the listed item is medically necessary to reduce asthma symptoms. Provision
151.3of these items must be preceded by a home environmental assessment for triggers of
151.4asthma and in-home asthma education on the proper medical management of asthma by a
151.5Certified Asthma Educator or public health nurse with asthma management training.
151.6 Subd. 2. Report. (a) Two years following implementation of the medical assistance
151.7coverage demonstration project established under this section, the commissioner of health,
151.8in collaboration with the Department of Human Services, must report to the legislature
151.9on the number of asthma-related hospital admittances that occurred in the population of
151.10children described in subdivision 1, before and after implementation of the demonstration
151.11project, and whether the demonstration project had an impact on asthma-related school
151.12absenteeism for this population of children.
151.13(b) The commissioner of health must seek nonstate funding to conduct this report.
151.14The reporting requirement is contingent upon the availability of nonstate funds.
151.15 Sec. 76. CLAIMS AND UTILIZATION DATA.
151.16The commissioner of human services, in consultation with the Health Services
151.17Policy Committee, shall develop and provide to the legislature by December 15, 2009, a
151.18methodology and any draft legislation necessary to allow for the release, upon request, of
151.19summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, on claims
151.20and utilization for medical assistance, general assistance medical care, and MinnesotaCare
151.21enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical
151.22School, Northwestern Health Sciences University, the Institute for Clinical Systems
151.23Improvement, and other research institutions, to conduct analyses of health care outcomes
151.24and treatment effectiveness, provided the research institutions do not release private or
151.25nonpublic data, or data for which dissemination is prohibited by law.
151.26 Sec. 77. ADMINISTRATION OF PUBLICLY FUNDED HEALTH CARE
151.27PROGRAMS.
151.28(a) The commissioner of human services, in cooperation with the representatives
151.29of county human services agencies and with input from organizations that advocate on
151.30behalf of families and children, shall develop a plan that, to the extent feasible, seeks to
151.31align standards, income and asset methodologies, and procedures for families and children
151.32under medical assistance and MinnesotaCare. The commissioner shall evaluate the impact
151.33of different approaches toward alignment on the number of potential medical assistance
151.34and MinnesotaCare enrollees who are families and children, and on administrative, health
152.1care, and other costs to the state. The commissioner shall present recommendations to the
152.2legislative committees with jurisdiction over health care by September 15, 2010.
152.3(b) The commissioner shall report in detail to the chair of the Health Care and
152.4Human Services Finance Committee of the house of representatives and to the chair of
152.5the Health and Human Services Division of the Finance Committee of the senate, prior
152.6to entering into any contracts involving counties for streamlined electronic enrollment
152.7and eligibility determinations for publicly funded health care programs, if such contracts
152.8would require payment from either the general fund, or the health care access fund, as
152.9described in Minnesota Statutes, sections 295.58 and 297I.05.
152.10 Sec. 78. COBRA PREMIUM STATE SUBSIDY.
152.11 Subdivision 1. Eligibility. (a) An individual and the individual's qualified
152.12beneficiaries shall be eligible for a state premium subsidy equal to 35 percent of the
152.13premiums the individual is required to pay for the continuation of health care coverage
152.14under COBRA, if the individual and the individual's qualified beneficiaries:
152.15(1) are eligible for the 65 percent COBRA continuation premium subsidy for health
152.16care coverage under the American Recovery and Reinvestment Act of 2009;
152.17(2) elect COBRA continuation health care coverage; and
152.18(3) are eligible for medical assistance under Minnesota Statutes, chapter 256B;
152.19general assistance medical care under Minnesota Statutes, section 256D.03; or
152.20MinnesotaCare under Minnesota Statutes, chapter 256L, except for the four-month barrier
152.21requirement under Minnesota Statutes, section 256L.07, subdivision 3.
152.22(b) Eligibility for the state subsidy shall continue for as long as the individual
152.23remains eligible for the COBRA premium subsidies provided under the American
152.24Recovery and Reinvestment Act of 2009.
152.25 Subd. 2. Subsidy. (a) The commissioner of human services shall pay 35 percent of
152.26the COBRA premiums that the individual must pay for continuation health care coverage
152.27for the individual and the individual's qualified beneficiaries, if the individual and the
152.28individual's qualified beneficiaries meet the requirements in subdivision 1.
152.29(b) The state subsidy payment required under this section shall be made directly to
152.30the entity to which the individual is required to make COBRA premium payments.
152.31(c) If any eligible individual has paid either the full amount of the COBRA premiums
152.32or 35 percent of the COBRA premiums before the date of enactment of this section, the
152.33individual is not entitled to a reimbursement of any premium paid.
152.34 Subd. 3. Notification. (a) All employers and plan administrators who are required to
152.35provide notice to all qualified individuals under the American Recovery and Reinvestment
153.1Act of 2009 must include information to qualified individuals residing in Minnesota of
153.2the availability of the state subsidy available under this section. The notice shall include
153.3the eligibility requirements for the state subsidy and that the individual must apply to the
153.4commissioner of human services to receive the state subsidy.
153.5(b) The commissioner of employment and economic development must inform an
153.6applicant for unemployment benefits of the availability of a state subsidy if the applicant
153.7elects COBRA continuation coverage and the applicant meets the eligibility requirements
153.8of this section.
153.9 Subd. 4. Exemption. Any individual who receives a state subsidy under this
153.10section is exempt from the four-month requirement under Minnesota Statutes, section
153.11256L.07, subdivision 3, if the individual or the individual's qualified beneficiaries apply
153.12for MinnesotaCare after the individual no longer receives COBRA continuation coverage.
153.13 Subd. 5. Expiration. This section expires December 31, 2010.
153.14 Sec. 79. FEDERAL APPROVAL.
153.15The commissioner of human services shall resubmit for federal approval the
153.16elimination of depreciation for self-employed farmers in determining income eligibility
153.17for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 19.
153.18 Sec. 80. REPEALER.
153.19Minnesota Statutes 2008, sections 256.962, subdivision 7; and 256L.17, subdivision
153.206, are repealed.
153.23 Section 1. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to
153.24read:
153.25 Subdivision 1. License required. (a) A home care provider may not operate in the
153.26state without a current license issued by the commissioner of health. A home care provider
153.27may hold a separate license for each class of home care licensure.
153.28 (b) Within ten days after receiving an application for a license, the commissioner
153.29shall acknowledge receipt of the application in writing. The acknowledgment must
153.30indicate whether the application appears to be complete or whether additional information
153.31is required before the application will be considered complete. Within 90 days after
153.32receiving a complete application, the commissioner shall either grant or deny the license.
153.33If an applicant is not granted or denied a license within 90 days after submitting a
154.1complete application, the license must be deemed granted. An applicant whose license has
154.2been deemed granted must provide written notice to the commissioner before providing a
154.3home care service.
154.4 (c) Each application for a home care provider license, or for a renewal of a license,
154.5shall be accompanied by a fee to be set by the commissioner under section144.122 .
154.6 (d) The commissioner of health, in consultation with the commissioner of human
154.7services, shall provide recommendations to the legislature by February 15, 2009, for
154.8provider standards for personal care assistant services as described in section256B.0655
154.9256B.0659.
154.10 Sec. 2. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:
154.11 Subd. 9. Employee. "Employee" means any person who performs services for
154.12another for hire including the following:
154.13(1) an alien;
154.14(2) a minor;
154.15(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and
154.16peace officer while engaged in the enforcement of peace or in the pursuit or capture of a
154.17person charged with or suspected of crime;
154.18(4) a person requested or commanded to aid an officer in arresting or retaking a
154.19person who has escaped from lawful custody, or in executing legal process, in which
154.20cases, for purposes of calculating compensation under this chapter, the daily wage of the
154.21person shall be the prevailing wage for similar services performed by paid employees;
154.22(5) a county assessor;
154.23(6) an elected or appointed official of the state, or of a county, city, town, school
154.24district, or governmental subdivision in the state. An officer of a political subdivision
154.25elected or appointed for a regular term of office, or to complete the unexpired portion of a
154.26regular term, shall be included only after the governing body of the political subdivision
154.27has adopted an ordinance or resolution to that effect;
154.28(7) an executive officer of a corporation, except those executive officers excluded
154.29by section176.041 ;
154.30(8) a voluntary uncompensated worker, other than an inmate, rendering services in
154.31state institutions under the commissioners of human services and corrections similar to
154.32those of officers and employees of the institutions, and whose services have been accepted
154.33or contracted for by the commissioner of human services or corrections as authorized by
154.34law. In the event of injury or death of the worker, the daily wage of the worker, for the
154.35purpose of calculating compensation under this chapter, shall be the usual wage paid at
155.1the time of the injury or death for similar services in institutions where the services are
155.2performed by paid employees;
155.3(9) a voluntary uncompensated worker engaged in emergency management as
155.4defined in section12.03, subdivision 4 , who is:
155.5(i) registered with the state or any political subdivision of it, according to the
155.6procedures set forth in the state or political subdivision emergency operations plan; and
155.7(ii) acting under the direction and control of, and within the scope of duties approved
155.8by, the state or political subdivision.
155.9The daily wage of the worker, for the purpose of calculating compensation under this
155.10chapter, shall be the usual wage paid at the time of the injury or death for similar services
155.11performed by paid employees;
155.12(10) a voluntary uncompensated worker participating in a program established by a
155.13local social services agency. For purposes of this clause, "local social services agency"
155.14means any agency established under section393.01 . In the event of injury or death of the
155.15worker, the wage of the worker, for the purpose of calculating compensation under this
155.16chapter, shall be the usual wage paid in the county at the time of the injury or death for
155.17similar services performed by paid employees working a normal day and week;
155.18(11) a voluntary uncompensated worker accepted by the commissioner of natural
155.19resources who is rendering services as a volunteer pursuant to section84.089 . The daily
155.20wage of the worker for the purpose of calculating compensation under this chapter, shall
155.21be the usual wage paid at the time of injury or death for similar services performed by
155.22paid employees;
155.23(12) a voluntary uncompensated worker in the building and construction industry
155.24who renders services for joint labor-management nonprofit community service projects.
155.25The daily wage of the worker for the purpose of calculating compensation under this
155.26chapter shall be the usual wage paid at the time of injury or death for similar services
155.27performed by paid employees;
155.28(13) a member of the military forces, as defined in section190.05 , while in state
155.29active service, as defined in section190.05, subdivision 5a . The daily wage of the member
155.30for the purpose of calculating compensation under this chapter shall be based on the
155.31member's usual earnings in civil life. If there is no evidence of previous occupation or
155.32earning, the trier of fact shall consider the member's earnings as a member of the military
155.33forces;
155.34(14) a voluntary uncompensated worker, accepted by the director of the Minnesota
155.35Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily
155.36wage of the worker, for the purposes of calculating compensation under this chapter,
156.1shall be the usual wage paid at the time of injury or death for similar services performed
156.2by paid employees;
156.3(15) a voluntary uncompensated worker, other than a student, who renders services
156.4at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the
156.5Blind, and whose services have been accepted or contracted for by the commissioner of
156.6education, as authorized by law. In the event of injury or death of the worker, the daily
156.7wage of the worker, for the purpose of calculating compensation under this chapter, shall
156.8be the usual wage paid at the time of the injury or death for similar services performed in
156.9institutions by paid employees;
156.10(16) a voluntary uncompensated worker, other than a resident of the veterans home,
156.11who renders services at a Minnesota veterans home, and whose services have been
156.12accepted or contracted for by the commissioner of veterans affairs, as authorized by law.
156.13In the event of injury or death of the worker, the daily wage of the worker, for the purpose
156.14of calculating compensation under this chapter, shall be the usual wage paid at the time of
156.15the injury or death for similar services performed in institutions by paid employees;
156.16(17) a worker performing services under section256B.0655
156.17recipient in the home of the recipient or in the community under section256B.0625,
156.18subdivision 19a , who is paid from government funds through a fiscal intermediary under
156.19section256B.0655, subdivision 7 256B.0659, subdivision 33. For purposes of maintaining
156.20workers' compensation insurance, the employer of the worker is as designated in law
156.21by the commissioner of the Department of Human Services, notwithstanding any other
156.22law to the contrary;
156.23(18) students enrolled in and regularly attending the Medical School of the
156.24University of Minnesota in the graduate school program or the postgraduate program. The
156.25students shall not be considered employees for any other purpose. In the event of the
156.26student's injury or death, the weekly wage of the student for the purpose of calculating
156.27compensation under this chapter, shall be the annualized educational stipend awarded to
156.28the student, divided by 52 weeks. The institution in which the student is enrolled shall
156.29be considered the "employer" for the limited purpose of determining responsibility for
156.30paying benefits under this chapter;
156.31(19) a faculty member of the University of Minnesota employed for an academic
156.32year is also an employee for the period between that academic year and the succeeding
156.33academic year if:
156.34(a) the member has a contract or reasonable assurance of a contract from the
156.35University of Minnesota for the succeeding academic year; and
157.1(b) the personal injury for which compensation is sought arises out of and in the
157.2course of activities related to the faculty member's employment by the University of
157.3Minnesota;
157.4(20) a worker who performs volunteer ambulance driver or attendant services is an
157.5employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other
157.6entity for which the worker performs the services. The daily wage of the worker for the
157.7purpose of calculating compensation under this chapter shall be the usual wage paid at the
157.8time of injury or death for similar services performed by paid employees;
157.9(21) a voluntary uncompensated worker, accepted by the commissioner of
157.10administration, rendering services as a volunteer at the Department of Administration. In
157.11the event of injury or death of the worker, the daily wage of the worker, for the purpose of
157.12calculating compensation under this chapter, shall be the usual wage paid at the time of the
157.13injury or death for similar services performed in institutions by paid employees;
157.14(22) a voluntary uncompensated worker rendering service directly to the Pollution
157.15Control Agency. The daily wage of the worker for the purpose of calculating compensation
157.16payable under this chapter is the usual going wage paid at the time of injury or death for
157.17similar services if the services are performed by paid employees;
157.18(23) a voluntary uncompensated worker while volunteering services as a first
157.19responder or as a member of a law enforcement assistance organization while acting
157.20under the supervision and authority of a political subdivision. The daily wage of the
157.21worker for the purpose of calculating compensation payable under this chapter is the
157.22usual going wage paid at the time of injury or death for similar services if the services
157.23are performed by paid employees;
157.24(24) a voluntary uncompensated member of the civil air patrol rendering service on
157.25the request and under the authority of the state or any of its political subdivisions. The
157.26daily wage of the member for the purposes of calculating compensation payable under this
157.27chapter is the usual going wage paid at the time of injury or death for similar services if
157.28the services are performed by paid employees; and
157.29(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in
157.30sections145A.04 and
145A.06 , responding at the request of or engaged in training
157.31conducted by the commissioner of health. The daily wage of the volunteer for the purposes
157.32of calculating compensation payable under this chapter is established in section145A.06 .
157.33A person who qualifies under this clause and who may also qualify under another clause
157.34of this subdivision shall receive benefits in accordance with this clause.
157.35If it is difficult to determine the daily wage as provided in this subdivision, the trier
157.36of fact may determine the wage upon which the compensation is payable.
158.1 Sec. 3. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:
158.2 Subd. 2. Personal care provider organizations. The commissioner shall conduct
158.3background studies on any individual required under sections256B.0651 and
256B.0653
158.4to256B.0656 and 256B.0659 to have a background study completed under this chapter.
158.5 Sec. 4. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:
158.6 Subd. 3. Personal care provider organizations. (a) The commissioner shall
158.7conduct a background study of an individual required to be studied under section245C.03,
158.8subdivision 2 , at least upon application for initial enrollment under sections
256B.0651
158.9and
256B.0653256B.0656 and 256B.0659.
158.10(b) Organizations required to initiate background studies under sections256B.0651
158.11and
256B.0653256B.0656 and 256B.0659 for individuals described in section
245C.03,
158.12subdivision 2 , must submit a completed background study form to the commissioner
158.13before those individuals begin a position allowing direct contact with persons served
158.14by the organization.
158.15 Sec. 5. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:
158.16 Subd. 3. Personal care provider organizations. The commissioner shall recover
158.17the cost of background studies initiated by a personal care provider organization under
158.18sections256B.0651 and
256B.0653256B.0656 and 256B.0659 through a fee of no
158.19more than $20 per study charged to the organization responsible for submitting the
158.20background study form. The fees collected under this subdivision are appropriated to the
158.21commissioner for the purpose of conducting background studies.
158.22 Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:
158.23 Subd. 16. Personal care services. (a) Notwithstanding any contrary language in
158.24this paragraph, the commissioner of human services and the commissioner of health shall
158.25jointly promulgate rules to be applied to the licensure of personal care services provided
158.26under the medical assistance program. The rules shall consider standards for personal care
158.27services that are based on the World Institute on Disability's recommendations regarding
158.28personal care services. These rules shall at a minimum consider the standards and
158.29requirements adopted by the commissioner of health under section144A.45 , which the
158.30commissioner of human services determines are applicable to the provision of personal
158.31care services, in addition to other standards or modifications which the commissioner of
158.32human services determines are appropriate.
159.1The commissioner of human services shall establish an advisory group including
159.2personal care consumers and providers to provide advice regarding which standards or
159.3modifications should be adopted. The advisory group membership must include not less
159.4than 15 members, of which at least 60 percent must be consumers of personal care services
159.5and representatives of recipients with various disabilities and diagnoses and ages. At least
159.651 percent of the members of the advisory group must be recipients of personal care.
159.7The commissioner of human services may contract with the commissioner of health
159.8to enforce the jointly promulgated licensure rules for personal care service providers.
159.9Prior to final promulgation of the joint rule the commissioner of human services
159.10shall report preliminary findings along with any comments of the advisory group and a
159.11plan for monitoring and enforcement by the Department of Health to the legislature by
159.12February 15, 1992.
159.13Limits on the extent of personal care services that may be provided to an individual
159.14must be based on the cost-effectiveness of the services in relation to the costs of inpatient
159.15hospital care, nursing home care, and other available types of care. The rules must
159.16provide, at a minimum:
159.17(1) that agencies be selected to contract with or employ and train staff to provide and
159.18supervise the provision of personal care services;
159.19(2) that agencies employ or contract with a qualified applicant that a qualified
159.20recipient proposes to the agency as the recipient's choice of assistant;
159.21(3) that agencies bill the medical assistance program for a personal care service
159.22by a personal care assistant and supervision by a qualified professional supervising the
159.23personal care assistant unless the recipient selects the fiscal agent option under section
159.24256B.0655, subdivision 7
256B.0659, subdivision 33;
159.25(4) that agencies establish a grievance mechanism; and
159.26(5) that agencies have a quality assurance program.
159.27(b) The commissioner may waive the requirement for the provision of personal care
159.28services through an agency in a particular county, when there are less than two agencies
159.29providing services in that county and shall waive the requirement for personal care
159.30assistants required to join an agency for the first time during 1993 when personal care
159.31services are provided under a relative hardship waiver under Minnesota Statutes 1992,
159.32section256B.0627, subdivision 4 , paragraph (b), clause (7), and at least two agencies
159.33providing personal care services have refused to employ or contract with the independent
159.34personal care assistant.
159.35 Sec. 7. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:
160.1 Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the
160.2person is under age 19 and qualifies as a disabled individual under United States Code,
160.3title 42, section 1382c(a), and would be eligible for medical assistance under the state
160.4plan if residing in a medical institution, and the child requires a level of care provided in
160.5a hospital, nursing facility, or intermediate care facility for persons with developmental
160.6disabilities, for whom home care is appropriate, provided that the cost to medical
160.7assistance under this section is not more than the amount that medical assistance would pay
160.8for if the child resides in an institution. After the child is determined to be eligible under
160.9this section, the commissioner shall review the child's disability under United States Code,
160.10title 42, section 1382c(a) and level of care defined under this section no more often than
160.11annually and may elect, based on the recommendation of health care professionals under
160.12contract with the state medical review team, to extend the review of disability and level of
160.13care up to a maximum of four years. The commissioner's decision on the frequency of
160.14continuing review of disability and level of care is not subject to administrative appeal
160.15under section256.045 . The county agency shall send a notice of disability review to the
160.16enrollee six months prior to the date the recertification of disability is due. Nothing in this
160.17subdivision shall be construed as affecting other redeterminations of medical assistance
160.18eligibility under this chapter and annual cost-effective reviews under this section.
160.19 (b) For purposes of this subdivision, "hospital" means an institution as defined
160.20in section144.696, subdivision 3 ,
144.55, subdivision 3 , or Minnesota Rules, part
160.214640.3600, and licensed pursuant to sections144.50 to
144.58 . For purposes of this
160.22subdivision, a child requires a level of care provided in a hospital if the child is determined
160.23by the commissioner to need an extensive array of health services, including mental health
160.24services, for an undetermined period of time, whose health condition requires frequent
160.25monitoring and treatment by a health care professional or by a person supervised by a
160.26health care professional, who would reside in a hospital or require frequent hospitalization
160.27if these services were not provided, and the daily care needs are more complex than
160.28a nursing facility level of care.
160.29 A child with serious emotional disturbance requires a level of care provided in a
160.30hospital if the commissioner determines that the individual requires 24-hour supervision
160.31because the person exhibits recurrent or frequent suicidal or homicidal ideation or
160.32behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that
160.33may become life threatening, recurrent or frequent severe socially unacceptable behavior
160.34associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing
160.35and chronic developmental problems requiring continuous skilled observation, or severe
161.1disabling symptoms for which office-centered outpatient treatment is not adequate, and
161.2which overall severely impact the individual's ability to function.
161.3 (c) For purposes of this subdivision, "nursing facility" means a facility which
161.4provides nursing care as defined in section144A.01, subdivision 5 , licensed pursuant to
161.5sections144A.02 to
144A.10 , which is appropriate if a person is in active restorative
161.6treatment; is in need of special treatments provided or supervised by a licensed nurse; or
161.7has unpredictable episodes of active disease processes requiring immediate judgment
161.8by a licensed nurse. For purposes of this subdivision, a child requires the level of care
161.9provided in a nursing facility if the child is determined by the commissioner to meet
161.10the requirements of the preadmission screening assessment document under section
161.11256B.0911
and the home care independent rating document under section
256B.0655,
161.12subdivision 4
, clause (3), adjusted to address age-appropriate standards for children age 18
161.13and under, pursuant to section
256B.0655, subdivision 3
161.14 (d) For purposes of this subdivision, "intermediate care facility for persons with
161.15developmental disabilities" or "ICF/MR" means a program licensed to provide services to
161.16persons with developmental disabilities under section252.28 , and chapter 245A, and a
161.17physical plant licensed as a supervised living facility under chapter 144, which together
161.18are certified by the Minnesota Department of Health as meeting the standards in Code of
161.19Federal Regulations, title 42, part 483, for an intermediate care facility which provides
161.20services for persons with developmental disabilities who require 24-hour supervision
161.21and active treatment for medical, behavioral, or habilitation needs. For purposes of this
161.22subdivision, a child requires a level of care provided in an ICF/MR if the commissioner
161.23finds that the child has a developmental disability in accordance with section256B.092 ,
161.24is in need of a 24-hour plan of care and active treatment similar to persons with
161.25developmental disabilities, and there is a reasonable indication that the child will need
161.26ICF/MR services.
161.27 (e) For purposes of this subdivision, a person requires the level of care provided
161.28in a nursing facility if the person requires 24-hour monitoring or supervision and a plan
161.29of mental health treatment because of specific symptoms or functional impairments
161.30associated with a serious mental illness or disorder diagnosis, which meet severity criteria
161.31for mental health established by the commissioner and published in March 1997 as
161.32the Minnesota Mental Health Level of Care for Children and Adolescents with Severe
161.33Emotional Disorders.
161.34 (f) The determination of the level of care needed by the child shall be made by
161.35the commissioner based on information supplied to the commissioner by the parent or
161.36guardian, the child's physician or physicians, and other professionals as requested by the
162.1commissioner. The commissioner shall establish a screening team to conduct the level of
162.2care determinations according to this subdivision.
162.3 (g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
162.4must assess the case to determine whether:
162.5 (1) the child qualifies as a disabled individual under United States Code, title 42,
162.6section 1382c(a), and would be eligible for medical assistance if residing in a medical
162.7institution; and
162.8 (2) the cost of medical assistance services for the child, if eligible under this
162.9subdivision, would not be more than the cost to medical assistance if the child resides in a
162.10medical institution to be determined as follows:
162.11 (i) for a child who requires a level of care provided in an ICF/MR, the cost of
162.12care for the child in an institution shall be determined using the average payment rate
162.13established for the regional treatment centers that are certified as ICF's/MR;
162.14 (ii) for a child who requires a level of care provided in an inpatient hospital setting
162.15according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
162.16Rules, part 9505.3520, items F and G; and
162.17 (iii) for a child who requires a level of care provided in a nursing facility according
162.18to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota
162.19Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to
162.20reflect rates which would be paid for children under age 16. The commissioner may
162.21authorize an amount up to the amount medical assistance would pay for a child referred to
162.22the commissioner by the preadmission screening team under section256B.0911 .
162.23 (h) Children eligible for medical assistance services under section256B.055,
162.24subdivision 12 , as of June 30, 1995, must be screened according to the criteria in this
162.25subdivision prior to January 1, 1996. Children found to be ineligible may not be removed
162.26from the program until January 1, 1996.
162.27 Sec. 8. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:
162.28 Subd. 2. Targeted case management; definitions. For purposes of subdivisions 3
162.29to 10, the following terms have the meanings given them:
162.30 (1) "home care service recipients" means those individuals receiving the following
162.31services under sections256B.0651 to
256B.0656 and 256B.0659: skilled nursing visits,
162.32home health aide visits, private duty nursing, personal care assistants, or therapies
162.33provided through a home health agency;
163.1 (2) "home care targeted case management" means the provision of targeted case
163.2management services for the purpose of assisting home care service recipients to gain
163.3access to needed services and supports so that they may remain in the community;
163.4 (3) "institutions" means hospitals, consistent with Code of Federal Regulations, title
163.542, section440.10 ; regional treatment center inpatient services, consistent with section
163.6245.474
; nursing facilities; and intermediate care facilities for persons with developmental
163.7disabilities;
163.8 (4) "relocation targeted case management" includes the provision of both county
163.9targeted case management and public or private vendor service coordination services
163.10for the purpose of assisting recipients to gain access to needed services and supports if
163.11they choose to move from an institution to the community. Relocation targeted case
163.12management may be provided during the lesser of:
163.13 (i) the last 180 consecutive days of an eligible recipient's institutional stay; or
163.14 (ii) the limits and conditions which apply to federal Medicaid funding for this
163.15service; and
163.16 (5) "targeted case management" means case management services provided to help
163.17recipients gain access to needed medical, social, educational, and other services and
163.18supports.
163.19 Sec. 9. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to read:
163.20 Subd. 3. Assessment and prior authorization process. Effective January 1, 1996,
163.21for purposes of providing informed choice, coordinating of local planning decisions, and
163.22streamlining administrative requirements, the assessment and prior authorization process
163.23for persons receiving both home care and home and community-based waivered services
163.24for persons with developmental disabilities shall meet the requirements of sections
163.25256B.0651
and
256B.0653256B.0656 and 256B.0659 with the following exceptions:
163.26(a) Upon request for home care services and subsequent assessment by the public
163.27health nurse under sections256B.0651 and
256B.0653256B.0656 and 256B.0659,
163.28the public health nurse shall participate in the screening process, as appropriate, and,
163.29if home care services are determined to be necessary, participate in the development
163.30of a service plan coordinating the need for home care and home and community-based
163.31waivered services with the assigned county case manager, the recipient of services, and
163.32the recipient's legal representative, if any.
163.33(b) The public health nurse shall give prior authorization for home care services
163.34to the extent that home care services are:
163.35(1) medically necessary;
164.1(2) chosen by the recipient and their legal representative, if any, from the array of
164.2home care and home and community-based waivered services available;
164.3(3) coordinated with other services to be received by the recipient as described
164.4in the service plan; and
164.5(4) provided within the county's reimbursement limits for home care and home and
164.6community-based waivered services for persons with developmental disabilities.
164.7(c) If the public health agency is or may be the provider of home care services to the
164.8recipient, the public health agency shall provide the commissioner of human services with
164.9a written plan that specifies how the assessment and prior authorization process will be
164.10held separate and distinct from the provision of services.
164.11 Sec. 10. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to
164.12read:
164.13 Subd. 2. Eligibility. (a) The self-directed supports option is available to a person
164.14who:
164.15 (1) is a recipient of medical assistance as determined under sections256B.055 ,
164.16256B.056
, and
256B.057, subdivision 9 ;
164.17 (2) is eligible for personal care assistant services under section256B.0655
164.18256B.0659;
164.19 (3) lives in the person's own apartment or home, which is not owned, operated, or
164.20controlled by a provider of services not related by blood or marriage;
164.21 (4) has the ability to hire, fire, supervise, establish staff compensation for, and
164.22manage the individuals providing services, and to choose and obtain items, related
164.23services, and supports as described in the participant's plan. If the recipient is not able to
164.24carry out these functions but has a legal guardian or parent to carry them out, the guardian
164.25or parent may fulfill these functions on behalf of the recipient; and
164.26 (5) has not been excluded or disenrolled by the commissioner.
164.27 (b) The commissioner may disenroll or exclude recipients, including guardians and
164.28parents, under the following circumstances:
164.29 (1) recipients who have been restricted by the Primary Care Utilization Review
164.30Committee may be excluded for a specified time period;
164.31 (2) recipients who exit the self-directed supports option during the recipient's
164.32service plan year shall not access the self-directed supports option for the remainder of
164.33that service plan year; and
164.34 (3) when the department determines that the recipient cannot manage recipient
164.35responsibilities under the program.
165.1 Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to
165.2read:
165.3 Subd. 6. Services covered. (a) Services covered under the self-directed supports
165.4option include:
165.5 (1) personal care assistant services under section256B.0655
165.6 (2) items, related services, and supports, including assistive technology, that increase
165.7independence or substitute for human assistance to the extent expenditures would
165.8otherwise be used for human assistance.
165.9 (b) Items, supports, and related services purchased under this option shall not be
165.10considered home care services for the purposes of section144A.43 .
165.11 Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to
165.12read:
165.13 Subd. 8. Self-directed budget requirements. The budget for the provision of the
165.14self-directed service option shall be equal to the greater of either:
165.15 (1) the annual amount of personal care assistant services under section256B.0655
165.16256B.0659 that the recipient has used in the most recent 12-month period; or
165.17 (2) the amount determined using the consumer support grant methodology under
165.18section256.476, subdivision 11 , except that the budget amount shall include the federal
165.19and nonfederal share of the average service costs.
165.20 Sec. 13. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
165.21 Subd. 17. Cost of services and supports. (a) The commissioner shall ensure
165.22that the average per capita expenditures estimated in any fiscal year for home and
165.23community-based waiver recipients does not exceed the average per capita expenditures
165.24that would have been made to provide institutional services for recipients in the absence
165.25of the waiver.
165.26(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
165.27need-based methods for allocating to local agencies the home and community-based
165.28waivered service resources available to support recipients with disabilities in need of
165.29the level of care provided in a nursing facility or a hospital. The commissioner shall
165.30allocate resources to single counties and county partnerships in a manner that reflects
165.31consideration of:
165.32(1) an incentive-based payment process for achieving outcomes;
165.33(2) the need for a state-level risk pool;
165.34(3) the need for retention of management responsibility at the state agency level; and
166.1(4) a phase-in strategy as appropriate.
166.2(c) Until the allocation methods described in paragraph (b) are implemented, the
166.3annual allowable reimbursement level of home and community-based waiver services
166.4shall be the greater of:
166.5(1) the statewide average payment amount which the recipient is assigned under the
166.6waiver reimbursement system in place on June 30, 2001, modified by the percentage of
166.7any provider rate increase appropriated for home and community-based services; or
166.8(2) an amount approved by the commissioner based on the recipient's extraordinary
166.9needs that cannot be met within the current allowable reimbursement level. The
166.10increased reimbursement level must be necessary to allow the recipient to be discharged
166.11from an institution or to prevent imminent placement in an institution. The additional
166.12reimbursement may be used to secure environmental modifications; assistive technology
166.13and equipment; and increased costs for supervision, training, and support services
166.14necessary to address the recipient's extraordinary needs. The commissioner may approve
166.15an increased reimbursement level for up to one year of the recipient's relocation from an
166.16institution or up to six months of a determination that a current waiver recipient is at
166.17imminent risk of being placed in an institution.
166.18(d) Beginning July 1, 2001, medically necessary private duty nursing services
166.19will be authorized under this section as complex and regular care according to sections
166.20256B.0651
and
256B.0653256B.0656 and 256B.0659. The rate established by the
166.21commissioner for registered nurse or licensed practical nurse services under any home and
166.22community-based waiver as of January 1, 2001, shall not be reduced.
166.23 Sec. 14. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to
166.24read:
166.25 Subd. 4a. Inclusion of home care costs in waiver rates. The commissioner
166.26shall adjust the limits of the established average daily reimbursement rates for waivered
166.27services to include the cost of home care services that may be provided to waivered
166.28services recipients. This adjustment must be used to maintain or increase services and
166.29shall not be used by county agencies for inflation increases for waivered services vendors.
166.30Home care services referenced in this section are those listed in section256B.0651,
166.31subdivision 2 . The average daily reimbursement rates established in accordance with
166.32the provisions of this subdivision apply only to the combined average, daily costs of
166.33waivered and home care services and do not change home care limitations under sections
166.34256B.0651
and
256B.0653256B.0656 and 256B.0659. Waivered services recipients
167.1receiving home care as of June 30, 1992, shall not have the amount of their services
167.2reduced as a result of this section.
167.3 Sec. 15. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:
167.4 Subd. 6. Excluded time. "Excluded time" means:
167.5(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter
167.6other than an emergency shelter, halfway house, foster home, semi-independent living
167.7domicile or services program, residential facility offering care, board and lodging facility
167.8or other institution for the hospitalization or care of human beings, as defined in section
167.9144.50
,
144A.01 , or
245A.02, subdivision 14 ; maternity home, battered women's shelter,
167.10or correctional facility; or any facility based on an emergency hold under sections
167.11253B.05, subdivisions 1 and 2
, and
253B.07, subdivision 6 ;
167.12(b) any period an applicant spends on a placement basis in a training and habilitation
167.13program, including a rehabilitation facility or work or employment program as defined
167.14in section268A.01 ; or receiving personal care assistant services pursuant to section
167.15256B.0655, subdivision 2
256B.0659; semi-independent living services provided under
167.16section252.275 , and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and
167.17habilitation programs and assisted living services; and
167.18(c) any placement for a person with an indeterminate commitment, including
167.19independent living.
167.20 Sec. 16. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:
167.21 Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
167.22256I.04, subdivision 3
, the county agency may negotiate a payment not to exceed $426.37
167.23for other services necessary to provide room and board provided by the group residence
167.24if the residence is licensed by or registered by the Department of Health, or licensed by
167.25the Department of Human Services to provide services in addition to room and board,
167.26and if the provider of services is not also concurrently receiving funding for services for
167.27a recipient under a home and community-based waiver under title XIX of the Social
167.28Security Act; or funding from the medical assistance program under section256B.0655,
167.29subdivision 2
167.30in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000.
167.31If funding is available for other necessary services through a home and community-based
167.32waiver, or personal care services under section256B.0655, subdivision 2
167.33then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided
167.34in law, in no case may the supplementary service rate exceed $426.37. The registration
168.1and licensure requirement does not apply to establishments which are exempt from state
168.2licensure because they are located on Indian reservations and for which the tribe has
168.3prescribed health and safety requirements. Service payments under this section may be
168.4prohibited under rules to prevent the supplanting of federal funds with state funds. The
168.5commissioner shall pursue the feasibility of obtaining the approval of the Secretary of
168.6Health and Human Services to provide home and community-based waiver services under
168.7title XIX of the Social Security Act for residents who are not eligible for an existing home
168.8and community-based waiver due to a primary diagnosis of mental illness or chemical
168.9dependency and shall apply for a waiver if it is determined to be cost-effective.
168.10(b) The commissioner is authorized to make cost-neutral transfers from the GRH
168.11fund for beds under this section to other funding programs administered by the department
168.12after consultation with the county or counties in which the affected beds are located.
168.13The commissioner may also make cost-neutral transfers from the GRH fund to county
168.14human service agencies for beds permanently removed from the GRH census under a plan
168.15submitted by the county agency and approved by the commissioner. The commissioner
168.16shall report the amount of any transfers under this provision annually to the legislature.
168.17(c) The provisions of paragraph (b) do not apply to a facility that has its
168.18reimbursement rate established under section256B.431, subdivision 4 , paragraph (c).
168.19 Sec. 17. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:
168.20 Subd. 3. Good cause exemptions for not attending orientation. (a) The county
168.21agency shall not impose the sanction under section256J.46 if it determines that the
168.22participant has good cause for failing to attend orientation. Good cause exists when:
168.23(1) appropriate child care is not available;
168.24(2) the participant is ill or injured;
168.25(3) a family member is ill and needs care by the participant that prevents the
168.26participant from attending orientation. For a caregiver with a child or adult in the
168.27household who meets the disability or medical criteria for home care services under
168.28section256B.0655, subdivision 1c
168.29services program under chapter 256B, or meets the criteria for severe emotional
168.30disturbance under section245.4871, subdivision 6 , or for serious and persistent mental
168.31illness under section245.462, subdivision 20 , paragraph (c), good cause also exists when
168.32an interruption in the provision of those services occurs which prevents the participant
168.33from attending orientation;
168.34(4) the caregiver is unable to secure necessary transportation;
168.35(5) the caregiver is in an emergency situation that prevents orientation attendance;
169.1(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
169.2(7) the caregiver documents other verifiable impediments to orientation attendance
169.3beyond the caregiver's control.
169.4(b) Counties must work with clients to provide child care and transportation
169.5necessary to ensure a caregiver has every opportunity to attend orientation.
169.6 Sec. 18. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:
169.7 Subdivision 1. Application. This section applies to residential treatment programs
169.8for children or group homes for children licensed under chapter 245A, residential
169.9services and programs for juveniles licensed under section241.021 , providers licensed
169.10pursuant to sections144A.01 to
144A.33 or sections
144A.43 to
144A.47 , personal care
169.11provider organizations under section256B.0655, subdivision 1g
169.12of day training and habilitation services under sections252.40 to
252.46 , board and
169.13lodging facilities licensed under chapter 157, intermediate care facilities for persons with
169.14developmental disabilities, and other facilities licensed to provide residential services to
169.15persons with developmental disabilities.
169.16 Sec. 19. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:
169.17 Subd. 11. Vulnerable adult. "Vulnerable adult" means any person 18 years of
169.18age or older who:
169.19(1) is a resident inpatient of a facility;
169.20(2) receives services at or from a facility required to be licensed to serve adults
169.21under sections245A.01 to
245A.15 , except that a person receiving outpatient services for
169.22treatment of chemical dependency or mental illness, or one who is committed as a sexual
169.23psychopathic personality or as a sexually dangerous person under chapter 253B, is not
169.24considered a vulnerable adult unless the person meets the requirements of clause (4);
169.25(3) receives services from a home care provider required to be licensed under section
169.26144A.46
; or from a person or organization that exclusively offers, provides, or arranges
169.27for personal care assistant services under the medical assistance program as authorized
169.28under sections256B.04, subdivision 16 ,
256B.0625, subdivision 19a ,
256B.0651 , and
169.29256B.0653256B.0656 and 256B.0659; or
169.30(4) regardless of residence or whether any type of service is received, possesses a
169.31physical or mental infirmity or other physical, mental, or emotional dysfunction:
169.32(i) that impairs the individual's ability to provide adequately for the individual's
169.33own care without assistance, including the provision of food, shelter, clothing, health
169.34care, or supervision; and
170.1(ii) because of the dysfunction or infirmity and the need for assistance, the individual
170.2has an impaired ability to protect the individual from maltreatment.
170.3 Sec. 20. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:
170.4 Subd. 6. Facility. (a) "Facility" means a hospital or other entity required to be
170.5licensed under sections144.50 to
144.58 ; a nursing home required to be licensed to
170.6serve adults under section144A.02 ; a residential or nonresidential facility required to
170.7be licensed to serve adults under sections245A.01 to
245A.16 ; a home care provider
170.8licensed or required to be licensed under section144A.46 ; a hospice provider licensed
170.9under sections144A.75 to
144A.755 ; or a person or organization that exclusively offers,
170.10provides, or arranges for personal care assistant services under the medical assistance
170.11program as authorized under sections256B.04, subdivision 16 ,
256B.0625, subdivision
170.1219a ,
256B.0651 , and
256B.0653256B.0656 , and 256B.0659.
170.13(b) For home care providers and personal care attendants, the term "facility" refers
170.14to the provider or person or organization that exclusively offers, provides, or arranges for
170.15personal care services, and does not refer to the client's home or other location at which
170.16services are rendered.
170.17 Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to
170.18read:
170.19 Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of
170.20age or older who:
170.21 (1) is a resident or inpatient of a facility;
170.22 (2) receives services at or from a facility required to be licensed to serve adults
170.23under sections245A.01 to
245A.15 , except that a person receiving outpatient services for
170.24treatment of chemical dependency or mental illness, or one who is served in the Minnesota
170.25sex offender program on a court-hold order for commitment, or is committed as a sexual
170.26psychopathic personality or as a sexually dangerous person under chapter 253B, is not
170.27considered a vulnerable adult unless the person meets the requirements of clause (4);
170.28 (3) receives services from a home care provider required to be licensed under section
170.29144A.46
; or from a person or organization that exclusively offers, provides, or arranges
170.30for personal care assistant services under the medical assistance program as authorized
170.31under sections256B.04, subdivision 16 ,
256B.0625, subdivision 19a ,
256B.0651 , and
170.32256B.0653
to
256B.0656 , and 256B.0659; or
170.33 (4) regardless of residence or whether any type of service is received, possesses a
170.34physical or mental infirmity or other physical, mental, or emotional dysfunction:
171.1 (i) that impairs the individual's ability to provide adequately for the individual's
171.2own care without assistance, including the provision of food, shelter, clothing, health
171.3care, or supervision; and
171.4 (ii) because of the dysfunction or infirmity and the need for assistance, the individual
171.5has an impaired ability to protect the individual from maltreatment.
171.8 Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to
171.9read:
171.10 Subd. 18. Mental health professional. "Mental health professional" means a
171.11person providing clinical services in the treatment of mental illness who is qualified in at
171.12least one of the following ways:
171.13 (1) in psychiatric nursing: a registered nurse who is licensed under sections148.171
171.14to148.285 ; and:
171.15 (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family
171.16psychiatric and mental health nursing by a national nurse certification organization; or
171.17 (ii) who has a master's degree in nursing or one of the behavioral sciences or related
171.18fields from an accredited college or university or its equivalent, with at least 4,000 hours
171.19of post-master's supervised experience in the delivery of clinical services in the treatment
171.20of mental illness;
171.21 (2) in clinical social work: a person licensed as an independent clinical social worker
171.22under chapter 148D, or a person with a master's degree in social work from an accredited
171.23college or university, with at least 4,000 hours of post-master's supervised experience in
171.24the delivery of clinical services in the treatment of mental illness;
171.25 (3) in psychology: an individual licensed by the Board of Psychology under sections
171.26148.88
to
148.98 who has stated to the Board of Psychology competencies in the diagnosis
171.27and treatment of mental illness;
171.28 (4) in psychiatry: a physician licensed under chapter 147 and certified by the
171.29American Board of Psychiatry and Neurology or eligible for board certification in
171.30psychiatry;
171.31 (5) in marriage and family therapy: the mental health professional must be a
171.32marriage and family therapist licensed under sections148B.29 to
148B.39 with at least
171.33two years of post-master's supervised experience in the delivery of clinical services in
171.34the treatment of mental illness;or
172.1 (6) in licensed professional clinical counseling, the mental health professional
172.2shall be a licensed professional clinical counselor under section 148B.5301 with at least
172.34,000 hours of postmaster's supervised experience in the delivery of clinical services in
172.4the treatment of mental illness; or
172.5 (7) in allied fields: a person with a master's degree from an accredited college or
172.6university in one of the behavioral sciences or related fields, with at least 4,000 hours of
172.7post-master's supervised experience in the delivery of clinical services in the treatment of
172.8mental illness.
172.9 Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:
172.10 Subdivision 1. Availability of outpatient services. (a) County boards must provide
172.11or contract for enough outpatient services within the county to meet the needs of adults
172.12with mental illness residing in the county. Services may be provided directly by the
172.13county through county-operated mental health centers or mental health clinics approved
172.14by the commissioner under section245.69, subdivision 2 ; by contract with privately
172.15operated mental health centers or mental health clinics approved by the commissioner
172.16under section245.69, subdivision 2 ; by contract with hospital mental health outpatient
172.17programs certified by the Joint Commission on Accreditation of Hospital Organizations;
172.18or by contract with a licensed mental health professional as defined in section245.462,
172.19subdivision 18 , clauses (1) to (4) (6). Clients may be required to pay a fee according to
172.20section245.481 . Outpatient services include:
172.21 (1) conducting diagnostic assessments;
172.22 (2) conducting psychological testing;
172.23 (3) developing or modifying individual treatment plans;
172.24 (4) making referrals and recommending placements as appropriate;
172.25 (5) treating an adult's mental health needs through therapy;
172.26 (6) prescribing and managing medication and evaluating the effectiveness of
172.27prescribed medication; and
172.28 (7) preventing placement in settings that are more intensive, costly, or restrictive
172.29than necessary and appropriate to meet client needs.
172.30 (b) County boards may request a waiver allowing outpatient services to be provided
172.31in a nearby trade area if it is determined that the client can best be served outside the
172.32county.
172.33 Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:
173.1 Subd. 27. Mental health professional. "Mental health professional" means a
173.2person providing clinical services in the diagnosis and treatment of children's emotional
173.3disorders. A mental health professional must have training and experience in working with
173.4children consistent with the age group to which the mental health professional is assigned.
173.5A mental health professional must be qualified in at least one of the following ways:
173.6 (1) in psychiatric nursing, the mental health professional must be a registered nurse
173.7who is licensed under sections148.171 to
148.285 and who is certified as a clinical
173.8specialist in child and adolescent psychiatric or mental health nursing by a national nurse
173.9certification organization or who has a master's degree in nursing or one of the behavioral
173.10sciences or related fields from an accredited college or university or its equivalent, with
173.11at least 4,000 hours of post-master's supervised experience in the delivery of clinical
173.12services in the treatment of mental illness;
173.13 (2) in clinical social work, the mental health professional must be a person licensed
173.14as an independent clinical social worker under chapter 148D, or a person with a master's
173.15degree in social work from an accredited college or university, with at least 4,000 hours of
173.16post-master's supervised experience in the delivery of clinical services in the treatment
173.17of mental disorders;
173.18 (3) in psychology, the mental health professional must be an individual licensed by
173.19the board of psychology under sections148.88 to
148.98 who has stated to the board of
173.20psychology competencies in the diagnosis and treatment of mental disorders;
173.21 (4) in psychiatry, the mental health professional must be a physician licensed under
173.22chapter 147 and certified by the American board of psychiatry and neurology or eligible
173.23for board certification in psychiatry;
173.24 (5) in marriage and family therapy, the mental health professional must be a
173.25marriage and family therapist licensed under sections148B.29 to
148B.39 with at least
173.26two years of post-master's supervised experience in the delivery of clinical services in the
173.27treatment of mental disorders or emotional disturbances;or
173.28 (6) in licensed professional clinical counseling, the mental health professional shall
173.29be a licensed professional clinical counselor under section 148B.5301 with at least 4,000
173.30hours of postmaster's supervised experience in the delivery of clinical services in the
173.31treatment of mental disorders or emotional disturbances; or
173.32 (7) in allied fields, the mental health professional must be a person with a master's
173.33degree from an accredited college or university in one of the behavioral sciences or related
173.34fields, with at least 4,000 hours of post-master's supervised experience in the delivery of
173.35clinical services in the treatment of emotional disturbances.
174.1 Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:
174.2 Subdivision 1. Availability of outpatient services. (a) County boards must provide
174.3or contract for enough outpatient services within the county to meet the needs of each
174.4child with emotional disturbance residing in the county and the child's family. Services
174.5may be provided directly by the county through county-operated mental health centers or
174.6mental health clinics approved by the commissioner under section245.69, subdivision 2 ;
174.7by contract with privately operated mental health centers or mental health clinics approved
174.8by the commissioner under section245.69, subdivision 2 ; by contract with hospital
174.9mental health outpatient programs certified by the Joint Commission on Accreditation
174.10of Hospital Organizations; or by contract with a licensed mental health professional as
174.11defined in section245.4871, subdivision 27 , clauses (1) to (4) (6). A child or a child's
174.12parent may be required to pay a fee based in accordance with section245.481 . Outpatient
174.13services include:
174.14 (1) conducting diagnostic assessments;
174.15 (2) conducting psychological testing;
174.16 (3) developing or modifying individual treatment plans;
174.17 (4) making referrals and recommending placements as appropriate;
174.18 (5) treating the child's mental health needs through therapy; and
174.19 (6) prescribing and managing medication and evaluating the effectiveness of
174.20prescribed medication.
174.21 (b) County boards may request a waiver allowing outpatient services to be provided
174.22in a nearby trade area if it is determined that the child requires necessary and appropriate
174.23services that are only available outside the county.
174.24 (c) Outpatient services offered by the county board to prevent placement must be at
174.25the level of treatment appropriate to the child's diagnostic assessment.
174.26 Sec. 5. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision
174.27to read:
174.28 Subd. 8a. Placing authority. "Placing authority" means a county, prepaid health
174.29plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to
174.309530.6655.
174.31 Sec. 6. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision
174.32to read:
174.33 Subd. 6. Monitoring. The commissioner shall gather and placing authorities shall
174.34provide information to measure compliance with Minnesota Rules, parts 9530.6600 to
175.19530.6655. The commissioner shall specify the format for data collection to facilitate
175.2tracking, aggregating, and using the information.
175.3 Sec. 7. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read:
175.4 Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
175.5dependency services to persons residing within its jurisdiction who meet criteria
175.6established by the commissioner for placement in a chemical dependency residential or
175.7nonresidential treatment service. Chemical dependency money must be administered
175.8by the local agencies according to law and rules adopted by the commissioner under
175.9sections14.001 to
14.69 .
175.10 (b) In order to contain costs,the county board shall, with the approval of the
175.11commissioner of human services, shall select eligible vendors of chemical dependency
175.12services who can provide economical and appropriate treatment. Unless the local agency
175.13is a social services department directly administered by a county or human services board,
175.14the local agency shall not be an eligible vendor under section254B.05 . The commissioner
175.15may approve proposals from county boards to provide services in an economical manner
175.16or to control utilization, with safeguards to ensure that necessary services are provided.
175.17If a county implements a demonstration or experimental medical services funding plan,
175.18the commissioner shall transfer the money as appropriate.If a county selects a vendor
175.19located in another state, the county shall ensure that the vendor is in compliance with the
175.20rules governing licensure of programs located in the state.
175.21 (c) A culturally specific vendor that provides assessments under a variance under
175.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
175.23persons not covered by the variance.
175.24EFFECTIVE DATE.This section is effective July 1, 2011.
175.25 Sec. 8. Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read:
175.26 Subd. 3. Local agencies to pay state for county share. Local agencies shall pay
175.27the state for the county share of the services authorized by the local agency, except when
175.28the payment is made according to section 254B.09, subdivision 8.
175.29 Sec. 9. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision
175.30to read:
175.31 Subd. 9. Commissioner to select vendors and set rates. (a) Effective July 1, 2011,
175.32the commissioner shall:
175.33(1) enter into agreements with eligible vendors that:
176.1(i) meet the standards in section 254B.05, subdivision 1;
176.2(ii) have good standing in all applicable licensure; and
176.3(iii) have a current approved provider agreement as a Minnesota health care program
176.4provider; and
176.5(2) set rates for services reimbursed under this chapter.
176.6(b) When setting rates, the commissioner shall consider the complexity and the
176.7acuity of the problems presented by the client.
176.8(c) When rates set under this section and rates set under section 254B.09, subdivision
176.98, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes.
176.10 Sec. 10. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read:
176.11 Subdivision 1. Licensure required. Programs licensed by the commissioner are
176.12eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
176.13notwithstanding the provisions of section245A.03 . American Indian programs located on
176.14federally recognized tribal lands that provide chemical dependency primary treatment,
176.15extended care, transitional residence, or outpatient treatment services, and are licensed by
176.16tribal government are eligible vendors. Detoxification programs are not eligible vendors.
176.17Programs that are not licensed as a chemical dependency residential or nonresidential
176.18treatment program by the commissioner or by tribal government are not eligible vendors.
176.19To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund,
176.20a vendor of a chemical dependency service must participate in the Drug and Alcohol
176.21Abuse Normative Evaluation System and the treatment accountability plan.
176.22Effective January 1, 2000, vendors of room and board are eligible for chemical
176.23dependency fund payment if the vendor:
176.24(1)is certified by the county or tribal governing body as having has rules prohibiting
176.25residents bringing chemicals into the facility or using chemicals while residing in the
176.26facility and provide consequences for infractions of those rules;
176.27(2) has a current contract with a county or tribal governing body;
176.28(3) is determined to meet applicable health and safety requirements;
176.29(4) is not a jail or prison; and
176.30(5) is not concurrently receiving funds under chapter 256I for the recipient.
176.31EFFECTIVE DATE.This section is effective July 1, 2011.
176.32 Sec. 11. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read:
176.33 Subd. 2. American Indian agreements. The commissioner may enter into
176.34agreements with federally recognized tribal units to pay for chemical dependency
177.1treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The
177.2agreements must clarify how the governing body of the tribal unit fulfills local agency
177.3responsibilities regarding:
177.4(1) selection of eligible vendors under section
254B.03, subdivision 1;
177.5(2) negotiation of agreements that establish vendor services and rates for programs
177.6located on the tribal governing body's reservation;
177.7(3) (1) the form and manner of invoicing; and
177.8(4) (2) provide that only invoices for eligible vendors according to section
254B.05
177.9will be included in invoices sent to the commissioner for payment, to the extent that
177.10money allocated under subdivisions 4 and 5 is used.
177.11EFFECTIVE DATE.This section is effective July 1, 2011.
177.12 Sec. 12. [254B.11] MAXIMUM RATES.
177.13The commissioner shall publish maximum rates for vendors of the consolidated
177.14chemical dependency treatment fund by July 1 of each year for implementation the
177.15following January 1. Rates for calendar year 2010 must not exceed 185 percent of the
177.16average rate on January 1, 2009, for each group of vendors with similar attributes. Unless
177.17a new rate methodology is developed under section 254B.12, rates for services provided on
177.18and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009,
177.19for each group of vendors with similar attributes. Payment for services provided by Indian
177.20Health Services or by agencies operated by Indian tribes for medical assistance-eligible
177.21individuals must be governed by the applicable federal rate methodology.
177.22 Sec. 13. [254B.12] RATE METHODOLOGY.
177.23The commissioner shall, with broad-based stakeholder input, develop a
177.24recommendation and present a report to the 2011 legislature, including proposed
177.25legislation for a new rate methodology for the consolidated chemical dependency
177.26treatment fund. The new methodology must replace county-negotiated rates with a
177.27uniform statewide methodology that must include a graduated reimbursement scale based
177.28on the patients' level of acuity and complexity.
177.29 Sec. 14. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to
177.30read:
177.31 Subd. 2. Definitions. For purposes of this section, the following terms have the
177.32meanings given them.
178.1 (a) "Intensive nonresidential rehabilitative mental health services" means adult
178.2rehabilitative mental health services as defined in section256B.0623, subdivision 2 ,
178.3paragraph (a), except that these services are provided by a multidisciplinary staff using
178.4a total team approach consistent with assertive community treatment, the Fairweather
178.5Lodge treatment model, as defined by the standards established by the National Coalition
178.6for Community Living, and other evidence-based practices, and directed to recipients with
178.7a serious mental illness who require intensive services.
178.8 (b) "Intensive residential rehabilitative mental health services" means short-term,
178.9time-limited services provided in a residential setting to recipients who are in need of
178.10more restrictive settings and are at risk of significant functional deterioration if they do
178.11not receive these services. Services are designed to develop and enhance psychiatric
178.12stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
178.13independent setting. Services must be directed toward a targeted discharge date with
178.14specified client outcomes and must be consistent with the Fairweather Lodge treatment
178.15model as defined in paragraph (a), and other evidence-based practices.
178.16 (c) "Evidence-based practices" are nationally recognized mental health services that
178.17are proven by substantial research to be effective in helping individuals with serious
178.18mental illness obtain specific treatment goals.
178.19 (d) "Overnight staff" means a member of the intensive residential rehabilitative
178.20mental health treatment team who is responsible during hours when recipients are
178.21typically asleep.
178.22 (e) "Treatment team" means all staff who provide services under this section to
178.23recipients. At a minimum, this includes the clinical supervisor, mental health professionals
178.24as defined in section245.462, subdivision 18 , clauses (1) to (5) (6); mental health
178.25practitioners as defined in section245.462, subdivision 17 ; mental health rehabilitation
178.26workers under section256B.0623, subdivision 5 , clause (3); and certified peer specialists
178.27under section256B.0615 .
178.28 Sec. 15. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to
178.29read:
178.30 Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health
178.31services must be provided by qualified individual provider staff of a certified provider
178.32entity. Individual provider staff must be qualified under one of the following criteria:
178.33 (1) a mental health professional as defined in section245.462, subdivision 18 ,
178.34clauses (1) to(5) (6). If the recipient has a current diagnostic assessment by a licensed
178.35mental health professional as defined in section245.462, subdivision 18 , clauses (1) to (5)
179.1(6), recommending receipt of adult mental health rehabilitative services, the definition of
179.2mental health professional for purposes of this section includes a person who is qualified
179.3under section245.462, subdivision 18 , clause (6) (7), and who holds a current and valid
179.4national certification as a certified rehabilitation counselor or certified psychosocial
179.5rehabilitation practitioner;
179.6 (2) a mental health practitioner as defined in section245.462, subdivision 17 . The
179.7mental health practitioner must work under the clinical supervision of a mental health
179.8professional;
179.9 (3) a certified peer specialist under section256B.0615 . The certified peer specialist
179.10must work under the clinical supervision of a mental health professional; or
179.11 (4) a mental health rehabilitation worker. A mental health rehabilitation worker
179.12means a staff person working under the direction of a mental health practitioner or mental
179.13health professional and under the clinical supervision of a mental health professional in
179.14the implementation of rehabilitative mental health services as identified in the recipient's
179.15individual treatment plan who:
179.16 (i) is at least 21 years of age;
179.17 (ii) has a high school diploma or equivalent;
179.18 (iii) has successfully completed 30 hours of training during the past two years in all
179.19of the following areas: recipient rights, recipient-centered individual treatment planning,
179.20behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
179.21psychotropic medications and side effects, functional assessment, local community
179.22resources, adult vulnerability, recipient confidentiality; and
179.23 (iv) meets the qualifications in subitem (A) or (B):
179.24 (A) has an associate of arts degree in one of the behavioral sciences or human
179.25services, or is a registered nurse without a bachelor's degree, or who within the previous
179.26ten years has:
179.27 (1) three years of personal life experience with serious and persistent mental illness;
179.28 (2) three years of life experience as a primary caregiver to an adult with a serious
179.29mental illness or traumatic brain injury; or
179.30 (3) 4,000 hours of supervised paid work experience in the delivery of mental health
179.31services to adults with a serious mental illness or traumatic brain injury; or
179.32 (B)(1) is fluent in the non-English language or competent in the culture of the
179.33ethnic group to which at least 20 percent of the mental health rehabilitation worker's
179.34clients belong;
179.35 (2) receives during the first 2,000 hours of work, monthly documented individual
179.36clinical supervision by a mental health professional;
180.1 (3) has 18 hours of documented field supervision by a mental health professional
180.2or practitioner during the first 160 hours of contact work with recipients, and at least six
180.3hours of field supervision quarterly during the following year;
180.4 (4) has review and cosignature of charting of recipient contacts during field
180.5supervision by a mental health professional or practitioner; and
180.6 (5) has 40 hours of additional continuing education on mental health topics during
180.7the first year of employment.
180.8 Sec. 16. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to
180.9read:
180.10 Subd. 5. Mobile crisis intervention staff qualifications. For provision of adult
180.11mental health mobile crisis intervention services, a mobile crisis intervention team is
180.12comprised of at least two mental health professionals as defined in section245.462,
180.13subdivision 18 , clauses (1) to (5) (6), or a combination of at least one mental health
180.14professional and one mental health practitioner as defined in section245.462, subdivision
180.1517 , with the required mental health crisis training and under the clinical supervision of
180.16a mental health professional on the team. The team must have at least two people with
180.17at least one member providing on-site crisis intervention services when needed. Team
180.18members must be experienced in mental health assessment, crisis intervention techniques,
180.19and clinical decision-making under emergency conditions and have knowledge of local
180.20services and resources. The team must recommend and coordinate the team's services
180.21with appropriate local resources such as the county social services agency, mental health
180.22services, and local law enforcement when necessary.
180.23 Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to
180.24read:
180.25 Subd. 8. Adult crisis stabilization staff qualifications. (a) Adult mental health
180.26crisis stabilization services must be provided by qualified individual staff of a qualified
180.27provider entity. Individual provider staff must have the following qualifications:
180.28 (1) be a mental health professional as defined in section245.462, subdivision 18 ,
180.29clauses (1) to(5) (6);
180.30 (2) be a mental health practitioner as defined in section245.462, subdivision 17 .
180.31The mental health practitioner must work under the clinical supervision of a mental health
180.32professional; or
180.33 (3) be a mental health rehabilitation worker who meets the criteria in section
180.34256B.0623, subdivision 5
, clause (3); works under the direction of a mental health
181.1practitioner as defined in section245.462, subdivision 17 , or under direction of a
181.2mental health professional; and works under the clinical supervision of a mental health
181.3professional.
181.4 (b) Mental health practitioners and mental health rehabilitation workers must have
181.5completed at least 30 hours of training in crisis intervention and stabilization during
181.6the past two years.
181.7 Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to
181.8read:
181.9 Subd. 42. Mental health professional. Notwithstanding Minnesota Rules, part
181.109505.0175, subpart 28, the definition of a mental health professional shall include a person
181.11who is qualified as specified in section245.462, subdivision 18 , clause clauses (5) and (6);
181.12or245.4871, subdivision 27 , clause clauses (5) and (6), for the purpose of this section and
181.13Minnesota Rules, parts 9505.0170 to 9505.0475.
181.14 Sec. 19. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to
181.15read:
181.16 Subdivision 1. Definitions. For purposes of this section, the following terms have
181.17the meanings given them.
181.18 (a) "Children's therapeutic services and supports" means the flexible package of
181.19mental health services for children who require varying therapeutic and rehabilitative
181.20levels of intervention. The services are time-limited interventions that are delivered using
181.21various treatment modalities and combinations of services designed to reach treatment
181.22outcomes identified in the individual treatment plan.
181.23 (b) "Clinical supervision" means the overall responsibility of the mental health
181.24professional for the control and direction of individualized treatment planning, service
181.25delivery, and treatment review for each client. A mental health professional who is an
181.26enrolled Minnesota health care program provider accepts full professional responsibility
181.27for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
181.28and oversees or directs the supervisee's work.
181.29 (c) "County board" means the county board of commissioners or board established
181.30under sections402.01 to
402.10 or
471.59 .
181.31 (d) "Crisis assistance" has the meaning given in section245.4871, subdivision 9a .
181.32 (e) "Culturally competent provider" means a provider who understands and can
181.33utilize to a client's benefit the client's culture when providing services to the client. A
181.34provider may be culturally competent because the provider is of the same cultural or
182.1ethnic group as the client or the provider has developed the knowledge and skills through
182.2training and experience to provide services to culturally diverse clients.
182.3 (f) "Day treatment program" for children means a site-based structured program
182.4consisting of group psychotherapy for more than three individuals and other intensive
182.5therapeutic services provided by a multidisciplinary team, under the clinical supervision
182.6of a mental health professional.
182.7 (g) "Diagnostic assessment" has the meaning given in section245.4871, subdivision
182.811 .
182.9 (h) "Direct service time" means the time that a mental health professional, mental
182.10health practitioner, or mental health behavioral aide spends face-to-face with a client
182.11and the client's family. Direct service time includes time in which the provider obtains
182.12a client's history or provides service components of children's therapeutic services and
182.13supports. Direct service time does not include time doing work before and after providing
182.14direct services, including scheduling, maintaining clinical records, consulting with others
182.15about the client's mental health status, preparing reports, receiving clinical supervision
182.16directly related to the client's psychotherapy session, and revising the client's individual
182.17treatment plan.
182.18 (i) "Direction of mental health behavioral aide" means the activities of a mental
182.19health professional or mental health practitioner in guiding the mental health behavioral
182.20aide in providing services to a client. The direction of a mental health behavioral aide
182.21must be based on the client's individualized treatment plan and meet the requirements in
182.22subdivision 6, paragraph (b), clause (5).
182.23 (j) "Emotional disturbance" has the meaning given in section245.4871, subdivision
182.2415 . For persons at least age 18 but under age 21, mental illness has the meaning given in
182.25section245.462, subdivision 20 , paragraph (a).
182.26 (k) "Individual behavioral plan" means a plan of intervention, treatment, and
182.27services for a child written by a mental health professional or mental health practitioner,
182.28under the clinical supervision of a mental health professional, to guide the work of the
182.29mental health behavioral aide.
182.30 (l) "Individual treatment plan" has the meaning given in section245.4871,
182.31subdivision 21 .
182.32 (m) "Mental health professional" means an individual as defined in section245.4871,
182.33subdivision 27 , clauses (1) to (5) (6), or tribal vendor as defined in section
256B.02,
182.34subdivision 7 , paragraph (b).
182.35 (n) "Preschool program" means a day program licensed under Minnesota Rules,
182.36parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
183.1supports provider to provide a structured treatment program to a child who is at least 33
183.2months old but who has not yet attended the first day of kindergarten.
183.3 (o) "Skills training" means individual, family, or group training designed to improve
183.4the basic functioning of the child with emotional disturbance and the child's family in the
183.5activities of daily living and community living, and to improve the social functioning of the
183.6child and the child's family in areas important to the child's maintaining or reestablishing
183.7residency in the community. Individual, family, and group skills training must:
183.8 (1) consist of activities designed to promote skill development of the child and the
183.9child's family in the use of age-appropriate daily living skills, interpersonal and family
183.10relationships, and leisure and recreational services;
183.11 (2) consist of activities that will assist the family's understanding of normal child
183.12development and to use parenting skills that will help the child with emotional disturbance
183.13achieve the goals outlined in the child's individual treatment plan; and
183.14 (3) promote family preservation and unification, promote the family's integration
183.15with the community, and reduce the use of unnecessary out-of-home placement or
183.16institutionalization of children with emotional disturbance.
183.17 Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to
183.18read:
183.19 Subd. 47. Treatment foster care services. Effective July 1,2007 2011, and subject
183.20to federal approval, medical assistance covers treatment foster care services according to
183.21section256B.0946 .
183.22 Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 12, is amended to
183.23read:
183.24 Subd. 12. Excluded services. The following services are not eligible for medical
183.25assistance payment as children's therapeutic services and supports:
183.26 (1) service components of children's therapeutic services and supports
183.27simultaneously provided by more than one provider entity unless prior authorization is
183.28obtained;
183.29 (2) treatment by multiple providers within the same agency at the same clock time;
183.30(3) children's therapeutic services and supports provided in violation of medical
183.31assistance policy in Minnesota Rules, part 9505.0220;
183.32(3) (4) mental health behavioral aide services provided by a personal care assistant
183.33who is not qualified as a mental health behavioral aide and employed by a certified
183.34children's therapeutic services and supports provider entity;
184.1(4) (5) service components of CTSS that are the responsibility of a residential or
184.2program license holder, including foster care providers under the terms of a service
184.3agreement or administrative rules governing licensure;
184.4(5) (6) adjunctive activities that may be offered by a provider entity but are not
184.5otherwise covered by medical assistance, including:
184.6 (i) a service that is primarily recreation oriented or that is provided in a setting that
184.7is not medically supervised. This includes sports activities, exercise groups, activities
184.8such as craft hours, leisure time, social hours, meal or snack time, trips to community
184.9activities, and tours;
184.10 (ii) a social or educational service that does not have or cannot reasonably be
184.11expected to have a therapeutic outcome related to the client's emotional disturbance;
184.12 (iii) consultation with other providers or service agency staff about the care or
184.13progress of a client;
184.14 (iv) prevention or education programs provided to the community; and
184.15 (v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and
184.16(6) (7) activities that are not direct service time.
184.17 Sec. 22. Minnesota Statutes 2008, section 256B.0944, is amended by adding a
184.18subdivision to read:
184.19 Subd. 4a. Alternative provider standards. If a provider entity demonstrates that,
184.20due to geographic or other barriers, it is not feasible to provide mobile crisis intervention
184.21services 24 hours a day, seven days a week, according to the standards in subdivision 4,
184.22paragraph (b), clause (1), the commissioner may approve a crisis response provider based
184.23on an alternative plan proposed by a provider entity. The alternative plan must:
184.24(1) result in increased access and a reduction in disparities in the availability of
184.25crisis services; and
184.26(2) provide mobile services outside of the usual nine-to-five office hours and on
184.27weekends and holidays.
184.28 Sec. 23. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to
184.29read:
184.30 Subdivision 1. Scope.Subject to federal approval Effective November 1, 2010, and
184.31subject to federal approval, medical assistance covers medically necessary, intensive
184.32nonresidential rehabilitative mental health services as defined in subdivision 2, for
184.33recipients as defined in subdivision 3, when the services are provided by an entity meeting
184.34the standards in this section.
185.1 Sec. 24. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read:
185.2 Subd. 73a. Qualified professional. (a) For physical illness, injury, or incapacity,
185.3a "qualified professional" means a licensed physician, a physician's assistant, a nurse
185.4practitioner, or a licensed chiropractor.
185.5 (b) For developmental disability and intelligence testing, a "qualified professional"
185.6means an individual qualified by training and experience to administer the tests necessary
185.7to make determinations, such as tests of intellectual functioning, assessments of adaptive
185.8behavior, adaptive skills, and developmental functioning. These professionals include
185.9licensed psychologists, certified school psychologists, or certified psychometrists working
185.10under the supervision of a licensed psychologist.
185.11 (c) For learning disabilities, a "qualified professional" means a licensed psychologist
185.12or school psychologist with experience determining learning disabilities.
185.13 (d) For mental health, a "qualified professional" means a licensed physician or a
185.14qualified mental health professional. A "qualified mental health professional" means:
185.15 (1) for children, in psychiatric nursing, a registered nurse who is licensed under
185.16sections148.171 to
148.285 , and who is certified as a clinical specialist in child
185.17and adolescent psychiatric or mental health nursing by a national nurse certification
185.18organization or who has a master's degree in nursing or one of the behavioral sciences
185.19or related fields from an accredited college or university or its equivalent, with at least
185.204,000 hours of post-master's supervised experience in the delivery of clinical services in
185.21the treatment of mental illness;
185.22 (2) for adults, in psychiatric nursing, a registered nurse who is licensed under
185.23sections148.171 to
148.285 , and who is certified as a clinical specialist in adult psychiatric
185.24and mental health nursing by a national nurse certification organization or who has a
185.25master's degree in nursing or one of the behavioral sciences or related fields from an
185.26accredited college or university or its equivalent, with at least 4,000 hours of post-master's
185.27supervised experience in the delivery of clinical services in the treatment of mental illness;
185.28 (3) in clinical social work, a person licensed as an independent clinical social worker
185.29under chapter 148D, or a person with a master's degree in social work from an accredited
185.30college or university, with at least 4,000 hours of post-master's supervised experience in
185.31the delivery of clinical services in the treatment of mental illness;
185.32 (4) in psychology, an individual licensed by the Board of Psychology under sections
185.33148.88
to
148.98 , who has stated to the Board of Psychology competencies in the
185.34diagnosis and treatment of mental illness;
186.1 (5) in psychiatry, a physician licensed under chapter 147 and certified by the
186.2American Board of Psychiatry and Neurology or eligible for board certification in
186.3psychiatry;and
186.4 (6) in marriage and family therapy, the mental health professional must be a
186.5marriage and family therapist licensed under sections148B.29 to
148B.39 , with at least
186.6two years of post-master's supervised experience in the delivery of clinical services in the
186.7treatment of mental illness; and
186.8 (7) in licensed professional clinical counseling, the mental health professional
186.9shall be a licensed professional clinical counselor under section 148B.5301 with at least
186.104,000 hours of postmaster's supervised experience in the delivery of clinical services in
186.11the treatment of mental illness.
186.12 Sec. 25. AUTISM SPECTRUM DISORDER TASK FORCE.
186.13(a) The Autism Spectrum Disorder Task Force is composed of 15 members,
186.14appointed as follows:
186.15(1) two members of the senate appointed by the Subcommittee on Committees of the
186.16Committee on Rules and Administration, one of whom must be a member of the minority;
186.17(2) two members of the house of representatives, one from the majority party,
186.18appointed by the speaker of the house, and one from the minority party, appointed by
186.19the minority leader;
186.20 (3) two members appointed by the legislature, with regard to geographic diversity in
186.21the state, who are parents of children with autism spectrum disorder (ASD); one member
186.22shall be appointed by the senate Subcommittee on Committees of the Committee on
186.23Rules and Administration making appointments for the senate; and one member shall be
186.24appointed by the speaker of the house making the appointments for the house;
186.25(4) one member appointed by the Minnesota chapter of the American Academy of
186.26Pediatrics who is a general primary care pediatrician;
186.27(5) one member appointed by the Minnesota Academy of Family Physicians who is
186.28a family practice physician;
186.29(6) one member appointed by the Minnesota Psychological Association who is a
186.30neuropsychologist;
186.31(7) one member appointed by the directors of public school student support services;
186.32(8) one member appointed by the Somali American Autism Foundation;
186.33(9) one member appointed by the ARC of Minnesota;
186.34(10) one member appointed by the Autism Society of Minnesota;
187.1(11) one member appointed by the Parent Advocacy Coalition for Educational
187.2Rights; and
187.3(12) one member appointed by the Minnesota Council of Health Plans.
187.4Appointments must be made by September 1, 2009. The Legislative Coordinating
187.5Commission shall provide meeting space for the task force. The senate member appointed
187.6by the minority leader of the senate shall convene the first meeting of the task force no
187.7later than October 1, 2009. The task force shall elect a chair at the first meeting.
187.8(b) If federal or state funding is available, the commissioners of education,
187.9employment and economic development, health, and human services shall provide
187.10assistance to the task force.
187.11(c) The task force shall develop recommendations and report on the following topics:
187.12(1) ways to improve services provided by all state and political subdivisions;
187.13(2) sources of public and private funding available for treatment and ways to
187.14improve efficiency in the use of these funds;
187.15(3) methods to improve coordination in the delivery of service between public
187.16and private agencies, health providers, and schools, and to address any geographic
187.17discrepancies in the delivery of services;
187.18(4) increasing the availability of and the training for medical providers and educators
187.19who identify and provide services to individuals with ASD; and
187.20(5) treatment options supported by peer-reviewed, established scientific research
187.21for individuals with ASD.
187.22(d) The task force shall coordinate with existing efforts at the Departments of
187.23Education, Health, Human Services, and Employment and Economic Development
187.24related to ASD.
187.25(e) By January 15 of each year, the task force shall provide a report regarding its
187.26findings and consideration of the topics listed under paragraph (c), and the action taken
187.27under paragraph (d), including draft legislation if necessary, to the chairs and ranking
187.28minority members of the legislative committees with jurisdiction over health and human
187.29services.
187.30(f) This section expires June 30, 2011.
187.31 Sec. 26. STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT
187.32PROJECT.
187.33 Subdivision 1. Establishment; purpose. There is established a state-county
187.34chemical health care home pilot project. The purpose of the pilot project is for the
187.35Department of Human Services and counties to authentically and creatively work in
188.1partnership to redesign the current chemical health service delivery system in a way
188.2that promotes greater accountability, productivity, and results in the delivery of state
188.3chemical dependency services. The pilot project or projects must look to provide
188.4appropriate flexibility in a way that ensures timely access to needed services as well
188.5as better aligning systems and services to offer the most appropriate level of chemical
188.6health care services to the client. This may include, but is not limited to, looking into new
188.7governance agreements, performance agreements, or service level agreements. Pilot
188.8projects must maintain eligibility requirements for the consolidated chemical dependency
188.9treatment fund, continue to meet the requirements of Minnesota Rules, parts 9530.6600 to
188.109530.6655 (also known as Rule 25) and Minnesota Rules, parts 9530.6405 to 9530.6505
188.11(also known as Rule 31), and must not put at risk current and future federal funding toward
188.12chemical health-related services in the state of Minnesota.
188.13 Subd. 2. Workgroup; report. A workgroup must be convened on or before July
188.1415, 2009, consisting of representatives from the Department of Human Services and
188.15potential participating counties to develop draft proposals for pilot projects meeting the
188.16requirements of this section. The workgroup shall report back to the legislative committees
188.17with jurisdiction over chemical health by January 15, 2010, for potential approval of one
188.18metro and one nonmetro county pilot project to be implemented beginning July 10, 2010.
188.19 Subd. 3. Report. The Department of Human Services shall evaluate the efficacy and
188.20feasibility of the pilot projects and report the results of that evaluation to the legislative
188.21committees having jurisdiction over chemical health by June 30, 2011. Expansion of pilot
188.22projects may occur only if the department's report finds the pilot projects effective.
188.23 Subd. 4. Expiration. This section expires June 30, 2012.
188.24EFFECTIVE DATE.This section is effective the day following final enactment.
188.27 Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to
188.28read:
188.29 Subd. 2. Definitions. For purposes of this section, the following terms have the
188.30meanings given.
188.31(a) "Assessment reference date" means the last day of the minimum data set
188.32observation period. The date sets the designated endpoint of the common observation
188.33period, and all minimum data set items refer back in time from that point.
189.1(b) "Case mix index" means the weighting factors assigned to the RUG-III
189.2classifications.
189.3(c) "Index maximization" means classifying a resident who could be assigned to
189.4more than one category, to the category with the highest case mix index.
189.5(d) "Minimum data set" means the assessment instrument specified by the Centers for
189.6Medicare and Medicaid Services and designated by the Minnesota Department of Health.
189.7(e) "Representative" means a person who is the resident's guardian or conservator,
189.8the person authorized to pay the nursing home expenses of the resident, a representative
189.9of the nursing home ombudsman's office whose assistance has been requested, or any
189.10other individual designated by the resident.
189.11(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
189.12facility's residents according to their clinical and functional status identified in data
189.13supplied by the facility's minimum data set.
189.14(g) "Activities of daily living" means grooming, dressing, bathing, transferring,
189.15mobility, positioning, eating, and toileting.
189.16(h) "Nursing facility level of care determination" means the assessment process
189.17that results in a determination of a resident's or prospective resident's need for nursing
189.18facility level of care as established in subdivision 11 for purposes of medical assistance
189.19payment of long-term care services for:
189.20(1) nursing facility services under section 256B.434 or 256B.441;
189.21(2) elderly waiver services under section 256B.0915;
189.22(3) CADI and TBI waiver services under section 256B.49; and
189.23(4) state payment of alternative care services under section 256B.0913.
189.24EFFECTIVE DATE.The section is effective January 1, 2011.
189.25 Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:
189.26 Subd. 4. Resident assessment schedule. (a) A facility must conduct and
189.27electronically submit to the commissioner of health case mix assessments that conform
189.28with the assessment schedule defined by Code of Federal Regulations, title 42, section
189.29483.20
, and published by the United States Department of Health and Human Services,
189.30Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
189.31Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made
189.32in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0,
189.33August 1996. The commissioner of health may substitute successor manuals or question
189.34and answer documents published by the United States Department of Health and Human
190.1Services, Centers for Medicare and Medicaid Services, to replace or supplement the
190.2current version of the manual or document.
190.3(b) The assessments used to determine a case mix classification for reimbursement
190.4include the following:
190.5(1) a new admission assessment must be completed by day 14 following admission;
190.6(2) an annual assessment must be completed within 366 days of the last
190.7comprehensive assessment;
190.8(3) a significant change assessment must be completed within 14 days of the
190.9identification of a significant change; and
190.10(4) the second quarterly assessment following either a new admission assessment,
190.11an annual assessment, or a significant change assessment, and all quarterly assessments
190.12beginning October 1, 2006. Each quarterly assessment must be completed within 92
190.13days of the previous assessment.
190.14(c) In addition to the assessments listed in paragraph (b), the assessments used to
190.15determine nursing facility level of care include the following:
190.16(1) preadmission screening completed under section 256B.0911, subdivision 4a,
190.17by a county, tribe, or managed care organization under contract with the Department
190.18of Human Services; and
190.19(2) a face-to-face long-term care consultation assessment completed under section
190.20256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization
190.21under contract with the Department of Human Services.
190.22EFFECTIVE DATE.The section is effective January 1, 2011.
190.23 Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:
190.24 Subd. 8. Request for reconsideration of resident classifications. (a) The resident,
190.25or resident's representative, or the nursing facility or boarding care home may request that
190.26the commissioner of health reconsider the assigned reimbursement classification. The
190.27request for reconsideration must be submitted in writing to the commissioner within
190.2830 days of the day the resident or the resident's representative receives the resident
190.29classification notice. The request for reconsideration must include the name of the
190.30resident, the name and address of the facility in which the resident resides, the reasons for
190.31the reconsideration, the requested classification changes, and documentation supporting
190.32the requested classification. The documentation accompanying the reconsideration request
190.33is limited to documentation which establishes that the needs of the resident at the time of
190.34the assessment justify a classification which is different than the classification established
190.35by the commissioner of health.
191.1(b) Upon request, the nursing facility must give the resident or the resident's
191.2representative a copy of the assessment form and the other documentation that was given
191.3to the commissioner of health to support the assessment findings. The nursing facility
191.4shall also provide access to and a copy of other information from the resident's record that
191.5has been requested by or on behalf of the resident to support a resident's reconsideration
191.6request. A copy of any requested material must be provided within three working days of
191.7receipt of a written request for the information. If a facility fails to provide the material
191.8within this time, it is subject to the issuance of a correction order and penalty assessment
191.9under sections144.653 and
144A.10 . Notwithstanding those sections, any correction order
191.10issued under this subdivision must require that the nursing facility immediately comply
191.11with the request for information and that as of the date of the issuance of the correction
191.12order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and
191.13an increase in the $100 fine by $50 increments for each day the noncompliance continues.
191.14(c) In addition to the information required under paragraphs (a) and (b), a
191.15reconsideration request from a nursing facility must contain the following information: (i)
191.16the date the reimbursement classification notices were received by the facility; (ii) the date
191.17the classification notices were distributed to the resident or the resident's representative;
191.18and (iii) a copy of a notice sent to the resident or to the resident's representative. This
191.19notice must inform the resident or the resident's representative that a reconsideration of the
191.20resident's classification is being requested, the reason for the request, that the resident's
191.21rate will change if the request is approved by the commissioner, the extent of the change,
191.22that copies of the facility's request and supporting documentation are available for review,
191.23and that the resident also has the right to request a reconsideration. If the facility fails to
191.24provide the required information with the reconsideration request, the request must be
191.25denied, and the facility may not make further reconsideration requests on that specific
191.26reimbursement classification.
191.27(d) Reconsideration by the commissioner must be made by individuals not involved
191.28in reviewing the assessment, audit, or reconsideration that established the disputed
191.29classification. The reconsideration must be based upon the initial assessment and upon the
191.30information provided to the commissioner under paragraphs (a) and (b). If necessary for
191.31evaluating the reconsideration request, the commissioner may conduct on-site reviews.
191.32Within 15 working days of receiving the request for reconsideration, the commissioner
191.33shall affirm or modify the original resident classification. The original classification
191.34must be modified if the commissioner determines that the assessment resulting in the
191.35classification did not accurately reflect the needs or assessment characteristics of the
191.36resident at the time of the assessment. The resident and the nursing facility or boarding
192.1care home shall be notified within five working days after the decision is made. A decision
192.2by the commissioner under this subdivision is the final administrative decision of the
192.3agency for the party requesting reconsideration.
192.4(e) The resident classification established by the commissioner shall be the
192.5classification that applies to the resident while the request for reconsideration is pending.
192.6If a request for reconsideration applies to an assessment used to determine nursing facility
192.7level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible
192.8for nursing facility level of care while the request for reconsideration is pending.
192.9(f) The commissioner may request additional documentation regarding a
192.10reconsideration necessary to make an accurate reconsideration determination.
192.11EFFECTIVE DATE.The section is effective January 1, 2011.
192.12 Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
192.13to read:
192.14 Subd. 11. Nursing facility level of care. (a) For purposes of medical assistance
192.15payment of long-term care services, a recipient must be determined, using assessments
192.16defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
192.17(1) the person needs the assistance of another person or constant supervision to begin
192.18and complete at least four of the following activities of living: bathing, bed mobility,
192.19dressing, eating, grooming, toileting, transferring, and walking;
192.20(2) the person needs the assistance of another person or constant supervision to begin
192.21and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
192.22(3) the person has significant difficulty with memory, using information, daily
192.23decision making, or behavioral needs that require intervention;
192.24(4) the person has had a qualifying nursing facility stay of at least 90 days; or
192.25(5) the person is determined to be at risk for nursing facility admission or
192.26readmission through a face-to-face long-term care consultation assessment as specified
192.27in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care
192.28organization under contract with the Department of Human Services. The person is
192.29considered at risk under this clause if the person currently lives alone or will live alone
192.30upon discharge and also meets one of the following criteria:
192.31(i) the person has experienced a fall resulting in a fracture;
192.32(ii) the person has been determined to be at risk of maltreatment or neglect,
192.33including self-neglect; or
192.34(iii) the person has a sensory impairment that substantially impacts functional ability
192.35and maintenance of a community residence.
193.1(b) The assessment used to establish medical assistance payment for nursing facility
193.2services must be the most recent assessment performed under subdivision 4, paragraph
193.3(b), that occurred no more than 90 calendar days before the effective date of medical
193.4assistance eligibility for payment of long-term care services. In no case shall medical
193.5assistance payment for long-term care services occur prior to the date of the determination
193.6of nursing facility level of care.
193.7(c) The assessment used to establish medical assistance payment for long-term care
193.8services provided under sections 256B.0915 and 256B.49 and alternative care payment
193.9for services provided under section 256B.0913 must be the most recent face-to-face
193.10assessment performed under section 256B.0911, subdivision 3a, that occurred no more
193.11than 60 calendar days before the effective date of medical assistance eligibility for
193.12payment of long-term care services.
193.13EFFECTIVE DATE.The section is effective January 1, 2011.
193.14 Sec. 5. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
193.15to read:
193.16 Subd. 12. Appeal of nursing facility level of care determination. A resident or
193.17prospective resident whose level of care determination results in a denial of long-term care
193.18services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
193.19paragraph (h), clause (7).
193.20EFFECTIVE DATE.The section is effective January 1, 2011.
193.21 Sec. 6. Minnesota Statutes 2008, section 144A.073, is amended by adding a
193.22subdivision to read:
193.23 Subd. 12. Extension of approval of moratorium exception projects.
193.24Notwithstanding subdivision 3, the commissioner of health shall extend project approval
193.25by an additional 18 months for an approved proposal for an exception to the nursing home
193.26licensure and certification moratorium if the proposal was approved under this section
193.27between July 1, 2007, and June 30, 2009.
193.28 Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read:
193.29 Subd. 2. Interpretation and enforcement of rights. These rights are established
193.30for the benefit of persons who receive home care services. "Home care services" means
193.31home care services as defined in section144A.43, subdivision 3 , and unlicensed personal
193.32care assistance services, including services covered by medical assistance under section
193.33256B.0625, subdivision 19a. A home care provider may not require a person to surrender
194.1these rights as a condition of receiving services. A guardian or conservator or, when there
194.2is no guardian or conservator, a designated person, may seek to enforce these rights. This
194.3statement of rights does not replace or diminish other rights and liberties that may exist
194.4relative to persons receiving home care services, persons providing home care services, or
194.5providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided
194.6to an individual at the time home care services, including personal care assistance
194.7services, are initiated. The copy shall also contain the address and phone number of the
194.8Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care
194.9and a brief statement describing how to file a complaint with these offices. Information
194.10about how to contact the Office of Ombudsman for Long-Term Care shall be included in
194.11notices of change in client fees and in notices where home care providers initiate transfer
194.12or discontinuation of services.
194.13 Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision
194.14to read:
194.15 Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
194.16initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
194.172960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
194.189555.6265, under this chapter for a physical location that will not be the primary residence
194.19of the license holder for the entire period of licensure. If a license is issued during this
194.20moratorium, and the license holder changes the license holder's primary residence away
194.21from the physical location of the foster care license, the commissioner shall revoke the
194.22license according to section 245A.07. Exceptions to the moratorium include:
194.23(1) foster care settings that are required to be registered under chapter 144D;
194.24(2) foster care licenses replacing foster care licenses in existence on the effective
194.25date of this section and determined to be needed by the commissioner under paragraph (b);
194.26(3) new foster care licenses determined to be needed by the commissioner under
194.27paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
194.28(4) new foster care licenses determined to be needed by the commissioner under
194.29paragraph (b) for persons requiring hospital level care; or
194.30(5) new foster care licenses determined to be needed by the commissioner for the
194.31transition of people from personal care assistance to the home and community-based
194.32services.
194.33(b) The commissioner shall determine the need for newly licensed foster care homes
194.34as defined under this subdivision. As part of the determination, the commissioner shall
194.35consider the availability of foster care capacity in the area which the licensee seeks to
195.1operate, and the recommendation of the local county board. The determination by the
195.2commissioner must be final. A determination of need is not required for a change in
195.3ownership at the same address.
195.4 (c) Residential settings that would otherwise be subject to the moratorium established
195.5in paragraph (a), that are in the process of receiving an adult or child foster care license as
195.6of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
195.7or child foster care license. For this paragraph, all of the following conditions must be met
195.8to be considered in process of receiving an adult or child foster care license:
195.9 (1) participants have made decisions to move into the residential setting, including
195.10documentation in each participant's care plan;
195.11 (2) the provider has purchased housing or has made a financial investment in the
195.12property;
195.13 (3) the lead agency has approved the plans, including costs for the residential setting
195.14for each individual;
195.15 (4) the completion of the licensing process, including all necessary inspections, is
195.16the only remaining component prior to being able to provide services; and
195.17 (5) the needs of the individuals cannot be met within the existing capacity in that
195.18county.
195.19To qualify for the process under this paragraph, the lead agency must submit
195.20documentation to the commissioner by August 1, 2009, that all of the above criteria are
195.21met.
195.22(d) The commissioner shall study the effects of the license moratorium under this
195.23subdivision and shall report back to the legislature by January 15, 2011.
195.24EFFECTIVE DATE.This section is effective the day following final enactment.
195.25 Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
195.26to read:
195.27 Subd. 8. Community residential setting license. (a) The commissioner shall
195.28establish provider standards for residential support services that integrate service standards
195.29and the residential setting under one license. The commissioner shall propose statutory
195.30language and an implementation plan for licensing requirements for residential support
195.31services to the legislature by January 15, 2011.
195.32(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
195.33for services in settings licensed as adult foster care under Minnesota Rules, parts
195.349555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to
196.12960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph
196.2(b), must be required to obtain a community residential setting license.
196.3 Sec. 10. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision
196.4to read:
196.5 Subd. 1a. Day training and habilitation rates. The commissioner shall establish
196.6a statewide rate-setting methodology for all day training and habilitation services. The
196.7rate-setting methodology must abide by the principles of transparency and equitability
196.8across the state. The methodology must involve a uniform process of structuring rates for
196.9each service and must promote quality and participant choice.
196.10 Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read:
196.11 Subdivision 1. Community-based programs established. The commissioner
196.12shall establish a system of state-operated, community-based programs for persons with
196.13developmental disabilities. For purposes of this section, "state-operated, community-based
196.14program" means a program administered by the state to provide treatment and habilitation
196.15in noninstitutional community settings to persons with developmental disabilities.
196.16Employees of the programs, except clients who work within and benefit from these
196.17treatment and habilitation programs, must be state employees under chapters 43A and
196.18179A. Although any clients who work within and benefit from these treatment and
196.19habilitation programs are not employees under chapters 43A and 179A, the Department
196.20of Human Services may consider clients who work within and benefit from these
196.21programs employees for federal tax purposes. The establishment of state-operated,
196.22community-based programs must be within the context of a comprehensive definition of
196.23the role of state-operated services in the state. The role of state-operated services must
196.24be defined within the context of a comprehensive system of services for persons with
196.25developmental disabilities. State-operated, community-based programs may include, but
196.26are not limited to, community group homes, foster care, supportive living services, day
196.27training and habilitation programs, and respite care arrangements. The commissioner
196.28may operate the pilot projects established under Laws 1985, First Special Session
196.29chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available
196.30appropriations, establish additional state-operated, community-based programs for
196.31persons with developmental disabilities. State-operated, community-based programs may
196.32accept admissions from regional treatment centers, from the person's own home, or from
196.33community programs. State-operated, community-based programs offering day program
196.34services may be provided for persons with developmental disabilities who are living in
197.1state-operated, community-based residential programs until July 1, 2000. No later than
197.21994, the commissioner, together with family members, counties, advocates, employee
197.3representatives, and other interested parties, shall begin planning so that by July 1, 2000,
197.4state-operated, community-based residential facilities will be in compliance with section
197.5252.41, subdivision 9
.
197.6 Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
197.7to read:
197.8 Subd. 29. State medical review team. (a) To ensure the timely processing of
197.9determinations of disability by the commissioner's state medical review team under
197.10sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
197.11(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
197.12submitted by county agencies with a referral and seek additional information from
197.13providers, applicants, and enrollees to support the determination of disability where
197.14necessary. Disability shall be determined according to the rules of title XVI and title
197.15XIX of the Social Security Act and pertinent rules and policies of the Social Security
197.16Administration.
197.17 (b) Prior to a denial or withdrawal of a requested determination of disability due
197.18to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
197.19necessary and appropriate to a determination of disability, and (2) assist applicants and
197.20enrollees to obtain the evidence, including, but not limited to, medical examinations
197.21and electronic medical records.
197.22(c) The commissioner shall provide the chairs of the legislative committees with
197.23jurisdiction over health and human services finance and budget the following information
197.24on the activities of the state medical review team by February 1, 2010, and annually
197.25thereafter:
197.26(1) the number of applications to the state medical review team that were denied,
197.27approved, or withdrawn;
197.28(2) the average length of time from receipt of the application to a decision;
197.29(3) the number of appeals and appeal results;
197.30(4) for applicants, their age, health coverage at the time of application, hospitalization
197.31history within three months of application, and whether an application for Social Security
197.32or Supplemental Security Income benefits is pending; and
197.33(5) specific information on the medical certification, licensure, or other credentials
197.34of the person or persons performing the medical review determinations and length of
197.35time in that position.
198.1 Sec. 13. [256.0281] INTERAGENCY DATA EXCHANGE.
198.2The Department of Human Services, the Department of Health, and the Office of the
198.3Ombudsman for Mental Health and Developmental Disabilities may establish interagency
198.4agreements governing the electronic exchange of data on providers and individuals
198.5collected, maintained, or used by each agency when such exchange is outlined by each
198.6agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
198.7(1) to improve provider enrollment processes for home and community-based
198.8services and state plan home care services;
198.9(2) to improve quality management of providers between state agencies;
198.10(3) to establish and maintain provider eligibility to participate as providers under
198.11Minnesota health care programs; or
198.12(4) to meet the quality assurance reporting requirements under federal law under
198.13section 1915(c) of the Social Security Act related to home and community-based waiver
198.14programs.
198.15Each interagency agreement must include provisions to ensure anonymity of individuals,
198.16including mandated reporters, and must outline the specific uses of and access to shared
198.17data within each agency. Electronic interfaces between source data systems developed
198.18under these interagency agreements must incorporate these provisions as well as other
198.19HIPPA provisions related to individual data.
198.20 Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read:
198.21 Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of
198.22transferring persons to the consumer support grant program from the family support
198.23program and personal care assistant services, home health aide services, or private duty
198.24nursing services, the amount of funds transferred by the commissioner between the
198.25family support program account, the medical assistance account, or the consumer support
198.26grant account shall be based on each county's participation in transferring persons to the
198.27consumer support grant program from those programs and services.
198.28 (b) At the beginning of each fiscal year, county allocations for consumer support
198.29grants shall be based on:
198.30 (1) the number of persons to whom the county board expects to provide consumer
198.31supports grants;
198.32 (2) their eligibility for current program and services;
198.33 (3) theamount of nonfederal dollars monthly grant levels allowed under subdivision
198.3411; and
199.1 (4) projected dates when persons will start receiving grants. County allocations shall
199.2be adjusted periodically by the commissioner based on the actual transfer of persons or
199.3service openings, and thenonfederal dollars monthly grant levels associated with those
199.4persons or service openings, to the consumer support grant program.
199.5 (c) The amount of funds transferred by the commissioner from the medical
199.6assistance account for an individual may be changed if it is determined by the county or its
199.7agent that the individual's need for support has changed.
199.8 (d) The authority to utilize funds transferred to the consumer support grant account
199.9for the purposes of implementing and administering the consumer support grant program
199.10will not be limited or constrained by the spending authority provided to the program
199.11of origination.
199.12 (e) The commissioner may use up to five percent of each county's allocation, as
199.13adjusted, for payments for administrative expenses, to be paid as a proportionate addition
199.14to reported direct service expenditures.
199.15 (f) The county allocation for each person or the person's legal representative or other
199.16authorized representative cannot exceed the amount allowed under subdivision 11.
199.17 (g) The commissioner may recover, suspend, or withhold payments if the county
199.18board, local agency, or grantee does not comply with the requirements of this section.
199.19 (h) Grant funds unexpended by consumers shall return to the state once a year. The
199.20annual return of unexpended grant funds shall occur in the quarter following the end of
199.21the state fiscal year.
199.22 Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read:
199.23 Subd. 11. Consumer support grant program after July 1, 2001.(a) Effective
199.24July 1, 2001, the commissioner shall allocate consumer support grant resources to
199.25serve additional individuals based on a review of Medicaid authorization and payment
199.26information of persons eligible for a consumer support grant from the most recent fiscal
199.27year. The commissioner shall use the following methodology to calculate maximum
199.28allowable monthly consumer support grant levels:
199.29 (1) For individuals whose program of origination is medical assistance home care
199.30under sections256B.0651 and
256B.0653 to
256B.0656 , the maximum allowable monthly
199.31grant levels are calculated by:
199.32 (i) determiningthe nonfederal share 50 percent of the average service authorization
199.33for each home care rating;
199.34 (ii) calculating the overall ratio of actual payments to service authorizations by
199.35program;
200.1 (iii) applying the overall ratio to the average service authorization level of each
200.2home care rating;
200.3 (iv) adjusting the result for any authorized rate increases provided by the legislature;
200.4and
200.5 (v) adjusting the result for the average monthly utilization per recipient.
200.6 (2) The commissioner may review and evaluate the methodology to reflect changes
200.7in the home careprogram's overall ratio of actual payments to service authorizations
200.8programs.
200.9(b) Effective January 1, 2004, persons previously receiving exception grants will
200.10have their grants calculated using the methodology in paragraph (a), clause (1). If a person
200.11currently receiving an exception grant wishes to have their home care rating reevaluated,
200.12they may request an assessment as defined in section
256B.0651, subdivision 1, paragraph
200.13(b).
200.14 Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:
200.15 Subd. 7. Consumer information and assistance and long-term care options
200.16counseling;senior linkage Senior LinkAge Line. (a) The Minnesota Board on Aging
200.17shall operate a statewideinformation and assistance service to aid older Minnesotans and
200.18their families in making informed choices about long-term care options and health care
200.19benefits. Language services to persons with limited English language skills may be made
200.20available. The service, known as Senior LinkAge Line, must be available during business
200.21hours through a statewide toll-free number and must also be available through the Internet.
200.22 (b) The service mustassist provide long-term care options counseling by assisting
200.23older adults, caregivers, and providers in accessing information and options counseling
200.24about choices in long-term care services that are purchased through private providers or
200.25available through public options. The service must:
200.26 (1) develop a comprehensive database that includes detailed listings in both
200.27consumer- and provider-oriented formats;
200.28 (2) make the database accessible on the Internet and through other telecommunication
200.29and media-related tools;
200.30 (3) link callers to interactive long-term care screening tools and make these tools
200.31available through the Internet by integrating the tools with the database;
200.32 (4) develop community education materials with a focus on planning for long-term
200.33care and evaluating independent living, housing, and service options;
200.34 (5) conduct an outreach campaign to assist older adults and their caregivers in
200.35finding information on the Internet and through other means of communication;
201.1 (6) implement a messaging system for overflow callers and respond to these callers
201.2by the next business day;
201.3 (7) link callers with county human services and other providers to receive more
201.4in-depth assistance and consultation related to long-term care options;
201.5 (8) link callers with quality profiles for nursing facilities and other providers
201.6developed by the commissioner of health;and
201.7 (9) incorporate information about housing with services and consumer rights
201.8within the MinnesotaHelp.info network long-term care database to facilitate consumer
201.9comparison of services and costs among housing with services establishments and with
201.10other in-home services and to support financial self-sufficiency as long as possible.
201.11Housing with services establishments and their arranged home care providers shall provide
201.12information to the commissioner of human services that is consistent with information
201.13required by the commissioner of health under section144G.06 , the Uniform Consumer
201.14Information Guide. The commissioner of human services shall provide the data to the
201.15Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
201.16care database.;
201.17(10) provide long-term care options counseling. Long-term care options counselors
201.18shall:
201.19(i) for individuals not eligible for case management under a public program or public
201.20funding source, provide interactive decision support under which consumers, family
201.21members, or other helpers are supported in their deliberations to determine appropriate
201.22long-term care choices in the context of the consumer's needs, preferences, values, and
201.23individual circumstances, including implementing a community support plan;
201.24(ii) provide Web-based educational information and collateral written materials to
201.25familiarize consumers, family members, or other helpers with the long-term care basics,
201.26issues to be considered, and the range of options available in the community;
201.27(iii) provide long-term care futures planning, which means providing assistance to
201.28individuals who anticipate having long-term care needs to develop a plan for the more
201.29distant future; and
201.30(iv) provide expertise in benefits and financing options for long-term care, including
201.31Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
201.32private pay options, and ways to access low or no-cost services or benefits through
201.33volunteer-based or charitable programs; and
201.34(11) using risk management and support planning protocols, provide long-term care
201.35options counseling to current residents of nursing homes deemed appropriate for discharge
201.36by the commissioner. In order to meet this requirement, the commissioner shall provide
202.1designated Senior LinkAge Line contact centers with a list of nursing home residents
202.2appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
202.3provide these residents, if they indicate a preference to receive long-term care options
202.4counseling, with initial assessment, review of risk factors, independent living support
202.5consultation, or referral to:
202.6(i) services under section 256B.0911, subdivision 3;
202.7(ii) designated care coordinators of contracted entities under section 256B.035 for
202.8persons who are enrolled in a managed care plan; or
202.9(iii) the long-term care consultation team for those who are appropriate for relocation
202.10service coordination due to high-risk factors or psychological or physical disability.
202.11(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
202.12of the statewide information and assistance, and submit this evaluation to the legislature
202.13by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
202.14in service delivery, continuity in information between the service and identified linkages,
202.15and potential use of private funding to enhance the service.
202.16 Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read:
202.17 Subd. 7. Aged, blind, or disabled persons. (a) Medical assistance may be paid for
202.18a person who meets the categorical eligibility requirements of the supplemental security
202.19income program or, who would meet those requirements except for excess income or
202.20assets, and who meets the other eligibility requirements of this section.
202.21(b) Following a determination that the applicant is not aged or blind and does not
202.22meet any other category of eligibility for medical assistance and has not been determined
202.23disabled by the Social Security Administration, applicants under this subdivision shall be
202.24referred to the commissioner's state medical review team for a determination of disability.
202.25 Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to
202.26read:
202.27 Subd. 6a. Home health services. Home health services are those services specified
202.28in Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical
202.29assistance covers home health services at a recipient's home residence. Medical assistance
202.30does not cover home health services for residents of a hospital, nursing facility, or
202.31intermediate care facility, unless the commissioner of human services hasprior authorized
202.32skilled nurse visits for less than 90 days for a resident at an intermediate care facility for
202.33persons with developmental disabilities, to prevent an admission to a hospital or nursing
202.34facility or unless a resident who is otherwise eligible is on leave from the facility and the
203.1facility either pays for the home health services or forgoes the facility per diem for the
203.2leave days that home health services are used. Home health services must be provided by
203.3a Medicare certified home health agency. All nursing and home health aide services must
203.4be provided according to sections256B.0651 to
256B.0656256B.0653 .
203.5 Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to
203.6read:
203.7 Subd. 7. Private duty nursing. Medical assistance covers private duty nursing
203.8services in a recipient's home. Recipients who are authorized to receive private duty
203.9nursing services in their home may use approved hours outside of the home during hours
203.10when normal life activities take them outside of their home. To use private duty nursing
203.11services at school, the recipient or responsible party must provide written authorization in
203.12the care plan identifying the chosen provider and the daily amount of services to be used at
203.13school. Medical assistance does not cover private duty nursing services for residents of a
203.14hospital, nursing facility, intermediate care facility, or a health care facility licensed by the
203.15commissioner of health, except as authorized in section256B.64 for ventilator-dependent
203.16recipients in hospitals or unless a resident who is otherwise eligible is on leave from the
203.17facility and the facility either pays for the private duty nursing services or forgoes the
203.18facility per diem for the leave days that private duty nursing services are used. Total hours
203.19of service and payment allowed for services outside the home cannot exceed that which is
203.20otherwise allowed in an in-home setting according to sections256B.0651 and
256B.0653
203.21256B.0654
to
256B.0656 . All private duty nursing services must be provided according to
203.22the limits established under sections256B.0651 and
256B.0653 to
256B.0656 . Private
203.23duty nursing services may not be reimbursed if the nurse is the family foster care provider
203.24of a recipient who is under age 18, unless allowed under section 256B.0654, subdivision 4.
203.25 Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to
203.26read:
203.27 Subd. 19a. Personal careassistant assistance services. Medical assistance covers
203.28personal careassistant assistance services in a recipient's home. Effective January 1,
203.292010, to qualify for personal careassistant assistance services, a recipient must require
203.30assistance and be determined dependent in one activity of daily living as defined in section
203.31256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section
203.32256B.0659, subdivision 1, paragraph (c). Beginning July 1, 2011, to qualify for personal
203.33care assistance services, a recipient must require assistance and be determined dependent
203.34in at least two activities of daily living as defined in section 256B.0659. Recipients or
204.1responsible parties must be able to identify the recipient's needs, direct and evaluate task
204.2accomplishment, and provide for health and safety. Approved hours may be used outside
204.3the home when normal life activities take them outside the home. To use personal care
204.4assistant assistance services at school, the recipient or responsible party must provide
204.5written authorization in the care plan identifying the chosen provider and the daily amount
204.6of services to be used at school. Total hours for services, whether actually performed
204.7inside or outside the recipient's home, cannot exceed that which is otherwise allowed for
204.8personal careassistant assistance services in an in-home setting according to sections
204.9256B.0651
and
256B.0653256B.0656 . Medical assistance does not cover personal care
204.10assistant assistance services for residents of a hospital, nursing facility, intermediate care
204.11facility, health care facility licensed by the commissioner of health, or unless a resident
204.12who is otherwise eligible is on leave from the facility and the facility either pays for the
204.13personal careassistant assistance services or forgoes the facility per diem for the leave
204.14days that personal careassistant assistance services are used. All personal care assistant
204.15assistance services must be provided according to sections256B.0651 and
256B.0653
204.16to256B.0656 . Personal care assistant assistance services may not be reimbursed if the
204.17personal care assistant is the spouse orlegal paid guardian of the recipient or the parent of
204.18a recipient under age 18, or the responsible party or the family foster care provider of a
204.19recipient who cannot direct the recipient's own care unless, in the case of a foster care
204.20provider, a county or state case manager visits the recipient as needed, but not less than
204.21every six months, to monitor the health and safety of the recipient and to ensure the goals
204.22of the care plan are met. Parents of adult recipients, adult children of the recipient or
204.23adult siblings of the recipient may be reimbursed for personal care assistant services,
204.24if they are granted a waiver under sections
256B.0651 and
256B.0653 to
256B.0656
204.25Notwithstanding the provisions of section256B.0655, subdivision 2, paragraph (b), clause
204.26(4) 256B.0659, the noncorporate legal unpaid guardian or conservator of an adult, who is
204.27not the responsible party and not the personal care provider organization, may begranted a
204.28hardship waiver under sections
256B.0651 and
256B.0653 to
256B.0656, to be reimbursed
204.29to provide personal careassistant assistance services to the recipient if the guardian or
204.30conservator meets all criteria for a personal care assistant according to section256B.0659 ,
204.31and shall not be considered to have a service provider interest for purposes of participation
204.32on the screening team under section256B.092, subdivision 7 .
204.33 Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to
204.34read:
205.1 Subd. 19c. Personal care. Medical assistance covers personal careassistant
205.2assistance services provided by an individual who is qualified to provide the services
205.3according to subdivision 19a and sections256B.0651 and
256B.0653256B.0656 ,
205.4where the services have a statement of need by a physician, provided in accordance with
205.5a plan, andare supervised by the recipient or a qualified professional. The physician's
205.6statement of need for personal care assistant services shall be documented on a form
205.7approved by the commissioner and include the diagnosis or condition of the person that
205.8results in a need for personal care assistant services and be updated when the person's
205.9medical condition requires a change, but at least annually if the need for personal care
205.10assistant services is ongoing.
205.11"Qualified professional" means a mental health professional as defined in section245.462,
205.12subdivision 18 , or
245.4871, subdivision 27 ; or a registered nurse as defined in sections
205.13148.171
to
148.285 , or a licensed social worker as defined in section
148B.21, or a
205.14qualified developmental disabilities specialist undersection 245B.07, subdivision 4 .
205.15As part of the assessment, the county public health nurse will assist the recipient or
205.16responsible party to identify the most appropriate person to provide supervision of the
205.17personal care assistant. The qualified professional shall perform the duties described
205.18required inMinnesota Rules, part 9505.0335, subpart 4 section 256B.0659.
205.19 Sec. 22. Minnesota Statutes 2008, section 256B.0641, subdivision 3, is amended to
205.20read:
205.21 Subd. 3. Facility in receivership. Subdivision 2 does not apply to the change of
205.22ownership of a facility to a nonrelated organization while the facility to be sold, transferred
205.23or reorganized is in receivership under section 144A.14, 144A.15,245A.12, or
245A.13 ,
205.24and the commissioner during the receivership has not determined the need to place
205.25residents of the facility into a newly constructed or newly established facility. Nothing
205.26in this subdivision limits the liability of a former owner.
205.27 Sec. 23. Minnesota Statutes 2008, section 256B.0651, is amended to read:
205.28256B.0651 HOME CARE SERVICES.
205.29 Subdivision 1. Definitions. (a)"Activities of daily living" includes eating, toileting,
205.30grooming, dressing, bathing, transferring, mobility, and positioning For the purposes of
205.31sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g)
205.32have the meanings given.
205.33(b) "Activities of daily living" has the meaning given in section 256B.0659,
205.34subdivision 1, paragraph (b).
206.1(c) "Assessment" means a review and evaluation of a recipient's need for home care
206.2services conducted in person.Assessments for home health agency services shall be
206.3conducted by a home health agency nurse. Assessments for medical assistance home care
206.4services for developmental disability and alternative care services for developmentally
206.5disabled home and community-based waivered recipients may be conducted by the county
206.6public health nurse to ensure coordination and avoid duplication. Assessments must be
206.7completed on forms provided by the commissioner within 30 days of a request for home
206.8care services by a recipient or responsible party.
206.9(c) (d) "Home care services" means a health service, determined by the commissioner
206.10as medically necessary, that is ordered by a physician and documented in a service plan
206.11that is reviewed by the physician at least once every 60 days for the provision of home
206.12health services, or private duty nursing, or at least once every 365 days for personal care.
206.13Home care services are provided to the recipient at the recipient's residence that is a
206.14place other than a hospital or long-term care facility or as specified in section
256B.0625
206.15means medical assistance covered services that are home health agency services, including
206.16skilled nurse visits; home health aide visits; physical therapy, occupational therapy,
206.17respiratory therapy, and language-speech pathology therapy; private duty nursing; and
206.18personal care assistance.
206.19(e) "Home residence," effective January 1, 2010, means a residence owned or rented
206.20by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid
206.21responsible party or legal representative; or a family foster home where the license holder
206.22lives with the recipient and is not paid to provide home care services for the recipient
206.23except as allowed under sections 256B.0651, subdivision 9, and 256B.0654, subdivision 4.
206.24(d) (f) "Medically necessary" has the meaning given in Minnesota Rules, parts
206.259505.0170 to 9505.0475.
206.26(e) "Telehomecare" means the use of telecommunications technology by a home
206.27health care professional to deliver home health care services, within the professional's
206.28scope of practice, to a patient located at a site other than the site where the practitioner
206.29is located.
206.30(g) "Ventilator-dependent" means an individual who receives mechanical ventilation
206.31for life support at least six hours per day and is expected to be or has been dependent on a
206.32ventilator for at least 30 consecutive days.
206.33 Subd. 2. Services covered. Home care services covered under this section and
206.34sections256B.0653256B.0656 and 256B.0659 include:
206.35(1) nursing services undersection sections
256B.0625, subdivision 6a, and
206.36256B.0653 ;
207.1(2) private duty nursing services undersection sections
256B.0625, subdivision
207.27 , and 256B.0654;
207.3(3) home health services undersection sections
256B.0625, subdivision 6a, and
207.4256B.0653 ;
207.5(4) personal careassistant assistance services under section sections
256B.0625,
207.6subdivision 19a , and 256B.0659;
207.7(5) supervision of personal careassistant assistance services provided by a qualified
207.8professional undersection sections
256B.0625, subdivision 19a , and 256B.0659;
207.9(6)qualified professional of personal care assistant services under the fiscal
207.10intermediary option as specified in section
256B.0655, subdivision 7;
207.11(7) face-to-face assessments by county public health nurses for services under
207.12section sections
256B.0625, subdivision 19a , 256B.0655, and 256B.0659; and
207.13(8) (7) service updates and review of temporary increases for personal care assistant
207.14assistance services by the county public health nurse for services undersection sections
207.15256B.0625, subdivision 19a
, and 256B.0659.
207.16 Subd. 3. Noncovered home care services. The following home care services are
207.17not eligible for payment under medical assistance:
207.18(1) skilled nurse visits for the sole purpose of supervision of the home health aide;
207.19(2) a skilled nursing visit:
207.20(i) only for the purpose of monitoring medication compliance with an established
207.21medication program for a recipient; or
207.22(ii) to administer or assist with medication administration, including injections,
207.23prefilling syringes for injections, or oral medication set-up of an adult recipient, when as
207.24determined and documented by the registered nurse, the need can be met by an available
207.25pharmacy or the recipient is physically and mentally able to self-administer or prefill
207.26a medication;
207.27(3) home care services to a recipient who is eligible for covered services under the
207.28Medicare program or any other insurance held by the recipient;
207.29(4) services to other members of the recipient's household;
207.30(5) a visit made by a skilled nurse solely to train other home health agency workers;
207.31(6) any home care service included in the daily rate of the community-based
207.32residential facility where the recipient is residing;
207.33(7) nursing and rehabilitation therapy services that are reasonably accessible to a
207.34recipient outside the recipient's place of residence, excluding the assessment, counseling
207.35and education, and personal assistant care;
208.1(8) any home health agency service, excluding personal care assistant services and
208.2private duty nursing services, which are performed in a place other than the recipient's
208.3residence; and
208.4(9) Medicare evaluation or administrative nursing visits on dual-eligible recipients
208.5that do not qualify for Medicare visit billing.
208.6(1) services provided in a nursing facility, hospital, or intermediate care facility with
208.7exceptions in section 256B.0653;
208.8(2) services for the sole purpose of monitoring medication compliance with an
208.9established medication program for a recipient;
208.10(3) home care services for covered services under the Medicare program or any other
208.11insurance held by the recipient;
208.12(4) services to other members of the recipient's household;
208.13(5) any home care service included in the daily rate of the community-based
208.14residential facility where the recipient is residing;
208.15(6) nursing and rehabilitation therapy services that are reasonably accessible to a
208.16recipient outside the recipient's place of residence, excluding the assessment, counseling
208.17and education, and personal assistance care; or
208.18(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients
208.19that do not qualify for Medicare visit billing.
208.20 Subd. 4.Prior Authorization; exceptions. All home care services above the limits
208.21in subdivision 11 must receive the commissioner'sprior authorization before services
208.22begin, except when:
208.23(1) the home care services were required to treat an emergency medical condition
208.24that if not immediately treated could cause a recipient serious physical or mental disability,
208.25continuation of severe pain, or death. The provider must request retroactive authorization
208.26no later than five working days after giving the initial service. The provider must be able
208.27to substantiate the emergency by documentation such as reports, notes, and admission or
208.28discharge histories;
208.29(2)the home care services were provided on or after the date on which the recipient's
208.30eligibility began, but before the date on which the recipient was notified that the case was
208.31opened. Authorization will be considered if the request is submitted by the provider
208.32within 20 working days of the date the recipient was notified that the case was opened;
208.33a recipient's medical assistance eligibility has lapsed, is then retroactively reinstated,
208.34and an authorization for home care services is completed based on the date of a current
208.35assessment, eligibility, and request for authorization;
209.1(3) a third-party payor for home care services has denied or adjusted a payment.
209.2Authorization requests must be submitted by the provider within 20 working days of the
209.3notice of denial or adjustment. A copy of the notice must be included with the request;
209.4(4) the commissioner has determined that a county or state human services agency
209.5has made an error; or
209.6(5)the professional nurse determines an immediate need for up to 40 skilled nursing
209.7or home health aide visits per calendar year and submits a request for authorization within
209.820 working days of the initial service date, and medical assistance is determined to be
209.9the appropriate payer. if a recipient enrolled in managed care experiences a temporary
209.10disenrollment from a health plan, the commissioner shall accept the current health plan
209.11authorization for personal care assistance services for up to 60 days. The request must
209.12be received within the first 30 days of the disenrollment. If the recipient's reenrollment
209.13in managed care is after the 60 days and before 90 days, the provider shall request an
209.14additional 30-day extension of the current health plan authorization, for a total limit of
209.1590 days from the time of disenrollment.
209.16Subd. 5. Retroactive authorization. A request for retroactive authorization will be
209.17evaluated according to the same criteria applied to prior authorization requests.
209.18 Subd. 6.Prior Authorization. (a) The commissioner, or the commissioner's
209.19designee, shall review the assessment,service update, request for temporary services,
209.20request for flexible use option, service plan, and any additional information that is
209.21submitted. The commissioner shall, within 30 days after receiving a complete request,
209.22assessment, and service plan, authorize home care services asfollows: provided in this
209.23section.
209.24(a) Home health services. (b) All Home health services provided by a home health
209.25aide including skilled nurse visits and home health aide visits must be prior authorized
209.26by the commissioner or the commissioner's designee.Prior Authorization must be based
209.27on medical necessity and cost-effectiveness when compared with other care options.
209.28The commissioner must receive the request for authorization of skilled nurse visits and
209.29home health aide visits within 20 working days of the start of service. When home health
209.30services are used in combination with personal care and private duty nursing, the cost of
209.31all home care services shall be considered for cost-effectiveness.The commissioner shall
209.32limit home health aide visits to no more than one visit each per day. The commissioner, or
209.33the commissioner's designee, may authorize up to two skilled nurse visits per day.
209.34(b) Ventilator-dependent recipients. (c) If the recipient is ventilator-dependent, the
209.35monthly medical assistance authorization for home care services shall not exceed what the
209.36commissioner would pay for care at the highest cost hospital designated as a long-term
210.1hospital under the Medicare program. For purposes of this paragraph, home care services
210.2means all direct care services provided in the home that would be included in the payment
210.3for care at the long-term hospital."Ventilator-dependent" means an individual who
210.4receives mechanical ventilation for life support at least six hours per day and is expected
210.5to be or has been dependent for at least 30 consecutive days. Recipients who meet the
210.6definition of ventilator dependent and the EN home care rating and utilize a combination
210.7of home care services are limited up to a total of 24 hours of home care services per day.
210.8Additional hours may be authorized when a recipient's assessment indicates a need for two
210.9staff to perform activities. Additional time is limited to four hours per day.
210.10 Subd. 7.Prior Authorization; time limits. (a) The commissioner or the
210.11commissioner's designee shall determine the time period for whicha prior an authorization
210.12shall be effectiveand, if flexible use has been requested, whether to allow the flexible use
210.13option. If the recipient continues to require home care services beyond the duration of
210.14theprior authorization, the home care provider must request a new prior authorization.
210.15A personal care provider agency must request a new personal careassistant assistance
210.16 services assessment, or service update if allowed, at least 60 days prior to the end of
210.17the currentprior authorization time period. The request for the assessment must be
210.18made on a form approved by the commissioner.Under no circumstances, other than the
210.19exceptions in subdivision 4, shall a prior An authorization must be valid prior to the date
210.20the commissioner receives the request or for no more than 12 months.
210.21(b) The amount and type of personal care assistance services authorized based
210.22upon the assessment and service plan must remain in effect for the recipient whether
210.23the recipient chooses a different provider or enrolls or disenrolls from a managed care
210.24plan under section 256B.0659, unless the service needs of the recipient change and new
210.25assessment is warranted under section 256B.0655, subdivision 1b.
210.26(c) A recipient who appeals a reduction in previously authorized home care
210.27services may continue previously authorized services, other than temporary services
210.28under subdivision 8, pending an appeal under section256.045 . The commissioner must
210.29provide ensure that the recipient has a copy of the most recent service plan that contains
210.30 a detailed explanation ofwhy the authorized services which areas of covered personal
210.31care assistance tasks are reducedin amount from those requested by the home care
210.32provider, and provide notice of the amount of time per day reduced, and the reasons for
210.33the reduction in the recipient's notice of denial, termination, or reduction.
210.34 Subd. 8.Prior Authorization requests; temporary services. The agency nurse,
210.35the independently enrolled private duty nurse, or county public health nurse may request
210.36a temporary authorization for home care servicesby telephone. The commissioner may
211.1approve a temporary level of home care services based on the assessment, and service
211.2or care plan information, and primary payer coverage determination information as
211.3required. Authorization for a temporary level of home care services including nurse
211.4supervision is limited to the time specified by the commissioner, but shall not exceed
211.545 days, unless extended because the county public health nurse has not completed the
211.6required assessment and service plan, or the commissioner's determination has not been
211.7made. The level of services authorized under this provision shall have no bearing on a
211.8futureprior authorization.
211.9 Subd. 9.Prior Authorization for foster care setting. (a) Home care services
211.10provided in an adult or child foster care setting must receiveprior authorization by the
211.11department commissioner according to the limits established in subdivision 11.
211.12(b) The commissioner may not authorize:
211.13(1) home care services that are the responsibility of the foster care provider under
211.14the terms of the foster care placement agreement, difficulty of care rate as of January 1,
211.152010, and administrative rules;
211.16(2) personal careassistant assistance services when the foster care license holder is
211.17also the personal care provider or personal care assistantunless the recipient can direct the
211.18recipient's own care, or case management is provided as required in section
256B.0625,
211.19subdivision 19a
211.20defined in section 256B.0625, subdivision 19a; or
211.21(3) personal care assistant services when the responsible party is an employee of, or
211.22under contract with, or has any direct or indirect financial relationship with the personal
211.23care provider or personal care assistant, unless case management is provided as required
211.24in section
256B.0625, subdivision 19a; or
211.25(4) (3) personal care assistant and private duty nursing services when the number
211.26of foster care residents licensed capacity is greater than four unless the county responsible
211.27for the recipient's foster placement made the placement prior to April 1, 1992, requests
211.28that personal care assistant and private duty nursing services be provided, and case
211.29management is provided as required in section
256B.0625, subdivision 19a
211.30Subd. 10. Limitation on payments. Medical assistance payments for home care
211.31services shall be limited according to subdivisions 4 to 12 and sections
256B.0654,
211.32subdivision 2
, and
256B.0655, subdivisions 3 and 4.
211.33 Subd. 11. Limits on services withoutprior authorization. A recipient may receive
211.34the following home care services during a calendar year:
212.1(1) up to two face-to-face assessments to determine a recipient's need for personal
212.2careassistant assistance services;
212.3(2) one service update done to determine a recipient's need for personal careassistant
212.4assistance services; and
212.5(3) up to nine face-to-face skilled nurse visits.
212.6 Subd. 12. Approval of home care services. The commissioner or the
212.7commissioner's designee shall determine the medical necessity of home care services,
212.8the level of caregiver according to subdivision 2, and the institutional comparison
212.9according to subdivisions 4 to 12 and sections256B.0654, subdivision 2 , and
256B.0655,
212.10subdivisions 3 and 4 , and 256B.0659, the cost-effectiveness of services, and the amount,
212.11scope, and duration of home care services reimbursable by medical assistance, based
212.12on the assessment, primary payer coverage determination information as required, the
212.13service plan, the recipient's age, the cost of services, the recipient's medical condition, and
212.14diagnosis or disability. The commissioner may publish additional criteria for determining
212.15medical necessity according to section256B.04 .
212.16 Subd. 13. Recovery of excessive payments. The commissioner shall seek
212.17monetary recovery from providers of payments made for services which exceed the limits
212.18established in this section and sections256B.0653 to
256B.0656 , and 256B.0659. This
212.19subdivision does not apply to services provided to a recipient at the previously authorized
212.20level pending an appeal under section256.045, subdivision 10 .
212.21 Subd. 14. Referrals to Medicare providers required. Home care providers that
212.22do not participate in or accept Medicare assignment must refer and document the referral
212.23of dual-eligible recipients to Medicare providers when Medicare is determined to be the
212.24appropriate payer for services and supplies and equipment. Providers must be terminated
212.25from participation in the medical assistance program for failure to make these referrals.
212.26 Subd. 15. Quality assurance for program integrity. The commissioner shall
212.27establish an ongoing quality assurance process for home care services to monitor program
212.28integrity, including provider standards and training, consumer surveys, and random
212.29reviews of documentation.
212.30 Subd. 16. Oversight of enrolled providers. The commissioner has the authority to
212.31request proof of documentation of meeting provider standards, quality standards of care,
212.32correct billing practices, and other information. Failure to comply with or to provide access
212.33and information to demonstrate compliance with laws, rules, or policies may result in
212.34suspension, denial, or termination of the provider agency's enrollment with the department.
213.1 Sec. 24. Minnesota Statutes 2008, section 256B.0652, is amended to read:
213.2256B.0652PRIOR AUTHORIZATION AND REVIEW OF HOME CARE
213.3SERVICES.
213.4 Subdivision 1. State coordination. The commissioner shall supervise the
213.5coordination of theprior authorization and review of home care services that are
213.6reimbursed by medical assistance.
213.7 Subd. 2. Duties. (a) The commissioner may contract with or employqualified
213.8registered nurses and necessary support staff, or contract with qualified agencies, to
213.9provide home careprior authorization and review services for medical assistance
213.10recipients who are receiving home care services.
213.11(b) Reimbursement for theprior authorization function shall be made through the
213.12medical assistance administrative authority. The state shall pay the nonfederal share.
213.13The functions will be to:
213.14(1) assess the recipient's individual need for services required to be cared for safely
213.15in the community;
213.16(2) ensure that aservice care plan that meets the recipient's needs is developed
213.17by the appropriate agency or individual;
213.18(3) ensure cost-effectiveness and nonduplication of medical assistance home care
213.19services;
213.20(4) recommend the approval or denial of the use of medical assistance funds to pay
213.21for home care services;
213.22(5) reassess the recipient's need for and level of home care services at a frequency
213.23determined by the commissioner;and
213.24(6) conduct on-site assessments when determined necessary by the commissioner
213.25and recommend changes to care plans that will provide more efficient and appropriate
213.26home care; and
213.27(7) on the department's Web site:
213.28(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies
213.29with the following information: main office address, contact information for the agency,
213.30counties in which services are provided, type of home care services provided, whether
213.31the personal care assistance choice option is offered, types of qualified professionals
213.32employed, number of personal care assistants employed, and data on staff turnover; and
213.33(ii) post data on home care services including information from both fee-for-service
213.34and managed care plans on recipients as available.
213.35(c) In addition, the commissioner or the commissioner's designee may:
214.1(1) review care plans, service plans, and reimbursement data for utilization of
214.2services that exceed community-based standards for home care, inappropriate home care
214.3services, medical necessity, home care services that do not meet quality of care standards,
214.4or unauthorized services and make appropriate referrals within the department or to other
214.5appropriate entities based on the findings;
214.6(2) assist the recipient in obtaining services necessary to allow the recipient to
214.7remain safely in or return to the community;
214.8(3) coordinate home care services with other medical assistance services under
214.9section256B.0625 ;
214.10(4) assist the recipient with problems related to the provision of home care services;
214.11(5) assure the quality of home care services; and
214.12(6) assure that all liable third-party payers including, but not limited to, Medicare
214.13have been used prior to medical assistance for home care services, including but not
214.14limited to, home health agency, elected hospice benefit, waivered services, alternative care
214.15program services, and personal care services.
214.16(d) For the purposes of this section, "home care services" means medical assistance
214.17services defined under section256B.0625, subdivisions 6a, 7, and 19a .
214.18 Subd. 3. Assessment andprior authorization process for persons receiving
214.19personal care assistance and developmental disabilities services.Effective January 1,
214.201996, For purposes of providing informed choice, coordinating of local planning decisions,
214.21and streamlining administrative requirements, the assessment andprior authorization
214.22process for persons receiving both home care and home and community-based waivered
214.23services for persons with developmental disabilities shall meet the requirements of
214.24sections256B.0651 and
256B.0653 to
256B.0656 with the following exceptions:
214.25(a) Upon request for home care services and subsequent assessment by the public
214.26health nurse under sections256B.0651 and
256B.0653 to
256B.0656 , the public health
214.27nurse shall participate in the screening process, as appropriate, and, if home care
214.28services are determined to be necessary, participate in the development of a service plan
214.29coordinating the need for home care and home and community-based waivered services
214.30with the assigned county case manager, the recipient of services, and the recipient's legal
214.31representative, if any.
214.32(b) The public health nurse shall giveprior authorization for home care services
214.33to the extent that home care services are:
214.34(1) medically necessary;
214.35(2) chosen by the recipient and their legal representative, if any, from the array of
214.36home care and home and community-based waivered services available;
215.1(3) coordinated with other services to be received by the recipient as described
215.2in the service plan; and
215.3(4) provided within the county's reimbursement limits for home care and home and
215.4community-based waivered services for persons with developmental disabilities.
215.5(c) If the public health agency is or may be the provider of home care services to the
215.6recipient, the public health agency shall provide the commissioner of human services with
215.7a written plan that specifies how the assessment andprior authorization process will be
215.8held separate and distinct from the provision of services.
215.9 Sec. 25. Minnesota Statutes 2008, section 256B.0653, is amended to read:
215.10256B.0653 HOME HEALTH AGENCYCOVERED SERVICES.
215.11 Subdivision 1.Homecare; skilled nurse visits Scope. "Skilled nurse visits" are
215.12provided in a recipient's residence under a plan of care or service plan that specifies a level
215.13of care which the nurse is qualified to provide. These services are:
215.14(1) nursing services according to the written plan of care or service plan and accepted
215.15standards of medical and nursing practice in accordance with chapter 148;
215.16(2) services which due to the recipient's medical condition may only be safely and
215.17effectively provided by a registered nurse or a licensed practical nurse;
215.18(3) assessments performed only by a registered nurse; and
215.19(4) teaching and training the recipient, the recipient's family, or other caregivers
215.20requiring the skills of a registered nurse or licensed practical nurse. This section applies to
215.21home health agency services including, home health aide, skilled nursing visits, physical
215.22therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.
215.23 Subd. 2.Telehomecare; skilled nurse visits Definitions. Medical assistance
215.24covers skilled nurse visits according to section
256B.0625, subdivision 6a, provided via
215.25telehomecare, for services which do not require hands-on care between the home care
215.26nurse and recipient. The provision of telehomecare must be made via live, two-way
215.27interactive audiovisual technology and may be augmented by utilizing store-and-forward
215.28technologies. Store-and-forward technology includes telehomecare services that do not
215.29occur in real time via synchronous transmissions, and that do not require a face-to-face
215.30encounter with the recipient for all or any part of any such telehomecare visit. Individually
215.31identifiable patient data obtained through real-time or store-and-forward technology must
215.32be maintained as health records according to sections 144.291 to 144.298. If the video
215.33is used for research, training, or other purposes unrelated to the care of the patient, the
215.34identity of the patient must be concealed. A communication between the home care nurse
215.35and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or
216.1a consultation between two health care practitioners, is not to be considered a telehomecare
216.2visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage
216.3of telehomecare is limited to two visits per day. All skilled nurse visits provided via
216.4telehomecare must be prior authorized by the commissioner or the commissioner's
216.5designee and will be covered at the same allowable rate as skilled nurse visits provided
216.6in-person. For the purposes of this section, the following terms have the meanings given.
216.7(a) "Assessment" means an evaluation of the recipient's medical need for home
216.8health agency services by a registered nurse or appropriate therapist that is conducted
216.9within 30 days of a request.
216.10(b) "Home care therapies" means occupational, physical, and respiratory therapy
216.11and speech-language pathology services provided in the home by a Medicare certified
216.12home health agency.
216.13(c) "Home health agency services" means services delivered in the recipient's home
216.14residence, except as specified in section 256B.0625, by a home health agency to a recipient
216.15with medical needs due to illness, disability, or physical conditions.
216.16(d) "Home health aide" means an employee of a home health agency who completes
216.17medically oriented tasks written in the plan of care for a recipient.
216.18(e) "Home health agency" means a home care provider agency that is
216.19Medicare-certified.
216.20(f) "Occupational therapy services" mean the services defined in Minnesota Rules,
216.21part 9505.0390.
216.22(g) "Physical therapy services" mean the services defined in Minnesota Rules, part
216.239505.0390.
216.24(h) "Respiratory therapy services" mean the services defined in chapter 147C and
216.25Minnesota Rules, part 4668.0003, subpart 37.
216.26(i) "Speech-language pathology services" mean the services defined in Minnesota
216.27Rules, part 9505.0390.
216.28(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks
216.29required due to a recipient's medical condition that can only be safely provided by a
216.30professional nurse to restore and maintain optimal health.
216.31(k) "Store-and-forward technology" means telehomecare services that do not occur
216.32in real time via synchronous transmissions such as diabetic and vital sign monitoring.
216.33(l) "Telehomecare" means the use of telecommunications technology via
216.34live, two-way interactive audiovisual technology which may be augmented by
216.35store-and-forward technology.
217.1(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to
217.2deliver a skilled nurse visit to a recipient located at a site other than the site where the
217.3nurse is located and is used in combination with face-to-face skilled nurse visits to
217.4adequately meet the recipient's needs.
217.5 Subd. 3.Therapies through home health agencies Home health aide visits.
217.6(a) Medical assistance covers physical therapy and related services, including specialized
217.7maintenance therapy. Services provided by a physical therapy assistant shall be
217.8reimbursed at the same rate as services performed by a physical therapist when the
217.9services of the physical therapy assistant are provided under the direction of a physical
217.10therapist who is on the premises. Services provided by a physical therapy assistant that are
217.11provided under the direction of a physical therapist who is not on the premises shall be
217.12reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy
217.13assistant must be provided by the physical therapist as described in Minnesota Rules, part
217.149505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may
217.15not both bill for services provided to a recipient on the same day.
217.16(b) Medical assistance covers occupational therapy and related services, including
217.17specialized maintenance therapy. Services provided by an occupational therapy assistant
217.18shall be reimbursed at the same rate as services performed by an occupational therapist
217.19when the services of the occupational therapy assistant are provided under the direction of
217.20the occupational therapist who is on the premises. Services provided by an occupational
217.21therapy assistant under the direction of an occupational therapist who is not on the
217.22premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction
217.23of the occupational therapy assistant must be provided by the occupational therapist as
217.24described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational
217.25therapist and occupational therapist assistant may not both bill for services provided
217.26to a recipient on the same day.
217.27(a) Home health aide visits must be provided by a certified home health aide
217.28using a written plan of care that is updated in compliance with Medicare regulations.
217.29A home health aide shall provide hands-on personal care, perform simple procedures
217.30as an extension of therapy or nursing services, and assist in instrumental activities of
217.31daily living as defined in section 256B.0659. Home health aide visits must be provided
217.32in the recipient's home.
217.33(b) All home health aide visits must have authorization under section 256B.0652.
217.34The commissioner shall limit home health aide visits to no more than one visit per day
217.35per recipient.
218.1(c) Home health aides must be supervised by a registered nurse or an appropriate
218.2therapist when providing services that are an extension of therapy.
218.3 Subd. 4. Skilled nurse visit services. (a) Skilled nurse visit services must be
218.4provided by a registered nurse or a licensed practical nurse under the supervision of a
218.5registered nurse, according to the written plan of care and accepted standards of medical
218.6and nursing practice according to chapter 148. Skilled nurse visit services must be ordered
218.7by a physician and documented in a plan of care that is reviewed and approved by the
218.8ordering physician at least once every 60 days. All skilled nurse visits must be medically
218.9necessary and provided in the recipient's home residence except as allowed under section
218.10256B.0625, subdivision 6a.
218.11(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of
218.12up to two visits per day per recipient. All visits must be based on assessed needs.
218.13(c) Telehomecare skilled nurse visits are allowed when the recipient's health status
218.14can be accurately measured and assessed without a need for a face-to-face, hands-on
218.15encounter. All telehomecare skilled nurse visits must have authorization and are paid at
218.16the same allowable rates as face-to-face skilled nurse visits.
218.17(d) The provision of telehomecare must be made via live, two-way interactive
218.18audiovisual technology and may be augmented by utilizing store-and-forward
218.19technologies. Individually identifiable patient data obtained through real-time or
218.20store-and-forward technology must be maintained as health records according to sections
218.21144.291 to 144.298. If the video is used for research, training, or other purposes unrelated
218.22to the care of the patient, the identity of the patient must be concealed.
218.23(e) Authorization for skilled nurse visits must be completed under section
218.24256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not
218.25require authorization. All telehomecare skilled nurse visits require authorization.
218.26 Subd. 5. Home care therapies. (a) Home care therapies include the following:
218.27physical therapy, occupational therapy, respiratory therapy, and speech and language
218.28pathology therapy services.
218.29(b) Home care therapies must be:
218.30(1) provided in the recipient's residence after it has been determined the recipient is
218.31unable to access outpatient therapy;
218.32(2) prescribed, ordered, or referred by a physician and documented in a plan of care
218.33and reviewed, according to Minnesota Rules, part 9505.0390;
218.34(3) assessed by an appropriate therapist; and
218.35(4) provided by a Medicare-certified home health agency enrolled as a Medicaid
218.36provider agency.
219.1(c) Restorative and specialized maintenance therapies must be provided according to
219.2Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
219.3used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
219.4(d) For both physical and occupational therapies, the therapist and the therapist's
219.5assistant may not both bill for services provided to a recipient on the same day.
219.6 Subd. 6. Noncovered home health agency services. The following are not eligible
219.7for payment under medical assistance as a home health agency service:
219.8(1) telehomecare skilled nurses services that is communication between the home
219.9care nurse and recipient that consists solely of a telephone conversation, facsimile,
219.10electronic mail, or a consultation between two health care practitioners;
219.11(2) the following skilled nurse visits:
219.12(i) for the purpose of monitoring medication compliance with an established
219.13medication program for a recipient;
219.14(ii) administering or assisting with medication administration, including injections,
219.15prefilling syringes for injections, or oral medication setup of an adult recipient, when,
219.16as determined and documented by the registered nurse, the need can be met by an
219.17available pharmacy or the recipient or a family member is physically and mentally able
219.18to self-administer or prefill a medication;
219.19(iii) services done for the sole purpose of supervision of the home health aide or
219.20personal care assistant;
219.21(iv) services done for the sole purpose to train other home health agency workers;
219.22(v) services done for the sole purpose of blood samples or lab draw when the
219.23recipient is able to access these services outside the home; and
219.24(vi) Medicare evaluation or administrative nursing visits required by Medicare;
219.25(3) home health aide visits when the following activities are the sole purpose for the
219.26visit: companionship, socialization, household tasks, transportation, and education; and
219.27(4) home care therapies provided in other settings such as a clinic, day program, or as
219.28an inpatient or when the recipient can access therapy outside of the recipient's residence.
219.29 Sec. 26. Minnesota Statutes 2008, section 256B.0654, is amended to read:
219.30256B.0654 PRIVATE DUTY NURSING.
219.31 Subdivision 1. Definitions.(a) "Assessment" means a review and evaluation of a
219.32recipient's need for home care services conducted in person. Assessments for private duty
219.33nursing shall be conducted by a registered private duty nurse. Assessments for medical
219.34assistance home care services for developmental disabilities and alternative care services
220.1for developmentally disabled home and community-based waivered recipients may be
220.2conducted by the county public health nurse to ensure coordination and avoid duplication.
220.3(b) (a) "Complex and regular private duty nursing care" means:
220.4(1) complex care is private duty nursing services provided to recipients who are
220.5ventilator dependent or for whom a physician has certified thatwere it not for private duty
220.6nursing the recipient would meet the criteria for inpatient hospital intensive care unit
220.7(ICU) level of care; and
220.8(2) regular care is private duty nursing provided to all other recipients.
220.9(b) "Private duty nursing" means ongoing professional nursing services by a
220.10registered or licensed practical nurse including assessment, professional nursing tasks, and
220.11education, based on an assessment and physician orders to maintain or restore optimal
220.12health of the recipient.
220.13(c) "Private duty nursing agency" means a medical assistance enrolled provider
220.14licensed under chapter 144A to provide private duty nursing services.
220.15(d) "Regular private duty nursing" means nursing services provided to a recipient
220.16who is considered stable and not at an inpatient hospital intensive care unit level of care,
220.17but may have episodes of instability that are not life threatening.
220.18(e) "Shared private duty nursing" means the provision of nursing services by a
220.19private duty nurse to two recipients at the same time and in the same setting.
220.20 Subd. 2. Authorization; private duty nursing services. (a) All private duty
220.21nursing services shall beprior authorized by the commissioner or the commissioner's
220.22designee.Prior Authorization for private duty nursing services shall be based on
220.23medical necessity and cost-effectiveness when compared with alternative care options.
220.24The commissioner may authorize medically necessary private duty nursing services in
220.25quarter-hour units when:
220.26(1) the recipient requires more individual and continuous care than can be provided
220.27during a skilled nurse visit; or
220.28(2) the cares are outside of the scope of services that can be provided by a home
220.29health aide or personal care assistant.
220.30(b) The commissioner may authorize:
220.31(1) up to two times the average amount of direct care hours provided in nursing
220.32facilities statewide for case mix classification "K" as established by the annual cost report
220.33submitted to the department by nursing facilities in May 1992;
220.34(2) private duty nursing in combination with other home care services up to the total
220.35cost allowed under section256B.0655, subdivision 4 ;
221.1(3) up to 16 hours per day if the recipient requires more nursing than the maximum
221.2number of direct care hours as established in clause (1) and the recipient meets the hospital
221.3admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.
221.4(c) The commissioner may authorize up to 16 hours per day of medically necessary
221.5private duty nursing services or up to 24 hours per day of medically necessary private duty
221.6nursing services until such time as the commissioner is able to make a determination of
221.7eligibility for recipients who are cooperatively applying for home care services under
221.8the community alternative care program developed under section256B.49 , or until it is
221.9determined by the appropriate regulatory agency that a health benefit plan is or is not
221.10required to pay for appropriate medically necessary health care services. Recipients
221.11or their representatives must cooperatively assist the commissioner in obtaining this
221.12determination. Recipients who are eligible for the community alternative care program
221.13may not receive more hours of nursing under this section and sections256B.0651 ,
221.14256B.0653
,
256B.0655, and
256B.0656, and 256B.0659 than would otherwise be
221.15authorized under section256B.49 .
221.16 Subd. 2a. Private duty nursing services. (a) Private duty nursing services must
221.17be used:
221.18(1) in the recipient's home or outside the home when normal life activities require;
221.19(2) when the recipient requires more individual and continuous care than can be
221.20provided during a skilled nurse visit; and
221.21(3) when the care required is outside of the scope of services that can be provided by
221.22a home health aide or personal care assistant.
221.23(b) Private duty nursing services must be:
221.24(1) assessed by a registered nurse on a form approved by the commissioner;
221.25(2) ordered by a physician and documented in a plan of care that is reviewed by the
221.26physician at least once every 60 days; and
221.27(3) authorized by the commissioner under section 256B.0652.
221.28 Subd. 2b. Noncovered private duty nursing services. Private duty nursing
221.29services do not cover the following:
221.30(1) nursing services by a nurse who is the family foster care provider of a person
221.31who has not reached 18 years of age unless allowed under subdivision 4;
221.32(2) nursing services to more than two persons receiving shared private duty nursing
221.33services from a private duty nurse in a single setting; and
221.34(3) nursing services provided by a registered nurse or licensed practical nurse who is
221.35the recipient's legal guardian or related to the recipient as spouse, parent, or family foster
222.1parent whether by blood, marriage, or adoption except as specified in section 256B.0652,
222.2subdivision 4.
222.3 Subd. 3. Shared private duty nursingcare option. (a) Medical assistance
222.4payments for shared private duty nursing services by a private duty nurse shall be limited
222.5according to this subdivision.For the purposes of this section and sections
256B.0651,
222.6256B.0653,
256B.0655, and
256B.0656, "private duty nursing agency" means an agency
222.7licensed under chapter 144A to provide private duty nursing services. Unless otherwise
222.8provided in this subdivision, all other statutory and regulatory provisions relating to
222.9private duty nursing services apply to shared private duty nursing services. Nothing in
222.10this subdivision shall be construed to reduce the total number of private duty nursing
222.11hours authorized for an individual recipient.
222.12(b) Recipients of private duty nursing services may share nursing staff and the
222.13commissioner shall provide a rate methodology for shared private duty nursing. For two
222.14persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the
222.15regular private duty nursing rates paid for serving a single individual by a registered nurse
222.16or licensed practical nurse. These rates apply only to situations in which both recipients
222.17are present and receive shared private duty nursing care on the date for which the service
222.18is billed. No more than two persons may receive shared private duty nursing services
222.19from a private duty nurse in a single setting.
222.20(c) (b) Shared private duty nursing care is the provision of nursing services by a
222.21private duty nurse to two medical assistance eligible recipients at the same time and in
222.22the same setting. This subdivision does not apply when a private duty nurse is caring for
222.23multiple recipients in more than one setting.
222.24(c) For the purposes of this subdivision, "setting" means:
222.25(1) the home residence or foster care home of one of the individual recipients as
222.26defined in section 256B.0651;or
222.27(2) a child care program licensed under chapter 245A or operated by a local school
222.28district or private school;or
222.29(3) an adult day care service licensed under chapter 245A; or
222.30(4) outside the home residence or foster care home of one of the recipients when
222.31normal life activities take the recipients outside the home.
222.32This subdivision does not apply when a private duty nurse is caring for multiple
222.33recipients in more than one setting.
222.34(d) The private duty nursing agency must offer the recipient the option of shared or
222.35one-on-one private duty nursing services. The recipient may withdraw from participating
222.36in a shared service arrangement at any time.
223.1(d) (e) The recipient or the recipient's legal representative, and the recipient's
223.2physician, in conjunction with thehome health care private duty nursing agency, shall
223.3determine:
223.4(1) whether shared private duty nursing care is an appropriate option based on the
223.5individual needs and preferences of the recipient; and
223.6(2) the amount of shared private duty nursing services authorized as part of the
223.7overall authorization of nursing services.
223.8(e) (f) The recipient or the recipient's legal representative, in conjunction with the
223.9private duty nursing agency, shall approve the setting, grouping, and arrangement of
223.10shared private duty nursing care based on the individual needs and preferences of the
223.11recipients. Decisions on the selection of recipients to share services must be based on the
223.12ages of the recipients, compatibility, and coordination of their care needs.
223.13(f) (g) The following items must be considered by the recipient or the recipient's
223.14legal representative and the private duty nursing agency, and documented in the recipient's
223.15health service record:
223.16(1) the additional training needed by the private duty nurse to provide care to
223.17two recipients in the same setting and to ensure that the needs of the recipients are met
223.18appropriately and safely;
223.19(2) the setting in which the shared private duty nursing care will be provided;
223.20(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness
223.21of the service and process used to make changes in service or setting;
223.22(4) a contingency plan which accounts for absence of the recipient in a shared private
223.23duty nursing setting due to illness or other circumstances;
223.24(5) staffing backup contingencies in the event of employee illness or absence; and
223.25(6) arrangements for additional assistance to respond to urgent or emergency care
223.26needs of the recipients.
223.27(g) The provider must offer the recipient or responsible party the option of shared or
223.28one-on-one private duty nursing services. The recipient or responsible party can withdraw
223.29from participating in a shared service arrangement at any time.
223.30(h)The private duty nursing agency must document the following in the
223.31health service record for each individual recipient sharing private duty nursing care
223.32The documentation for shared private duty nursing must be on a form approved by
223.33the commissioner for each individual recipient sharing private duty nursing. The
223.34documentation must be part of the recipient's health service record and include:
223.35(1) permission by the recipient or the recipient's legal representative for the
223.36maximum number of shared nursingcare hours per week chosen by the recipient and
224.1permission for shared private duty nursing services provided in and outside the recipient's
224.2home residence;
224.3(2) permission by the recipient or the recipient's legal representative for shared
224.4private duty nursing services provided outside the recipient's residence;
224.5(3) permission by the recipient or the recipient's legal representative for others to
224.6receive shared private duty nursing services in the recipient's residence;
224.7(4) revocation by the recipient or the recipient's legal representative of for the shared
224.8private duty nursingcare authorization, or the shared care to be provided to others in the
224.9recipient's residence, or the shared private duty nursing services to be provided outside
224.10permission, or services provided to others in and outside the recipient's residence; and
224.11(5) (3) daily documentation of the shared private duty nursing services provided by
224.12each identified private duty nurse, including:
224.13(i) the names of each recipient receiving shared private duty nursing services
224.14together;
224.15(ii) the setting for the shared services, including the starting and ending times that
224.16the recipient received shared private duty nursing care; and
224.17(iii) notes by the private duty nurse regarding changes in the recipient's condition,
224.18problems that may arise from the sharing of private duty nursing services, and scheduling
224.19and care issues.
224.20(i) Unless otherwise provided in this subdivision, all other statutory and regulatory
224.21provisions relating to private duty nursing services apply to shared private duty nursing
224.22services.
224.23Nothing in this subdivision shall be construed to reduce the total number of private
224.24duty nursing hours authorized for an individual recipient under subdivision 2.
224.25(i) The commissioner shall provide a rate methodology for shared private duty
224.26nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed
224.271.5 times the regular private duty nursing rates paid for serving a single individual by a
224.28registered nurse or licensed practical nurse. These rates apply only to situations in which
224.29both recipients are present and receive shared private duty nursing care on the date for
224.30which the service is billed.
224.31 Subd. 4. Hardship criteria; private duty nursing. (a) Payment is allowed for
224.32extraordinary services that require specialized nursing skills and are provided by parents
224.33of minor children, family foster parents, spouses, and legal guardians who are providing
224.34private duty nursing care under the following conditions:
224.35(1) the provision of these services is not legally required of the parents, spouses,
224.36or legal guardians;
225.1(2) the services are necessary to prevent hospitalization of the recipient; and
225.2(3) the recipient is eligible for state plan home care or a home and community-based
225.3waiver and one of the following hardship criteria are met:
225.4(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to
225.5provide nursing care for the recipient;or
225.6(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with
225.7less compensation to provide nursing care for the recipient;or
225.8(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to
225.9provide nursing care for the recipient; or
225.10(iv) because of labor conditions, special language needs, or intermittent hours of
225.11care needed, the parent, spouse, or legal guardian is needed in order to provide adequate
225.12private duty nursing services to meet the medical needs of the recipient.
225.13(b) Private duty nursing may be provided by a parent, spouse, family foster parent,
225.14or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services
225.15provided by a parent, spouse, family foster parent, or legal guardian cannot be used in
225.16lieu of nursing services covered and available under liable third-party payors, including
225.17Medicare. The private duty nursing provided by a parent, spouse, family foster parent, or
225.18legal guardian must be included in the serviceplan agreement. Authorized skilled nursing
225.19services for a single recipient or recipients with the same residence and provided by the
225.20parent, spouse, family foster parent, or legal guardian may not exceed 50 percent of the
225.21total approved nursing hours, or eight hours per day, whichever is less, up to a maximum
225.22of 40 hours per week. A parent or parents, spouse, family foster parent, or legal guardian
225.23shall not provide more than 40 hours of services in a seven-day period. For parents, family
225.24foster parents, and legal guardians, 40 hours is the total amount allowed regardless of the
225.25number of children or adults who receive services. Nothing in this subdivision precludes
225.26the parent's, spouse's, or legal guardian's obligation of assuming the nonreimbursed family
225.27responsibilities of emergency backup caregiver and primary caregiver.
225.28(c) A parent, family foster parent, or a spouse may not be paid to provide private
225.29duty nursing care if:
225.30(1) the parent or spouse fails to pass a criminal background check according to
225.31chapter 245C, or if;
225.32(2) it has been determined by thehome health private duty nursing agency, the
225.33case manager, or the physician that the private duty nursingcare provided by the parent,
225.34family foster parent, spouse, or legal guardian is unsafe; or
225.35(3) the parent, family foster parent, spouse, or legal guardian do not follow physician
225.36orders.
226.1(d) For purposes of this section, "assessment" means a review and evaluation of a
226.2recipient's need for home care services conducted in person. Assessments for private duty
226.3nursing must be conducted by a registered nurse.
226.4 Sec. 27. Minnesota Statutes 2008, section 256B.0655, subdivision 1b, is amended to
226.5read:
226.6 Subd. 1b. Assessment. "Assessment" means a review and evaluation of a recipient's
226.7need for home care services conducted in person. Assessments for personal care assistant
226.8services shall be conducted by the county public health nurse or a certified public
226.9health nurse under contract with the county.A face-to-face An in-person assessment
226.10must include: documentation of health status, determination of need, evaluation of
226.11service effectiveness, identification of appropriate services, service plan development
226.12or modification, coordination of services, referrals and follow-up to appropriate payers
226.13and community resources, completion of required reports, recommendation of service
226.14authorization, and consumer education. Once the need for personal care assistant
226.15services is determined under this section or sections256B.0651 ,
256B.0653 ,
256B.0654 ,
226.16and256B.0656 , the county public health nurse or certified public health nurse under
226.17contract with the county is responsible for communicating this recommendation to the
226.18commissioner and the recipient.A face-to-face assessment for personal care assistant
226.19services is conducted on those recipients who have never had a county public health
226.20nurse assessment. A face-to-face An in-person assessment must occur at least annually or
226.21when there is a significant change in the recipient's condition or when there is a change
226.22in the need for personal care assistant services. A service update may substitute for
226.23the annual face-to-face assessment when there is not a significant change in recipient
226.24condition or a change in the need for personal care assistant service. A service update
226.25may be completed by telephone, used when there is no need for an increase in personal
226.26care assistant services, and used for two consecutive assessments if followed by a
226.27face-to-face assessment. A service update must be completed on a form approved by the
226.28commissioner. A service update or review for temporary increase includes a review of
226.29initial baseline data, evaluation of service effectiveness, redetermination of service need,
226.30modification of service plan and appropriate referrals, update of initial forms, obtaining
226.31service authorization, and on going consumer education. Assessments must be completed
226.32on forms provided by the commissioner within 30 days of a request for home care services
226.33by a recipient or responsible party or personal care provider agency.
227.1 Sec. 28. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to
227.2read:
227.3 Subd. 4.Prior Authorization; personal care assistance and qualified
227.4professional.The commissioner, or the commissioner's designee, shall review the
227.5assessment, service update, request for temporary services, request for flexible use option,
227.6service plan, and any additional information that is submitted. The commissioner shall,
227.7within 30 days after receiving a complete request, assessment, and service plan, authorize
227.8home care services as follows:
227.9(1) (a) All personal care assistant assistance services and, supervision by a
227.10qualified professional,if requested by the recipient, and additional services beyond the
227.11limits established in section 256B.0651, subdivision 11, must beprior authorized by
227.12the commissioner or the commissioner's designee before services begin except for the
227.13assessments established insection sections
256B.0651, subdivision 11, and 256B.0911 .
227.14The authorization for personal care assistance and qualified professional services under
227.15section 256B.0659 must be completed within 30 days after receiving a complete request.
227.16(b) The amount of personal careassistant assistance services authorized must be
227.17based on the recipient's home care rating. The home care rating shall be determined by
227.18the commissioner or the commissioner's designee based on information submitted to the
227.19commissioner identifying the following:
227.20(1) total number of dependencies of activities of daily living as defined in section
227.21256B.0659;
227.22(2) number of complex health-related functions as defined in section 256B.0659; and
227.23(3) number of behavior descriptions as defined in section 256B.0659.
227.24(c) The methodology to determine total time for personal care assistance services for
227.25each home care rating is based on the median paid units per day for each home care rating
227.26from fiscal year 2007 data for the personal care assistance program. Each home care rating
227.27has a base level of hours assigned. Additional time is added through the assessment and
227.28identification of the following:
227.29(1) 30 additional minutes per day for a dependency in each critical activity of daily
227.30living as defined in section 256B.0659;
227.31(2) 30 additional minutes per day for each complex health-related function as
227.32defined in section 256B.0659; and
227.33(3) 30 additional minutes per day for each behavior issue as defined in section
227.34256B.0659.
227.35(d) A limit of 96 units of qualified professional supervision may be authorized for
227.36each recipient receiving personal care assistance services. A request to the commissioner
228.1to exceed this total in a calendar year must be requested by the personal care provider
228.2agency on a form approved by the commissioner.
228.3A child may not be found to be dependent in an activity of daily living if because
228.4of the child's age an adult would either perform the activity for the child or assist the
228.5child with the activity and the amount of assistance needed is similar to the assistance
228.6appropriate for a typical child of the same age. Based on medical necessity, the
228.7commissioner may authorize:
228.8(A) up to two times the average number of direct care hours provided in nursing
228.9facilities for the recipient's comparable case mix level; or
228.10(B) up to three times the average number of direct care hours provided in nursing
228.11facilities for recipients who have complex medical needs or are dependent in at least seven
228.12activities of daily living and need physical assistance with eating or have a neurological
228.13diagnosis; or
228.14(C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care
228.15provided in a regional treatment center for recipients who have Level I behavior, plus any
228.16inflation adjustment as provided by the legislature for personal care service; or
228.17(D) up to the amount the commissioner would pay, as of July 1, 1991, plus any
228.18inflation adjustment provided for home care services, for care provided in a regional
228.19treatment center for recipients referred to the commissioner by a regional treatment center
228.20preadmission evaluation team. For purposes of this clause, home care services means
228.21all services provided in the home or community that would be included in the payment
228.22to a regional treatment center; or
228.23(E) up to the amount medical assistance would reimburse for facility care for
228.24recipients referred to the commissioner by a preadmission screening team established
228.25under section
256B.0911 or
256B.092; and
228.26(F) a reasonable amount of time for the provision of supervision by a qualified
228.27professional of personal care assistant services, if a qualified professional is requested by
228.28the recipient or responsible party.
228.29(2) The number of direct care hours shall be determined according to the annual cost
228.30report submitted to the department by nursing facilities. The average number of direct care
228.31hours, as established by May 1, 1992, shall be calculated and incorporated into the home
228.32care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.
228.33(3) The home care rating shall be determined by the commissioner or the
228.34commissioner's designee based on information submitted to the commissioner by the
228.35county public health nurse on forms specified by the commissioner. The home care rating
228.36shall be a combination of current assessment tools developed under sections
256B.0911
229.1and
256B.501 with an addition for seizure activity that will assess the frequency and
229.2severity of seizure activity and with adjustments, additions, and clarifications that are
229.3necessary to reflect the needs and conditions of recipients who need home care including
229.4children and adults under 65 years of age. The commissioner shall establish these forms
229.5and protocols under this section and sections
256B.0651,
256B.0653,
256B.0654, and
229.6256B.0656 and shall use an advisory group, including representatives of recipients,
229.7providers, and counties, for consultation in establishing and revising the forms and
229.8protocols.
229.9(4) A recipient shall qualify as having complex medical needs if the care required is
229.10difficult to perform and because of recipient's medical condition requires more time than
229.11community-based standards allow or requires more skill than would ordinarily be required
229.12and the recipient needs or has one or more of the following:
229.13(A) daily tube feedings;
229.14(B) daily parenteral therapy;
229.15(C) wound or decubiti care;
229.16(D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy
229.17care, oxygen, mechanical ventilation;
229.18(E) catheterization;
229.19(F) ostomy care;
229.20(G) quadriplegia; or
229.21(H) other comparable medical conditions or treatments the commissioner determines
229.22would otherwise require institutional care.
229.23(5) A recipient shall qualify as having Level I behavior if there is reasonable
229.24supporting evidence that the recipient exhibits, or that without supervision, observation, or
229.25redirection would exhibit, one or more of the following behaviors that cause, or have the
229.26potential to cause:
229.27(A) injury to the recipient's own body;
229.28(B) physical injury to other people; or
229.29(C) destruction of property.
229.30(6) Time authorized for personal care relating to Level I behavior in paragraph
229.31(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of
229.32intervention required.
229.33(7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a
229.34daily basis one or more of the following behaviors that interfere with the completion of
229.35personal care assistant services under subdivision 2, paragraph (a):
229.36(A) unusual or repetitive habits;
230.1(B) withdrawn behavior; or
230.2(C) offensive behavior.
230.3(8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses
230.4(A) to (C), shall be rated as comparable to a recipient with complex medical needs under
230.5paragraph (4). If a recipient has both complex medical needs and Level II behavior, the
230.6home care rating shall be the next complex category up to the maximum rating under
230.7paragraph (1), clause (B).
230.8EFFECTIVE DATE.The amendments to paragraphs (a) and (b) are effective
230.9January 1, 2010.
230.10 Sec. 29. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to
230.11read:
230.12 Subd. 8. Self-directed budget requirements. The budget for the provision of the
230.13self-directed service option shall beequal to the greater of either established based on:
230.14 (1)the annual amount of personal care assistant services under section
256B.0655
230.15that the recipient has used in the most recent 12-month period assessed personal care
230.16assistance units, not to exceed the maximum number of personal care assistance units
230.17available, as determined by section 256B.0655;or and
230.18 (2)the amount determined using the consumer support grant methodology under
230.19section
256.476, subdivision 11, except that the budget amount shall include the federal
230.20and nonfederal share of the average service costs. the personal care assistance unit rate:
230.21 (i) with a reduction to the unit rate to pay for a program administrator as defined in
230.22subdivision 10; and
230.23 (ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for
230.24the state.
230.25 Sec. 30. Minnesota Statutes 2008, section 256B.0657, is amended by adding a
230.26subdivision to read:
230.27 Subd. 12. Enrollment and evaluation. Enrollment in the self-directed supports
230.28option is available to current personal care assistance recipients upon annual personal care
230.29assistance reassessment, with a maximum enrollment of 1,000 people in the first fiscal
230.30year of implementation and an additional 1,000 people in the second fiscal year. The
230.31commissioner shall evaluate the self-directed supports option during the first two years of
230.32implementation and make any necessary changes prior to the option becoming available
230.33statewide.
231.1 Sec. 31. [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.
231.2 Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in
231.3paragraphs (b) to (p) have the meanings given unless otherwise provided in text.
231.4(b) "Activities of daily living" means grooming, dressing, bathing, transferring,
231.5mobility, positioning, eating, and toileting.
231.6(c) "Behavior," effective January 1, 2010, means a category to determine the home
231.7care rating and is based on the criteria found in this section. "Level I behavior" means
231.8physical aggression towards self, others, or destruction of property that requires the
231.9immediate response of another person.
231.10(d) "Complex health-related needs," effective January 1, 2010, means a category to
231.11determine the home care rating and is based on the criteria found in this section.
231.12(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
231.13mobility, eating, and toileting.
231.14(f) "Dependency in activities of daily living" means a person requires assistance to
231.15begin and complete one or more of the activities of daily living.
231.16(g) "Health-related procedures and tasks" means procedures and tasks that can
231.17be delegated or assigned by a licensed health care professional under state law to be
231.18performed by a personal care assistant.
231.19(h) "Instrumental activities of daily living" means activities to include meal planning
231.20and preparation; basic assistance with paying bills; shopping for food, clothing, and
231.21other essential items; performing household tasks integral to the personal care assistance
231.22services; communication by telephone and other media; and traveling, including to
231.23medical appointments and to participate in the community.
231.24(i) "Managing employee" has the same definition as Code of Federal Regulations,
231.25title 42, section 455.
231.26(j) "Qualified professional" means a professional providing supervision of personal
231.27care assistance services and staff as defined in section 256B.0625, subdivision 19c.
231.28(k) "Personal care assistance provider agency" means a medical assistance enrolled
231.29provider that provides or assists with providing personal care assistance services and
231.30includes personal care assistance provider organizations, personal care assistance choice
231.31agency, class A licensed nursing agency, and Medicare-certified home health agency.
231.32(l) "Personal care assistant" or "PCA" means an individual employed by a personal
231.33care assistance agency who provides personal care assistance services.
231.34(m) "Personal care assistance care plan" means a written description of personal
231.35care assistance services developed by the personal care assistance provider according
231.36to the service plan.
232.1(n) "Responsible party" means an individual who is capable of providing the support
232.2necessary to assist the recipient to live in the community.
232.3(o) "Self-administered medication" means medication taken orally, by injection or
232.4insertion, or applied topically without the need for assistance.
232.5(p) "Service plan" means a written summary of the assessment and description of the
232.6services needed by the recipient.
232.7 Subd. 2. Personal care assistance services; covered services. (a) The personal
232.8care assistance services eligible for payment include services and supports furnished
232.9to an individual, as needed, to assist in:
232.10(1) activities of daily living;
232.11(2) health-related procedures and tasks;
232.12(3) observation and redirection of behaviors; and
232.13(4) instrumental activities of daily living.
232.14(b) Activities of daily living include the following covered services:
232.15(1) dressing, including assistance with choosing, application, and changing of
232.16clothing and application of special appliances, wraps, or clothing;
232.17(2) grooming, including assistance with basic hair care, oral care, shaving, applying
232.18cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included,
232.19except for recipients who are diabetic or have poor circulation;
232.20(3) bathing, including assistance with basic personal hygiene and skin care;
232.21(4) eating, including assistance with hand washing and application of orthotics
232.22required for eating, transfers, and feeding;
232.23(5) transfers, including assistance with transferring the recipient from one seating or
232.24reclining area to another;
232.25(6) mobility, including assistance with ambulation, including use of a wheelchair.
232.26Mobility does not include providing transportation for a recipient;
232.27(7) positioning, including assistance with positioning or turning a recipient for
232.28necessary care and comfort; and
232.29(8) toileting, including assistance with helping recipient with bowel or bladder
232.30elimination and care including transfers, mobility, positioning, feminine hygiene, use of
232.31toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and
232.32adjusting clothing.
232.33(c) Health-related procedures and tasks include the following covered services:
232.34(1) range of motion and passive exercise to maintain a recipient's strength and
232.35muscle functioning;
233.1(2) assistance with self-administered medication as defined by this section, including
233.2reminders to take medication, bringing medication to the recipient, and assistance with
233.3opening medication under the direction of the recipient or responsible party;
233.4(3) interventions for seizure disorders, including monitoring and observation; and
233.5(4) other activities considered within the scope of the personal care service and
233.6meeting the definition of health-related procedures and tasks under this section.
233.7(d) A personal care assistant may provide health-related procedures and tasks
233.8associated with the complex health-related needs of a recipient if the procedures and
233.9tasks meet the definition of health-related procedures and tasks under this section and the
233.10personal care assistant is trained by a qualified professional and demonstrates competency
233.11to safely complete the procedures and tasks. Delegation of health-related procedures and
233.12tasks and all training must be documented in the personal care assistance care plan and the
233.13recipient's and personal care assistant's files.
233.14(e) Effective January 1, 2010, for a personal care assistant to provide the
233.15health-related procedures and tasks of tracheostomy suctioning and services to recipients
233.16on ventilator support there must be:
233.17(1) delegation and training by a registered nurse, certified or licensed respiratory
233.18therapist, or a physician;
233.19(2) utilization of clean rather than sterile procedure;
233.20(3) specialized training about the health-related procedures and tasks and equipment,
233.21including ventilator operation and maintenance;
233.22(4) individualized training regarding the needs of the recipient; and
233.23(5) supervision by a qualified professional who is a registered nurse.
233.24(f) Effective January 1, 2010, a personal care assistant may observe and redirect the
233.25recipient for episodes where there is a need for redirection due to behaviors. Training of
233.26the personal care assistant must occur based on the needs of the recipient, the personal
233.27care assistance care plan, and any other support services provided.
233.28(g) Instrumental activities of daily living under subdivision 1, paragraph (h).
233.29 Subd. 3. Noncovered personal care assistance services. (a) Personal care
233.30assistance services are not eligible for medical assistance payment under this section
233.31when provided:
233.32(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal
233.33guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision
233.349a, or responsible party;
233.35(2) in lieu of other staffing options in a residential or child care setting;
233.36(3) solely as a child care or babysitting service; or
234.1(4) without authorization by the commissioner or the commissioner's designee.
234.2(b) The following personal care services are not eligible for medical assistance
234.3payment under this section when provided in residential settings:
234.4(1) effective January 1, 2010, when the provider of home care services who is not
234.5related by blood, marriage, or adoption owns or otherwise controls the living arrangement,
234.6including licensed or unlicensed services; or
234.7(2) when personal care assistance services are the responsibility of a residential or
234.8program license holder under the terms of a service agreement and administrative rules.
234.9(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible
234.10for medical assistance reimbursement for personal care assistance services under this
234.11section include:
234.12(1) sterile procedures;
234.13(2) injections of fluids and medications into veins, muscles, or skin;
234.14(3) home maintenance or chore services;
234.15(4) homemaker services not an integral part of assessed personal care assistance
234.16services needed by a recipient;
234.17(5) application of restraints or implementation of procedures under section 245.825;
234.18(6) instrumental activities of daily living for children under the age of 18; and
234.19(7) assessments for personal care assistance services by personal care assistance
234.20provider agencies or by independently enrolled registered nurses.
234.21 Subd. 4. Assessment for personal care assistance services. (a) An assessment
234.22as defined in section 256B.0655, subdivision 1b, must be completed for personal care
234.23assistance services.
234.24(b) The following limitations apply to the assessment:
234.25(1) a person must be assessed as dependent in an activity of daily living based
234.26on the person's need, on a daily basis, for:
234.27(i) cueing and constant supervision to complete the task; or
234.28(ii) hands-on assistance to complete the task; and
234.29(2) a child may not be found to be dependent in an activity of daily living if because
234.30of the child's age an adult would either perform the activity for the child or assist the child
234.31with the activity. Assistance needed is the assistance appropriate for a typical child of
234.32the same age.
234.33(c) Assessment for complex health-related needs must meet the criteria in this
234.34paragraph. During the assessment process, a recipient qualifies as having complex
234.35health-related needs if the recipient has one or more of the interventions that are ordered by
234.36a physician, specified in a personal care assistance care plan, and found in the following:
235.1(1) tube feedings requiring:
235.2(i) a gastro/jejunostomy tube; or
235.3(ii) continuous tube feeding lasting longer than 12 hours per day;
235.4(2) wounds described as:
235.5 (i) stage III or stage IV;
235.6 (ii) multiple wounds;
235.7 (iii) requiring sterile or clean dressing changes or a wound vac; or
235.8 (iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
235.9specialized care;
235.10 (3) parenteral therapy described as:
235.11 (i) IV therapy more than two times per week lasting longer than four hours for
235.12each treatment; or
235.13 (ii) total parenteral nutrition (TPN) daily;
235.14 (4) respiratory interventions including:
235.15 (i) oxygen required more than eight hours per day;
235.16 (ii) respiratory vest more than one time per day;
235.17 (iii) bronchial drainage treatments more than two times per day;
235.18 (iv) sterile or clean suctioning more than six times per day;
235.19 (v) dependence on another to apply respiratory ventilation augmentation devises
235.20such as BiPAP and CPAP; and
235.21 (vi) ventilator dependence under section 256B.0652;
235.22 (5) insertion and maintenance of catheter including:
235.23(i) sterile catheter changes more than one time per month;
235.24(ii) clean self-catheterization more than six times per day; or
235.25(iii) bladder irrigations;
235.26(6) bowel program more than two times per week requiring more than 30 minutes to
235.27perform each time;
235.28(7) neurological intervention including:
235.29(i) seizures more than two times per week and requiring significant physical
235.30assistance to maintain safety; or
235.31(ii) swallowing disorders diagnosed by a physician and requiring specialized
235.32assistance from another on a daily basis; and
235.33(8) other congenital or acquired diseases creating a need for significantly increased
235.34direct hands-on assistance and interventions in six to eight activities of daily living.
236.1(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient
236.2qualifies as having a need for assistance due to behaviors if the recipient's behavior requires
236.3assistance at least four times per week and shows one or more of the following behaviors:
236.4(1) physical aggression towards self or others, or destruction of property that requires
236.5the immediate response of another person;
236.6(2) increased vulnerability due to cognitive deficits or socially inappropriate
236.7behavior; or
236.8(3) verbally aggressive and resistive to care.
236.9 Subd. 5. Service, support planning, and referral. (a) The assessor, with the
236.10recipient or responsible party, shall review the assessment information and determine
236.11referrals for other payers, services, and community supports as appropriate.
236.12(b) The recipient must be referred for evaluation, services, or supports that are
236.13appropriate to help meet the recipient's needs including, but not limited to, the following
236.14circumstances:
236.15(1) when there is another payer who is responsible to provide the service to meet
236.16the recipient's needs;
236.17(2) when the recipient qualifies for assistance due to mental illness or behaviors
236.18under this section, a referral for a mental health diagnostic and functional assessment
236.19must be completed, or referral must be made for other specific mental health services or
236.20other community services;
236.21(3) when the recipient is eligible for medical assistance and meets medical assistance
236.22eligibility for a home health aide or skilled nurse visit;
236.23(4) when the recipient would benefit from an evaluation for another service; and
236.24(5) when there is a more appropriate service to meet the assessed needs.
236.25 (c) The reimbursement rates for public health nurse visits that relate to the provision
236.26of personal care assistance services under this section and section256B.0625, subdivision
236.2719a , are:
236.28 (1) $210.50 for a face-to-face assessment visit;
236.29 (2) $105.25 for each service update; and
236.30 (3) $105.25 for each request for a temporary service increase.
236.31 (d) The rates specified in paragraph (c) must be adjusted to reflect provider rate
236.32increases for personal care assistance services that are approved by the legislature for the
236.33fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied
236.34by the legislature to provider rate increases for personal care assistance services also
236.35apply to adjustments under this paragraph.
237.1 (e) Effective July 1, 2008, the payment rate for an assessment under this section and
237.2section256B.0651 shall be reduced by 25 percent when the assessment is not completed
237.3on time and the service agreement documentation is not submitted in time to continue
237.4services. The commissioner shall reduce the amount of the claim for those assessments
237.5that are not submitted on time.
237.6 Subd. 6. Service plan. The service plan must be completed by the assessor with the
237.7recipient and responsible party on a form determined by the commissioner and include
237.8a summary of the assessment with a description of the need, authorized amount, and
237.9expected outcomes and goals of personal care assistance services. The recipient and
237.10the provider chosen by the recipient or responsible party must be given a copy of the
237.11completed service plan within ten working days of the assessment. The recipient or
237.12responsible party must be given information by the assessor about the options in the
237.13personal care assistance program to allow for review and decision making.
237.14 Subd. 7. Personal care assistance care plan. (a) Each recipient must have a
237.15current personal care assistance care plan based on the service plan in subdivision 6 that is
237.16developed by the qualified professional with the recipient and responsible party. A copy of
237.17the most current personal care assistance care plan is required to be in the recipient's home
237.18and in the recipient's file at the provider agency.
237.19(b) The personal care assistance care plan must have the following components:
237.20(1) start and end date of the care plan;
237.21(2) recipient demographic information, including name and telephone number;
237.22(3) emergency numbers, procedures, and a description of measures to address
237.23identified safety and vulnerability issues, including a backup staffing plan;
237.24(4) name of responsible party and instructions for contact;
237.25(5) description of the recipient's individualized needs for assistance with activities of
237.26daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
237.27(6) dated signatures of recipient or responsible party and qualified professional.
237.28(c) The personal care assistance care plan must have instructions and comments
237.29about the recipient's needs for assistance and any special instructions or procedures
237.30required. The month-to-month plan for the use of personal care assistance services is part
237.31of the personal care assistance care plan. The personal care assistance care plan must
237.32be completed within the first week after start of services with a personal care provider
237.33agency and must be updated as needed when there is a change in need for personal care
237.34assistance services. A new personal care assistance care plan is required annually at the
237.35time of the reassessment.
238.1 Subd. 8. Communication with recipient's physician. The personal care assistance
238.2program requires communication with the recipient's physician about a recipient's assessed
238.3needs for personal care assistance services. The commissioner shall work with the state
238.4medical director to develop options for communication with the recipient's physician.
238.5 Subd. 9. Responsible party; generally. (a) "Responsible party," effective January
238.61, 2010, means an individual who is capable of providing the support necessary to assist
238.7the recipient to live in the community.
238.8(b) A responsible party must be 18 years of age, actively participate in planning and
238.9directing of personal care assistance services, and attend all assessments for the recipient.
238.10(c) A responsible party must not be the:
238.11(1) personal care assistant;
238.12(2) home care provider agency owner or staff; or
238.13(3) county staff acting as part of employment.
238.14(d) A licensed family foster parent who lives with the recipient may be the
238.15responsible party as long as the family foster parent meets the other responsible party
238.16requirements.
238.17(e) A responsible party is required when:
238.18(1) the person is a minor according to section 524.5-102, subdivision 10;
238.19(2) the person is an incapacitated adult according to section 524.5-102, subdivision
238.206, resulting in a court-appointed guardian; or
238.21(3) the assessment according to section 256B.0655, subdivision 1b, determines that
238.22the recipient is in need of a responsible party to direct the recipient's care.
238.23(f) There may be two persons designated as the responsible party for reasons such
238.24as divided households and court-ordered custodies. Each person named as responsible
238.25party must meet the program criteria and responsibilities.
238.26(g) The recipient or the recipient's legal representative shall appoint a responsible
238.27party if necessary to direct and supervise the care provided to the recipient. The
238.28responsible party must be identified at the time of assessment and listed on the recipient's
238.29service agreement and personal care assistance care plan.
238.30 Subd. 10. Responsible party; duties; delegation. (a) A responsible party shall
238.31enter into a written agreement with a personal care assistance provider agency, on a form
238.32determined by the commissioner, to perform the following duties:
238.33(1) be available while care is provided in a method agreed upon by the individual
238.34or the individual's legal representative and documented in the recipient's personal care
238.35assistance care plan;
239.1(2) monitor personal care assistance services to ensure the recipient's personal care
239.2assistance care plan is being followed; and
239.3(3) review and sign personal care assistance time sheets after services are provided
239.4to provide verification of the personal care assistance services.
239.5Failure to provide the support required by the recipient must result in a referral to the
239.6county common entry point.
239.7(b) Responsible parties who are parents of minors or guardians of minors or
239.8incapacitated persons may delegate the responsibility to another adult who is not the
239.9personal care assistant during a temporary absence of at least 24 hours but not more
239.10than six months. The person delegated as a responsible party must be able to meet the
239.11definition of the responsible party, except that the delegated responsible party is required
239.12to reside with the recipient only while serving as the responsible party. The responsible
239.13party must ensure that the delegate performs the functions of the responsible party, is
239.14identified at the time of the assessment, and is listed on the personal care assistance
239.15care plan. The responsible party must communicate to the personal care assistance
239.16provider agency about the need for a delegate responsible party, including the name of the
239.17delegated responsible party, dates the delegated responsible party will be living with the
239.18recipient, and contact numbers.
239.19 Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
239.20must meet the following requirements:
239.21(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
239.22of age with these additional requirements:
239.23(i) supervision by a qualified professional every 60 days; and
239.24(ii) employment by only one personal care assistance provider agency responsible
239.25for compliance with current labor laws;
239.26(2) be employed by a personal care assistance provider agency;
239.27(3) enroll with the department as a personal care assistant after clearing a background
239.28study. Before a personal care assistant provides services, the personal care assistance
239.29provider agency must initiate a background study on the personal care assistant under
239.30chapter 245C, and the personal care assistance provider agency must have received a
239.31notice from the commissioner that the personal care assistant is:
239.32(i) not disqualified under section 245C.14; or
239.33(ii) is disqualified, but the personal care assistant has received a set aside of the
239.34disqualification under section 245C.22;
239.35(4) be able to effectively communicate with the recipient and personal care
239.36assistance provider agency;
240.1(5) be able to provide covered personal care assistance services according to the
240.2recipient's personal care assistance care plan, respond appropriately to recipient needs,
240.3and report changes in the recipient's condition to the supervising qualified professional
240.4or physician;
240.5(6) not be a consumer of personal care assistance services;
240.6(7) maintain daily written records including, but not limited to, time sheets under
240.7subdivision 12;
240.8(8) effective January 1, 2010, complete standardized training as determined by the
240.9commissioner before completing enrollment. Personal care assistant training must include
240.10successful completion of the following training components: basic first aid, vulnerable
240.11adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of
240.12personal care assistants including information about assistance with lifting and transfers
240.13for recipients, emergency preparedness, orientation to positive behavioral practices, fraud
240.14issues, and completion of time sheets. Upon completion of the training components,
240.15the personal care assistant must demonstrate the competency to provide assistance to
240.16recipients;
240.17(9) complete training and orientation on the needs of the recipient within the first
240.18seven days after the services begin; and
240.19(10) be limited to providing and being paid for up to 310 hours per month of personal
240.20care assistance services regardless of the number of recipients being served or the number
240.21of personal care assistance provider agencies enrolled with.
240.22(b) A legal guardian may be a personal care assistant if the guardian is not being paid
240.23for the guardian services and meets the criteria for personal care assistants in paragraph (a).
240.24(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant
240.25include parents and stepparents of minors, spouses, paid legal guardians, family foster
240.26care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
240.27staff of a residential setting.
240.28 Subd. 12. Documentation of personal care assistance services provided. (a)
240.29Personal care assistance services for a recipient must be documented daily by each personal
240.30care assistant, on a time sheet form approved by the commissioner. All documentation
240.31may be Web-based, electronic, or paper documentation. The completed form must be
240.32submitted on a monthly basis to the provider and kept in the recipient's health record.
240.33(b) The activity documentation must correspond to the personal care assistance care
240.34plan and be reviewed by the qualified professional.
241.1(c) The personal care assistant time sheet must be on a form approved by the
241.2commissioner documenting time the personal care assistant provides services in the home.
241.3The following criteria must be included in the time sheet:
241.4(1) full name of personal care assistant and individual provider number;
241.5(2) provider name and telephone numbers;
241.6(3) full name of recipient;
241.7(4) consecutive dates, including month, day, and year, and arrival and departure
241.8time with a.m. or p.m. notations;
241.9(5) signatures of recipient or the responsible party;
241.10(6) personal signature of the personal care assistant;
241.11(7) any shared care provided, if applicable;
241.12(8) a statement that it is a federal crime to provide false information on personal
241.13care service billings for medical assistance payments; and
241.14(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
241.15 Subd. 13. Qualified professional; qualifications. (a) The qualified professional
241.16must be employed by a personal care assistance provider agency and meet the definition
241.17under section 256B.0625, subdivision 19c. Before a qualified professional provides
241.18services, the personal care assistance provider agency must initiate a background study on
241.19the qualified professional under chapter 245C, and the personal care assistance provider
241.20agency must have received a notice from the commissioner that the qualified professional:
241.21(1) is not disqualified under section 245C.14; or
241.22(2) is disqualified, but the qualified professional has received a set aside of the
241.23disqualification under section 245C.22.
241.24(b) The qualified professional shall perform the duties of training, supervision, and
241.25evaluation of the personal care assistance staff and evaluation of the effectiveness of
241.26personal care assistance services. The qualified professional shall:
241.27(1) develop and monitor with the recipient a personal care assistance care plan based
241.28on the service plan and individualized needs of the recipient;
241.29(2) develop and monitor with the recipient a monthly plan for the use of personal
241.30care assistance services;
241.31(3) review documentation of personal care assistance services provided;
241.32(4) provide training and ensure competency for the personal care assistant in the
241.33individual needs of the recipient; and
241.34(5) document all training, communication, evaluations, and needed actions to
241.35improve performance of the personal care assistants.
242.1(c) The qualified professional shall complete the provider training with basic
242.2information about the personal care assistance program approved by the commissioner
242.3within six months of the date hired by a personal care assistance provider agency.
242.4Qualified professionals who have completed the required trainings as an employee with a
242.5personal care assistance provider agency do not need to repeat the required trainings if they
242.6are hired by another agency, if they have completed the training within the last three years.
242.7 Subd. 14. Qualified professional; duties. (a) Effective January 1, 2010, all personal
242.8care assistants must be supervised by a qualified professional.
242.9(b) Through direct training, observation, return demonstrations, and consultation
242.10with the staff and the recipient, the qualified professional must ensure and document
242.11that the personal care assistant is:
242.12(1) capable of providing the required personal care assistance services;
242.13(2) knowledgeable about the plan of personal care assistance services before services
242.14are performed; and
242.15(3) able to identify conditions that should be immediately brought to the attention of
242.16the qualified professional.
242.17(c) The qualified professional shall evaluate the personal care assistant within the
242.18first 14 days of starting to provide services for a recipient except for the personal care
242.19assistance choice option under subdivision 19, paragraph (a), clause (4). The qualified
242.20professional shall evaluate the personal care assistance services for a recipient through
242.21direct observation of a personal care assistant's work:
242.22(1) at least every 90 days thereafter for the first year of a recipient's services; and
242.23(2) every 120 days after the first year of a recipient's service or whenever needed for
242.24response to a recipient's request for increased supervision of the personal care assistance
242.25staff.
242.26(d) Communication with the recipient is a part of the evaluation process of the
242.27personal care assistance staff.
242.28(e) At each supervisory visit, the qualified professional shall evaluate personal care
242.29assistance services including the following information:
242.30(1) satisfaction level of the recipient with personal care assistance services;
242.31(2) review of the month-to-month plan for use of personal care assistance services;
242.32(3) review of documentation of personal care assistance services provided;
242.33(4) whether the personal care assistance services are meeting the goals of the service
242.34as stated in the personal care assistance care plan and service plan;
242.35(5) a written record of the results of the evaluation and actions taken to correct any
242.36deficiencies in the work of a personal care assistant; and
243.1(6) revision of the personal care assistance care plan as necessary in consultation
243.2with the recipient or responsible party, to meet the needs of the recipient.
243.3(f) The qualified professional shall complete the required documentation in the
243.4agency recipient and employee files and the recipient's home, including the following
243.5documentation:
243.6(1) the personal care assistance care plan based on the service plan and individualized
243.7needs of the recipient;
243.8(2) a month-to-month plan for use of personal care assistance services;
243.9(3) changes in need of the recipient requiring a change to the level of service and the
243.10personal care assistance care plan;
243.11(4) evaluation results of supervision visits and identified issues with personal care
243.12assistance staff with actions taken;
243.13(5) all communication with the recipient and personal care assistance staff; and
243.14(6) hands-on training or individualized training for the care of the recipient.
243.15(g) The documentation in paragraph (f) must be done on agency forms.
243.16(h) The services that are not eligible for payment as qualified professional services
243.17include:
243.18(1) direct professional nursing tasks that could be assessed and authorized as skilled
243.19nursing tasks;
243.20(2) supervision of personal care assistance completed by telephone;
243.21(3) agency administrative activities;
243.22(4) training other than the individualized training required to provide care for a
243.23recipient; and
243.24(5) any other activity that is not described in this section.
243.25 Subd. 15. Flexible use. (a) "Flexible use" means the scheduled use of authorized
243.26hours of personal care assistance services, which vary within a service authorization
243.27period covering no more than six months, in order to more effectively meet the needs and
243.28schedule of the recipient. Each 12-month service agreement is divided into two six-month
243.29authorization date spans. No more than 75 percent of the total authorized units for a
243.3012-month service agreement may be used in a six-month date span.
243.31(b) Authorization of flexible use occurs during the authorization process under
243.32section 256B.0652. The flexible use of authorized hours does not increase the total
243.33amount of authorized hours available to a recipient. The commissioner shall not authorize
243.34additional personal care assistance services to supplement a service authorization that
243.35is exhausted before the end date under a flexible service use plan, unless the assessor
243.36determines a change in condition and a need for increased services is established.
244.1Authorized hours not used within the six-month period must not be carried over to another
244.2time period.
244.3(c) A recipient who has terminated personal care assistance services before the end
244.4of the 12-month authorization period must not receive additional hours upon reapplying
244.5during the same 12-month authorization period, except if a change in condition is
244.6documented. Services must be prorated for the remainder of the 12-month authorization
244.7period based on the first six-month assessment.
244.8(d) The recipient, responsible party, and qualified professional must develop a
244.9written month-to-month plan of the projected use of personal care assistance services that
244.10is part of the personal care assistance care plan and ensures:
244.11(1) that the health and safety needs of the recipient are met throughout both date
244.12spans of the authorization period; and
244.13(2) that the total authorized amount of personal care assistance services for each date
244.14span must not be used before the end of each date span in the authorization period.
244.15(e) The personal care assistance provider agency shall monitor the use of personal
244.16care assistance services to ensure health and safety needs of the recipient are met
244.17throughout both date spans of the authorization period. The commissioner or the
244.18commissioner's designee shall provide written notice to the provider and the recipient or
244.19responsible party when a recipient is at risk of exceeding the personal care assistance
244.20services prior to the end of the six-month period.
244.21(f) Misuse and abuse of the flexible use of personal care assistance services resulting
244.22in the overuse of units in a manner where the recipient will not have enough units to meet
244.23their needs for assistance and ensure health and safety for the entire six-month date span
244.24may lead to an action by the commissioner. The commissioner may take action including,
244.25but not limited to: (1) restricting recipients to service authorizations of no more than one
244.26month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring
244.27a qualified professional to monitor and report services on a monthly basis.
244.28 Subd. 16. Shared services. (a) Medical assistance payments for shared personal
244.29care assistance services are limited according to this subdivision.
244.30(b) Shared service is the provision of personal care assistance services by a personal
244.31care assistant to two or three recipients, eligible for medical assistance, who voluntarily
244.32enter into an agreement to receive services at the same time and in the same setting.
244.33(c) For the purposes of this subdivision, "setting" means:
244.34(1) the home residence or family foster care home of one or more of the individual
244.35recipients; or
245.1(2) a child care program licensed under chapter 245A or operated by a local school
245.2district or private school.
245.3(d) Shared personal care assistance services follow the same criteria for covered
245.4services as subdivision 2.
245.5(e) Noncovered shared personal care assistance services include the following:
245.6(1) services for more than three recipients by one personal care assistant at one time;
245.7(2) staff requirements for child care programs under chapter 245C;
245.8(3) caring for multiple recipients in more than one setting;
245.9(4) additional units of personal care assistance based on the selection of the option;
245.10and
245.11(5) use of more than one personal care assistance provider agency for the shared
245.12care services.
245.13(f) The option of shared personal care assistance is elected by the recipient or the
245.14responsible party with the assistance of the assessor. The option must be determined
245.15appropriate based on the ages of the recipients, compatibility, and coordination of their
245.16assessed care needs. The recipient or the responsible party, in conjunction with the
245.17qualified professional, shall arrange the setting and grouping of shared services based
245.18on the individual needs and preferences of the recipients. The personal care assistance
245.19provider agency shall offer the recipient or the responsible party the option of shared or
245.20one-on-one personal care assistance services or a combination of both. The recipient or
245.21the responsible party may withdraw from participating in a shared services arrangement at
245.22any time.
245.23(g) Authorization for the shared service option must be determined by the
245.24commissioner based on the criteria that the shared service is appropriate to meet all of the
245.25recipients' needs and their health and safety is maintained. The authorization of shared
245.26services is part of the overall authorization of personal care assistance services. Nothing
245.27in this subdivision must be construed to reduce the total number of hours authorized for
245.28an individual recipient.
245.29(h) A personal care assistant providing shared personal care assistance services must:
245.30(1) receive training specific for each recipient served; and
245.31(2) follow all required documentation requirements for time and services provided.
245.32(i) A qualified professional shall:
245.33(1) evaluate the ability of the personal care assistant to provide services for all of
245.34the recipients in a shared setting;
246.1(2) visit the shared setting as services are being provided at least once every six
246.2months or whenever needed for response to a recipient's request for increased supervision
246.3of the personal care assistance staff;
246.4(3) provide ongoing monitoring and evaluation of the effectiveness and
246.5appropriateness of the shared services;
246.6(4) develop a contingency plan with each of the recipients which accounts for
246.7absence of the recipient in a share services setting due to illness or other circumstances;
246.8(5) obtain permission from each of the recipients who are sharing a personal care
246.9assistant for number of shared hours for services provided inside and outside the home
246.10residence; and
246.11(6) document the training completed by the personal care assistants specific to the
246.12shared setting and recipients sharing services.
246.13 Subd. 17. Shared services; rates. The commissioner shall provide a rate system for
246.14shared personal care assistance services. For two persons sharing services, the rate paid
246.15to a provider must not exceed one and one-half times the rate paid for serving a single
246.16individual, and for three persons sharing services, the rate paid to a provider must not
246.17exceed twice the rate paid for serving a single individual. These rates apply only when all
246.18of the criteria for the shared care personal care assistance service have been met.
246.19 Subd. 18. Personal care assistance choice option; generally. (a) The
246.20commissioner may allow a recipient of personal care assistance services to use a fiscal
246.21intermediary to assist the recipient in paying and accounting for medically necessary
246.22covered personal care assistance services. Unless otherwise provided in this section, all
246.23other statutory and regulatory provisions relating to personal care assistance services apply
246.24to a recipient using the personal care assistance choice option.
246.25(b) Personal care assistance choice is an option of the personal care assistance
246.26program that allows the recipient who receives personal care assistance services to be
246.27responsible for the hiring, training, scheduling, and firing of personal care assistants. This
246.28program offers greater control and choice for the recipient in who provides the personal
246.29care assistance service and when the service is scheduled. The recipient or the recipient's
246.30responsible party must choose a personal care assistance choice provider agency as
246.31a fiscal intermediary. This personal care assistance choice provider agency manages
246.32payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is
246.33responsible for providing the consumer training and support in managing the recipient's
246.34personal care assistance services.
247.1 Subd. 19. Personal care assistance choice option; qualifications; duties. (a)
247.2Under personal care assistance choice, the recipient or responsible party shall:
247.3(1) recruit, hire, schedule, and terminate personal care assistants and a qualified
247.4professional;
247.5(2) develop a personal care assistance care plan based on the assessed needs
247.6and addressing the health and safety of the recipient with the assistance of a qualified
247.7professional as needed;
247.8(3) orient and train the personal care assistant with assistance as needed from the
247.9qualified professional;
247.10(4) effective January 1, 2010, supervise and evaluate the personal care assistant with
247.11the qualified professional, who is required to visit the recipient at least every 180 days;
247.12(5) monitor and verify in writing and report to the personal care assistance choice
247.13agency the number of hours worked by the personal care assistant and the qualified
247.14professional;
247.15(6) engage in an annual face-to-face reassessment to determine continuing eligibility
247.16and service authorization; and
247.17(7) use the same personal care assistance choice provider agency if shared personal
247.18assistance care is being used.
247.19(b) The personal care assistance choice provider agency shall:
247.20(1) meet all personal care assistance provider agency standards;
247.21(2) enter into a written agreement with the recipient, responsible party, and personal
247.22care assistants;
247.23(3) not be related as a parent, child, sibling, or spouse to the recipient, qualified
247.24professional, or the personal care assistant; and
247.25(4) ensure arm's-length transactions without undue influence or coercion with the
247.26recipient and personal care assistant.
247.27(c) The duties of the personal care assistance choice provider agency are to:
247.28(1) be the employer of the personal care assistant and the qualified professional for
247.29employment law and related regulations including, but not limited to, purchasing and
247.30maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
247.31and liability insurance, and submit any or all necessary documentation including, but not
247.32limited to, workers' compensation and unemployment insurance;
247.33(2) bill the medical assistance program for personal care assistance services and
247.34qualified professional services;
247.35(3) request and complete background studies that comply with the requirements for
247.36personal care assistants and qualified professionals;
248.1(4) pay the personal care assistant and qualified professional based on actual hours
248.2of services provided;
248.3(5) withhold and pay all applicable federal and state taxes;
248.4(6) verify and keep records of hours worked by the personal care assistant and
248.5qualified professional;
248.6(7) make the arrangements and pay taxes and other benefits, if any; and comply with
248.7any legal requirements for a Minnesota employer;
248.8(8) enroll in the medical assistance program as a personal care assistance choice
248.9agency; and
248.10(9) enter into a written agreement as specified in subdivision 20 before services
248.11are provided.
248.12 Subd. 20. Personal care assistance choice option; administration. (a) Before
248.13services commence under the personal care assistance choice option, and annually
248.14thereafter, the personal care assistance choice provider agency, recipient, or responsible
248.15party, each personal care assistant, and the qualified professional shall enter into a written
248.16agreement. The agreement must include at a minimum:
248.17(1) duties of the recipient, qualified professional, personal care assistant, and
248.18personal care assistance choice provider agency;
248.19(2) salary and benefits for the personal care assistant and the qualified professional;
248.20(3) administrative fee of the personal care assistance choice provider agency and
248.21services paid for with that fee, including background study fees;
248.22(4) grievance procedures to respond to complaints;
248.23(5) procedures for hiring and terminating the personal care assistant; and
248.24(6) documentation requirements including, but not limited to, time sheets, activity
248.25records, and the personal care assistance care plan.
248.26(b) Effective January 1, 2010, except for the administrative fee of the personal care
248.27assistance choice provider agency as reported on the written agreement, the remainder
248.28of the rates paid to the personal care assistance choice provider agency must be used to
248.29pay for the salary and benefits for the personal care assistant or the qualified professional.
248.30The provider agency must use a minimum of 72.5 percent of the revenue generated by
248.31the medical assistance rate for personal care assistance services for employee personal
248.32care assistant wages and benefits.
248.33(c) The commissioner shall deny, revoke, or suspend the authorization to use the
248.34personal care assistance choice option if:
248.35(1) it has been determined by the qualified professional or public health nurse that
248.36the use of this option jeopardizes the recipient's health and safety;
249.1(2) the parties have failed to comply with the written agreement specified in this
249.2subdivision;
249.3(3) the use of the option has led to abusive or fraudulent billing for personal care
249.4assistance services; or
249.5(4) the department terminates the personal care assistance choice option.
249.6(d) The recipient or responsible party may appeal the commissioner's decision in
249.7paragraph (c) according to section 256.045. The denial, revocation, or suspension to
249.8use the personal care assistance choice option must not affect the recipient's authorized
249.9level of personal care assistance services.
249.10 Subd. 21. Requirements for initial enrollment of personal care assistance
249.11provider agencies. (a) All personal care assistance provider agencies must provide, at the
249.12time of enrollment as a personal care assistance provider agency in a format determined
249.13by the commissioner, information and documentation that includes, but is not limited to,
249.14the following:
249.15(1) the personal care assistance provider agency's current contact information
249.16including address, telephone number, and e-mail address;
249.17(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
249.18provider's payments from Medicaid in the previous year, whichever is less;
249.19(3) proof of fidelity bond coverage in the amount of $20,000;
249.20(4) proof of workers' compensation insurance coverage;
249.21(5) a description of the personal care assistance provider agency's organization
249.22identifying the names of all owners, managing employees, staff, board of directors, and
249.23the affiliations of the directors, owners, or staff to other service providers;
249.24(6) a copy of the personal care assistance provider agency's written policies and
249.25procedures including: hiring of employees; training requirements; service delivery;
249.26and employee and consumer safety including process for notification and resolution
249.27of consumer grievances, identification and prevention of communicable diseases, and
249.28employee misconduct;
249.29(7) copies of all other forms the personal care assistance provider agency uses in
249.30the course of daily business including, but not limited to:
249.31(i) a copy of the personal care assistance provider agency's time sheet if the time
249.32sheet varies from the standard time sheet for personal care assistance services approved
249.33by the commissioner, and a letter requesting approval of the personal care assistance
249.34provider agency's nonstandard time sheet;
249.35(ii) the personal care assistance provider agency's template for the personal care
249.36assistance care plan; and
250.1(iii) the personal care assistance provider agency's template and the written
250.2agreement in subdivision 20 for recipients using the personal care assistance choice
250.3option, if applicable;
250.4(8) a list of all trainings and classes that the personal care assistance provider agency
250.5requires of its staff providing personal care assistance services;
250.6(9) documentation that the personal care assistance provider agency and staff have
250.7successfully completed all the training required by this section;
250.8(10) documentation of the agency's marketing practices;
250.9(11) disclosure of ownership, leasing, or management of all residential properties
250.10that is used or could be used for providing home care services; and
250.11(12) documentation that the agency will use the following percentages of revenue
250.12generated from the medical assistance rate paid for personal care assistance services
250.13for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
250.14personal care assistance choice option and 72.5 percent of revenue from other personal
250.15care assistance providers.
250.16(b) Personal care assistance provider agencies shall provide the information specified
250.17in paragraph (a) to the commissioner at the time the personal care assistance provider
250.18agency enrolls as a vendor or upon request from the commissioner. The commissioner
250.19shall collect the information specified in paragraph (a) from all personal care assistance
250.20providers beginning upon enactment of this section.
250.21(c) All personal care assistance provider agencies shall complete mandatory training
250.22as determined by the commissioner before enrollment as a provider. Personal care
250.23assistance provider agencies are required to send all owners, qualified professionals
250.24employed by the agency, and all other managing employees to the initial and subsequent
250.25trainings. Personal care assistance provider agency billing staff shall complete training
250.26about personal care assistance program financial management. This training is effective
250.27upon enactment of this section. Any personal care assistance provider agency enrolled
250.28before that date shall, if it has not already, complete the provider training within 18 months
250.29of the effective date of this section. Any new owners, new qualified professionals, and new
250.30managing employees are required to complete mandatory training as a requisite of hiring.
250.31 Subd. 22. Annual review for personal care providers. (a) All personal care
250.32assistance provider agencies shall resubmit, on an annual basis, the information specified
250.33in subdivision 21, in a format determined by the commissioner, and provide a copy of the
250.34personal care assistance provider agency's most current version of its grievance policies
250.35and procedures along with a written record of grievances and resolutions of the grievances
251.1that the personal care assistance provider agency has received in the previous year and any
251.2other information requested by the commissioner.
251.3(b) The commissioner shall send annual review notification to personal care
251.4assistance provider agencies 30 days prior to renewal. The notification must:
251.5(1) list the materials and information the personal care assistance provider agency is
251.6required to submit;
251.7(2) provide instructions on submitting information to the commissioner; and
251.8(3) provide a due date by which the commissioner must receive the requested
251.9information.
251.10Personal care assistance provider agencies shall submit required documentation for
251.11annual review within 30 days of notification from the commissioner. If no documentation
251.12is submitted, the personal care assistance provider agency enrollment number must be
251.13terminated or suspended.
251.14(c) Personal care assistance provider agencies also currently licensed under
251.15Minnesota Rules, part 4668.0012, as a class A provider or currently certified for
251.16participation in Medicare as a home health agency are deemed in compliance with
251.17the personal care assistance requirements for enrollment, annual review process, and
251.18documentation.
251.19 Subd. 23. Enrollment requirements following termination. (a) A terminated
251.20personal care assistance provider agency, including all named individuals on the current
251.21enrollment disclosure form and known or discovered affiliates of the personal care
251.22assistance provider agency, is not eligible to enroll as a personal care assistance provider
251.23agency for two years following the termination.
251.24(b) After the two-year period in paragraph (a), if the provider seeks to reenroll
251.25as a personal care assistance provider agency, the personal care assistance provider
251.26agency must be placed on a one-year probation period, beginning after completion of
251.27the following:
251.28(1) the department's provider trainings under this section; and
251.29(2) initial enrollment requirements under subdivision 21.
251.30(c) During the probationary period the commissioner shall complete site visits and
251.31request submission of documentation to review compliance with program policy.
251.32 Subd. 24. Personal care assistance provider agency; general duties. A personal
251.33care assistance provider agency shall:
251.34(1) enroll as a Medicaid provider meeting all provider standards, including
251.35completion of the required provider training;
251.36(2) comply with general medical assistance coverage requirements;
252.1(3) demonstrate compliance with law and policies of the personal care assistance
252.2program to be determined by the commissioner;
252.3(4) comply with background study requirements;
252.4(5) verify and keep records of hours worked by the personal care assistant and
252.5qualified professional;
252.6(6) market agency services only through printed information in brochures and on
252.7Web sites and not engage in any agency-initiated direct contact or marketing in person, by
252.8phone, or other electronic means to potential recipients, guardians, or family members;
252.9(7) pay the personal care assistant and qualified professional based on actual hours
252.10of services provided;
252.11(8) withhold and pay all applicable federal and state taxes;
252.12(9) effective January 1, 2010, document that the agency uses a minimum of 72.5
252.13percent of the revenue generated by the medical assistance rate for personal care assistance
252.14services for employee personal care assistant wages and benefits;
252.15(10) make the arrangements and pay unemployment insurance, taxes, workers'
252.16compensation, liability insurance, and other benefits, if any;
252.17(11) enter into a written agreement under subdivision 20 before services are provided;
252.18(12) report suspected neglect and abuse to the common entry point according to
252.19section 256B.0651;
252.20(13) provide the recipient with a copy of the home care bill of rights at start of
252.21service; and
252.22 (14) request reassessments at least 60 days prior to the end of the current
252.23authorization for personal care assistance services, on forms provided by the commissioner.
252.24 Subd. 25. Personal care assistance provider agency; background studies.
252.25Personal care assistance provider agencies enrolled to provide personal care assistance
252.26services under the medical assistance program shall comply with the following:
252.27(1) owners who have a five percent interest or more and all managing employees
252.28are subject to a background study as provided in chapter 245C. This applies to currently
252.29enrolled personal care assistance provider agencies and those agencies seeking enrollment
252.30as a personal care assistance provider agency. Managing employee has the same meaning
252.31as Code of Federal Regulations, title 42, section 455. An organization is barred from
252.32enrollment if:
252.33(i) the organization has not initiated background studies on owners and managing
252.34employees; or
252.35(ii) the organization has initiated background studies on owners and managing
252.36employees, but the commissioner has sent the organization a notice that an owner or
253.1managing employee of the organization has been disqualified under section 245C.14,
253.2and the owner or managing employee has not received a set aside of the disqualification
253.3under section 245C.22;
253.4(2) a background study must be initiated and completed for all qualified
253.5professionals; and
253.6(3) a background study must be initiated and completed for all personal care
253.7assistants.
253.8 Subd. 26. Personal care assistance provider agency; communicable disease
253.9prevention. A personal care assistance provider agency shall establish and implement
253.10policies and procedures for prevention, control, and investigation of infections and
253.11communicable diseases according to current nationally recognized infection control
253.12practices or guidelines established by the United States Centers for Disease Control and
253.13Prevention, as well as applicable regulations of other federal or state agencies.
253.14 Subd. 27. Personal care assistance provider agency; ventilator training. The
253.15personal care assistance provider agency is required to provide training for the personal
253.16care assistant responsible for working with a recipient who is ventilator dependent. All
253.17training must be administered by a respiratory therapist, nurse, or physician. Qualified
253.18professional supervision by a nurse must be completed and documented on file in the
253.19personal care assistant's employment record and the recipient's health record. If offering
253.20personal care services to a ventilator-dependent recipient, the personal care assistance
253.21provider agency shall demonstrate the ability to:
253.22(1) train the personal care assistant;
253.23(2) supervise the personal care assistant in ventilator operation and maintenance; and
253.24(3) supervise the recipient and responsible party in ventilator operation and
253.25maintenance.
253.26 Subd. 28. Personal care assistance provider agency; required documentation.
253.27Required documentation must be completed and kept in the personal care assistance
253.28provider agency file or the recipient's home residence. The required documentation
253.29consists of:
253.30(1) employee files, including:
253.31(i) applications for employment;
253.32(ii) background study requests and results;
253.33(iii) orientation records about the agency policies;
253.34(iv) trainings completed with demonstration of competence;
253.35(v) supervisory visits;
254.1(vi) evaluations of employment; and
254.2(vii) signature on fraud statement;
254.3(2) recipient files, including:
254.4(i) demographics;
254.5(ii) emergency contact information and emergency backup plan;
254.6(iii) personal care assistance service plan;
254.7(iv) personal care assistance care plan;
254.8(v) month-to-month service use plan;
254.9(vi) all communication records;
254.10(vii) start of service information, including the written agreement with recipient; and
254.11(viii) date the home care bill of rights was given to the recipient;
254.12(3) agency policy manual, including:
254.13(i) policies for employment and termination;
254.14(ii) grievance policies with resolution of consumer grievances;
254.15(iii) staff and consumer safety;
254.16(iv) staff misconduct; and
254.17(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
254.18resolution of consumer grievances;
254.19(4) time sheets for each personal care assistant along with completed activity sheets
254.20for each recipient served; and
254.21(5) agency marketing and advertising materials and documentation of marketing
254.22activities and costs.
254.23 Subd. 29. Transitional assistance. The commissioner, counties, health plans,
254.24tribes, and personal care assistance providers shall work together to provide transitional
254.25assistance for recipients and families to come into compliance with the new requirements
254.26of this section and ensure the personal care assistance services are not provided by the
254.27housing provider.
254.28 Subd. 30. Notice of service changes to recipients. The commissioner must provide:
254.29(1) by October 31, 2009, information to recipients likely to be affected that (i)
254.30describes the changes to the personal care assistance program that may result in the
254.31loss of access to personal care assistance services, and (ii) includes resources to obtain
254.32further information; and
254.33(2) notice of changes in medical assistance home care services to each affected
254.34recipient at least 30 days before the effective date of the change.
254.35The notice shall include how to get further information on the changes, how to get help to
254.36obtain other services, a list of community resources, and appeal rights. Notwithstanding
255.1section 256.045, a recipient may request continued services pending appeal within the
255.2time period allowed to request an appeal.
255.3EFFECTIVE DATE.Subdivisions 4, 22, and 27 are effective January 1, 2010.
255.4 Sec. 32. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to
255.5read:
255.6 Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
255.7services is to assist persons with long-term or chronic care needs in making long-term
255.8care decisions and selecting options that meet their needs and reflect their preferences.
255.9The availability of, and access to, information and other types of assistance, including
255.10assessment and support planning, is also intended to prevent or delay certified nursing
255.11facility placements and to provide transition assistance after admission. Further, the goal
255.12of these services is to contain costs associated with unnecessary certified nursing facility
255.13admissions. Long-term consultation services must be available to any person regardless
255.14of public program eligibility. Thecommissioners commissioner of human services and
255.15health shall seek to maximize use of available federal and state funds and establish the
255.16broadest program possible within the funding available.
255.17(b) These services must be coordinated withservices long-term care options
255.18counseling provided under section256.975, subdivision 7 , and with services provided by
255.19other public and private agencies in the community section 256.01, subdivision 24, for
255.20telephone assistance and follow up and to offer a variety of cost-effective alternatives to
255.21persons with disabilities and elderly persons. The county or tribal agency or managed
255.22care plan providing long-term care consultation services shall encourage the use of
255.23volunteers from families, religious organizations, social clubs, and similar civic and
255.24service organizations to provide community-based services.
255.25 Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to
255.26read:
255.27 Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
255.28(a) "Long-term care consultation services" means:
255.29(1)providing information and education to the general public regarding availability
255.30of the services authorized under this section;
255.31(2) an intake process that provides access to the services described in this section;
255.32(3) assessment of the health, psychological, and social needs of referred individuals;
255.33(4) assistance in identifying services needed to maintain an individual in the least
255.34restrictive most inclusive environment;
256.1(5) (2) providing recommendations on cost-effective community services that are
256.2available to the individual;
256.3(6) (3) development of an individual's person-centered community support plan;
256.4(7) (4) providing information regarding eligibility for Minnesota health care
256.5programs;
256.6(5) face-to-face long-term care consultation assessments, which may be completed
256.7in a hospital, nursing facility, intermediate care facility for persons with developmental
256.8disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
256.9residence;
256.10(8) preadmission (6) federally mandated screening to determine the need for
256.11anursing facility institutional level of care under section 256B.0911, subdivision 4,
256.12paragraph (a);
256.13(9) preliminary (7) determination of Minnesota health care programs home and
256.14community-based waiver service eligibility including level of care determination for
256.15individuals who needa nursing facility an institutional level of care as defined under
256.16section 144.0724, subdivision 11, or 256B.092, service eligibility including state plan
256.17home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs
256.18(a) and (c), based on assessment and support plan development with appropriate referrals
256.19for final determination;
256.20(10) (8) providing recommendations for nursing facility placement when there are
256.21no cost-effective community services available; and
256.22(11) (9) assistance to transition people back to community settings after facility
256.23admission.
256.24(b) "Long-term options counseling" means the services provided by the linkage
256.25lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
256.26telephone assistance and follow up once a long-term care consultation assessment has
256.27been completed.
256.28(b) (c) "Minnesota health care programs" means the medical assistance program
256.29under chapter 256B and the alternative care program under section256B.0913 .
256.30(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
256.31plans administering long-term care consultation assessment and support planning services.
256.32EFFECTIVE DATE.This section is effective January 1, 2011.
256.33 Sec. 34. Minnesota Statutes 2008, section 256B.0911, is amended by adding a
256.34subdivision to read:
257.1 Subd. 2b. Certified assessors. (a) Beginning January 1, 2011, each lead agency
257.2shall use certified assessors who have completed training and certification process
257.3determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate
257.4best practices in assessment and support planning including person-centered planning
257.5principals and have a common set of skills that must ensure consistency and equitable
257.6access to services statewide. Assessors must be part of a multidisciplinary team of
257.7professionals that includes public health nurses, social workers, and other professionals
257.8as defined in paragraph (b). For persons with complex health care needs, a public health
257.9nurse or registered nurse from a multidisciplinary team must be consulted.
257.10(b) Certified assessors are persons with a minimum of a bachelor's degree in social
257.11work, nursing with a public health nursing certificate, or other closely related field with at
257.12least one year of home and community-based experience or a two-year registered nursing
257.13degree with at least three years of home and community-based experience that have
257.14received training and certification specific to assessment and consultation for long-term
257.15care services in the state.
257.16 Sec. 35. Minnesota Statutes 2008, section 256B.0911, is amended by adding a
257.17subdivision to read:
257.18 Subd. 2c. Assessor training and certification. The commissioner shall develop a
257.19curriculum and an assessor certification process to begin no later than January 1, 2010.
257.20All existing lead agency staff designated to provide the services defined in subdivision
257.211a must be certified by December 30, 2010. Each lead agency is required to ensure that
257.22they have sufficient numbers of certified assessors to provide long-term consultation
257.23assessment and support planning within the timelines and parameters of the service by
257.24January 1, 2011. Certified assessors are required to be recertified every three years.
257.25 Sec. 36. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to
257.26read:
257.27 Subd. 3. Long-term care consultation team. (a) Until January 1, 2011, a long-term
257.28care consultation team shall be established by the county board of commissioners. Each
257.29local consultation team shall consist of at least one social worker and at least one public
257.30health nurse from their respective county agencies. The board may designate public
257.31health or social services as the lead agency for long-term care consultation services. If a
257.32county does not have a public health nurse available, it may request approval from the
257.33commissioner to assign a county registered nurse with at least one year experience in
258.1home care to participate on the team. Two or more counties may collaborate to establish
258.2a joint local consultation team or teams.
258.3(b) The team is responsible for providing long-term care consultation services to
258.4all persons located in the county who request the services, regardless of eligibility for
258.5Minnesota health care programs.
258.6(c) The commissioner shall allow arrangements and make recommendations that
258.7encourage counties to collaborate to establish joint local long-term care consultation teams
258.8to ensure that long-term care consultations are done within the timelines and parameters
258.9of the service. This includes integrated service models as required in subdivision 1,
258.10paragraph (b).
258.11 Sec. 37. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to
258.12read:
258.13 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
258.14services planning, or other assistance intended to support community-based living,
258.15including persons who need assessment in order to determine waiver or alternative
258.16care program eligibility, must be visited by a long-term care consultation team within
258.17ten working 15 calendar days after the date on which an assessment was requested or
258.18recommended. After January 1, 2011, these requirements also apply to personal care
258.19assistance services, private duty nursing, and home health agency services, on timelines
258.20established in subdivision 5. Face-to-face assessments must be conducted according
258.21to paragraphs (b) to (i).
258.22 (b) The county may utilize a team of either the social worker or public health nurse,
258.23or both,. After January 1, 2011, lead agencies shall use certified assessors to conduct the
258.24assessment in a face-to-face interview. The consultation team members must confer
258.25regarding the most appropriate care for each individual screened or assessed.
258.26 (c) Thelong-term care consultation team must assess the health and social needs of
258.27the person assessment must be comprehensive and include a person-centered assessment
258.28of the health, psychological, functional, environmental, and social needs of referred
258.29individuals and provide information necessary to develop a support plan that meets the
258.30consumers needs, using an assessment form provided by the commissioner.
258.31 (d) Theteam must conduct the assessment must be conducted in a face-to-face
258.32interview with the person being assessed and the person's legal representative,if applicable
258.33as required by legally executed documents, and other individuals as requested by the
258.34person, who can provide information on the needs, strengths, and preferences of the
259.1person necessary to develop a support plan that ensures the person's health and safety, but
259.2who is not a provider of service or has any financial interest in the provision of services.
259.3 (e) Theteam must provide the person, or the person's legal representative, must
259.4be provided with written recommendations forfacility- or community-based services.
259.5The team must document or institutional care that include documentation that the most
259.6cost-effective alternatives available were offered to the individual. For purposes of
259.7this requirement, "cost-effective alternatives" means community services and living
259.8arrangements that cost the same as or less thannursing facility institutional care.
259.9 (f) If the person chooses to use community-based services, theteam must provide
259.10the person or the person's legal representative must be provided with a written community
259.11support plan, regardless of whether the individual is eligible for Minnesota health care
259.12programs.The A person may request assistance in developing a community support plan
259.13 identifying community supports without participating in a complete assessment. Upon
259.14a request for assistance identifying community support, the person must be transferred
259.15or referred to the services available under sections 256.975, subdivision 7, and 256.01,
259.16subdivision 24, for telephone assistance and follow up.
259.17 (g) The person has the right to make the final decision betweennursing
259.18facility institutional placement and community placement after the screening team's
259.19recommendation recommendations have been provided, except as provided in subdivision
259.204a, paragraph (c).
259.21 (h) The team must give the person receiving assessment or support planning, or
259.22the person's legal representative, materials, and forms supplied by the commissioner
259.23containing the following information:
259.24 (1) the need for and purpose of preadmission screening if the person selects nursing
259.25facility placement;
259.26 (2) the role of the long-term care consultation assessment and support planning in
259.27waiver and alternative care program eligibility determination;
259.28 (3) information about Minnesota health care programs;
259.29 (4) the person's freedom to accept or reject the recommendations of the team;
259.30 (5) the person's right to confidentiality under the Minnesota Government Data
259.31Practices Act, chapter 13;
259.32 (6) the long-term care consultant's decision regarding the person's need fornursing
259.33facility institutional level of care as determined under criteria established in section
259.34144.0724, subdivision 11, or 256B.092; and
260.1 (7) the person's right to appeal the decision regarding the need for nursing facility
260.2level of care or the county's final decisions regarding public programs eligibility according
260.3to section256.045, subdivision 3 .
260.4 (i) Face-to-face assessment completed as part of eligibility determination for
260.5the alternative care, elderly waiver, community alternatives for disabled individuals,
260.6community alternative care, and traumatic brain injury waiver programs under sections
260.7256B.0915
,
256B.0917 , and
256B.49 is valid to establish service eligibility for no more
260.8than 60 calendar days after the date of assessment. The effective eligibility start date
260.9for these programs can never be prior to the date of assessment. If an assessment was
260.10completed more than 60 days before the effective waiver or alternative care program
260.11eligibility start date, assessment and support plan information must be updated in a
260.12face-to-face visit and documented in the department's Medicaid Management Information
260.13System (MMIS). The effective date of program eligibility in this case cannot be prior to
260.14the date the updated assessment is completed.
260.15 Sec. 38. Minnesota Statutes 2008, section 256B.0911, subdivision 3b, is amended to
260.16read:
260.17 Subd. 3b. Transition assistance. (a) A long-term care consultation team shall
260.18provide assistance to persons residing in a nursing facility, hospital, regional treatment
260.19center, or intermediate care facility for persons with developmental disabilities who
260.20request or are referred for assistance. Transition assistance must include assessment,
260.21community support plan development, referrals to long-term care options counseling
260.22under section 256B.975, subdivision 10, for community support plan implementation and
260.23to Minnesota health care programs, and referrals to programs that provide assistance
260.24with housing. Transition assistance must also include information about the Centers for
260.25Independent Living and the Senior LinkAge Line, and about other organizations that
260.26can provide assistance with relocation efforts, and information about contacting these
260.27organizations to obtain their assistance and support.
260.28 (b) The county shall develop transition processes with institutional social workers
260.29and discharge planners to ensure that:
260.30 (1) persons admitted to facilities receive information about transition assistance
260.31that is available;
260.32 (2) the assessment is completed for persons within ten working days of the date of
260.33request or recommendation for assessment; and
260.34 (3) there is a plan for transition and follow-up for the individual's return to the
260.35community. The plan must require notification of other local agencies when a person
261.1who may require assistance is screened by one county for admission to a facility located
261.2in another county.
261.3 (c) If a person who is eligible for a Minnesota health care program is admitted to a
261.4nursing facility, the nursing facility must include a consultation team member or the case
261.5manager in the discharge planning process.
261.6 Sec. 39. Minnesota Statutes 2008, section 256B.0911, subdivision 3c, is amended to
261.7read:
261.8 Subd. 3c. Transition to housing with services. (a) Housing with services
261.9establishments offering or providing assisted living under chapter 144G shall inform
261.10all prospective residents of the availability of and contact information for transitional
261.11consultation services under this subdivision prior to executing a lease or contract with the
261.12prospective resident. The purpose of transitional long-term care consultation is to support
261.13persons with current or anticipated long-term care needs in making informed choices
261.14among options that include the most cost-effective and least restrictive settings, and to
261.15delay spenddown to eligibility for publicly funded programs by connecting people to
261.16alternative services in their homes before transition to housing with services. Regardless
261.17of the consultation, prospective residents maintain the right to choose housing with
261.18services or assisted living if that option is their preference.
261.19 (b) Transitional consultation services are provided as determined by the
261.20commissioner of human services in partnership with county long-term care consultation
261.21units, and the Area Agencies on Aging, and are a combination of telephone-based
261.22and in-person assistance provided under models developed by the commissioner. The
261.23consultation shall be performed in a manner that provides objective and complete
261.24information. Transitional consultation must be provided within five working days of the
261.25request of the prospective resident as follows:
261.26 (1) the consultation must be provided by a qualified professional as determined by
261.27the commissioner;
261.28 (2) the consultation must include a review of the prospective resident's reasons for
261.29considering assisted living, the prospective resident's personal goals, a discussion of the
261.30prospective resident's immediate and projected long-term care needs, and alternative
261.31community services or assisted living settings that may meet the prospective resident's
261.32needs; and
261.33 (3) the prospective resident shall be informed of the availability of long-term care
261.34consultation services described in subdivision 3a that are available at no charge to the
261.35prospective resident to assist the prospective resident in assessment and planning to meet
262.1the prospective resident's long-term care needs. The Senior LinkAge Line and long-term
262.2care consultation team shall give the highest priority to referrals who are at highest risk of
262.3nursing facility placement or as needed for determining eligibility.
262.4 Sec. 40. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to
262.5read:
262.6 Subd. 4a. Preadmission screening activities related to nursing facility
262.7admissions. (a) All applicants to Medicaid certified nursing facilities, including certified
262.8boarding care facilities, must be screened prior to admission regardless of income, assets,
262.9or funding sources for nursing facility care, except as described in subdivision 4b. The
262.10purpose of the screening is to determine the need for nursing facility level of care as
262.11described in paragraph (d) and to complete activities required under federal law related to
262.12mental illness and developmental disability as outlined in paragraph (b).
262.13(b) A person who has a diagnosis or possible diagnosis of mental illness or
262.14developmental disability must receive a preadmission screening before admission
262.15regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need
262.16for further evaluation and specialized services, unless the admission prior to screening is
262.17authorized by the local mental health authority or the local developmental disabilities case
262.18manager, or unless authorized by the county agency according to Public Law 101-508.
262.19The following criteria apply to the preadmission screening:
262.20(1) the county must use forms and criteria developed by the commissioner to identify
262.21persons who require referral for further evaluation and determination of the need for
262.22specialized services; and
262.23(2) the evaluation and determination of the need for specialized services must be
262.24done by:
262.25(i) a qualified independent mental health professional, for persons with a primary or
262.26secondary diagnosis of a serious mental illness; or
262.27(ii) a qualified developmental disability professional, for persons with a primary or
262.28secondary diagnosis of developmental disability. For purposes of this requirement, a
262.29qualified developmental disability professional must meet the standards for a qualified
262.30developmental disability professional under Code of Federal Regulations, title 42, section
262.31483.430
.
262.32(c) The local county mental health authority or the state developmental disability
262.33authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
262.34nursing facility if the individual does not meet the nursing facility level of care criteria or
262.35needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
263.1purposes of this section, "specialized services" for a person with developmental disability
263.2means active treatment as that term is defined under Code of Federal Regulations, title
263.342, section483.440 (a)(1).
263.4(d) The determination of the need for nursing facility level of care must be made
263.5according to criteria established in section 144.0724, subdivision 11, and 256B.092,
263.6using forms developed by the commissioner. In assessing a person's needs, consultation
263.7team members shall have a physician available for consultation and shall consider the
263.8assessment of the individual's attending physician, if any. The individual's physician must
263.9be included if the physician chooses to participate. Other personnel may be included on
263.10the team as deemed appropriate by the county.
263.11EFFECTIVE DATE.The section is effective January 1, 2011.
263.12 Sec. 41. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to
263.13read:
263.14 Subd. 5. Administrative activity. The commissioner shallminimize the number
263.15of forms required in the provision of long-term care consultation services and shall
263.16limit the screening document to items necessary for community support plan approval,
263.17reimbursement, program planning, evaluation, and policy development streamline the
263.18processes, including timelines for when assessments need to be completed, required to
263.19provide the services in this section and shall implement integrated solutions to automate
263.20the business processes to the extent necessary for community support plan approval,
263.21reimbursement, program planning, evaluation, and policy development.
263.22 Sec. 42. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to
263.23read:
263.24 Subd. 6. Payment for long-term care consultation services. (a) The total payment
263.25for each county must be paid monthly by certified nursing facilities in the county. The
263.26monthly amount to be paid by each nursing facility for each fiscal year must be determined
263.27by dividing the county's annual allocation for long-term care consultation services by 12
263.28to determine the monthly payment and allocating the monthly payment to each nursing
263.29facility based on the number of licensed beds in the nursing facility. Payments to counties
263.30in which there is no certified nursing facility must be made by increasing the payment
263.31rate of the two facilities located nearest to the county seat.
263.32 (b) The commissioner shall include the total annual payment determined under
263.33paragraph (a) for each nursing facility reimbursed under section256B.431 or
256B.434
263.34according to section256B.431, subdivision 2b , paragraph (g).
264.1 (c) In the event of the layaway, delicensure and decertification, or removal from
264.2layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
264.3the per diem payment amount in paragraph (b) and may adjust the monthly payment
264.4amount in paragraph (a). The effective date of an adjustment made under this paragraph
264.5shall be on or after the first day of the month following the effective date of the layaway,
264.6delicensure and decertification, or removal from layaway.
264.7 (d) Payments for long-term care consultation services are available to the county
264.8or counties to cover staff salaries and expenses to provide the services described in
264.9subdivision 1a. The county shall employ, or contract with other agencies to employ, within
264.10the limits of available funding, sufficient personnel to provide long-term care consultation
264.11services while meeting the state's long-term care outcomes and objectives as defined in
264.12section256B.0917, subdivision 1 . The county shall be accountable for meeting local
264.13objectives as approved by the commissioner in the biennial home and community-based
264.14services quality assurance plan on a form provided by the commissioner.
264.15 (e) Notwithstanding section256B.0641 , overpayments attributable to payment of the
264.16screening costs under the medical assistance program may not be recovered from a facility.
264.17 (f) The commissioner of human services shall amend the Minnesota medical
264.18assistance plan to include reimbursement for the local consultation teams.
264.19 (g) The county may bill, as case management services, assessments, support
264.20planning, and follow-along provided to persons determined to be eligible for case
264.21management under Minnesota health care programs. No individual or family member
264.22shall be charged for an initial assessment or initial support plan development provided
264.23under subdivision 3a or 3b.
264.24(h) The commissioner shall develop an alternative payment methodology for
264.25long-term care consultation services that includes the funding available under this
264.26subdivision, and sections 256B.092 and 256B.0659. In developing the new payment
264.27methodology, the commissioner shall consider the maximization of federal funding for
264.28this activity.
264.29 Sec. 43. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to
264.30read:
264.31 Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
264.32reimbursement for nursing facilities shall be authorized for a medical assistance recipient
264.33only if a preadmission screening has been conducted prior to admission or the county has
264.34authorized an exemption. Medical assistance reimbursement for nursing facilities shall
264.35not be provided for any recipient who the local screener has determined does not meet the
265.1level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
265.2if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
265.3Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
265.4mental illness is approved by the local mental health authority or an admission for a
265.5recipient with developmental disability is approved by the state developmental disability
265.6authority.
265.7 (b) The nursing facility must not bill a person who is not a medical assistance
265.8recipient for resident days that preceded the date of completion of screening activities as
265.9required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
265.10resident days in the nursing facility resident day totals reported to the commissioner.
265.11EFFECTIVE DATE.The section is effective January 1, 2011.
265.12 Sec. 44. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to
265.13read:
265.14 Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
265.15 (a) Funding for services under the alternative care program is available to persons who
265.16meet the following criteria:
265.17 (1) the person has been determined by a community assessment under section
265.18256B.0911
to be a person who would require the level of care provided in a nursing
265.19facility, but for the provision of services under the alternative care program. Effective
265.20January 1, 2011, this determination must be made according to the criteria established in
265.21section 144.0724, subdivision 11;
265.22 (2) the person is age 65 or older;
265.23 (3) the person would be eligible for medical assistance within 135 days of admission
265.24to a nursing facility;
265.25 (4) the person is not ineligible for the payment of long-term care services by the
265.26medical assistance program due to an asset transfer penalty under section256B.0595 or
265.27equity interest in the home exceeding $500,000 as stated in section256B.056 ;
265.28 (5) the person needs long-term care services that are not funded through other state
265.29or federal funding;
265.30 (6) except for individuals described in clause (7), the monthly cost of the alternative
265.31care services funded by the program for this person does not exceed 75 percent of the
265.32monthly limit described under section256B.0915, subdivision 3a . This monthly limit
265.33does not prohibit the alternative care client from payment for additional services, but in no
265.34case may the cost of additional services purchased under this section exceed the difference
265.35between the client's monthly service limit defined under section256B.0915, subdivision
266.13 , and the alternative care program monthly service limit defined in this paragraph. If
266.2care-related supplies and equipment or environmental modifications and adaptations are or
266.3will be purchased for an alternative care services recipient, the costs may be prorated on a
266.4monthly basis for up to 12 consecutive months beginning with the month of purchase.
266.5If the monthly cost of a recipient's other alternative care services exceeds the monthly
266.6limit established in this paragraph, the annual cost of the alternative care services shall be
266.7determined. In this event, the annual cost of alternative care services shall not exceed 12
266.8times the monthly limit described in this paragraph;and
266.9 (7) for individuals assigned a case mix classification A as described under section
266.10256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily
266.11living, (ii) only one dependency in bathing, dressing, grooming, or walking, or (iii) a
266.12dependency score of less than three if eating is the only dependency as determined by an
266.13assessment performed under section 256B.0911, the monthly cost of alternative care
266.14services funded by the program cannot exceed $600 per month for all new participants
266.15enrolled in the program on or after July 1, 2009. This monthly limit shall be applied to
266.16all other participants who meet this criteria at reassessment. This monthly limit shall be
266.17increased annually as described in section 256B.0915, subdivision 3a, paragraph (a). This
266.18monthly limit does not prohibit the alternative care client from payment for additional
266.19services, but in no case may the cost of additional services purchased exceed the difference
266.20between the client's monthly service limit defined in this clause and the limit described in
266.21clause (6) for case mix classification A; and
266.22(8) the person is making timely payments of the assessed monthly fee.
266.23A person is ineligible if payment of the fee is over 60 days past due, unless the person
266.24agrees to:
266.25 (i) the appointment of a representative payee;
266.26 (ii) automatic payment from a financial account;
266.27 (iii) the establishment of greater family involvement in the financial management of
266.28payments; or
266.29 (iv) another method acceptable to the lead agency to ensure prompt fee payments.
266.30 The lead agency may extend the client's eligibility as necessary while making
266.31arrangements to facilitate payment of past-due amounts and future premium payments.
266.32Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
266.33reinstated for a period of 30 days.
266.34 (b) Alternative care funding under this subdivision is not available for a person
266.35who is a medical assistance recipient or who would be eligible for medical assistance
266.36without a spenddown or waiver obligation. A person whose initial application for medical
267.1assistance and the elderly waiver program is being processed may be served under the
267.2alternative care program for a period up to 60 days. If the individual is found to be eligible
267.3for medical assistance, medical assistance must be billed for services payable under the
267.4federally approved elderly waiver plan and delivered from the date the individual was
267.5found eligible for the federally approved elderly waiver plan. Notwithstanding this
267.6provision, alternative care funds may not be used to pay for any service the cost of which:
267.7(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
267.8or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
267.9to participate in the federally approved elderly waiver program under the special income
267.10standard provision.
267.11 (c) Alternative care funding is not available for a person who resides in a licensed
267.12nursing home, certified boarding care home, hospital, or intermediate care facility, except
267.13for case management services which are provided in support of the discharge planning
267.14process for a nursing home resident or certified boarding care home resident to assist with
267.15a relocation process to a community-based setting.
267.16 (d) Alternative care funding is not available for a person whose income is greater
267.17than the maintenance needs allowance under section256B.0915, subdivision 1d , but equal
267.18to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
267.19year for which alternative care eligibility is determined, who would be eligible for the
267.20elderly waiver with a waiver obligation.
267.21 Sec. 45. Minnesota Statutes 2008, section 256B.0915, subdivision 3a, is amended to
267.22read:
267.23 Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
267.24waivered services to an individual elderly waiver client except for individuals described
267.25in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
267.26mix resident class to which the elderly waiver client would be assigned under Minnesota
267.27Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
267.28as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
267.29which the resident assessment system as described in section256B.438 for nursing home
267.30rate determination is implemented. Effective on the first day of the state fiscal year in
267.31which the resident assessment system as described in section256B.438 for nursing home
267.32rate determination is implemented and the first day of each subsequent state fiscal year, the
267.33monthly limit for the cost of waivered services to an individual elderly waiver client shall
267.34be the rate of the case mix resident class to which the waiver client would be assigned
267.35under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
268.1previous state fiscal year, adjusted by the greater of any legislatively adopted home and
268.2community-based services percentage rate increase or the average statewide percentage
268.3increase in nursing facility payment rates.
268.4 (b) The monthly limit for the cost of waivered services to an individual elderly
268.5waiver client assigned to a case mix classification A under paragraph (a) with (1) no
268.6dependencies in activities of daily living, (2) only one dependency in bathing, dressing,
268.7grooming, or walking, or (3) a dependency score of less than three if eating is the only
268.8dependency, shall be the lower of the case mix classification amount for case mix A as
268.9determined under paragraph (a) or the case mix classification amount for case mix A
268.10effective on October 1, 2008, per month for all new participants enrolled in the program
268.11on or after July 1, 2009. This monthly limit shall be applied to all other participants who
268.12meet this criteria at reassessment.
268.13(c) If extended medical supplies and equipment or environmental modifications are
268.14or will be purchased for an elderly waiver client, the costs may be prorated for up to
268.1512 consecutive months beginning with the month of purchase. If the monthly cost of a
268.16recipient's waivered services exceeds the monthly limit established in paragraph (a) or (b),
268.17the annual cost of all waivered services shall be determined. In this event, the annual cost
268.18of all waivered services shall not exceed 12 times the monthly limit of waivered services
268.19as described in paragraph (a) or (b).
268.20 Sec. 46. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to
268.21read:
268.22 Subd. 3e. Customized living service rate. (a) Payment for customized living
268.23services shall be a monthly ratenegotiated and authorized by the lead agency within the
268.24parameters established by the commissioner. The payment agreement must delineate the
268.25services that have been customized for each recipient and specify the amount of each
268.26component service included in the recipient's customized living serviceto be provided
268.27plan. The lead agency shall ensure that there is a documented needfor all within the
268.28parameters established by the commissioner for all component customized living services
268.29authorized.Customized living services must not include rent or raw food costs.
268.30(b) Thenegotiated payment rate must be based on the amount of component services
268.31to be provided utilizing component rates established by the commissioner. Counties and
268.32tribes shall use tools issued by the commissioner to develop and document customized
268.33living service plans and rates.
269.1Negotiated (c) Component service rates must not exceed payment rates for
269.2comparable elderly waiver or medical assistance services and must reflect economies of
269.3scale. Customized living services must not include rent or raw food costs.
269.4(b) (d) The individualized monthly negotiated authorized payment for the
269.5customized livingservices service plan shall not exceed the nonfederal share, in effect
269.6on July 1 of the state fiscal year for which the rate limit is being calculated, 50 percent
269.7of the greater of either the statewide or any of the geographic groups' weighted average
269.8monthly nursing facility rate of the case mix resident class to which the elderly waiver
269.9eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
269.10less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until
269.11the July 1 of the state fiscal year in which the resident assessment system as described
269.12in section256B.438 for nursing home rate determination is implemented. Effective on
269.13July 1 of the state fiscal year in which the resident assessment system as described in
269.14section256B.438 for nursing home rate determination is implemented and July 1 of each
269.15subsequent state fiscal year, the individualized monthlynegotiated authorized payment
269.16for the services described in this clause shall not exceed the limitdescribed in this clause
269.17which was in effect on June 30 of the previous state fiscal yearand which has been
269.18adjusted by the greater of any legislatively adopted home and community-based services
269.19cost-of-living percentage increase or any legislatively adopted statewide percent rate
269.20increase for nursing facilities updated annually based on legislatively adopted changes to
269.21all service rate maximums for home and community-based service providers.
269.22(c) (e) Customized living services are delivered by a provider licensed by the
269.23Department of Health as a class A or class F home care provider and provided in a
269.24building that is registered as a housing with services establishment under chapter 144D.
269.25 Sec. 47. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to
269.26read:
269.27 Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
269.28paymentrates rate for 24-hour customized living services is a monthly rate negotiated
269.29and authorized by the lead agency within the parameters established by the commissioner
269.30of human services. The payment agreement must delineate theservices that have been
269.31customized for each recipient and specify the amount of each component service included
269.32in each recipient's customized living serviceto be provided plan. The lead agency
269.33shall ensure that there is a documented need within the parameters established by the
269.34commissioner for all component customized living services authorized. The lead agency
270.1shall not authorize 24-hour customized living services unless there is a documented need
270.2for 24-hour supervision.
270.3(b) For purposes of this section, "24-hour supervision" means that the recipient
270.4requires assistance due to needs related to one or more of the following:
270.5 (1) intermittent assistance with toileting, positioning, or transferring;
270.6 (2) cognitive or behavioral issues;
270.7 (3) a medical condition that requires clinical monitoring; or
270.8 (4)other conditions or needs as defined by the commissioner of human services for
270.9all new participants enrolled in the program on or after January 1, 2011, and all other
270.10participants at their first reassessment after January 1, 2011, dependency in at least two
270.11of the following activities of daily living as determined by assessment under section
270.12256B.0911: bathing; dressing; grooming; walking; or eating; and needs medication
270.13management and at least 50 hours of service per month. The lead agency shall ensure that
270.14the frequency and mode of supervision of the recipient and the qualifications of staff
270.15providing supervision are described and meet the needs of the recipient.Customized
270.16living services must not include rent or raw food costs.
270.17(c) Thenegotiated payment rate for 24-hour customized living services must be
270.18based on the amount of component services to be provided utilizing component rates
270.19established by the commissioner. Counties and tribes will use tools issued by the
270.20commissioner to develop and document customized living plans and authorize rates.
270.21Negotiated (d) Component service rates must not exceed payment rates for
270.22comparable elderly waiver or medical assistance services and must reflect economies
270.23of scale.
270.24(e) The individuallynegotiated authorized 24-hour customized living payments,
270.25in combination with the payment for other elderly waiver services, including case
270.26management, must not exceed the recipient's community budget cap specified in
270.27subdivision 3a. Customized living services must not include rent or raw food costs.
270.28(f) The individually authorized 24-hour customized living payment rates shall not
270.29exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
270.30living services in effect and in the Medicaid management information systems on March
270.3131, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
270.32to 9549.0059, to which elderly waiver service clients are assigned. When there are
270.33fewer than 50 authorizations in effect in the case mix resident class, the commissioner
270.34shall multiply the calculated service payment rate maximum for the A classification by
270.35the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
270.369549.0059, to determine the applicable payment rate maximum. Service payment rate
271.1maximums shall be updated annually based on legislatively adopted changes to all service
271.2rates for home and community-based service providers.
271.3 (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
271.4may establish alternative payment rate systems for 24-hour customized living services in
271.5housing with services establishments which are freestanding buildings with a capacity of
271.616 or fewer, by applying a single hourly rate for covered component services provided
271.7in either:
271.8 (1) licensed corporate adult foster homes; or
271.9 (2) specialized dementia care units which meet the requirements of section 144D.065
271.10and in which:
271.11 (i) each resident is offered the option of having their own apartment; or
271.12 (ii) the units are licensed as board and lodge establishments with maximum capacity
271.13of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
271.14subparts 1, 2, 3, and 4, item A.
271.15 Sec. 48. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to
271.16read:
271.17 Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
271.18shall receive an initial assessment of strengths, informal supports, and need for services
271.19in accordance with section256B.0911, subdivisions 3, 3a, and 3b . A reassessment of a
271.20client served under the elderly waiver must be conducted at least every 12 months and at
271.21other times when the case manager determines that there has been significant change in
271.22the client's functioning. This may include instances where the client is discharged from
271.23the hospital. There must be a determination that the client requires nursing facility level of
271.24care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments
271.25to initiate and maintain participation in the waiver program.
271.26(b) Regardless of other assessments identified in section 144.0724, subdivision
271.274, as appropriate to determine nursing facility level of care for purposes of medical
271.28assistance payment for nursing facility services, only face-to-face assessments conducted
271.29according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
271.30level of care determination will be accepted for purposes of initial and ongoing access to
271.31waiver service payment.
271.32EFFECTIVE DATE.This section is effective January 1, 2011.
271.33 Sec. 49. Minnesota Statutes 2008, section 256B.0915, is amended by adding a
271.34subdivision to read:
272.1 Subd. 10. Waiver payment rates; managed care organizations. The
272.2commissioner shall adjust the elderly waiver capitation payment rates for managed care
272.3organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
272.4service rate limits for customized living services and 24-hour customized living services
272.5under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical
272.6assistance rates paid to customized living providers by managed care organizations
272.7under this section shall not exceed the maximum service rate limits determined by the
272.8commissioner under subdivisions 3e and 3h.
272.9 Sec. 50. Minnesota Statutes 2008, section 256B.0916, subdivision 2, is amended to
272.10read:
272.11 Subd. 2. Distribution of funds; partnerships. (a) Beginning with fiscal year 2000,
272.12the commissioner shall distribute all funding available for home and community-based
272.13waiver services for persons with developmental disabilities to individual counties or to
272.14groups of counties that form partnerships to jointly plan, administer, and authorize funding
272.15for eligible individuals. The commissioner shall encourage counties to form partnerships
272.16that have a sufficient number of recipients and funding to adequately manage the risk
272.17and maximize use of available resources.
272.18 (b) Counties must submit a request for funds and a plan for administering the
272.19program as required by the commissioner. The plan must identify the number of clients to
272.20be served, their ages, and their priority listing based on:
272.21 (1) requirements in Minnesota Rules, part 9525.1880; and
272.22 (2)unstable living situations due to the age or incapacity of the primary caregiver;
272.23statewide priorities identified in section 256B.092, subdivision 12.
272.24(3) the need for services to avoid out-of-home placement of children;
272.25(4) the need to serve persons affected by private sector ICF/MR closures; and
272.26(5) the need to serve persons whose consumer support grant exception amount
272.27was eliminated in 2004.
272.28The plan must also identify changes made to improve services to eligible persons and to
272.29improve program management.
272.30 (c) In allocating resources to counties, priority must be given to groups of counties
272.31that form partnerships to jointly plan, administer, and authorize funding for eligible
272.32individuals and to counties determined by the commissioner to have sufficient waiver
272.33capacity to maximize resource use.
273.1 (d) Within 30 days after receiving the county request for funds and plans, the
273.2commissioner shall provide a written response to the plan that includes the level of
273.3resources available to serve additional persons.
273.4 (e) Counties are eligible to receive medical assistance administrative reimbursement
273.5for administrative costs under criteria established by the commissioner.
273.6 Sec. 51. Minnesota Statutes 2008, section 256B.0917, is amended by adding a
273.7subdivision to read:
273.8 Subd. 14. Essential community supports grants. (a) The purpose of the essential
273.9community supports grant program is to provide targeted services to persons 65 years and
273.10older who need essential community support, but whose needs do not meet the level of
273.11care required for nursing facility placement under section 144.0724, subdivision 11.
273.12(b) Within the limits of the appropriation and not to exceed $400 per person per
273.13month, funding must be available to a person who:
273.14(1) is age 65 or older;
273.15(2) is not eligible for medical assistance;
273.16(3) would otherwise be financially eligible for the alternative care program under
273.17section 256B.0913, subdivision 4;
273.18(4) has received a community assessment under section 256B.0911, subdivision 3a
273.19or 3b, and does not require the level of care provided in a nursing facility;
273.20(5) has a community support plan; and
273.21(6) has been determined by a community assessment under section 256B.0911,
273.22subdivision 3a or 3b, to be a person who would require provision of at least one of the
273.23following services, as defined in the approved elderly waiver plan, in order to maintain
273.24their community residence:
273.25(i) caregiver support;
273.26(ii) homemaker;
273.27(iii) chore; or
273.28(iv) a personal emergency response device or system.
273.29(c) The person receiving any of the essential community supports in this subdivision
273.30must also receive service coordination as part of their community support plan.
273.31(d) A person who has been determined to be eligible for an essential community
273.32support grant must be reassessed at least annually and continue to meet the criteria in
273.33paragraph (b) to remain eligible for an essential community support grant.
274.1(e) The commissioner shall allocate grants to counties and tribes under contract with
274.2the department based upon the historic use of the medical assistance elderly waiver and
274.3alternative care grant programs and other criteria as determined by the commissioner.
274.4EFFECTIVE DATE.This section is effective January 1, 2011.
274.5 Sec. 52. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to
274.6read:
274.7 Subd. 8a. County concurrence. (a) If the county of financial responsibility wishes
274.8to place a person in another county for services, the county of financial responsibility shall
274.9seek concurrence from the proposed county of service and the placement shall be made
274.10cooperatively between the two counties. Arrangements shall be made between the two
274.11counties for ongoing social service, including annual reviews of the person's individual
274.12service plan. The county where services are provided may not make changes in the
274.13person's service plan without approval by the county of financial responsibility.
274.14(b) When a person has been screened and authorized for services in an intermediate
274.15care facility for persons with developmental disabilities or for home and community-based
274.16services for persons with developmental disabilities, the case manager shall assist that
274.17person in identifying a service provider who is able to meet the needs of the person
274.18according to the person's individual service plan. If the identified service is to be provided
274.19in a county other than the county of financial responsibility, the county of financial
274.20responsibility shall request concurrence of the county where the person is requesting to
274.21receive the identified services. The county of service may refuse to concur if:
274.22(1) it can demonstrate that the provider is unable to provide the services identified in
274.23the person's individual service plan as services that are needed and are to be provided; or
274.24(2) in the case of an intermediate care facility for persons with developmental
274.25disabilities, there has been no authorization for admission by the admission review team
274.26as required in section256B.0926 ; or.
274.27(3) in the case of home and community-based services for persons with
274.28developmental disabilities, the county of service can demonstrate that the prospective
274.29provider has failed to substantially comply with the terms of a past contract or has had a
274.30prior contract terminated within the last 12 months for failure to provide adequate services,
274.31or has received a notice of intent to terminate the contract.
274.32(c) The county of service shall notify the county of financial responsibility of
274.33concurrence or refusal to concur no later than 20 working days following receipt of the
274.34written request. Unless other mutually acceptable arrangements are made by the involved
274.35county agencies, the county of financial responsibility is responsible for costs of social
275.1services and the costs associated with the development and maintenance of the placement.
275.2The county of service may request that the county of financial responsibility purchase
275.3case management services from the county of service or from a contracted provider
275.4of case management when the county of financial responsibility is not providing case
275.5management as defined in this section and rules adopted under this section, unless other
275.6mutually acceptable arrangements are made by the involved county agencies. Standards
275.7for payment limits under this section may be established by the commissioner. Financial
275.8disputes between counties shall be resolved as provided in section256G.09 .
275.9 Sec. 53. Minnesota Statutes 2008, section 256B.092, is amended by adding a
275.10subdivision to read:
275.11 Subd. 11. Residential support services. (a) Upon federal approval, there is
275.12established a new service called residential support that is available on the CAC, CADI,
275.13DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent
275.14necessary to ensure there is no duplication between other services. Residential support
275.15services must be provided by vendors licensed as a community residential setting as
275.16defined in section 245A.11, subdivision 8.
275.17(b) Residential support services must meet the following criteria:
275.18(1) providers of residential support services must own or control the residential site;
275.19(2) the residential site must not be the primary residence of the license holder;
275.20(3) the residential site must have a designated program supervisor responsible for
275.21program oversight, development, and implementation of policies and procedures;
275.22(4) the provider of residential support services must provide supervision, training,
275.23and assistance as described in the person's community support plan; and
275.24(5) the provider of residential support services must meet the requirements of
275.25licensure and additional requirements of the person's community support plan.
275.26(c) Providers of residential support services that meet the definition in paragraph (a)
275.27must be registered using a process determined by the commissioner beginning July 1, 2009.
275.28 Sec. 54. Minnesota Statutes 2008, section 256B.092, is amended by adding a
275.29subdivision to read:
275.30 Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
275.31establish statewide priorities for individuals on the waiting list for developmental
275.32disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
275.33include, but are not limited to, individuals who continue to have a need for waiver services
275.34after they have maximized the use of state plan services and other funding resources,
276.1including natural supports, prior to accessing waiver services, and who meet at least one
276.2of the following criteria:
276.3(1) have unstable living situations due to the age, incapacity, or sudden loss of
276.4the primary caregivers;
276.5(2) are moving from an institution due to bed closures;
276.6(3) experience a sudden closure of their current living arrangement;
276.7(4) require protection from confirmed abuse, neglect, or exploitation;
276.8(5) experience a sudden change in need that can no longer be met through state plan
276.9services or other funding resources alone; or
276.10(6) meet other priorities established by the department.
276.11(b) When allocating resources to lead agencies, the commissioner must take into
276.12consideration the number of individuals waiting who meet statewide priorities and the
276.13lead agencies' current use of waiver funds and existing service options.
276.14(c) The commissioner shall evaluate the impact of the use of statewide priorities and
276.15provide recommendations to the legislature on whether to continue the use of statewide
276.16priorities in the November 1, 2011, annual report required by the commissioner in sections
276.17256B.0916, subdivision 7, and 256B.49, subdivision 21.
276.18 Sec. 55. [256B.0948] FOSTER CARE RATE LIMITS.
276.19The commissioner shall decrease by five percent rates for adult foster care and
276.20supportive living services that are reimbursed under section 256B.092 or 256B.49, and
276.21are above the 95th percentile of the statewide rates for the service. The reduction in rates
276.22shall take into account the acuity of individuals served based on the methodology used to
276.23allocate dollars to local lead agency budgets, and assure that affected service rates are not
276.24reduced below the rate level represented by the above percentile due to this rate change.
276.25Lead agency contracts for services specified in this section shall be amended to implement
276.26these rate changes for services rendered on or after July 1, 2009. The commissioner shall
276.27make corresponding reductions to waiver allocations and capitated rates.
276.28 Sec. 56. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:
276.29 Subdivision 1. Subrogation. Upon furnishing medical assistance or alternative
276.30care services under section 256B.0913 to any person who has private accident or health
276.31care coverage, or receives or has a right to receive health or medical care from any
276.32type of organization or entity, or has a cause of action arising out of an occurrence that
276.33necessitated the payment of medical assistance, the state agency or the state agency's agent
276.34shall be subrogated, to the extent of the cost of medical care furnished, to any rights the
277.1person may have under the terms of the coverage, or against the organization or entity
277.2providing or liable to provide health or medical care, or under the cause of action.
277.3 The right of subrogation created in this section includes all portions of the cause
277.4of action, notwithstanding any settlement allocation or apportionment that purports to
277.5dispose of portions of the cause of action not subject to subrogation.
277.6 Sec. 57. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:
277.7 Subd. 5. Private benefits to be used first. Private accident and health care coverage
277.8including Medicare for medical services is primary coverage and must be exhausted before
277.9medical assistanceis or alternative care services are paid for medical services including
277.10home health care, personal care assistant services, hospice, supplies and equipment, or
277.11services covered under a Centers for Medicare and Medicaid Services waiver. When a
277.12person who is otherwise eligible for medical assistance has private accident or health care
277.13coverage, including Medicare or a prepaid health plan, the private health care benefits
277.14available to the person must be used first and to the fullest extent.
277.15 Sec. 58. Minnesota Statutes 2008, section 256B.434, subdivision 4, is amended to read:
277.16 Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
277.17have their payment rates determined under this section rather than section256B.431 , the
277.18commissioner shall establish a rate under this subdivision. The nursing facility must enter
277.19into a written contract with the commissioner.
277.20 (b) A nursing facility's case mix payment rate for the first rate year of a facility's
277.21contract under this section is the payment rate the facility would have received under
277.22section256B.431 .
277.23 (c) A nursing facility's case mix payment rates for the second and subsequent years
277.24of a facility's contract under this section are the previous rate year's contract payment
277.25rates plus an inflation adjustment and, for facilities reimbursed under this section or
277.26section256B.431 , an adjustment to include the cost of any increase in Health Department
277.27licensing fees for the facility taking effect on or after July 1, 2001. The index for the
277.28inflation adjustment must be based on the change in the Consumer Price Index-All Items
277.29(United States City average) (CPI-U) forecasted by the commissioner of finance's national
277.30economic consultant, as forecasted in the fourth quarter of the calendar year preceding
277.31the rate year. The inflation adjustment must be based on the 12-month period from the
277.32midpoint of the previous rate year to the midpoint of the rate year for which the rate is
277.33being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001,
277.34July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1,
278.12008, October 1, 2009,and October 1, 2010, October 1, 2011, and October 1, 2012. This
278.2paragraph shall apply only to the property-related payment rate, except that adjustments
278.3to include the cost of any increase in Health Department licensing fees taking effect on
278.4or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to the property
278.5payment rate under this section and section256B.431 shall be effective on October 1.
278.6In determining the amount of the property-related payment rate adjustment under this
278.7paragraph, the commissioner shall determine the proportion of the facility's rates that are
278.8property-related based on the facility's most recent cost report.
278.9 (d) The commissioner shall develop additional incentive-based payments of up to
278.10five percent above a facility's operating payment rate for achieving outcomes specified
278.11in a contract. The commissioner may solicit contract amendments and implement those
278.12which, on a competitive basis, best meet the state's policy objectives. The commissioner
278.13shall limit the amount of any incentive payment and the number of contract amendments
278.14under this paragraph to operate the incentive payments within funds appropriated for this
278.15purpose. The contract amendments may specify various levels of payment for various
278.16levels of performance. Incentive payments to facilities under this paragraph may be in the
278.17form of time-limited rate adjustments or onetime supplemental payments. In establishing
278.18the specified outcomes and related criteria, the commissioner shall consider the following
278.19state policy objectives:
278.20 (1) successful diversion or discharge of residents to the residents' prior home or other
278.21community-based alternatives;
278.22 (2) adoption of new technology to improve quality or efficiency;
278.23 (3) improved quality as measured in the Nursing Home Report Card;
278.24 (4) reduced acute care costs; and
278.25 (5) any additional outcomes proposed by a nursing facility that the commissioner
278.26finds desirable.
278.27 (e) Notwithstanding the threshold in section256B.431, subdivision 16 , facilities that
278.28take action to come into compliance with existing or pending requirements of the life
278.29safety code provisions or federal regulations governing sprinkler systems must receive
278.30reimbursement for the costs associated with compliance if all of the following conditions
278.31are met:
278.32 (1) the expenses associated with compliance occurred on or after January 1, 2005,
278.33and before December 31, 2008;
278.34 (2) the costs were not otherwise reimbursed under subdivision 4f or section
278.35144A.071
or
144A.073 ; and
279.1 (3) the total allowable costs reported under this paragraph are less than the minimum
279.2threshold established under section256B.431, subdivision 15 , paragraph (e), and
279.3subdivision 16.
279.4The commissioner shall use money appropriated for this purpose to provide to qualifying
279.5nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
279.62008. Nursing facilities that have spent money or anticipate the need to spend money
279.7to satisfy the most recent life safety code requirements by (1) installing a sprinkler
279.8system or (2) replacing all or portions of an existing sprinkler system may submit to the
279.9commissioner by June 30, 2007, on a form provided by the commissioner the actual
279.10costs of a completed project or the estimated costs, based on a project bid, of a planned
279.11project. The commissioner shall calculate a rate adjustment equal to the allowable
279.12costs of the project divided by the resident days reported for the report year ending
279.13September 30, 2006. If the costs from all projects exceed the appropriation for this
279.14purpose, the commissioner shall allocate the money appropriated on a pro rata basis
279.15to the qualifying facilities by reducing the rate adjustment determined for each facility
279.16by an equal percentage. Facilities that used estimated costs when requesting the rate
279.17adjustment shall report to the commissioner by January 31, 2009, on the use of this
279.18money on a form provided by the commissioner. If the nursing facility fails to provide
279.19the report, the commissioner shall recoup the money paid to the facility for this purpose.
279.20If the facility reports expenditures allowable under this subdivision that are less than
279.21the amount received in the facility's annualized rate adjustment, the commissioner shall
279.22recoup the difference.
279.23 Sec. 59. Minnesota Statutes 2008, section 256B.434, is amended by adding a
279.24subdivision to read:
279.25 Subd. 21. Payment of post-PERA pension benefit costs. Nursing facilities that
279.26convert or converted after September 30, 2006, from public to private ownership shall
279.27have a portion of their post-PERA pension costs treated as a component of the historic
279.28operating rate. Effective for the rate years beginning on or after October 1, 2009, and prior
279.29to October 1, 2016, the commissioner shall determine the pension costs to be included
279.30in the facility's base for determining rates under this section by using the following
279.31formula: post-privatization pension benefit costs as a percent of salary shall be determined
279.32from either the cost report for the first full reporting year after privatization or the most
279.33recent report year available, whichever is later. This percentage shall be applied to the
279.34salary costs of the alternative payment system base rate year to determine the allowable
279.35amount of pension costs. The adjustments provided for in sections 256B.431, 256B.434,
280.1256B.441, and any other law enacted after the base rate year and prior to the year for
280.2which rates are being determined shall be applied to the allowable amount. The adjusted
280.3allowable amount shall be added to the operating rate effective the first rate year PERA
280.4ceases to remain as a pass-through component of the rate.
280.5 Sec. 60. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:
280.6 Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
280.7services shall calculate the amount of the planned closure rate adjustment available under
280.8subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
280.9(1) the amount available is the net reduction of nursing facility beds multiplied
280.10by $2,080;
280.11(2) the total number of beds in the nursing facility or facilities receiving the planned
280.12closure rate adjustment must be identified;
280.13(3) capacity days are determined by multiplying the number determined under
280.14clause (2) by 365; and
280.15(4) the planned closure rate adjustment is the amount available in clause (1), divided
280.16by capacity days determined under clause (3).
280.17(b) A planned closure rate adjustment under this section is effective on the first day
280.18of the month following completion of closure of the facility designated for closure in the
280.19application and becomes part of the nursing facility's total operating payment rate.
280.20(c) Applicants may use the planned closure rate adjustment to allow for a property
280.21payment for a new nursing facility or an addition to an existing nursing facility or as an
280.22operating payment rate adjustment. Applications approved under this subdivision are
280.23exempt from other requirements for moratorium exceptions under section144A.073,
280.24subdivisions 2 and 3 .
280.25(d) Upon the request of a closing facility, the commissioner must allow the facility a
280.26closure rate adjustment as provided under section144A.161, subdivision 10 .
280.27(e) A facility that has received a planned closure rate adjustment may reassign it
280.28to another facility that is under the same ownership at any time within three years of its
280.29effective date. The amount of the adjustment shall be computed according to paragraph (a).
280.30(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
280.31the commissioner shall recalculate planned closure rate adjustments for facilities that
280.32delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
280.33bed dollar amount. The recalculated planned closure rate adjustment shall be effective
280.34from the date the per bed dollar amount is increased.
281.1(g) For planned closures approved after June 30, 2009, the commissioner of human
281.2services shall calculate the amount of the planned closure rate adjustment available under
281.3subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
281.4 Sec. 61. Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to
281.5read:
281.6 Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years
281.7beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
281.8under this section shall be phased in by blending the operating rate with the operating
281.9payment rate determined under section256B.434 . For purposes of this subdivision, the
281.10rate to be used that is determined under section256B.434 shall not include the portion of
281.11the operating payment rate related to performance-based incentive payments under section
281.12256B.434, subdivision 4
, paragraph (d). For the rate year beginning October 1, 2008, the
281.13operating payment rate for each facility shall be 13 percent of the operating payment rate
281.14from this section, and 87 percent of the operating payment rate from section256B.434 .
281.15For the rateyear period beginning October 1, 2009, through September 30, 2013, the
281.16operating payment rate for each facility shall be 14 percent of the operating payment rate
281.17from this section, and 86 percent of the operating payment rate from section256B.434 .
281.18For the rate year beginning October 1, 2010, the operating payment rate for each facility
281.19shall be 14 percent of the operating payment rate from this section, and 86 percent of the
281.20operating payment rate from section
256B.434. For the rate year beginning October 1,
281.212011, the operating payment rate for each facility shall be 31 percent of the operating
281.22payment rate from this section, and 69 percent of the operating payment rate from section
281.23256B.434. For the rate year beginning October 1, 2012, the operating payment rate for
281.24each facility shall be 48 percent of the operating payment rate from this section, and 52
281.25percent of the operating payment rate from section
256B.434. For the rate year beginning
281.26October 1, 2013, the operating payment rate for each facility shall be 65 percent of the
281.27operating payment rate from this section, and 35 percent of the operating payment rate
281.28from section256B.434 . For the rate year beginning October 1, 2014, the operating
281.29payment rate for each facility shall be 82 percent of the operating payment rate from this
281.30section, and 18 percent of the operating payment rate from section256B.434 . For the rate
281.31year beginning October 1, 2015, the operating payment rate for each facility shall be the
281.32operating payment rate determined under this section. The blending of operating payment
281.33rates under this section shall be performed separately for each RUG's class.
282.1 (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
282.2to the operating payment rate increases under paragraph (a) by creating a minimum
282.3percentage increase and a maximum percentage increase.
282.4 (1) Each nursing facility that receives a blended October 1, 2008, operating payment
282.5rate increase under paragraph (a) of less than one percent, when compared to its operating
282.6payment rate on September 30, 2008, computed using rates with RUG's weight of1.00 ,
282.7shall receive a rate adjustment of one percent.
282.8 (2) The commissioner shall determine a maximum percentage increase that will
282.9result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
282.10facilities with a blended October 1, 2008, operating payment rate increase under paragraph
282.11(a) greater than the maximum percentage increase determined by the commissioner, when
282.12compared to its operating payment rate on September 30, 2008, computed using rates with
282.13a RUG's weight of1.00 , shall receive the maximum percentage increase.
282.14 (3) Nursing facilities with a blended October 1, 2008, operating payment rate
282.15increase under paragraph (a) greater than one percent and less than the maximum
282.16percentage increase determined by the commissioner, when compared to its operating
282.17payment rate on September 30, 2008, computed using rates with a RUG's weight of1.00 ,
282.18shall receive the blended October 1, 2008, operating payment rate increase determined
282.19under paragraph (a).
282.20 (4) The October 1, 2009, through October 1, 2015, operating payment rate for
282.21facilities receiving the maximum percentage increase determined in clause (2) shall be
282.22the amount determined under paragraph (a) less the difference between the amount
282.23determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
282.24(2). This rate restriction does not apply to rate increases provided in any other section.
282.25 (c) A portion of the funds received under this subdivision that are in excess of
282.26operating payment rates that a facility would have received under section256B.434 , as
282.27determined in accordance with clauses (1) to (3), shall be subject to the requirements in
282.28section256B.434, subdivision 19 , paragraphs (b) to (h).
282.29 (1) Determine the amount of additional funding available to a facility, which shall be
282.30equal to total medical assistance resident days from the most recent reporting year times
282.31the difference between the blended rate determined in paragraph (a) for the rate year being
282.32computed and the blended rate for the prior year.
282.33 (2) Determine the portion of all operating costs, for the most recent reporting year,
282.34that are compensation related. If this value exceeds 75 percent, use 75 percent.
282.35 (3) Subtract the amount determined in clause (2) from 75 percent.
283.1 (4) The portion of the fund received under this subdivision that shall be subject to
283.2the requirements in section256B.434, subdivision 19 , paragraphs (b) to (h), shall equal
283.3the amount determined in clause (1) times the amount determined in clause (3).
283.4 Sec. 62. Minnesota Statutes 2008, section 256B.441, subdivision 58, is amended to
283.5read:
283.6 Subd. 58. Implementation delay. Within six months prior to the effective date of
283.7(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits
283.8under subdivision 50; and (3) the removal of planned closure rate adjustments and single
283.9bed room incentives from external fixed costs under subdivision 53, the commissioner
283.10shall compare the average operating cost for all facilities combined from the most recent
283.11cost reports to the average medical assistance operating payment rates for all facilities
283.12combined from the same time period. Each provision shall not go into effect until the
283.13average medical assistance operating payment rate is at least 92 percent of the average
283.14operating cost. The rebasing of property payment rates under subdivision 1, and the
283.15removal of planned closure rate adjustments and single-bed room incentives from external
283.16fixed costs under subdivision 53 shall not go into effect until 82 percent of the operating
283.17payment rate from this section is phased in as described in subdivision 55.
283.18 Sec. 63. Minnesota Statutes 2008, section 256B.441, is amended by adding a
283.19subdivision to read:
283.20 Subd. 59. Single-bed payments for medical assistance recipients. Effective
283.21October 1, 2009, the amount paid for a private room under Minnesota Rules, part
283.229549.0070, subpart 3, is reduced from 115 percent to 111.5 percent.
283.23 Sec. 64. Minnesota Statutes 2008, section 256B.49, is amended by adding a
283.24subdivision to read:
283.25 Subd. 11a. Waivered services waiting list. (a) The commissioner shall establish
283.26statewide priorities for individuals on the waiting list for CAC, CADI, and TBI waiver
283.27services, as of January 1, 2010. The statewide priorities must include, but are not limited
283.28to, individuals who continue to have a need for waiver services after they have maximized
283.29the use of state plan services and other funding resources, including natural supports, prior
283.30to accessing waiver services, and who meet at least one of the following criteria:
283.31(1) have unstable living situations due to the age, incapacity, or sudden loss of
283.32the primary caregivers;
283.33(2) are moving from an institution due to bed closures;
284.1(3) experience a sudden closure of their current living arrangement;
284.2(4) require protection from confirmed abuse, neglect, or exploitation;
284.3(5) experience a sudden change in need that can no longer be met through state plan
284.4services or other funding resources alone; or
284.5(6) meet other priorities established by the department.
284.6(b) When allocating resources to lead agencies, the commissioner must take into
284.7consideration the number of individuals waiting who meet statewide priorities and the
284.8lead agencies' current use of waiver funds and existing service options.
284.9(c) The commissioner shall evaluate the impact of the use of statewide priorities and
284.10provide recommendations to the legislature on whether to continue the use of statewide
284.11priorities in the November 1, 2011, annual report required by the commissioner in sections
284.12256B.0916, subdivision 7, and 256B.49, subdivision 21.
284.13 Sec. 65. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:
284.14 Subd. 12. Informed choice. Persons who are determined likely to require the level
284.15of care provided in a nursing facility as determined under sections 144.0724, subdivision
284.1611, and 256B.0911, or hospital shall be informed of the home and community-based
284.17support alternatives to the provision of inpatient hospital services or nursing facility
284.18services. Each person must be given the choice of either institutional or home and
284.19community-based services using the provisions described in section256B.77, subdivision
284.202 , paragraph (p).
284.21EFFECTIVE DATE.This section is effective January 1, 2011.
284.22 Sec. 66. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:
284.23 Subd. 13. Case management. (a) Each recipient of a home and community-based
284.24waiver shall be provided case management services by qualified vendors as described
284.25in the federally approved waiver application. The case management service activities
284.26provided will include:
284.27 (1) assessing the needs of the individual within 20 working days of a recipient's
284.28request;
284.29 (2) developing the written individual service plan within ten working days after the
284.30assessment is completed;
284.31 (3) informing the recipient or the recipient's legal guardian or conservator of service
284.32options;
284.33 (4) assisting the recipient in the identification of potential service providers;
284.34 (5) assisting the recipient to access services;
285.1 (6) coordinating, evaluating, and monitoring of the services identified in the service
285.2plan;
285.3 (7) completing the annual reviews of the service plan; and
285.4 (8) informing the recipient or legal representative of the right to have assessments
285.5completed and service plans developed within specified time periods, and to appeal county
285.6action or inaction under section256.045, subdivision 3 , including the determination of
285.7nursing facility level of care.
285.8 (b) The case manager may delegate certain aspects of the case management service
285.9activities to another individual provided there is oversight by the case manager. The case
285.10manager may not delegate those aspects which require professional judgment including
285.11assessments, reassessments, and care plan development.
285.12EFFECTIVE DATE.This section is effective January 1, 2011.
285.13 Sec. 67. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:
285.14 Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
285.15strengths, informal support systems, and need for services shall be completed within
285.1620 working days of the recipient's request. Reassessment of each recipient's strengths,
285.17support systems, and need for services shall be conducted at least every 12 months and at
285.18other times when there has been a significant change in the recipient's functioning.
285.19(b) There must be a determination that the client requires a hospital level of care or a
285.20nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and
285.21subsequent assessments to initiate and maintain participation in the waiver program.
285.22(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
285.23appropriate to determine nursing facility level of care for purposes of medical assistance
285.24payment for nursing facility services, only face-to-face assessments conducted according
285.25to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
285.26determination or a nursing facility level of care determination must be accepted for
285.27purposes of initial and ongoing access to waiver services payment.
285.28(d) Persons with developmental disabilities who apply for services under the nursing
285.29facility level waiver programs shall be screened for the appropriate level of care according
285.30to section256B.092 .
285.31(c) (e) Recipients who are found eligible for home and community-based services
285.32under this section before their 65th birthday may remain eligible for these services after
285.33their 65th birthday if they continue to meet all other eligibility factors.
285.34EFFECTIVE DATE.The section is effective January 1, 2011.
286.1 Sec. 68. Minnesota Statutes 2008, section 256B.49, is amended by adding a
286.2subdivision to read:
286.3 Subd. 22. Residential support services. For the purposes of this section, the
286.4provisions of section 256B.092, subdivision 11, are controlling.
286.5 Sec. 69. [256B.4912] HOME AND COMMUNITY-BASED WAIVERS;
286.6PROVIDERS AND PAYMENT.
286.7 Subdivision 1. Provider qualifications. For the home and community-based
286.8waivers providing services to seniors and individuals with disabilities, the commissioner
286.9shall establish:
286.10(1) agreements with enrolled waiver service providers to ensure providers meet
286.11qualifications defined in the waiver plans;
286.12(2) regular reviews of provider qualifications; and
286.13(3) processes to gather the necessary information to determine provider
286.14qualifications.
286.15By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision
286.1611, that are employees of waiver service providers must meet the requirements of chapter
286.17245C prior to providing waiver services and as part of ongoing enrollment. Upon federal
286.18approval, this requirement must also apply to consumer-directed community supports.
286.19 Subd. 2. Rate-setting methodologies. The commissioner shall establish
286.20statewide rate-setting methodologies that meet federal waiver requirements for home
286.21and community-based waiver services for individuals with disabilities. The rate-setting
286.22methodologies must abide by the principles of transparency and equitability across the
286.23state. The methodologies must involve a uniform process of structuring rates for each
286.24service and must promote quality and participant choice.
286.25 Sec. 70. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to
286.26read:
286.27 Subd. 2. Contract provisions. (a) The service contract with each intermediate
286.28care facility must include provisions for:
286.29(1) modifying payments when significant changes occur in the needs of the
286.30consumers;
286.31(2)the establishment and use of a quality improvement plan. Using criteria and
286.32options for performance measures developed by the commissioner, each intermediate care
286.33facility must identify a minimum of one performance measure on which to focus its efforts
286.34for quality improvement during the contract period;
287.1(3) appropriate and necessary statistical information required by the commissioner;
287.2(4) (3) annual aggregate facility financial information; and
287.3(5) (4) additional requirements for intermediate care facilities not meeting the
287.4standards set forth in the service contract.
287.5(b) The commissioner of human services and the commissioner of health, in
287.6consultation with representatives from counties, advocacy organizations, and the provider
287.7community, shall review the consolidated standards under chapter 245B and the supervised
287.8living facility rule under Minnesota Rules, chapter 4665, to determine what provisions
287.9in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for
287.10intermediate care facilities in order to enable facilities to implement the performance
287.11measures in their contract and provide quality services to residents without a duplication
287.12of or increase in regulatory requirements.
287.13 Sec. 71. Minnesota Statutes 2008, section 256B.5012, is amended by adding a
287.14subdivision to read:
287.15 Subd. 8. ICF/MR rate decreases effective July 1, 2009. Effective July 1, 2009,
287.16the commissioner shall decrease each facility reimbursed under this section operating
287.17payment adjustments equal to 2.58 percent of the operating payment rates in effect on
287.18June 30, 2009. For each facility, the commissioner shall implement the rate reduction,
287.19based on occupied beds, using the percentage specified in this subdivision multiplied by
287.20the total payment rate, including the variable rate but excluding the property-related
287.21payment rate, in effect on the preceding date. The total rate reduction shall include the
287.22adjustment provided in section 256B.502, subdivision 7.
287.23 Sec. 72. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
287.24 Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
287.25and sections256L.12 and
256D.03 , shall be entered into or renewed on a calendar year
287.26basis beginning January 1, 1996. Managed care contracts which were in effect on June
287.2730, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
287.28through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
287.29commissioner may issue separate contracts with requirements specific to services to
287.30medical assistance recipients age 65 and older.
287.31 (b) A prepaid health plan providing covered health services for eligible persons
287.32pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
287.33of its contract with the commissioner. Requirements applicable to managed care programs
288.1under chapters 256B, 256D, and 256L, established after the effective date of a contract
288.2with the commissioner take effect when the contract is next issued or renewed.
288.3 (c) Effective for services rendered on or after January 1, 2003, the commissioner
288.4shall withhold five percent of managed care plan payments under this section for the
288.5prepaid medical assistance and general assistance medical care programs pending
288.6completion of performance targets. Each performance target must be quantifiable,
288.7objective, measurable, and reasonably attainable, except in the case of a performance
288.8target based on a federal or state law or rule. Criteria for assessment of each performance
288.9target must be outlined in writing prior to the contract effective date. The managed
288.10care plan must demonstrate, to the commissioner's satisfaction, that the data submitted
288.11regarding attainment of the performance target is accurate. The commissioner shall
288.12periodically change the administrative measures used as performance targets in order
288.13to improve plan performance across a broader range of administrative services. The
288.14performance targets must include measurement of plan efforts to contain spending
288.15on health care services and administrative activities. The commissioner may adopt
288.16plan-specific performance targets that take into account factors affecting only one plan,
288.17including characteristics of the plan's enrollee population. The withheld funds must be
288.18returned no sooner than July of the following year if performance targets in the contract
288.19are achieved. The commissioner may exclude special demonstration projects under
288.20subdivision 23. A managed care plan or a county-based purchasing plan under section
288.21256B.692
may include as admitted assets under section
62D.044 any amount withheld
288.22under this paragraph that is reasonably expected to be returned.
288.23 (d)(1) Effective for services rendered on or after January 1, 2009, the commissioner
288.24shall withhold three percent of managed care plan payments under this section for the
288.25prepaid medical assistance and general assistance medical care programs. The withheld
288.26funds must be returned no sooner than July 1 and no later than July 31 of the following
288.27year. The commissioner may exclude special demonstration projects under subdivision 23.
288.28 (2) A managed care plan or a county-based purchasing plan under section256B.692
288.29may include as admitted assets under section
62D.044 any amount withheld under
288.30this paragraph. The return of the withhold under this paragraph is not subject to the
288.31requirements of paragraph (c).
288.32(e) Effective for services provided on or after January 1, 2010, the commissioner
288.33shall require that managed care plans use the assessment and authorization processes,
288.34forms, timelines, standards, documentation, and data reporting requirements, protocols,
288.35billing processes, and policies consistent with medical assistance fee-for-service or the
288.36Department of Human Services contract requirements consistent with medical assistance
289.1fee-for-service or the Department of Human Services contract requirements for all
289.2personal care assistance services under section 256B.0659.
289.3 Sec. 73. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read:
289.4 Subd. 5. Special needs. In addition to the state standards of assistance established in
289.5subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
289.6Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
289.7center, or a group residential housing facility.
289.8 (a) The county agency shall pay a monthly allowance for medically prescribed
289.9diets if the cost of those additional dietary needs cannot be met through some other
289.10maintenance benefit. The need for special diets or dietary items must be prescribed by
289.11a licensed physician. Costs for special diets shall be determined as percentages of the
289.12allotment for a one-person household under the thrifty food plan as defined by the United
289.13States Department of Agriculture. The types of diets and the percentages of the thrifty
289.14food plan that are covered are as follows:
289.15 (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
289.16 (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
289.17of thrifty food plan;
289.18 (3) controlled protein diet, less than 40 grams and requires special products, 125
289.19percent of thrifty food plan;
289.20 (4) low cholesterol diet, 25 percent of thrifty food plan;
289.21 (5) high residue diet, 20 percent of thrifty food plan;
289.22 (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
289.23 (7) gluten-free diet, 25 percent of thrifty food plan;
289.24 (8) lactose-free diet, 25 percent of thrifty food plan;
289.25 (9) antidumping diet, 15 percent of thrifty food plan;
289.26 (10) hypoglycemic diet, 15 percent of thrifty food plan; or
289.27 (11) ketogenic diet, 25 percent of thrifty food plan.
289.28 (b) Payment for nonrecurring special needs must be allowed for necessary home
289.29repairs or necessary repairs or replacement of household furniture and appliances using
289.30the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
289.31as long as other funding sources are not available.
289.32 (c) A fee for guardian or conservator service is allowed at a reasonable rate
289.33negotiated by the county or approved by the court. This rate shall not exceed five percent
289.34of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
289.35guardian or conservator is a member of the county agency staff, no fee is allowed.
290.1 (d) The county agency shall continue to pay a monthly allowance of $68 for
290.2restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
290.31990, and who eats two or more meals in a restaurant daily. The allowance must continue
290.4until the person has not received Minnesota supplemental aid for one full calendar month
290.5or until the person's living arrangement changes and the person no longer meets the criteria
290.6for the restaurant meal allowance, whichever occurs first.
290.7 (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
290.8is allowed for representative payee services provided by an agency that meets the
290.9requirements under SSI regulations to charge a fee for representative payee services. This
290.10special need is available to all recipients of Minnesota supplemental aid regardless of
290.11their living arrangement.
290.12 (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
290.13maximum allotment authorized by the federal Food Stamp Program for a single individual
290.14which is in effect on the first day of July of each year will be added to the standards of
290.15assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
290.16as shelter needy and are: (i) relocating from an institution, or an adult mental health
290.17residential treatment program under section256B.0622 ; (ii) eligible for the self-directed
290.18supports option as defined under section256B.0657, subdivision 2 ; or (iii) home and
290.19community-based waiver recipients living in their own home or rented or leased apartment
290.20which is not owned, operated, or controlled by a provider of service not related by blood
290.21or marriage.
290.22 (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
290.23shelter needy benefit under this paragraph is considered a household of one. An eligible
290.24individual who receives this benefit prior to age 65 may continue to receive the benefit
290.25after the age of 65.
290.26 (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
290.27exceed 40 percent of the assistance unit's gross income before the application of this
290.28special needs standard. "Gross income" for the purposes of this section is the applicant's or
290.29recipient's income as defined in section256D.35, subdivision 10 , or the standard specified
290.30in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
290.31state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
290.32considered shelter needy for purposes of this paragraph.
290.33(g) Notwithstanding this subdivision, recipients of home and community-based
290.34services may relocate to services without 24-hour supervision and receive the equivalent
290.35of the recipient's group residential housing allocation in Minnesota supplemental
290.36assistance shelter needy funding if the cost of the services and housing is equal to or less
291.1than provided to the recipient in home and community-based services and the relocation is
291.2the recipient's choice and is approved by the recipient or guardian.
291.3(h) To access housing and services as provided in paragraph (g), the recipient may
291.4choose housing that may or may not be owned, operated, or controlled by the recipient's
291.5service provider.
291.6(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The
291.7commissioner shall assess the development of publicly owned housing, other housing
291.8alternatives, and whether a public equity housing fund may be established that would
291.9maintain the state's interest, to the extent paid from group residential housing and
291.10Minnesota supplemental aid shelter needy funds in provider-owned housing so that when
291.11sold, the state would recover its share for a public equity fund to be used for future public
291.12needs under this chapter. The commissioner shall report findings and recommendations to
291.13the legislative committees and budget divisions with jurisdiction over health and human
291.14services policy and financing by January 15, 2012.
291.15(j) In selecting prospective services needed by recipients for whom home and
291.16community-based services have been authorized, the recipient and the recipient's guardian
291.17shall first consider alternatives to home and community-based services. Minnesota
291.18supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental
291.19aid shelter needy funding as provided in this section shall remain permanent unless the
291.20recipient with the recipient's guardian later chooses to access home and community-based
291.21services.
291.22 Sec. 74. Minnesota Statutes 2008, section 626.556, subdivision 3c, is amended to read:
291.23 Subd. 3c. Local welfare agency, Department of Human Services or Department
291.24of Health responsible for assessing or investigating reports of maltreatment. (a)
291.25The county local welfare agency is the agency responsible for assessing or investigating
291.26allegations of maltreatment in child foster care, family child care,and legally unlicensed
291.27child careand in, juvenile correctional facilities licensed under section 241.021 located
291.28in the local welfare agency's county, and unlicensed personal care assistance provider
291.29organizations providing services and receiving reimbursements under chapter 256B.
291.30(b) The Department of Human Services is the agency responsible for assessing or
291.31investigating allegations of maltreatment in facilities licensed under chapters 245A and
291.32245B, except for child foster care and family child care.
291.33(c) The Department of Health is the agency responsible for assessing or investigating
291.34allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58,
291.35and in unlicensed home health care and 144A.46.
292.1(d) The commissioners of human services, public safety, and education must
292.2jointly submit a written report by January 15, 2007, to the education policy and finance
292.3committees of the legislature recommending the most efficient and effective allocation
292.4of agency responsibility for assessing or investigating reports of maltreatment and must
292.5specifically address allegations of maltreatment that currently are not the responsibility
292.6of a designated agency.
292.7 Sec. 75. Minnesota Statutes 2008, section 626.5572, subdivision 13, is amended to
292.8read:
292.9 Subd. 13. Lead agency. "Lead agency" is the primary administrative agency
292.10responsible for investigating reports made under section626.557 .
292.11(a) The Department of Health is the lead agency for the facilities which are licensed
292.12or are required to be licensed as hospitals, home care providers, nursing homes, residential
292.13care homes, or boarding care homes.
292.14(b) The Department of Human Services is the lead agency for the programs licensed
292.15or required to be licensed as adult day care, adult foster care, programs for people with
292.16developmental disabilities, mental health programs, or chemical health programs, or
292.17personal care provider organizations.
292.18(c) The county social service agency or its designee is the lead agency for all
292.19other reports, including reports involving vulnerable adults receiving services from an
292.20unlicensed personal care provider organization under section 256B.0659.
292.21 Sec. 76. DEVELOPMENT OF ALTERNATIVE SERVICES.
292.22The commissioner of human services, in consultation with advocates, consumers,
292.23and legislators, shall develop alternative services to personal care assistance services for
292.24persons with mental health and other behavioral challenges who can benefit from other
292.25services that more appropriately meet their needs and assist them in living independently
292.26in the community. In the development of these services, the commissioner shall:
292.27(1) take into consideration ways in which these alternative services will qualify for
292.28federal financial participation; and
292.29(2) analyze a variety of alternatives, including but not limited to a 1915(i) state
292.30plan option.
292.31The commissioner shall report to the legislature by January 15, 2011, with plans for
292.32implementation of these services by July 1, 2011.
292.33 Sec. 77. 30-DAY NOTICE REQUIRED.
293.1Notwithstanding any contrary provision in law, persons impacted by amendments
293.2in this article to Minnesota Statutes, sections 256B.0625, subdivision 19c; 256B.0655,
293.3subdivision 4; 256B.0659; and 256B.0911, subdivision 1, must be given a 30-day notice
293.4of action by the commissioner. This section expires July 1, 2011.
293.5 Sec. 78. COLA COMPENSATION REQUIREMENTS.
293.6Effective July 1, 2009, providers who received rate increases under Laws 2007,
293.7chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15,
293.8section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years
293.92008 and 2009 are no longer required to continue or retain employee compensation or
293.10wage-related increases required by those sections. This paragraph shall not apply to
293.11employees covered by a collective bargaining agreement.
293.12 Sec. 79. PROVIDER RATE AND GRANT REDUCTIONS.
293.13(a) The commissioner of human services shall decrease grants, allocations,
293.14reimbursement rates, or rate limits, as applicable, by 2.58 percent effective July 1, 2009,
293.15for services rendered on or after that date. County or tribal contracts for services specified
293.16in this section must be amended to pass through these rate reductions within 60 days of
293.17the effective date of the decrease and must be retroactive from the effective date of the
293.18rate decrease.
293.19(b) The annual rate decreases described in this section must be provided to:
293.20(1) home and community-based waivered services for persons with developmental
293.21disabilities or related conditions, including consumer-directed community supports, under
293.22Minnesota Statutes, section 256B.501;
293.23(2) home and community-based waivered services for the elderly, including
293.24consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
293.25(3) waivered services under community alternatives for disabled individuals,
293.26including consumer-directed community supports, under Minnesota Statutes, section
293.27256B.49;
293.28(4) community alternative care waivered services, including consumer-directed
293.29community supports, under Minnesota Statutes, section 256B.49;
293.30(5) traumatic brain injury waivered services, including consumer-directed
293.31community supports, under Minnesota Statutes, section 256B.49;
293.32(6) nursing services and home health services under Minnesota Statutes, section
293.33256B.0625, subdivision 6a;
293.34(7) personal care services and qualified professional supervision of personal care
293.35services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
294.1(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
294.2subdivision 7;
294.3(9) day training and habilitation services for adults with developmental disabilities
294.4or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
294.5additional cost of rate adjustments on day training and habilitation services, provided as a
294.6social service under Minnesota Statutes, section 256M.60;
294.7(10) alternative care services under Minnesota Statutes, section 256B.0913;
294.8(11) the group residential housing supplementary service rate under Minnesota
294.9Statutes, section 256I.05, subdivision 1a;
294.10(12) semi-independent living services (SILS) under Minnesota Statutes, section
294.11252.275, including SILS funding under county social services grants formerly funded
294.12under Minnesota Statutes, chapter 256I;
294.13(13) community support services for deaf and hard-of-hearing adults with mental
294.14illness who use or wish to use sign language as their primary means of communication
294.15under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
294.16grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9;
294.17and Laws 1997, First Special Session chapter 5, section 20;
294.18(14) physical therapy services under Minnesota Statutes, sections 256B.0625,
294.19subdivision 8, and 256D.03, subdivision 4;
294.20(15) occupational therapy services under Minnesota Statutes, sections 256B.0625,
294.21subdivision 8a, and 256D.03, subdivision 4;
294.22(16) speech-language therapy services under Minnesota Statutes, section 256D.03,
294.23subdivision 4, and Minnesota Rules, part 9505.0390;
294.24(17) respiratory therapy services under Minnesota Statutes, section 256D.03,
294.25subdivision 4, and Minnesota Rules, part 9505.0295;
294.26(18) consumer support grants under Minnesota Statutes, section 256.476;
294.27(19) family support grants under Minnesota Statutes, section 252.32;
294.28(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
294.29and 256B.0928;
294.30(21) disability linkage line grants under Minnesota Statutes, section 256.01,
294.31subdivision 24; and
294.32(22) housing access grants under Minnesota Statutes, section 256B.0658.
294.33(c) A managed care plan receiving state payments for the services in this section
294.34must include these decreases in their payments to providers effective on October 1
294.35following the effective date of the rate decrease.
295.1 Sec. 80. RECOMMENDATIONS FOR PERSONAL CARE ASSISTANCE
295.2SERVICES CHANGES, CONSULTATION WITH STAKEHOLDERS, AND DATA
295.3REPORTING.
295.4The commissioner shall:
295.5(1) consult with existing stakeholder groups convened under the commissioner's
295.6authority, including the home and community-based expert services panel beginning in
295.7August 2009 on implementation of the changes in the personal care assistance program,
295.8assistance for recipients whose services and housing must change, alternative services
295.9for those whose personal care assistance services are terminated or reduced, costs for
295.10those whose services will change, data on the effects of the changes in the personal care
295.11assistance program for recipients, and ongoing data on personal care assistance services
295.12for public reporting; and
295.13(2) report data on the training developed and delivered for all types of participants in
295.14the personal care assistance program, audit and financial integrity measures and results,
295.15information developed for consumers and responsible parties, available demographic,
295.16health care service use, and housing information about individuals who no longer qualify
295.17for personal care assistance, and quality assurance measures and results to the legislative
295.18committees with jurisdiction over health and human services policy and finance by
295.19January 15, 2010, and January 15, 2011.
295.20 Sec. 81. ESTABLISHING A SINGLE SET OF STANDARDS.
295.21(a) The commissioner of human services shall consult with disability service
295.22providers, advocates, counties, and consumer families to develop a single set of standards
295.23governing services for people with disabilities receiving services under the home and
295.24community-based waiver services program to replace all or portions of existing laws and
295.25rules including, but not limited to, data practices, licensure of facilities and providers,
295.26background studies, reporting of maltreatment of minors, reporting of maltreatment of
295.27vulnerable adults, and the psychotropic medication checklist. The standards must:
295.28(1) enable optimum consumer choice;
295.29(2) be consumer driven;
295.30(3) link services to individual needs and life goals;
295.31(4) be based on quality assurance and individual outcomes;
295.32(5) utilize the people closest to the recipient, who may include family, friends, and
295.33health and service providers, in conjunction with the recipient's risk management plan to
295.34assist the recipient or the recipient's guardian in making decisions that meet the recipient's
295.35needs in a cost-effective manner and assure the recipient's health and safety;
296.1(6) utilize person-centered planning; and
296.2(7) maximize federal financial participation.
296.3(b) The commissioner may consult with existing stakeholder groups convened under
296.4the commissioner's authority, including the home and community-based expert services
296.5panel established by the commissioner in 2008, to meet all or some of the requirements
296.6of this section.
296.7(c) The commissioner shall provide the reports and plans required by this section to
296.8the legislative committees and budget divisions with jurisdiction over health and human
296.9services policy and finance by January 15, 2012.
296.10 Sec. 82. COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED
296.11WAIVER PROGRAMS.
296.12The commissioner of human services shall confer with representatives of recipients,
296.13advocacy groups, counties, providers, and health plans to develop and update a common
296.14service menu for home and community-based waiver programs. The commissioner may
296.15consult with existing stakeholder groups convened under the commissioner's authority to
296.16meet all or some of the requirements of this section.
296.17 Sec. 83. INTERMEDIATE CARE FACILITIES FOR PERSONS WITH
296.18DEVELOPMENTAL DISABILITIES REPORT.
296.19The commissioner of human services shall consult with providers and advocates of
296.20intermediate care facilities for persons with developmental disabilities to monitor progress
296.21made in response to the commissioner's December 15, 2008, report to the legislature
296.22regarding intermediate care facilities for persons with developmental disabilities.
296.23 Sec. 84. HOUSING OPTIONS.
296.24The commissioner of human services, in consultation with the commissioner of
296.25administration and the Minnesota Housing Finance Agency, and representatives of
296.26counties, residents' advocacy groups, consumers of housing services, and provider
296.27agencies shall explore ways to maximize the availability and affordability of housing
296.28choices available to persons with disabilities or who need care assistance due to other
296.29health challenges. A goal shall also be to minimize state physical plant costs in order to
296.30serve more persons with appropriate program and care support. Consideration shall be
296.31given to:
296.32(1) improved access to rent subsidies;
296.33(2) use of cooperatives, land trusts, and other limited equity ownership models;
297.1(3) whether a public equity housing fund should be established that would maintain
297.2the state's interest, to the extent paid from state funds, including group residential housing
297.3and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that
297.4when sold, the state would recover its share for a public equity fund to be used for future
297.5public needs under this chapter;
297.6(4) the desirability of the state acquiring an ownership interest or promoting the
297.7use of publicly owned housing;
297.8(5) promoting more choices in the market for accessible housing that meets the
297.9needs of persons with physical challenges; and
297.10(6) what consumer ownership models, if any, are appropriate.
297.11The commissioner shall provide a written report on the findings of the evaluation of
297.12housing options to the chairs and ranking minority members of the house of representatives
297.13and senate standing committees with jurisdiction over health and human services policy
297.14and funding by December 15, 2010. This report shall replace the November 1, 2010,
297.15annual report by the commissioner required in Minnesota Statutes, sections 256B.0916,
297.16subdivision 7, and 256B.49, subdivision 21.
297.17 Sec. 85. REVISOR'S INSTRUCTION.
297.18 Subdivision 1. Renumbering of Minnesota Statutes, section 256B.0652,
297.19authorization and review of home care services. (a) The revisor of statutes shall
297.20renumber each section of Minnesota Statutes listed in column A with the number in
297.21column B.
298.3(b) The revisor of statutes shall make necessary cross-reference changes in statutes
298.4and rules consistent with the renumbering in paragraph (a). The Department of Human
298.5Services shall assist the revisor with any cross-reference changes. The revisor may make
298.6changes necessary to correct the punctuation, grammar, or structure of the remaining text
298.7to conform with the intent of the renumbering in paragraph (a).
298.8 Subd. 2. Renumbering personal care assistance services. The revisor of statutes
298.9shall replace any reference to Minnesota Statutes, section 256B.0655 with section
298.10256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross
298.11reference changes that are necessary as a result of this section. The Department of Human
298.12Services shall assist the revisor in making these changes, and if necessary, shall draft a
298.13corrections bill with changes for introduction in the 2010 legislative session. The revisor
298.14may make changes to punctuation, grammar, or sentence structure to preserve the integrity
298.15of statutes and effectuate the intention of this section.
298.16 Sec. 86. REPEALER.
298.17(a) Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e,
298.181h, 1i, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 2, 3, and 4, are
298.19repealed.
298.20(b) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431,
298.21subdivision 23, are repealed effective May 1, 2009.
298.22(c) Minnesota Statutes 2008, section 256B.0655, subdivisions 1f, 1g, and 2, are
298.23repealed effective January 1, 2010.
298.27 Section 1. [402A.01] CITATION.
298.28Sections 402A.01 to 402A.50 may be cited as the "State-County Results,
298.29Accountability, and Service Delivery Reform Act."
298.30 Sec. 2. [402A.10] DEFINITIONS.
298.31 Subdivision 1. Terms defined. For the purposes of this chapter, the terms defined
298.32in this section have the meanings given.
299.1 Subd. 2. Commissioner. "Commissioner" means the commissioner of human
299.2services.
299.3 Subd. 3. Council. "Council" means the State-County Results, Accountability, and
299.4Service Delivery Redesign Council established in section 402A.20.
299.5 Subd. 4. Essential human services or essential services. "Essential human
299.6services" or "essential services" means assistance and services to recipients or potential
299.7recipients of public welfare and other services delivered by counties that are mandated in
299.8federal and state law that are to be available in all counties of the state.
299.9 Subd. 5. Service delivery authority. "Service delivery authority" means a single
299.10county, or group of counties operating by execution of a joint powers agreement under
299.11section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of
299.12the county board of commissioners to participate in the redesign under this chapter.
299.13 Subd. 6. Steering committee. "Steering committee" means the Steering Committee
299.14on Performance and Outcome Reforms.
299.15EFFECTIVE DATE.This section is effective the day following final enactment.
299.16 Sec. 3. [402A.15] STEERING COMMITTEE ON PERFORMANCE AND
299.17OUTCOME REFORMS.
299.18 Subdivision 1. Duties. (a) The Steering Committee on Performance and Outcome
299.19Reforms shall develop a uniform process to establish and review performance and
299.20outcome standards for all essential human services based on the current level of resources
299.21available, and to develop appropriate reporting measures and a uniform accountability
299.22process for responding to a county's or human service authority's failure to make adequate
299.23progress on achieving performance measures. The accountability process shall focus on
299.24the performance measures rather than inflexible implementation requirements.
299.25(b) The steering committee shall:
299.26(1) by November 1, 2009, establish an agreed upon list of essential services;
299.27(2) by February 15, 2010, develop and recommend to the legislature a uniform,
299.28graduated process, in addition to the remedies identified in section 402A.18, for responding
299.29to a county's failure to make adequate progress on achieving performance measures; and
299.30(3) by December 15, 2012, for each essential service make recommendations to the
299.31legislature regarding (1) performance measures and goals based on those measures for
299.32each essential service, (2) a system for reporting on the performance measures and goals,
299.33and (3) appropriate resources, including funding, needed to achieve those performance
299.34measures and goals. The resource recommendations shall take into consideration program
300.1demand and the unique differences of local areas in geography and the populations
300.2served. Priority shall be given to services with the greatest variation in availability and
300.3greatest administrative demands. By January 15 of each year starting January 15, 2011,
300.4the steering committee shall report its recommendations to the governor and legislative
300.5committees with jurisdiction over health and human services. As part of its report, the
300.6steering committee shall, as appropriate, recommend statutory provisions, rules and
300.7requirements, and reports that should be repealed or eliminated.
300.8(c) As far as possible, the performance measures, reporting system, and funding
300.9shall be consistent across program areas. The development of performance measures shall
300.10consider the manner in which data will be collected and performance will be reported.
300.11The steering committee shall consider state and local administrative costs related to
300.12collecting data and reporting outcomes when developing performance measures. The
300.13steering committee shall correlate the performance measures and goals to available
300.14levels of resources, including state and local funding. The steering committee shall
300.15take into consideration that the goal of implementing changes to program monitoring
300.16and reporting the progress toward achieving outcomes is to significantly minimize the
300.17cost of administrative requirements and to allow funds freed by reduced administrative
300.18expenditures to be used to provide additional services, allow flexibility in service design
300.19and management, and focus energies on achieving program and client outcomes.
300.20(d) In making its recommendations, the steering committee shall consider input from
300.21the council established in section 402A.20. The steering committee shall review the
300.22measurable goals established in a memorandum of understanding entered into under
300.23section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied
300.24as statewide performance outcomes.
300.25(e) The steering committee shall form work groups that include persons who provide
300.26or receive essential services and representatives of organizations who advocate on behalf
300.27of those persons.
300.28(f) By December 15, 2009, the steering committee shall establish a three-year
300.29schedule for completion of its work. The schedule shall be published on the Department of
300.30Human Services Web site and reported to the legislative committees with jurisdiction over
300.31health and human services. In addition, the commissioner shall post quarterly updates on
300.32the progress of the steering committee on the Department of Human Services Web site.
300.33 Subd. 2. Composition. (a) The steering committee shall include:
300.34(1) the commissioner of human services, or designee, and two additional
300.35representatives of the department;
301.1(2) two county commissioners, representative of rural and urban counties, selected
301.2by the Association of Minnesota Counties;
301.3(3) two county directors of human services, representative of rural and urban
301.4counties, selected by the Minnesota Association of County Social Service Administrators;
301.5and
301.6(4) three clients or client advocates representing different populations receiving
301.7services from the Department of Human Services, who are appointed by the commissioner.
301.8(b) The commissioner, or designee, and a county commissioner shall serve as
301.9cochairs of the committee. The committee shall be convened within 60 days of final
301.10enactment of this legislation.
301.11(c) State agency staff shall serve as informational resources and staff to the steering
301.12committee. Statewide county associations may assemble county program data as required.
301.13(d) To promote information sharing and coordination between the steering committee
301.14and council, one of the county representatives from paragraph (a), clause (2), and one of the
301.15county representatives from paragraph (a), clause (3), must also serve as a representative
301.16on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).
301.17EFFECTIVE DATE.This section is effective the day following final enactment.
301.18 Sec. 4. [402A.18] COMMISSIONER POWER TO REMEDY FAILURE TO
301.19MEET PERFORMANCE OUTCOMES.
301.20 Subdivision 1. Underperforming county; specific service. If the commissioner
301.21determines that a county or service delivery authority is deficient in achieving minimum
301.22performance outcomes for a specific essential service, the commissioner may impose
301.23the following remedies:
301.24(1) voluntary incorporation of the administration and operation of the specific
301.25essential service with an existing service delivery authority or another county. A
301.26service delivery authority or county incorporating an underperforming county shall
301.27not be financially liable for the costs associated with remedying performance outcome
301.28deficiencies;
301.29(2) mandatory incorporation of the administration and operation of the specific
301.30essential service with an existing service delivery authority or another county. A
301.31service delivery authority or county incorporating an underperforming county shall
301.32not be financially liable for the costs associated with remedying performance outcome
301.33deficiencies; or
301.34(3) transfer of authority for program administration and operation of the specific
301.35essential service to the commissioner.
302.1 Subd. 2. Underperforming county; more than one-half of service. If the
302.2commissioner determines that a county or service delivery authority is deficient in
302.3achieving minimum performance outcomes for more than one-half of the defined essential
302.4service, the commissioner may impose the following remedies:
302.5(1) voluntary incorporation of the administration and operation of the specific
302.6essential service with an existing service delivery authority or another county. A
302.7service delivery authority or county incorporating an underperforming county shall
302.8not be financially liable for the costs associated with remedying performance outcome
302.9deficiencies;
302.10(2) mandatory incorporation of the administration and operation of the specific
302.11essential service with an existing service delivery authority or another county. A
302.12service delivery authority or county incorporating an underperforming county shall
302.13not be financially liable for the costs associated with remedying performance outcome
302.14deficiencies; or
302.15(3) transfer of authority for program administration and operation of the specific
302.16essential service to the commissioner.
302.17 Subd. 3. Conditions prior to imposing remedies. Before the commissioner may
302.18impose the remedies authorized under this section, the following conditions must be met:
302.19(1) the county or service delivery authority determined by the commissioner
302.20to be deficient in achieving minimum performance outcomes has the opportunity, in
302.21coordination with the council, to develop a program outcome improvement plan. The
302.22program outcome improvement plan must be developed no later than six months from the
302.23date of the deficiency determination; and
302.24(2) the council has conducted an assessment of the program outcome improvement
302.25plan to determine if the county or service delivery authority has made satisfactory progress
302.26toward performance outcomes and has made a recommendation about remedies to the
302.27commissioner. The review and recommendation must be made to the commissioner within
302.2812 months from the date of the deficiency determination.
302.29 Sec. 5. [402A.20] COUNCIL.
302.30 Subdivision 1. Council. (a) The State-County Results, Accountability, and Service
302.31Delivery Redesign Council is established. Appointed council members must be appointed
302.32by their respective agencies, associations, or governmental units by November 1, 2009.
302.33The council shall be cochaired by the commissioner of human services, or designee, and a
302.34county representative from paragraph (b), clause (4) or (5), appointed by the Association
302.35of Minnesota Counties. Recommendations of the council must be approved by a majority
303.1of the council members. The provisions of section 15.059 do not apply to this council,
303.2and this council does not expire.
303.3(b) The council must consist of the following members:
303.4(1) two legislators appointed by the speaker of the house, one from the minority
303.5and one from the majority;
303.6(2) two legislators appointed by the Senate Rules Committee, one from the majority
303.7and one from the minority;
303.8(3) the commissioner of human services, or designee, and three employees from
303.9the department;
303.10(4) two county commissioners appointed by the Association of Minnesota Counties;
303.11(5) two county representatives appointed by the Minnesota Association of County
303.12Social Service Administrators;
303.13(6) one representative appointed by AFSCME as a nonvoting member; and
303.14(7) one representative appointed by the Teamsters as a nonvoting member.
303.15(c) Administrative support to the council may be provided by the Association of
303.16Minnesota Counties and affiliates.
303.17(d) Member agencies and associations are responsible for initial and subsequent
303.18appointments to the council.
303.19 Subd. 2. Council duties. The council shall:
303.20(1) provide review of the redesign process;
303.21(2) certify, in accordance with section 402A.30, subdivision 4, the formation of
303.22a service delivery authority, including the memorandum of understanding in section
303.23402A.30, subdivision 2, paragraph (b);
303.24(3) ensure the consistency of the memoranda of understanding entered into
303.25under section 402A.30, subdivision 2, paragraph (b), with the performance standards
303.26recommended by the steering committee and enacted by the legislature;
303.27(4) ensure the consistency of the memoranda of understanding, to the extent
303.28appropriate, or other memoranda of understanding entered into by other service delivery
303.29authorities;
303.30(5) establish a process to take public input on the service delivery framework
303.31specified in the memorandum of understanding in section 402A.30, subdivision 2,
303.32paragraph (b);
303.33(6) form work groups as necessary to carry out the duties of the council under the
303.34redesign;
304.1(7) serve as a forum for resolving conflicts among participating counties or between
304.2participating counties and the commissioner of human services, provided nothing in this
304.3section is intended to create a formal binding legal process;
304.4(8) engage in the program improvement process established in section 402A.18,
304.5subdivision 3; and
304.6(9) identify and recommend incentives for counties to participate in human services
304.7authorities.
304.8EFFECTIVE DATE.This section is effective the day following final enactment.
304.9 Sec. 6. [402A.30] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
304.10 Subdivision 1. Establishment. After certification by the council and approval by
304.11the commissioner, in accordance with subdivision 4, a county or consortium of counties
304.12may establish a service delivery authority to redesign the delivery of some or all essential
304.13services. Once a county or consortium of counties establishes a service delivery authority,
304.14no county that is a participant in the service delivery authority may participate in or be
304.15a member of any other service delivery authority. The service delivery authority may
304.16allow an additional county or counties to join the service delivery authority subject to the
304.17approval of the council and the commissioner.
304.18 Subd. 2. New state-county governance framework. (a) To establish a service
304.19delivery authority, each participating county and the state must enter into a binding
304.20memorandum of understanding to establish a joint state-county service delivery
304.21framework:
304.22(b) The memorandum of understanding must:
304.23(1) comply with current state and federal law except where waivers are approved
304.24under clause (7);
304.25(2) define the scope of essential services over which the service delivery authority
304.26has jurisdiction;
304.27(3) designate a single administrative structure to oversee the delivery of services over
304.28which the service delivery authority has jurisdiction and identify a single administrative
304.29agent for purposes of contact and communication with the department;
304.30(4) define measurable performance and outcome goals in key operational areas
304.31that the service delivery authority is expected to achieve, provided that the performance
304.32goals must, at a minimum, satisfy performance outcomes recommended by the steering
304.33committee and enacted into law;
305.1(5) identify the state and local resources, including funding and administrative and
305.2information technology support, and other requirements necessary for the service delivery
305.3authority to achieve the performance and outcome goals;
305.4(6) state the relief available to the service delivery authority if the resource
305.5commitments identified in clause (5) are not met;
305.6(7) identify in the agreement the waivers from statutory requirements that are needed
305.7to ensure greater local control and flexibility to determine the most cost-effective means
305.8of achieving specified measurable goals and the date by which the commissioner shall
305.9grant the identified waivers;
305.10(8) set forth a graduated accountability process and penalties for responding to a
305.11county's failure to make adequate progress on achieving performance and outcome goals;
305.12(9) set forth a reasonable level of targeted reductions in overhead and administrative
305.13costs for each county participating in the service delivery authority; and
305.14(10) set forth the terms under which a county may withdraw from participation.
305.15The memorandum of understanding may be later amended to add additional services over
305.16which the service delivery authority has jurisdiction.
305.17(c) Nothing in this chapter precludes local governments from utilizing sections
305.18465.81 and 465.82 to establish procedures for local governments to merge, with the
305.19consent of the voters. Any agreement under paragraph (b) must be governed by this
305.20chapter. Nothing in this chapter limits the authority of a county board to enter into
305.21contractual agreements for services not covered by the provisions of a memorandum of
305.22understanding establishing a service delivery authority with other agencies or with other
305.23units of government.
305.24 Subd. 3. Duties. The service delivery authority shall:
305.25(1) within the scope of essential services set forth in the memorandum of
305.26understanding establishing the authority, carry out the responsibilities required of local
305.27agencies under chapter 393 and human services boards under chapter 402;
305.28(2) manage the public resources devoted to human services and other public services
305.29delivered or purchased by the counties that are subsidized or regulated by the Department
305.30of Human Services under chapters 245 and 267;
305.31(3) employ staff to assist in carrying out its duties;
305.32(4) develop and maintain a continuity of operations plan to ensure the continued
305.33operation or resumption of essential human services functions in the event of any business
305.34interruption according to local, state, and federal emergency planning requirements;
305.35(5) receive and expend funds received for the redesign process under the
305.36memorandum of understanding;
306.1(6) plan and deliver services directly or through contract with other governmental
306.2or nongovernmental providers;
306.3(7) rent, purchase, sell, and otherwise dispose of real and personal property as
306.4necessary to carry out the redesign; and
306.5(8) carry out any other service designated as a responsibility of a county.
306.6 Subd. 4. Process for establishing a service delivery authority. (a) The county or
306.7consortium of counties proposing to form a service delivery authority shall, in conjunction
306.8with the commissioner, prevent a proposed memorandum of understanding to the council
306.9accompanied by a resolution from the board of commissioners of each participating
306.10county stating the county's intent to participate in a service delivery authority.
306.11(b) The council shall certify a county or consortium of counties as a service delivery
306.12authority if:
306.13(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and
306.14(2) the county or consortium of counties are:
306.15(i) a single county with a population of 55,000 or more;
306.16(ii) a consortium of counties with a total combined population of 55,000 or more and
306.17the counties comprising the consortium are in reasonable geographic proximity; or
306.18(iii) four or more counties in reasonable geographic proximity without regard
306.19to population.
306.20The council may recommend that the commissioner of human services exempt a
306.21single county or multicounty service delivery authority from the minimum population
306.22standard if that service delivery authority can demonstrate that it can otherwise meet
306.23the requirements of this chapter.
306.24(c) After the council has certified a county or consortium of counties as a service
306.25delivery authority, the commissioner may enter into the memoranda of understanding with
306.26the participating counties to form the service delivery authority.
306.27 Subd. 5. Single county service delivery authority. For counties with populations
306.28over 55,000, the board of county commissioners may be the service delivery authority and
306.29retain existing authority under law.
306.30 Sec. 7. [402A.45] ESSENTIAL SERVICES OUTSIDE THE JURISDICTION OF
306.31A SERVICE DELIVERY AUTHORITY.
306.32(a) With the approval of the council, a county that is a participant in a service
306.33delivery authority may enter into cooperative arrangements with other service delivery
306.34authorities or other counties to provide essential services that are not within the jurisdiction
306.35and duties of the service delivery authority.
307.1(b) With the approval of the council, a service delivery authority may enter into a
307.2cooperative arrangement with a nonparticipating county to provide an essential service
307.3within the jurisdiction and duties of the service delivery authority.
307.4 Sec. 8. [402A.50] PRIVATE SECTOR FUNDING.
307.5The council may support stakeholder agencies, if not otherwise prohibited by law, to
307.6separately or jointly seek and receive funds to provide expert technical assistance to the
307.7council, the council's work group, and any subwork groups for executing the provisions
307.8of the redesign.
307.9 Sec. 9. APPROPRIATION.
307.10$350,000 is appropriated for the biennium beginning July 1, 2009, from the general
307.11fund to the State-County Results, Accountability, and Service Delivery Redesign Council,
307.12for the purposes of the State-County Results, Accountability, and Service Delivery Reform
307.13Act under Minnesota Statutes, sections 402A.01 to 402A.50. The council shall establish a
307.14methodology for distributing funds to certified service delivery authorities for the purposes
307.15of carrying out the requirements of the redesign.
307.18 Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to
307.19read:
307.20 Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
307.21 (1) for a water supply well that is not in use under a maintenance permit, $175
307.22annually;
307.23 (2) for construction of a monitoring well, $215, which includes the state core
307.24function fee;
307.25 (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
307.26 (4) for a monitoring well owned by a federal agency, state agency, or local unit of
307.27government that is unsealed under a maintenance permit, $50 annually. "Local unit of
307.28government" means a statutory or home rule charter city, town, county, or soil and water
307.29conservation district, watershed district, an organization formed for the joint exercise of
307.30powers under section 471.59, a board of health or community health board, or other
307.31special purpose district or authority with local jurisdiction in water and related land
307.32resources management;
307.33(5) for monitoring wells used as a leak detection device at a single motor fuel retail
307.34outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
308.1chemical facility site, the construction permit fee is $215, which includes the state core
308.2function fee, per site regardless of the number of wells constructed on the site, and
308.3the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site
308.4regardless of the number of monitoring wells located on site;
308.5(5) (6) for a groundwater thermal exchange device, in addition to the notification fee
308.6for water supply wells, $215, which includes the state core function fee;
308.7(6) (7) for a vertical heat exchanger with less than ten tons of heating/cooling
308.8capacity, $215;
308.9(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;
308.10(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling
308.11capacity, $650;
308.12(7) (10) for a dewatering well that is unsealed under a maintenance permit, $175
308.13annually for each dewatering well, except a dewatering project comprising more than five
308.14dewatering wells shall be issued a single permit for $875 annually for dewatering wells
308.15recorded on the permit; and
308.16(8) (11) for an elevator boring, $215 for each boring.
308.17 Sec. 2. Minnesota Statutes 2008, section 144.121, subdivision 1a, is amended to read:
308.18 Subd. 1a. Fees for ionizing radiation-producing equipment. (a) A facility with
308.19ionizing radiation-producing equipment must pay an annual initial or annual renewal
308.20registration fee consisting of a base facility fee of$66 $100 and an additional fee for
308.21each radiation source, as follows:
308.31(b) A facility with radiation therapy and accelerator equipment must pay an annual
308.32registration fee of $500. A facility with an industrial accelerator must pay an annual
308.33registration fee of $150.
309.1(c) Electron microscopy equipment is exempt from the registration fee requirements
309.2of this section.
309.3 Sec. 3. Minnesota Statutes 2008, section 144.121, subdivision 1b, is amended to read:
309.4 Subd. 1b. Penalty fee for late registration. Applications for initial or renewal
309.5registrations submitted to the commissioner after the time specified by the commissioner
309.6shall be accompanied bya penalty fee of $20 an amount equal to 25 percent of the fee
309.7due in addition to the fees prescribed in subdivision 1a.
309.8 Sec. 4. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:
309.9 Subd. 1a. Fees. All plans and specifications for public pool and spa construction,
309.10installation, or alteration or requests for a variance that are submitted to the commissioner
309.11according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate
309.12fees. All public pool construction plans submitted for review after January 1, 2009,
309.13must be certified by a professional engineer registered in the state of Minnesota. If the
309.14commissioner determines, upon review of the plans, that inadequate fees were paid, the
309.15necessary additional fees shall be paid before plan approval. For purposes of determining
309.16fees, a project is defined as a proposal to construct or install a public pool, spa, special
309.17purpose pool, or wading pool and all associated water treatment equipment and drains,
309.18gutters, decks, water recreation features, spray pads, and those design and safety features
309.19that are within five feet of any pool or spa. The commissioner shall charge the following
309.20fees for plan review and inspection of public pools and spas and for requests for variance
309.21from the public pool and spa rules:
309.22 (1) each pool,$800 $1,500;
309.23 (2) each spa pool,$500 $800;
309.24 (3) each slide,$400 $600;
309.25 (4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses
309.26(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum
309.27fee of$10,000 $15,000;
309.28 (5) alterations to an existing pool without changing the size or configuration of
309.29the pool,$400 $600;
309.30 (6) removal or replacement of pool disinfection equipment only,$75 $100; and
309.31 (7) request for variance from the public pool and spa rules, $500.
309.32 Sec. 5. Minnesota Statutes 2008, section 144.125, subdivision 1, is amended to read:
310.1 Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
310.2officer or other person in charge of each institution caring for infants 28 days or less
310.3of age, (2) the person required in pursuance of the provisions of section144.215 , to
310.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
310.5birth, to arrange to have administered to every infant or child in its care tests for heritable
310.6and congenital disorders according to subdivision 2 and rules prescribed by the state
310.7commissioner of health. Testing and the recording and reporting of test results shall be
310.8performed at the times and in the manner prescribed by the commissioner of health. The
310.9commissioner shall charge a fee so that the total of fees collected will approximate the
310.10costs of conducting the tests and implementing and maintaining a system to follow-up
310.11infants with heritable or congenital disorders, including hearing loss detected through the
310.12early hearing detection and intervention program under section144.966 . The fee is $101
310.13per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The
310.14increased fee amount shall be deposited in the general fund. Costs associated with capital
310.15expenditures and the development of new procedures may be prorated over a three-year
310.16period when calculating the amount of the fees.
310.17EFFECTIVE DATE.This section is effective July 1, 2010.
310.18 Sec. 6. Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read:
310.19 Subdivision 1.Permits License required. The state commissioner of health is
310.20authorized to issuepermits for the operation of youth camps which are required to obtain
310.21the permits a license according to chapter 157.
310.22 Sec. 7. Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read:
310.23 Subd. 3. Issuance ofpermits license. If the commissioner should determine from
310.24the application that the health and safety of the persons using the camp will be properly
310.25safeguarded, the commissioner may, prior to actual inspection of the camp, issue the
310.26permit license in writing. No fee shall be charged for the permit. The permit license shall
310.27be posted in a conspicuous place on the premises occupied by the camp.
310.28 Sec. 8. Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision
310.29to read:
310.30 Subd. 8a. Disclosure pamphlet. "Disclosure pamphlet" means the EPA pamphlet
310.31titled "Renovate Right: Important Lead Hazard Information for Families, Child Care
310.32Providers and Schools" developed under section 406(a) of the Toxic Substance Control
310.33Act.
311.1 Sec. 9. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to
311.2read:
311.3 Subd. 22b. Lead sampling technician. "Lead sampling technician" means an
311.4individual who performs clearance inspections fornonabatement or nonorder lead hazard
311.5reduction renovation sites, and lead dust sampling in other settings, or visual assessment
311.6for deteriorated paint for nonabatement sites, and who is registered with the commissioner
311.7under section144.9505 .
311.8 Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to
311.9read:
311.10 Subd. 26a. Regulated lead work. (a) "Regulated lead work" means:
311.11(1) abatement;
311.12(2) interim controls;
311.13(3) a clearance inspection;
311.14(4) a lead hazard screen;
311.15(5) a lead inspection;
311.16(6) a lead risk assessment;
311.17(7) lead project designer services;
311.18(8) lead sampling technician services;or
311.19(9) swab team services.;
311.20(10) renovation activities; or
311.21(11) activities performed to comply with lead orders issued by a board of health.
311.22(b) Regulated lead work does not include abatement, interim controls, swab team
311.23services, or renovation activities that disturb painted surfaces that total no more than:
311.24(1) activities such as remodeling, renovation, installation, rehabilitation, or
311.25landscaping activities, the primary intent of which is to remodel, repair, or restore a
311.26structure or dwelling, rather than to permanently eliminate lead hazards, even though these
311.27activities may incidentally result in a reduction in lead hazards; or
311.28(2) interim control activities that are not performed as a result of a lead order and
311.29that do not disturb painted surfaces that total more than:
311.30(i) (1) 20 square feet (two square meters) on exterior surfaces; or
311.31(ii) two (2) six square feet (0.2 0.6 square meters) in an interior room; or.
311.32(iii) ten percent of the total surface area on an interior or exterior type of component
311.33with a small surface area.
312.1 Sec. 11. Minnesota Statutes 2008, section 144.9501, is amended by adding a
312.2subdivision to read:
312.3 Subd. 26b. Renovation. "Renovation" means the modification of any affected
312.4property that results in the disturbance of painted surfaces, unless that activity is performed
312.5as an abatement. A renovation performed for the purpose of converting a building or part
312.6of a building into an affected property is a renovation under this subdivision.
312.7 Sec. 12. Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to
312.8read:
312.9 Subd. 1g. Certified lead firm.A person within the state intending to directly
312.10perform or cause to be performed through subcontracting or similar delegation any
312.11regulated lead work shall first obtain certification from the commissioner A person who
312.12employs individuals to perform regulated lead work outside of the person's property must
312.13obtain certification as a lead firm. The certificate must be in writing, contain an expiration
312.14date, be signed by the commissioner, and give the name and address of the person to
312.15whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted
312.16with each application. The certificate or a copy of the certificate must be readily available
312.17at the worksite for review by the contracting entity, the commissioner, and other public
312.18health officials charged with the health, safety, and welfare of the state's citizens.
312.19 Sec. 13. Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read:
312.20 Subd. 4. Notice of regulated lead work. (a) At least five working days before
312.21starting work at each regulated lead worksite, the person performing the regulated lead
312.22work shall give written notice to the commissioner and the appropriate board of health.
312.23(b) This provision does not apply to lead hazard screen, lead inspection, lead risk
312.24assessment, lead sampling technician, renovation, or lead project design activities.
312.25 Sec. 14. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:
312.26 Subd. 2. Regulated lead work standards and methods. (a) The commissioner
312.27shall adopt rules establishing regulated lead work standards and methods in accordance
312.28with the provisions of this section, for lead in paint, dust, drinking water, and soil in
312.29a manner that protects public health and the environment for all residences, including
312.30residences also used for a commercial purpose, child care facilities, playgrounds, and
312.31schools.
312.32(b) In the rules required by this section, the commissioner shall require lead hazard
312.33reduction of intact paint only if the commissioner finds that the intact paint is on a
313.1chewable or lead-dust producing surface that is a known source of actual lead exposure to
313.2a specific individual. The commissioner shall prohibit methods that disperse lead dust into
313.3the air that could accumulate to a level that would exceed the lead dust standard specified
313.4under this section. The commissioner shall work cooperatively with the commissioner
313.5of administration to determine which lead hazard reduction methods adopted under this
313.6section may be used for lead-safe practices including prohibited practices, preparation,
313.7disposal, and cleanup. The commissioner shall work cooperatively with the commissioner
313.8of the Pollution Control Agency to develop disposal procedures. In adopting rules under
313.9this section, the commissioner shall require the best available technology for regulated
313.10lead work methods, paint stabilization, and repainting.
313.11(c) The commissioner of health shall adopt regulated lead work standards and
313.12methods for lead in bare soil in a manner to protect public health and the environment.
313.13The commissioner shall adopt a maximum standard of 100 parts of lead per million in
313.14bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts
313.15of lead per million. Soil lead hazard reduction methods shall focus on erosion control
313.16and covering of bare soil.
313.17(d) The commissioner shall adopt regulated lead work standards and methods for
313.18lead in dust in a manner to protect the public health and environment. Dust standards
313.19shall use a weight of lead per area measure and include dust on the floor, on the window
313.20sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust
313.21removal and other practices which minimize the formation of lead dust from paint, soil, or
313.22other sources.
313.23(e) The commissioner shall adopt lead hazard reduction standards and methods for
313.24lead in drinking water both at the tap and public water supply system or private well
313.25in a manner to protect the public health and the environment. The commissioner may
313.26adopt the rules for controlling lead in drinking water as contained in Code of Federal
313.27Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include
313.28an educational approach of minimizing lead exposure from lead in drinking water.
313.29(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
313.30removal of exterior lead-based coatings from residences and steel structures by abrasive
313.31blasting methods is conducted in a manner that protects health and the environment.
313.32(g) All regulated lead work standards shall provide reasonable margins of safety that
313.33are consistent with more than a summary review of scientific evidence and an emphasis on
313.34overprotection rather than underprotection when the scientific evidence is ambiguous.
313.35(h) No unit of local government shall have an ordinance or regulation governing
313.36regulated lead work standards or methods for lead in paint, dust, drinking water, or soil
314.1that require a different regulated lead work standard or method than the standards or
314.2methods established under this section.
314.3(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit
314.4of local government of an innovative lead hazard reduction method which is consistent
314.5in approach with methods established under this section.
314.6(j) The commissioner shall adopt rules for issuing lead orders required under section
314.7144.9504
, rules for notification of abatement or interim control activities requirements,
314.8and other rules necessary to implement sections144.9501 to
144.9512 .
314.9(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the
314.10Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property
314.11where a child or pregnant female resides is conducted in a manner that protects health
314.12and the environment.
314.13(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of
314.14the Toxic Substances Control Act.
314.15 Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:
314.16 Subd. 3. Licensure and certification. The commissioner shall adopt rules to
314.17license lead supervisors, lead workers, lead project designers, lead inspectors,and lead
314.18risk assessors, and lead sampling technicians. The commissioner shall also adopt rules
314.19requiring certification of firms that perform regulated lead workand rules requiring
314.20registration of lead sampling technicians. The commissioner shall require periodic renewal
314.21of licenses, and certificates, and registrations and shall establish the renewal periods.
314.22 Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:
314.23 Subd. 4. Lead training course. The commissioner shall establish by rule
314.24requirements for training course providers and the renewal period for each lead-related
314.25training course required for certification or licensure. The commissioner shall establish
314.26criteria in rules for the content and presentation of training courses intended to qualify
314.27trainees for licensure under subdivision 3. The commissioner shall establish criteria
314.28in rules for the content and presentation of training courses for leadinterim control
314.29workers renovation and lead sampling technicians. Training course permit fees shall be
314.30nonrefundable and must be submitted with each application in the amount of $500 for an
314.31initial training course, $250 for renewal of a permit for an initial training course, $250 for
314.32a refresher training course, and $125 for renewal of a permit of a refresher training course.
314.33 Sec. 17. Minnesota Statutes 2008, section 144.9512, subdivision 2, is amended to read:
315.1 Subd. 2. Grants; administration. Within the limits of the available appropriation,
315.2the commissioner shall make grants toa nonprofit organization currently operating the
315.3CLEARCorps lead hazard reduction project organizations to train workers to provide lead
315.4screening, education, outreach, and swab team services for residential property. Projects
315.5that provide Americorps funding or positions, or leverage matching funds, as part of the
315.6delivery of the services must be given priority for the grant funds.
315.7 Sec. 18. Minnesota Statutes 2008, section 144.966, is amended by adding a subdivision
315.8to read:
315.9 Subd. 3a. Support services to families. The commissioner shall contract with
315.10a nonprofit organization to provide support and assistance to families with children
315.11who are deaf or have a hearing loss. The family support provided must include direct
315.12parent-to-parent assistance and information on communication, educational, and medical
315.13options. The commissioner shall give preference to a nonprofit organization that has the
315.14ability to provide these services throughout the state.
315.15 Sec. 19. Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read:
315.16 Subd. 2.Certification Accreditation. "Certification" means written
315.17acknowledgment of a laboratory's demonstrated capability to perform tests for a specific
315.18purpose "Accreditation" means written acknowledgment that a laboratory has the
315.19policies, procedures, equipment, and practices to produce reliable data in the analysis of
315.20environmental samples.
315.21EFFECTIVE DATE.This section is effective July 1, 2009.
315.22 Sec. 20. Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read:
315.23 Subd. 4.Contract Commercial laboratory. "Contract Commercial laboratory"
315.24means a laboratory that performs tests on samples on a contract or fee-for-service basis.
315.25EFFECTIVE DATE.This section is effective July 1, 2009.
315.26 Sec. 21. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision
315.27to read:
315.28 Subd. 5a. Field of testing. "Field of testing" means the combination of analyte,
315.29method, matrix, and test category for which a laboratory may hold accreditation.
315.30EFFECTIVE DATE.This section is effective July 1, 2009.
316.1 Sec. 22. Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read:
316.2 Subd. 6. Laboratory. "Laboratory" means the state, a person, corporation, or other
316.3entity, including governmental, that examines, analyzes, or tests samples in a specified
316.4physical location.
316.5EFFECTIVE DATE.This section is effective July 1, 2009.
316.6 Sec. 23. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision
316.7to read:
316.8 Subd. 8. Test category. "Test category" means the combination of program and
316.9category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10),
316.10and 3a, paragraph (a), clauses (1) to (5).
316.11EFFECTIVE DATE.This section is effective July 1, 2009.
316.12 Sec. 24. Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read:
316.13 Subdivision 1. Authorization. The commissioner of healthmay certify shall
316.14accredit environmental laboratoriesthat test environmental samples according to national
316.15standards developed using a consensus process as established by Circular A-119,
316.16published by the United States Office of Management and Budget.
316.17EFFECTIVE DATE.This section is effective July 1, 2009.
316.18 Sec. 25. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:
316.19 Subd. 2. Rules and standards. The commissioner may adopt rules toimplement
316.20this section, including: carry out the commissioner's responsibilities under the national
316.21standards specified in subdivisions 1 and 2a.
316.22(1) procedures, requirements, and fee adjustments for laboratory certification,
316.23including provisional status and recertification;
316.24(2) standards and fees for certificate approval, suspension, and revocation;
316.25(3) standards for environmental samples;
316.26(4) analysis methods that assure reliable test results;
316.27(5) laboratory quality assurance, including internal quality control, proficiency
316.28testing, and personnel training; and
316.29(6) criteria for recognition of certification programs of other states and the federal
316.30government.
316.31EFFECTIVE DATE.This section is effective July 1, 2009.
317.1 Sec. 26. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
317.2to read:
317.3 Subd. 2a. Standards. The commissioner shall accredit laboratories according to
317.4the most current environmental laboratory accreditation standards under subdivision 1
317.5and as accepted by the accreditation bodies recognized by the National Environmental
317.6Laboratory Accreditation Program (NELAP) of the NELAC Institute.
317.7EFFECTIVE DATE.This section is effective July 1, 2009.
317.8 Sec. 27. Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read:
317.9 Subd. 3. Annual fees. (a) An application forcertification accreditation under
317.10subdivision1 6 must be accompanied by the biennial fee annual fees specified in this
317.11subdivision. Thefees are for annual fees include:
317.12(1) basecertification accreditation fee, $1,600 $1,500;
317.13(2) sample preparation techniquesfees fee, $100 $200 per technique; and
317.14(3) an administrative fee for laboratories located outside this state, $3,750; and
317.15(4) test categorycertification fees:.
318.5(b)Laboratories located outside of this state that require an on-site inspection shall be
318.6assessed an additional $3,750 fee. For the programs in subdivision 3a, the commissioner
318.7may accredit laboratories for fields of testing under the categories listed in clauses (1) to
318.8(10) upon completion of the application requirements provided by subdivision 6 and
318.9receipt of the fees for each category under each program that accreditation is requested.
318.10The categories offered and related fees include:
318.11(1) microbiology, $450;
318.12(2) inorganics, $450;
318.13(3) metals, $1,000;
318.14(4) volatile organics, $1,300;
318.15(5) other organics, $1,300;
318.16(6) radiochemistry, $1,500;
318.17(7) emerging contaminants, $1,500;
318.18(8) agricultural contaminants, $1,250;
318.19(9) toxicity (bioassay), $1,000; and
318.20(10) physical characterization, $250.
318.21(c) The totalbiennial certification annual fee includes the base fee, the sample
318.22preparation techniques fees, the test category fees per program, and, when applicable,the
318.23on-site inspection fee an administrative fee for out-of-state laboratories.
318.24(d) Fees must be set so that the total fees support the laboratory certification program.
318.25Direct costs of the certification service include program administration, inspections, the
318.26agency's general support costs, and attorney general costs attributable to the fee function.
318.27(e) A change fee shall be assessed if a laboratory requests additional analytes
318.28or methods at any time other than when applying for or renewing its certification. The
318.29change fee is equal to the test category certification fee for the analyte.
318.30(f) A variance fee shall be assessed if a laboratory requests and is granted a variance
318.31from a rule adopted under this section. The variance fee is $500 per variance.
318.32(g) Refunds or credits shall not be made for analytes or methods requested but
318.33not approved.
318.34(h) Certification of a laboratory shall not be awarded until all fees are paid.
319.1 Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
319.2to read:
319.3 Subd. 3a. Available programs, categories, and analytes. (a) The commissioner
319.4shall accredit laboratories that test samples under the following programs:
319.5(1) the clean water program, such as compliance monitoring under the federal Clean
319.6Water Act, and ambient monitoring of surface and groundwater, or analysis of biological
319.7tissue;
319.8(2) the safe drinking water program, including compliance monitoring under the
319.9federal Safe Drinking Water Act, and the state requirements for monitoring private wells;
319.10(3) the resource conservation and recovery program, including federal and state
319.11requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and
319.12groundwater monitoring wells not intended as drinking water sources;
319.13(4) the underground storage tank program; and
319.14(5) the clean air program, including air and emissions testing under the federal Clean
319.15Air Act, and state and federal requirements for vapor intrusion monitoring.
319.16(b) The commissioner shall maintain and publish a list of analytes available for
319.17accreditation. The list must be reviewed at least once every six months and the changes
319.18published in the State Register and posted on the program's Web site. The commissioner
319.19shall publish the notification of changes and review comments on the changes no less than
319.2030 days from the date the list is published.
319.21 Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
319.22to read:
319.23 Subd. 3b. Additional fees. (a) Laboratories located outside of this state that require
319.24an on-site assessment more frequent than once every two years must pay an additional
319.25assessed fee of $3,000 per assessment for each additional on-site assessment conducted.
319.26The laboratory must pay the fee within 15 business days of receiving the commissioner's
319.27notification that an on-site assessment is required. The commissioner may conduct
319.28additional on-site assessments to determine a laboratory's continued compliance with
319.29the standards provided in subdivision 2a.
319.30(b) A late fee of $200 shall be added to the annual fee for accredited laboratories
319.31submitting renewal applications to the commissioner after November 1.
319.32(c) A change fee shall be assessed if a laboratory requests additional fields of testing
319.33at any time other than when initially applying for or renewing its accreditation. A change
319.34fee does not apply for applications to add fields of testing for new analytes in response
319.35to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid
320.1accreditation for the changed test category and applies for additional analytes within the
320.2same test category. The change fee is equal to the applicable test category fee for the
320.3field of testing requested. An application that requests accreditation of multiple fields of
320.4testing within a test category requires a single payment of the applicable test category fee
320.5per application submitted.
320.6(d) A variance fee shall be assessed if a laboratory requests a variance from a
320.7standard provided in subdivision 2a. The variance fee is $500 per variance.
320.8(e) The commissioner shall assess a fee for changes to laboratory information
320.9regarding ownership, name, address, or personnel. Laboratories must submit changes
320.10through the application process under subdivision 6. The information update fee is $250
320.11per application.
320.12(f) Fees must be set so that the total fees support the laboratory accreditation
320.13program. Direct costs of the accreditation service include program administration,
320.14assessments, the agency's general support costs, and attorney general costs attributable
320.15to the fee function.
320.16 Sec. 30. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
320.17to read:
320.18 Subd. 3c. Refunds and nonpayment. Refunds or credits shall not be made for
320.19applications received but not approved. Accreditation of a laboratory shall not be awarded
320.20until all fees are paid.
320.21 Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
320.22to read:
320.23 Subd. 6. Application. (a) Laboratories seeking accreditation must apply on a form
320.24provided by the commissioner, include the laboratory's procedures and quality manual,
320.25and pay the applicable fees.
320.26(b) Laboratories may be fixed-base or mobile. The commissioner shall accredit
320.27mobile laboratories individually and require a vehicle identification number, license
320.28plate number, or other uniquely identifying information in addition to the application
320.29requirements of paragraph (a).
320.30(c) Laboratories maintained on separate properties, even though operated under the
320.31same management or ownership, must apply separately. Laboratories with more than one
320.32building on the same or adjoining properties do not need to submit a separate application.
320.33(d) The commissioner may accredit laboratories located out-of-state. Accreditation
320.34for out-of-state laboratories may be obtained directly from the commissioner following
321.1the requirements in paragraph (a), or out-of-state laboratories may be accredited through
321.2a reciprocal agreement if the laboratory:
321.3(1) is accredited by a NELAP-recognized accreditation body for those fields of
321.4testing in which the laboratory requests accreditation from the commissioner;
321.5(2) submits an application and documentation according to this subdivision; and
321.6(3) submits a current copy of the laboratory's unexpired accreditation from a
321.7NELAP-recognized accreditation body showing the fields of accreditation for which the
321.8laboratory is currently accredited.
321.9(e) Under the conflict of interest determinations provided in section 43A.38,
321.10subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories
321.11operated by agencies of the executive branch of the state. If accreditation is required,
321.12laboratories operated by agencies of the executive branch of the state must apply for
321.13accreditation through any other NELAP-recognized accreditation body.
321.14EFFECTIVE DATE.This section is effective July 1, 2009.
321.15 Sec. 32. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
321.16to read:
321.17 Subd. 6a. Implementation and effective date. All laboratories must comply with
321.18standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to
321.19applications received and accreditations issued after June 30, 2009. Accreditations issued
321.20on or before June 30, 2009, shall expire upon their current expiration date.
321.21 Sec. 33. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
321.22to read:
321.23 Subd. 7. Initial accreditation and annual accreditation renewal. (a) The
321.24commissioner shall issue or renew accreditation after receipt of the completed application
321.25and documentation required in this section, provided the laboratory maintains compliance
321.26with the standards specified in subdivision 2a, and attests to the compliance on the
321.27application form.
321.28(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
321.29applying for accreditation after December 31. The fees are prorated on a quarterly basis
321.30beginning with the quarter in which the commissioner receives the completed application
321.31from the laboratory.
321.32(c) Applications for renewal of accreditation must be received by November 1 and
321.33no earlier than October 1 of each year. The commissioner shall send annual renewal
322.1notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
322.2not exempt laboratories from meeting the annual November 1 renewal date.
322.3(d) The commissioner shall issue all accreditations for the calendar year for which
322.4the application is made, and the accreditation shall expire on December 31 of that year.
322.5(e) The accreditation of any laboratory that fails to submit a renewal application
322.6and fees to the commissioner expires automatically on December 31 without notice or
322.7further proceeding. Any person who operates a laboratory as accredited after expiration of
322.8accreditation or without having submitted an application and paid the fees is in violation
322.9of the provisions of this section and is subject to enforcement action under sections
322.10144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
322.11accreditation may reapply under subdivision 6.
322.12EFFECTIVE DATE.This section is effective July 1, 2009.
322.13 Sec. 34. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:
322.14 Subdivision 1. Remedies available. The provisions of chapters 103I and 157 and
322.15sections115.71 to
115.77 ;
144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12),
322.16(13), (14), and (15) ;
144.1201 to
144.1204 ;
144.121 ;
144.1222 ;
144.35 ;
144.381 to
322.17144.385
;
144.411 to
144.417 ;
144.495 ;
144.71 to
144.74 ;
144.9501 to
144.9512 ; 144.97
322.18to 144.98;144.992 ;
326.70 to
326.785 ;
327.10 to
327.131 ; and
327.14 to
327.28 and
322.19all rules, orders, stipulation agreements, settlements, compliance agreements, licenses,
322.20registrations, certificates, and permits adopted or issued by the department or under any
322.21other law now in force or later enacted for the preservation of public health may, in
322.22addition to provisions in other statutes, be enforced under this section.
322.23EFFECTIVE DATE.This section is effective July 1, 2009.
322.24 Sec. 35. Minnesota Statutes 2008, section 153A.17, is amended to read:
322.25153A.17 EXPENSES; FEES.
322.26The expenses for administering the certification requirements including the
322.27complaint handling system for hearing aid dispensers in sections
153A.14 and
153A.15
322.28and the Consumer Information Center under section
153A.18 must be paid from
322.29initial application and examination fees, renewal fees, penalties, and fines. All fees
322.30are nonrefundable. The certificate application fee is $350, the examination fee is $250
322.31for the written portion and $250 for the practical portion each time one or the other is
322.32taken, and the trainee application fee is $200. The penalty fee for late submission of a
322.33renewal application is $200. The fee for verification of certification to other jurisdictions
322.34or entities is $25. All fees, penalties, and fines received must be deposited in the state
323.1government special revenue fund. The commissioner may prorate the certification fee for
323.2new applicants based on the number of quarters remaining in the annual certification
323.3period. (a) The expenses for administering the certification requirements, including the
323.4complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15,
323.5and the Consumer Information Center under section 153A.18, must be paid from initial
323.6application and examination fees, renewal fees, penalties, and fines.
323.7 (b) The fees are as follows:
323.8(1) the initial and annual renewal certification application fee is $600;
323.9(2) the initial examination fee for the written portion is $500, and for each time it
323.10is taken, thereafter;
323.11(3) the initial examination fee for the practical portion is $1,200, and $600 for each
323.12time it is taken, thereafter; for individuals meeting the requirements of section 148.515,
323.13subdivision 2, the fee for the practical portion of the hearing instrument dispensing
323.14examination is $250 each time it is taken;
323.15(4) the trainee application fee is $200;
323.16(5) the penalty fee for late submission of a renewal application is $200; and
323.17(6) the fee for verification of certification to other jurisdictions or entities is $25.
323.18(c) The commissioner may prorate the certification fee for new applicants based on
323.19the number of quarters remaining in the annual certification period.
323.20(d) All fees are nonrefundable. All fees, penalties, and fines received must be
323.21deposited in the state government special revenue fund.
323.22(e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid
323.23at the time of initial certification application or renewal to recover the commissioner's
323.24accumulated direct expenditures for administering the requirements of this chapter.
323.25 Sec. 36. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision
323.26to read:
323.27 Subd. 20. Youth camp. "Youth camp" has the meaning given in section 144.71,
323.28subdivision 2.
323.29 Sec. 37. Minnesota Statutes 2008, section 157.16, is amended to read:
323.30157.16 LICENSES REQUIRED; FEES.
323.31 Subdivision 1. License required annually. A license is required annually for every
323.32person, firm, or corporation engaged in the business of conducting a food and beverage
323.33service establishment, youth camp, hotel, motel, lodging establishment, public pool, or
323.34resort. Any person wishing to operate a place of business licensed in this section shall
324.1first make application, pay the required fee specified in this section, and receive approval
324.2for operation, including plan review approval.Seasonal and temporary food stands and
324.3Special event food stands are not required to submit plans. Nonprofit organizations
324.4operating a special event food stand with multiple locations at an annual one-day event
324.5shall be issued only one license. Application shall be made on forms provided by the
324.6commissioner and shall require the applicant to state the full name and address of the
324.7owner of the building, structure, or enclosure, the lessee and manager of the food and
324.8beverage service establishment, hotel, motel, lodging establishment, public pool, or resort;
324.9the name under which the business is to be conducted; and any other information as may
324.10be required by the commissioner to complete the application for license.
324.11 Subd. 2. License renewal. Initial and renewal licenses for all food and beverage
324.12service establishments, youth camps, hotels, motels, lodging establishments, public pools,
324.13and resorts shall be issuedfor the calendar year for which application is made and shall
324.14expire on December 31 of such year on an annual basis. Any person who operates a place
324.15of business after the expiration date of a license or without having submitted an application
324.16and paid the fee shall be deemed to have violated the provisions of this chapter and shall
324.17be subject to enforcement action, as provided in the Health Enforcement Consolidation
324.18Act, sections144.989 to
144.993 . In addition, a penalty of $50 $60 shall be added to the
324.19total of the license fee for any food and beverage service establishment operating without
324.20a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or
324.21a special event food stand, and a penalty of$100 $120 shall be added to the total of the
324.22license fee for all restaurants, food carts, hotels, motels, lodging establishments, youth
324.23camps, public pools, and resorts operating without a license for a period of up to 30 days.
324.24A late fee of$300 $360 shall be added to the license fee for establishments operating more
324.25than 30 days without a license.
324.26 Subd. 2a. Food manager certification. An applicant for certification or certification
324.27renewal as a food manager must submit to the commissioner a$28 $35 nonrefundable
324.28certification fee payable to the Department of Health. The commissioner shall issue a
324.29duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant
324.30submits a completed application on a form provided by the commissioner for a duplicate
324.31certificate and pays $20 to the department for the cost of duplication.
324.32 Subd. 3. Establishment fees; definitions. (a) The following fees are required
324.33for food and beverage service establishments, youth camps, hotels, motels, lodging
324.34establishments, public pools, and resorts licensed under this chapter. Food and beverage
324.35service establishments must pay the highest applicable fee under paragraph (d), clause
325.1(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable
325.2fee under paragraph (d), clause (6) or (7). The license fee for new operators previously
325.3licensed under this chapter for the same calendar year is one-half of the appropriate annual
325.4license fee, plus any penalty that may be required. The license fee for operators opening
325.5on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
325.6that may be required.
325.7 (b) All food and beverage service establishments, except special event food stands,
325.8and all hotels, motels, lodging establishments, public pools, and resorts shall pay an
325.9annual base fee of $150.
325.10 (c) A special event food stand shall pay a flat fee of$40 $50 annually. "Special event
325.11food stand" means a fee category where food is prepared or served in conjunction with
325.12celebrations, county fairs, or special events from a special event food stand as defined
325.13in section157.15 .
325.14 (d) In addition to the base fee in paragraph (b), each food and beverage service
325.15establishment, other than a special event food stand, and each hotel, motel, lodging
325.16establishment, public pool, and resort shall pay an additional annual fee for each fee
325.17category, additional food service, or required additional inspection specified in this
325.18paragraph:
325.19 (1) Limited food menu selection,$50 $60. "Limited food menu selection" means a
325.20fee category that provides one or more of the following:
325.21 (i) prepackaged food that receives heat treatment and is served in the package;
325.22 (ii) frozen pizza that is heated and served;
325.23 (iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
325.24 (iv) soft drinks, coffee, or nonalcoholic beverages; or
325.25 (v) cleaning for eating, drinking, or cooking utensils, when the only food served
325.26is prepared off site.
325.27 (2) Small establishment, including boarding establishments,$100 $120. "Small
325.28establishment" means a fee category that has no salad bar and meets one or more of
325.29the following:
325.30 (i) possesses food service equipment that consists of no more than a deep fat fryer, a
325.31grill, two hot holding containers, and one or more microwave ovens;
325.32 (ii) serves dipped ice cream or soft serve frozen desserts;
325.33 (iii) serves breakfast in an owner-occupied bed and breakfast establishment;
325.34 (iv) is a boarding establishment; or
325.35 (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum
325.36patron seating capacity of not more than 50.
326.1 (3) Medium establishment,$260 $310. "Medium establishment" means a fee
326.2category that meets one or more of the following:
326.3 (i) possesses food service equipment that includes a range, oven, steam table, salad
326.4bar, or salad preparation area;
326.5 (ii) possesses food service equipment that includes more than one deep fat fryer,
326.6one grill, or two hot holding containers; or
326.7 (iii) is an establishment where food is prepared at one location and served at one or
326.8more separate locations.
326.9 Establishments meeting criteria in clause (2), item (v), are not included in this fee
326.10category.
326.11 (4) Large establishment,$460 $540. "Large establishment" means either:
326.12 (i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a
326.13medium establishment, (B) seats more than 175 people, and (C) offers the full menu
326.14selection an average of five or more days a week during the weeks of operation; or
326.15 (ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium
326.16establishment, and (B) prepares and serves 500 or more meals per day.
326.17 (5) Other food and beverage service, including food carts, mobile food units,
326.18seasonal temporary food stands, and seasonal permanent food stands,$50 $60.
326.19 (6) Beer or wine table service,$50 $60. "Beer or wine table service" means a fee
326.20category where the only alcoholic beverage service is beer or wine, served to customers
326.21seated at tables.
326.22 (7) Alcoholic beverage service, other than beer or wine table service,$135 $165.
326.23 "Alcohol beverage service, other than beer or wine table service" means a fee
326.24category where alcoholic mixed drinks are served or where beer or wine are served from
326.25a bar.
326.26 (8) Lodging per sleeping accommodation unit,$8 $10, including hotels, motels,
326.27lodging establishments, and resorts, up to a maximum of$800 $1,000. "Lodging per
326.28sleeping accommodation unit" means a fee category including the number of guest rooms,
326.29cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the
326.30number of beds in a dormitory.
326.31 (9) First public pool,$180 $325; each additional public pool, $100 $175. "Public
326.32pool" means a fee category that has the meaning given in section144.1222, subdivision 4 .
326.33 (10) First spa,$110 $175; each additional spa, $50 $100. "Spa pool" means a fee
326.34category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
326.35 (11) Private sewer or water,$50 $60. "Individual private water" means a fee
326.36category with a water supply other than a community public water supply as defined in
327.1Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an
327.2individual sewage treatment system which uses subsurface treatment and disposal.
327.3 (12) Additional food service,$130 $150. "Additional food service" means a location
327.4at a food service establishment, other than the primary food preparation and service area,
327.5used to prepare or serve food to the public.
327.6 (13) Additional inspection fee,$300 $360. "Additional inspection fee" means a
327.7fee to conduct the second inspection each year for elementary and secondary education
327.8facility school lunch programs when required by the Richard B. Russell National School
327.9Lunch Act.
327.10 (e) A feeof $350 for review of the construction plans must accompany the initial
327.11license application for restaurants, hotels, motels, lodging establishments,or resorts with
327.12five or more sleeping units., seasonal food stands, and mobile food units. The fee for
327.13this construction plan review is as follows:
328.1 (f) When existing food and beverage service establishments, hotels, motels, lodging
328.2establishments,or resorts, seasonal food stands, and mobile food units are extensively
328.3remodeled, a feeof $250 must be submitted with the remodeling plans. A fee of $250
328.4must be submitted for new construction or remodeling for a restaurant with a limited food
328.5menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for
328.6a hotel, motel, resort, or lodging establishment addition of less than five sleeping units.
328.7The fee for this construction plan review is as follows:
328.26 (g)Seasonal temporary food stands and Special event food stands are not required to
328.27submit construction or remodeling plans for review.
328.28(h) Youth camps shall pay an annual single fee for food and lodging as follows:
328.29(1) camps with up to 99 campers, $325;
328.30(2) camps with 100 to 199 campers, $550; and
328.31(3) camps with 200 or more campers; $750.
329.1 Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that
329.2operates a licensed boarding establishment, food and beverage service establishment,
329.3seasonal temporary or permanent food stand, special event food stand, mobile food unit,
329.4food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the
329.5commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee
329.6for establishments licensed by the Department of Health is required at the same time the
329.7licensure fee is due. For establishments licensed by local governments, the fee is due by
329.8July 1 of each year.
329.9 Subd. 4. Posting requirements. Every food and beverage service establishment,
329.10for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must have
329.11the license posted in a conspicuous place at the establishment. Mobile food units, food
329.12carts, and seasonal temporary food stands shall be issued decals with the initial license and
329.13each calendar year with license renewals. The current license year decal must be placed on
329.14the unit or stand in a location determined by the commissioner. Decals are not transferable.
329.15 Sec. 38. Minnesota Statutes 2008, section 157.22, is amended to read:
329.16157.22 EXEMPTIONS.
329.17This chaptershall not be construed to does not apply to:
329.18(1) interstate carriers under the supervision of the United States Department of
329.19Health and Human Services;
329.20(2) any building constructed and primarily used for religious worship;
329.21(3) any building owned, operated, and used by a college or university in accordance
329.22with health regulations promulgated by the college or university under chapter 14;
329.23(4) any person, firm, or corporation whose principal mode of business is licensed
329.24under sections28A.04 and
28A.05 , is exempt at that premises from licensure as a food
329.25or beverage establishment; provided that the holding of any license pursuant to sections
329.2628A.04
and
28A.05 shall not exempt any person, firm, or corporation from the applicable
329.27provisions of this chapter or the rules of the state commissioner of health relating to
329.28food and beverage service establishments;
329.29(5) family day care homes and group family day care homes governed by sections
329.30245A.01
to
245A.16 ;
329.31(6) nonprofit senior citizen centers for the sale of home-baked goods;
329.32(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3),
329.33501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of
329.341986, or organizations related to or affiliated with such fraternal or patriotic organizations.
330.1Such organizations may organize events at which home-prepared food is donated by
330.2organization members for sale at the events, provided:
330.3(i) the event is not a circus, carnival, or fair;
330.4(ii) the organization controls the admission of persons to the event, the event agenda,
330.5or both; and
330.6(iii) the organization's licensed kitchen is not used in any manner for the event;
330.7(8) food not prepared at an establishment and brought in by individuals attending a
330.8potluck event for consumption at the potluck event. An organization sponsoring a potluck
330.9event under this clause may advertise the potluck event to the public through any means.
330.10Individuals who are not members of an organization sponsoring a potluck event under this
330.11clause may attend the potluck event and consume the food at the event. Licensed food
330.12establishments other than schools cannot be sponsors of potluck events. A school may
330.13sponsor and hold potluck events in areas of the school other than the school's kitchen,
330.14provided that the school's kitchen is not used in any manner for the potluck event. For
330.15purposes of this clause, "school" means a public school as defined in section120A.05,
330.16subdivisions 9, 11, 13, and 17 , or a nonpublic school, church, or religious organization
330.17at which a child is provided with instruction in compliance with sections120A.22 and
330.18120A.24
. Potluck event food shall not be brought into a licensed food establishment
330.19kitchen;and
330.20(9) a home school in which a child is provided instruction at home; and
330.21(10) concession stands operated in conjunction with school-sponsored events on
330.22school property are exempt from the 21-day restriction.
330.23 Sec. 39. Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision
330.24to read:
330.25 Subd. 9. Special event recreational camping area. "Special event recreational
330.26camping area" means a recreational camping area which operates no more than two times
330.27annually and for no more than 14 consecutive days.
330.28 Sec. 40. Minnesota Statutes 2008, section 327.15, is amended to read:
330.29327.15 LICENSE REQUIRED; RENEWAL;PLANS FOR EXPANSION FEES.
330.30 Subdivision 1. License required; plan review. No person, firm or corporation shall
330.31establish, maintain, conduct or operate a manufactured home park or recreational camping
330.32area within this state without first obtaininga an annual license therefor from the state
330.33Department of Health. Any person wishing to obtain a license shall submit an application,
330.34pay the required fee specified in this section, and receive approval for operation, including
331.1plan review approval. Application shall be made on forms provided by the commissioner
331.2and shall require the applicant to state the full name and address of the owner of the
331.3manufactured home park or recreational camping area, the name under which the business
331.4is to be conducted, and any other information as may be required by the commissioner
331.5to complete the application for license. Any person, firm, or corporation desiring to
331.6operate either a manufactured home park or a recreational camping area on the same site
331.7in connection with the other, need only obtain one license.A license shall expire and be
331.8renewed as prescribed by the commissioner pursuant to section
144.122. The license shall
331.9state the number of manufactured home sites and recreational camping sites allowed
331.10according to state commissioner of health approval.No renewal license shall be issued if
331.11the number of sites specified in the application exceeds those of the original application
331.12The number of licensed sites shall not be increased unless the plans for expansionor
331.13the construction for expansion are first submitted and the expansion is approved by
331.14the Department of Health.Any manufactured home park or recreational camping area
331.15located in more than one municipality shall be dealt with as two separate manufactured
331.16home parks or camping areas. The license shall be conspicuously displayed in the office
331.17of the manufactured home park or camping area. The license is not transferableas to to
331.18another person or place.
331.19 Subd. 2. License renewal. Initial and renewal licenses for all manufactured home
331.20parks and recreational camping areas shall be issued annually and shall have an expiration
331.21date included on the license. Any person who operates a manufactured home park or
331.22recreational camping area after the expiration date of a license or without having submitted
331.23an application and paid the fee shall be deemed to have violated the provisions of this
331.24chapter and shall be subject to enforcement action, as provided in the Health Enforcement
331.25Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall
331.26be added to the total of the license fee for any manufactured home park or recreational
331.27camping area operating without a license for a period of up to 30 days. A late fee of $360
331.28shall be added to the license fee for any manufactured home park or recreational camping
331.29area operating more than 30 days without a license.
331.30 Subd. 3. Fees, manufactured home parks and recreational camping areas. (a)
331.31The following fees are required for manufactured home parks and recreational camping
331.32areas licensed under this chapter. Recreational camping areas and manufactured home
331.33parks shall pay the highest applicable fee under paragraph (c). The license fee for new
331.34operators of a manufactured home park or recreational camping area previously licensed
331.35under this chapter for the same calendar year is one-half of the appropriate annual license
331.36fee, plus any penalty that may be required. The license fee for operators opening on
332.1or after October 1 is one-half of the appropriate annual license fee, plus any penalty
332.2that may be required.
332.3(b) All manufactured home parks and recreational camping areas shall pay the
332.4following annual base fee:
332.5(1) a manufactured home park, $150; and
332.6(2) a recreational camping area with:
332.7(i) 24 or less sites, $50;
332.8(ii) 25-99 sites, $212; and
332.9(iii) 100 or more sites, $300.
332.10In addition to the base fee, manufactured home parks and recreational camping areas shall
332.11pay $4 for each licensed site. This paragraph does not apply to special event recreational
332.12camping areas or to operators of a manufactured home park or a recreational camping area
332.13licensed under section 157.16 for the same location.
332.14(c) In addition to the fee in paragraph (b), each manufactured home park or
332.15recreational camping area shall pay an additional annual fee for each fee category
332.16specified in this paragraph:
332.17(1) Manufactured home parks and recreational camping areas with public swimming
332.18pools and spas shall pay the appropriate fees specified in section 157.16.
332.19(2) Individual private sewer or water, $60. "Individual private water" means a fee
332.20category with a water supply other than a community public water supply as defined in
332.21Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an
332.22individual sewage treatment system which uses subsurface treatment and disposal.
332.23(d) The following fees must accompany a plan review application for initial
332.24construction of a manufactured home park or recreational camping area:
332.25(1) for initial construction of less than 25 sites, $375;
332.26(2) for initial construction of 25 to less than 100 sites, $400; and
332.27(3) for initial construction of 100 or more sites, $500.
332.28(e) The following fees must accompany a plan review application when an existing
332.29manufactured home park or recreational camping area is expanded:
332.30(1) for expansion of less than 25 sites, $250;
332.31(2) for expansion of 25 and less than 100 sites, $300; and
332.32(3) for expansion of 100 or more sites, $450.
332.33 Subd. 4. Fees, special event recreational camping areas. (a) The following fees
332.34are required for special event recreational camping areas licensed under this chapter.
332.35(b) All special event recreational camping areas shall pay an annual fee of $150 plus
332.36$1 for each licensed site.
333.1(c) A special event recreational camping area shall pay a late fee of $360 for failing
333.2to obtain a license prior to operating.
333.3(d) The following fees must accompany a plan review application for initial
333.4construction of a special event recreational camping area:
333.5(1) for initial construction of less than 25 special event recreational camping sites,
333.6$375;
333.7(2) for initial construction of 25 to less than 100 sites, $400; and
333.8(3) for initial construction of 100 or more sites, $500.
333.9(e) The following fees must accompany a plan review application for expansion of a
333.10special event recreational camping area:
333.11(1) for expansion of less than 25 sites, $250;
333.12(2) for expansion of 25 and less than 100 sites, $300; and
333.13(3) for expansion of 100 or more sites, $450.
333.14 Sec. 41. Minnesota Statutes 2008, section 327.16, is amended to read:
333.15327.16LICENSE PLAN REVIEW APPLICATION.
333.16 Subdivision 1. Made to state Department of Health. The plan review application
333.17forlicense to operate and maintain a manufactured home park or recreational camping
333.18area shall be made to the state Department of Health, at such office and in such manner
333.19as may be prescribed by that department.
333.20 Subd. 2. Contents. Theapplicant for a primary license or annual license shall make
333.21application in writing plan review application shall be made upon a form provided by the
333.22state Department of Health setting forth:
333.23(1) The full name and address of the applicant or applicants, or names and addresses
333.24of the partners if the applicant is a partnership, or the names and addresses of the officers
333.25if the applicant is a corporation.
333.26(2) A legal description of the site, lot, field, or tract of land upon which the applicant
333.27proposes to operate and maintain a manufactured home park or recreational camping area.
333.28(3) The proposed and existing facilities on and about the site, lot, field, or tract of
333.29land for the proposed construction or alteration and maintaining of a sanitary community
333.30building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry
333.31facilities, source of water supply, sewage, garbage and waste disposal; except that no
333.32toilet facilities shall be required in any manufactured home park which permits only
333.33manufactured homes equipped with toilet facilities discharging to water carried sewage
333.34disposal systems; and method of fire and storm protection.
334.1(4) The proposed method of lighting the structures and site, lot, field, or tract of land
334.2upon which the manufactured home park or recreational camping area is to be located.
334.3(5) The calendar months of the year which the applicant will operate the
334.4manufactured home park or recreational camping area.
334.5(6) Plans and drawings for new construction or alteration, including buildings, wells,
334.6plumbing and sewage disposal systems.
334.7 Subd. 3.Fees; Approval. The application for the primary license plan review shall
334.8be submitted with all plans and specifications enumerated in subdivision 2,and payment
334.9of a fee in an amount prescribed by the state commissioner of health pursuant to section
334.10144.122
334.11county wherein the park is to be located, or a statement from the municipality or county
334.12that it does not require an approved zoning permit.The fee for the annual license shall be
334.13in an amount prescribed by the state commissioner of health pursuant to section
144.122.
334.14All license fees paid to the commissioner of health shall be turned over to the state
334.15treasury. The fee submitted for the primary license plan review shall be retained by the
334.16state even though the proposed project is not approved and a license is denied.
334.17When construction has been completed in accordance with approved plans and
334.18specifications the state commissioner of health shall promptly cause the manufactured
334.19home park or recreational camping area and appurtenances thereto to be inspected. When
334.20the inspection and report has been made and the state commissioner of health finds that
334.21all requirements of sections327.10 ,
327.11 ,
327.14 to
327.28 , and such conditions of
334.22health and safety as the state commissioner of health may require, have been met by
334.23the applicant, the state commissioner of health shall forthwith issue theprimary license
334.24in the name of the state.
334.25 Subd. 4.Sanitary facilities Compliance with current state law. During the
334.26pendency of the application for such primary license any change in the sanitary or safety
334.27facilities of the intended manufactured home park or recreational camping area shall be
334.28immediately reported in writing to the state Department of Health through the office
334.29through which the application was made. If no objection is made by the state Department
334.30of Health to such change in such sanitary or safety facilities within 60 days of the date
334.31such change is reported, it shall be deemed to have the approval of the state Department of
334.32Health. Any manufactured home park or recreational camping area must be constructed
334.33and operated according to all applicable state electrical, fire, plumbing, and building codes.
334.34 Subd. 5. Permit. When the plans and specifications have been approved, the state
334.35Department of Health shall issue an approval report permitting the applicant to construct
335.1or make alterations upon a manufactured home park or recreational camping area and the
335.2appurtenances thereto according to the plans and specifications presented.
335.3Such approval does not relieve the applicant from securing building permits in
335.4municipalities that require permits or from complying with any other municipal ordinance
335.5or ordinances, applicable thereto, not in conflict with this statute.
335.6 Subd. 6. Denial of construction. If the application to construct or make alterations
335.7upon a manufactured home park or recreational camping area and the appurtenances
335.8thereto or aprimary license to operate and maintain the same is denied by the state
335.9commissioner of health, the commissioner shall so state in writing giving the reason
335.10or reasons for denying the application. If the objections can be corrected the applicant
335.11may amend the application and resubmit it for approval, and if denied the applicant may
335.12appeal from the decision of the state commissioner of health as provided in section
335.13144.99, subdivision 10
.
335.14 Sec. 42. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:
335.15 Subdivision 1. Rules. No domestic animals or house pets of occupants of
335.16manufactured home parks or recreational camping areas shall be allowed to run at large,
335.17or commit any nuisances within the limits of a manufactured home park or recreational
335.18camping area. Each manufactured home park or recreational camping area licensed under
335.19the provisions of sections327.10 ,
327.11 , and
327.14 to
327.28 shall, among other things,
335.20provide for the following, in the manner hereinafter specified:
335.21 (1) A responsible attendant or caretaker shall be in charge of every manufactured
335.22home park or recreational camping area at all times, who shall maintain the park or
335.23area, and its facilities and equipment in a clean, orderly and sanitary condition. In any
335.24manufactured home park containing more than 50 lots, the attendant, caretaker, or other
335.25responsible park employee, shall be readily available at all times in case of emergency.
335.26 (2) All manufactured home parks shall be well drained and be located so that the
335.27drainage of the park area will not endanger any water supply. No wastewater from
335.28manufactured homes or recreational camping vehicles shall be deposited on the surface of
335.29the ground. All sewage and other water carried wastes shall be discharged into a municipal
335.30sewage system whenever available. When a municipal sewage system is not available, a
335.31sewage disposal system acceptable to the state commissioner of health shall be provided.
335.32 (3) No manufactured home shall be located closer than three feet to the side lot lines
335.33of a manufactured home park, if the abutting property is improved property, or closer than
335.34ten feet to a public street or alley. Each individual site shall abut or face on a driveway
335.35or clear unoccupied space of not less than 16 feet in width, which space shall have
336.1unobstructed access to a public highway or alley. There shall be an open space of at least
336.2ten feet between the sides of adjacent manufactured homes including their attachments
336.3and at least three feet between manufactured homes when parked end to end. The space
336.4between manufactured homes may be used for the parking of motor vehicles and other
336.5property, if the vehicle or other property is parked at least ten feet from the nearest
336.6adjacent manufactured home position. The requirements of this paragraph shall not apply
336.7to recreational camping areas and variances may be granted by the state commissioner
336.8of health in manufactured home parks when the variance is applied for in writing and in
336.9the opinion of the commissioner the variance will not endanger the health, safety, and
336.10welfare of manufactured home park occupants.
336.11 (4) An adequate supply of water of safe, sanitary quality shall be furnished at each
336.12manufactured home park or recreational camping area. The source of the water supply
336.13shall first be approved by the state Department of Health.
336.14 (5) All plumbing shall be installed in accordance with the rules of the state
336.15commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.
336.16 (6) In the case of a manufactured home park with less than ten manufactured homes,
336.17a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of
336.18the park in times of severe weather conditions, such as tornadoes, high winds, and floods.
336.19The shelter or evacuation plan shall be developed with the assistance and approval of
336.20the municipality where the park is located and shall be posted at conspicuous locations
336.21throughout the park. The park owner shall provide each resident with a copy of the
336.22approved shelter or evacuation plan, as provided by section327C.01, subdivision 1c .
336.23Nothing in this paragraph requires the Department of Health to review or approve any
336.24shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan
336.25submitted by a park shall not be grounds for action against the park by the Department of
336.26Health if the park has made a good faith effort to develop the plan and obtain municipal
336.27approval.
336.28 (7) A manufactured home park with ten or more manufactured homes, licensed prior
336.29to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the
336.30evacuation of park residents to a safe place of shelter within a reasonable distance of the
336.31park for use by park residents in times of severe weather, including tornadoes and high
336.32winds. The shelter or evacuation plan must be approved by the municipality by March 1,
336.331989. The municipality may require the park owner to construct a shelter if it determines
336.34that a safe place of shelter is not available within a reasonable distance from the park. A
336.35copy of the municipal approval and the plan shall be submitted by the park owner to the
337.1Department of Health. The park owner shall provide each resident with a copy of the
337.2approved shelter or evacuation plan, as provided by section327C.01, subdivision 1c .
337.3 (8) A manufactured home park with ten or more manufactured homes, receiving
337.4a primary an initial license after March 1, 1988, must provide the type of shelter required
337.5by section327.205 , except that for manufactured home parks established as temporary,
337.6emergency housing in a disaster area declared by the President of the United States or
337.7the governor, an approved evacuation plan may be provided in lieu of a shelter for a
337.8period not exceeding 18 months.
337.9 (9) For the purposes of this subdivision, "park owner" and "resident" have the
337.10meaning meanings given them in section
327C.01 .
337.11 Sec. 43. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision
337.12to read:
337.13 Subd. 4. Special event recreational camping areas. Each special event camping
337.14area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.
337.15(1) Recreational camping vehicles and tents, including attachments, must be
337.16separated from each other and other structures by at least seven feet.
337.17(2) A minimum area of 300 square feet per site must be provided and the total
337.18number of sites must not exceed one site for every 300 square feet of usable land area.
337.19(3) Each site must abut or face a driveway or clear unoccupied space of at least 16
337.20feet in width, which space must have unobstructed access to a public roadway.
337.21(4) If no approved on-site water supply system is available, hauled water may be
337.22used, provided that persons using hauled water comply with Minnesota Rules, parts
337.234720.4000 to 4720.4600.
337.24(5) Nonburied sewer lines may be permitted provided they are of approved materials,
337.25watertight, and properly maintained.
337.26(6) If a sanitary dumping station is not provided on-site, arrangements must be
337.27made with a licensed sewage pumper to service recreational camping vehicle holding
337.28tanks as needed.
337.29(7) Toilet facilities must be provided consisting of toilets connected to an approved
337.30sewage disposal system, portable toilets, or approved, properly constructed privies.
337.31(8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.
337.32(9) Toilets must be not more than 400 feet from any site.
337.33(10) If a central building or buildings are provided with running water, then toilets
337.34and handwashing lavatories must be provided in the building or buildings that meet the
337.35requirements of this subdivision.
338.1(11) Showers, if provided, must be provided in the ratio of one shower for each sex
338.2for each 250 sites. Showerheads must be provided, where running water is available, for
338.3each camping event exceeding two nights.
338.4(12) Central toilet and shower buildings, if provided, must be constructed with
338.5adequate heating, ventilation, and lighting, and floors of impervious material sloped
338.6to drain. Walls must be of a washable material. Permanent facilities must meet the
338.7requirements of the Americans with Disabilities Act.
338.8(13) An adequate number of durable, covered, watertight containers must be
338.9provided for all garbage and refuse. Garbage and refuse must be collected as often as
338.10necessary to prevent nuisance conditions.
338.11(14) Campgrounds must be located in areas free of poison ivy or other noxious
338.12weeds considered detrimental to health. Sites must not be located in areas of tall grass or
338.13weeds and sites must be adequately drained.
338.14(15) Campsites for recreational vehicles may not be located on inclines of greater
338.15than eight percent grade or one inch drop per lineal foot.
338.16(16) A responsible attendant or caretaker must be available on-site at all times during
338.17the operation of any special event recreational camping area that has 50 or more sites.
338.18 Sec. 44. MINNESOTA COLORECTAL CANCER PREVENTION
338.19DEMONSTRATION PROJECT.
338.20 Subdivision 1. Establishment. The commissioner of health shall award grants
338.21to Hennepin County Medical Center and MeritCare Bemidji for a colorectal screening
338.22demonstration project to provide screening to uninsured and underinsured women and
338.23men. The project shall expire December 31, 2010.
338.24 Subd. 2. Eligibility. To be eligible for colorectal screening under this demonstration
338.25project, an applicant must:
338.26(1) be at least 50 years of age, or under the age of 50 and at high risk for colon cancer;
338.27(2) be uninsured, or if insured, have coverage that does not cover the full cost of
338.28colorectal cancer screenings;
338.29(3) not be eligible for medical assistance, general assistance medical care, or
338.30MinnesotaCare programs; and
338.31(4) have a gross family income at or below 250 percent of the federal poverty level.
338.32 Subd. 3. Services. Services provided under this project shall include:
338.33(1) colorectal cancer screening, according to standard practices of medicine, or
338.34guidelines provided by the Institute for Clinical Systems Improvement or the American
338.35Cancer Society;
339.1(2) follow-up services for abnormal tests; and
339.2(3) diagnostic services to determine the extent and proper course of treatment.
339.3 Subd. 4. Project evaluation. The commissioner of health shall evaluate the
339.4demonstration project and make recommendations for increasing the number of persons in
339.5Minnesota who receive recommended colon cancer screening. The commissioner of health
339.6shall submit the evaluation and recommendations to the legislature by January 15, 2011.
339.7 Sec. 45. RESEARCH OF EXPOSURE PATHWAYS FOR
339.8PERFLUOROCHEMICALS.
339.9The commissioner of health shall study and report to the legislature by January
339.1015, 2011, on the exposure pathways for perfluorochemicals, focusing on food sources
339.11that might be affected by contact with contaminated water or air. This research will be
339.12performed to the extent that nonstate funds and environmental health tracking funds are
339.13available and include garden vegetables produced or consumed by a representative sample
339.14of the population from the east metropolitan area including indigenous people and people
339.15of color. In developing and performing the research, the commissioner must convene and
339.16consult with a citizen advisory group consisting of residents from the east metropolitan
339.17area, including indigenous people and people of color.
339.18 Sec. 46. FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.
339.19The commissioner of health must provide a grant to the Hennepin County Medical
339.20Center for a one-year feasibility pilot project to collect occupational, residential, and
339.21military service history data from newly diagnosed cancer patients at the Hennepin
339.22County Medical Center's Cancer Center. Funding for this grant shall come from the
339.23Department of Health's current resources for the Chronic Disease and Environmental
339.24Epidemiology Section.
339.25Under this pilot project, Hennepin County Medical Center will design an expansion
339.26of its existing cancer registry to include the collection of additional data, including the
339.27cancer patient's occupational, residential, and military service history. Patient consent is
339.28required for collection of these additional data. The consent must be in writing and must
339.29contain notice informing the patient about private and confidential data concerning the
339.30patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled
339.31to opt out of the project at any time. The data collection expansion may also include the
339.32cancer patient's possible toxic environmental exposure history, if known. The purpose of
339.33this pilot project is to determine the following:
339.34(1) the feasibility of collecting these data on a statewide scale;
340.1(2) the potential design of a self-administered patient questionnaire template; and
340.2(3) necessary qualifications for staff who will collect these data.
340.3Hennepin County Medical Center must report the results of this pilot project to the
340.4legislature by October 1, 2010.
340.5 Sec. 47. SMOKING CESSATION.
340.6The commissioner of health must prioritize smoking prevention and smoking
340.7cessation activities in low-income, indigenous, and minority communities in their
340.8collaborations with the organization specifically described in Minnesota Statutes, section
340.9144.396, subdivision 8.
340.10 Sec. 48. MEDICAL RESPONSE UNIT REIMBURSEMENT PILOT PROGRAM.
340.11(a) The Department of Public Safety or its contract designee shall collaborate
340.12with the Minnesota Ambulance Association to create the parameters of the medical
340.13response unit reimbursement pilot program, including determining criteria for baseline
340.14data reporting.
340.15(b) In conducting the pilot program, the Department of Public Safety must consult
340.16with the Minnesota Ambulance Association, Minnesota Fire Chiefs Association,
340.17Emergency Services Regulatory Board, and the Minnesota Council of Health Plans to:
340.18(1) identify no more than five medical response units registered as medical response
340.19units with the Minnesota Emergency Medical Services Regulatory Board according to
340.20Minnesota Statutes, chapter 144E, to participate in the program;
340.21(2) outline and develop criteria for reimbursement;
340.22(3) determine the amount of reimbursement for each unit response; and
340.23(4) collect program data to be analyzed for a final report.
340.24(c) Further criteria for the medical response unit reimbursement pilot program
340.25shall include:
340.26(1) the pilot program will expire on December 31, 2010, or when the appropriation
340.27is extended, whichever occurs first;
340.28(2) a report shall be made to the legislature by March 1, 2011, by the Department
340.29of Public Safety or its contractor as to the effectiveness and value of this reimbursement
340.30pilot program to the emergency medical services delivery system, any actual or potential
340.31savings to the health care system, and impact on patient outcomes;
340.32(3) participating medical response units must adhere to the requirements of this
340.33pilot program outlined in an agreement between the Department of Public Safety and
340.34the medical response unit, including but not limited to, requirements relating to data
340.35collection, response criteria, and patient outcomes and disposition;
341.1(4) individual entities licensed to provide ambulance care under Minnesota Statutes,
341.2chapter 144E, are not eligible for participation in this pilot program;
341.3(5) if a participating medical response unit withdraws from the pilot program, the
341.4Department of Public Safety in consultation with the Minnesota Ambulance Association
341.5may choose another pilot site if funding is available;
341.6(6) medical response units must coordinate their operations under this pilot project
341.7with the ambulance service or services licensed to provide care in their first response
341.8geographic areas;
341.9(7) licensed ambulance services that participate with the medical response unit in
341.10the pilot program assume no financial or legal liability for the actions of the participating
341.11medical response unit; and
341.12(8) the Department of Public Safety and its pilot program partners have no ongoing
341.13responsibility to reimburse medical response units beyond the parameters of the pilot
341.14program.
341.15 Sec. 49. REVIEW OF PROPOSED REGULATIONS FOR BODY ART
341.16TECHNICIANS AND BODY ART ESTABLISHMENTS.
341.17The commissioner of health shall review proposed regulatory legislation for
341.18body art technicians and body art establishments and develop recommendations on the
341.19proper level of regulation needed for body art technicians and establishments in order
341.20to protect public health. The recommendations must include a review of how other
341.21states comply with the American Association of Blood Banks standards, how regulatory
341.22requirements affect currently operating body art establishments, and the appropriate level
341.23of coordination between the state and local jurisdictions that currently regulate body art
341.24establishments. The commissioner shall submit the results of the review and possible
341.25regulatory recommendations for body art technicians and establishments to the chairs and
341.26ranking minority members of the legislative committees with jurisdiction over health
341.27care by January 15, 2010.
341.28 Sec. 50. HEARING AIDS; ENFORCEMENT.
341.29Costs incurred by the Minnesota Department of Health for conducting investigations
341.30of unlicensed hearing aid dispensers shall be apportioned between all licensed or
341.31credentialed professions that dispense hearing aids.
341.32EFFECTIVE DATE.This section is effect July 1, 2011.
341.33 Sec. 51. REPEALER.
342.1(a) Minnesota Statutes 2008, sections 103I.112; 144.9501, subdivision 17b; and
342.2327.14, subdivisions 5 and 6, are repealed.
342.3(b) Minnesota Rules, part 4626.2015, subpart 9, is repealed.
342.6 Section 1. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to
342.7read:
342.8 Subdivision 1. Application fees. Application fees for licensure are as follows:
342.9(1) for a licensed social worker, $45;
342.10(2) for a licensed graduate social worker, $45;
342.11(3) for a licensed independent social worker,$90 $45;
342.12(4) for a licensed independent clinical social worker,$90 $45;
342.13(5) for a temporary license, $50; and
342.14(6) for a licensure by endorsement,$150 $85.
342.15The fee for criminal background checks is the fee charged by the Bureau of Criminal
342.16Apprehension. The criminal background check fee must be included with the application
342.17fee as required pursuant to section148D.055 .
342.18 Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:
342.19 Subd. 2. License fees. License fees are as follows:
342.20(1) for a licensed social worker,$115.20 $81;
342.21(2) for a licensed graduate social worker,$201.60 $144;
342.22(3) for a licensed independent social worker,$302.40 $216;
342.23(4) for a licensed independent clinical social worker,$331.20 $238.50;
342.24(5) for an emeritus license, $43.20; and
342.25(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
342.26If the licensee's initial license term is less or more than 24 months, the required
342.27license fees must be prorated proportionately.
342.28 Sec. 3. Minnesota Statutes 2008, section 148D.180, subdivision 3, is amended to read:
342.29 Subd. 3. Renewal fees. Renewal fees for licensure are as follows:
342.30(1) for a licensed social worker,$115.20 $81;
342.31(2) for a licensed graduate social worker,$201.60 $144;
342.32(3) for a licensed independent social worker,$302.40 $216; and
342.33(4) for a licensed independent clinical social worker,$331.20 $238.50.
343.1 Sec. 4. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:
343.2 Subd. 5. Late fees. Late fees are as follows:
343.3(1) renewal late fee,one-half one-fourth of the renewal fee specified in subdivision
343.43; and
343.5(2) supervision plan late fee, $40.
343.6 Sec. 5. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:
343.7 Subdivision 1. Application fees. Application fees for licensure are as follows:
343.8 (1) for a licensed social worker, $45;
343.9 (2) for a licensed graduate social worker, $45;
343.10 (3) for a licensed independent social worker,$90 $45;
343.11 (4) for a licensed independent clinical social worker,$90 $45;
343.12 (5) for a temporary license, $50; and
343.13 (6) for a licensure by endorsement,$150 $85.
343.14 The fee for criminal background checks is the fee charged by the Bureau of Criminal
343.15Apprehension. The criminal background check fee must be included with the application
343.16fee as required according to section148E.055 .
343.17 Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read:
343.18 Subd. 2. License fees. License fees are as follows:
343.19 (1) for a licensed social worker,$115.20 $81;
343.20 (2) for a licensed graduate social worker,$201.60 $144;
343.21 (3) for a licensed independent social worker,$302.40 $216;
343.22 (4) for a licensed independent clinical social worker,$331.20 $238.50;
343.23 (5) for an emeritus license, $43.20; and
343.24 (6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
343.25 If the licensee's initial license term is less or more than 24 months, the required
343.26license fees must be prorated proportionately.
343.27 Sec. 7. Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read:
343.28 Subd. 3. Renewal fees. Renewal fees for licensure are as follows:
343.29 (1) for a licensed social worker,$115.20 $81;
343.30 (2) for a licensed graduate social worker,$201.60 $144;
343.31 (3) for a licensed independent social worker,$302.40 $216; and
343.32 (4) for a licensed independent clinical social worker,$331.20 $238.50.
344.1 Sec. 8. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:
344.2 Subd. 5. Late fees. Late fees are as follows:
344.3 (1) renewal late fee,one-half one-fourth of the renewal fee specified in subdivision
344.43; and
344.5 (2) supervision plan late fee, $40.
344.6 Sec. 9. Minnesota Statutes 2008, section 152.126, subdivision 1, is amended to read:
344.7 Subdivision 1. Definitions. For purposes of this section, the terms defined in this
344.8subdivision have the meanings given.
344.9 (a) "Board" means the Minnesota State Board of Pharmacy established under
344.10chapter 151.
344.11 (b) "Controlled substances" means those substances listed in section152.02 ,
344.12subdivisions 3and 4 to 5, and those substances defined by the board pursuant to section
344.13152.02, subdivisions 7
, 8, and 12.
344.14 (c) "Dispense" or "dispensing" has the meaning given in section151.01, subdivision
344.1530. Dispensing does not include the direct administering of a controlled substance to a
344.16patient by a licensed health care professional.
344.17 (d) "Dispenser" means a person authorized by law to dispense a controlled substance,
344.18pursuant to a valid prescription. For the purposes of this section, a dispenser does not
344.19include a licensed hospital pharmacy that distributes controlled substances for inpatient
344.20hospital care or a veterinarian who is dispensing prescriptions under section156.18 .
344.21 (e) "Prescriber" means a licensed health care professional who is authorized to
344.22prescribe a controlled substance under section152.12, subdivision 1 .
344.23 (f) "Prescription" has the meaning given in section151.01, subdivision 16 .
344.24 Sec. 10. Minnesota Statutes 2008, section 152.126, subdivision 2, is amended to read:
344.25 Subd. 2. Prescription electronic reporting system. (a) The board shall establish
344.26by January 1, 2010, an electronic system for reporting the information required under
344.27subdivision 4 for all controlled substances dispensed within the state.
344.28 (b) The board may contract with a vendor for the purpose of obtaining technical
344.29assistance in the design, implementation, operation, and maintenance of the electronic
344.30reporting system.The vendor's role shall be limited to providing technical support to the
344.31board concerning the software, databases, and computer systems required to interface with
344.32the existing systems currently used by pharmacies to dispense prescriptions and transmit
344.33prescription data to other third parties.
345.1 Sec. 11. Minnesota Statutes 2008, section 152.126, subdivision 6, is amended to read:
345.2 Subd. 6. Access to reporting system data. (a) Except as indicated in this
345.3subdivision, the data submitted to the board under subdivision 4 is private data on
345.4individuals as defined in section13.02, subdivision 12 , and not subject to public disclosure.
345.5 (b) Except as specified in subdivision 5, the following persons shall be considered
345.6permissible users and may access the data submitted under subdivision 4 in the same or
345.7similar manner, and for the same or similar purposes, as those persons who are authorized
345.8to access similar private data on individuals under federal and state law:
345.9 (1) a prescriber, to the extent the information relates specifically to a current patient,
345.10to whom the prescriber is prescribing or considering prescribing any controlled substance;
345.11 (2) a dispenser, to the extent the information relates specifically to a current patient
345.12to whom that dispenser is dispensing or considering dispensing any controlled substance;
345.13 (3) an individual who is the recipient of a controlled substance prescription for
345.14which data was submitted under subdivision 4, or a guardian of the individual, parent or
345.15guardian of a minor, or health care agent of the individual acting under a health care
345.16directive under chapter 145C;
345.17 (4) personnel of the board specifically assigned to conduct a bona fide investigation
345.18of a specific licensee;
345.19 (5) personnel of the board engaged in the collection of controlled substance
345.20prescription information as part of the assigned duties and responsibilities under this
345.21section;
345.22 (6) authorized personnel of a vendor under contract with the board who are engaged
345.23in the design, implementation, operation, and maintenance of the electronic reporting
345.24system as part of the assigned duties and responsibilities of their employment, provided
345.25that access to data is limited to the minimum amount necessary totest and maintain the
345.26system databases carry out such duties and responsibilities;
345.27 (7) federal, state, and local law enforcement authorities acting pursuant to a valid
345.28search warrant; and
345.29 (8) personnel of the medical assistance program assigned to use the data collected
345.30under this section to identify recipients whose usage of controlled substances may warrant
345.31restriction to a single primary care physician, a single outpatient pharmacy, or a single
345.32hospital.
345.33 For purposes of clause (3), access by an individual includes persons in the definition
345.34of an individual under section13.02 .
345.35 (c) Any permissible user identified in paragraph (b), who directly accesses
345.36the data electronically, shall implement and maintain a comprehensive information
346.1security program that contains administrative, technical, and physical safeguards that
346.2are appropriate to the user's size and complexity, and the sensitivity of the personal
346.3information obtained. The permissible user shall identify reasonably foreseeable internal
346.4and external risks to the security, confidentiality, and integrity of personal information
346.5that could result in the unauthorized disclosure, misuse, or other compromise of the
346.6information and assess the sufficiency of any safeguards in place to control the risks.
346.7 (d) The board shall not release data submitted under this section unless it is provided
346.8with evidence, satisfactory to the board, that the person requesting the information is
346.9entitled to receive the data.
346.10 (e) The board shall not release the name of a prescriber without the written consent
346.11of the prescriber or a valid search warrant or court order. The board shall provide a
346.12mechanism for a prescriber to submit to the board a signed consent authorizing the release
346.13of the prescriber's name when data containing the prescriber's name is requested.
346.14 (f) The board shall maintain a log of all persons who access the data and shall ensure
346.15that any permissible user complies with paragraph (c) prior to attaining direct access to
346.16the data.
346.17(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into
346.18pursuant to subdivision 2. A vendor shall not use data collected under this section for
346.19any purpose not specified in this section.
346.20 Sec. 12. REPEALER.
346.21Minnesota Statutes 2008, section 148D.180, subdivision 8, is repealed.
346.26 The dollar amounts shown are added to or, if shown in parentheses, are subtracted
346.27from the appropriations in Laws 2008, chapter 363, from the general fund, or any other
346.28fund named, to the Department of Human Services for the purposes specified in this
346.29article, to be available for the fiscal year indicated for each purpose. The figure "2009"
346.30used in this article means that the appropriation or appropriations listed are available
346.31for the fiscal year ending June 30, 2009.
347.13The amounts that may be spent from this
347.14appropriation for each purpose are as follows:
348.1The amounts that may be spent from this
348.2appropriation for each purpose are as follows:
348.11The amounts that may be spent from this
348.12appropriation for each purpose are as follows:
348.16 Sec. 3. EFFECTIVE DATE.
348.17Sections 1 and 2 are effective the day following final enactment.
348.21 The amounts shown in this section summarize direct appropriations by fund made
348.22in this article.
349.7 The sums shown in the columns marked "Appropriations" are appropriated to the
349.8agencies and for the purposes specified in this article. The appropriations are from the
349.9general fund, or another named fund, and are available for the fiscal years indicated
349.10for each purpose. The figures "2010" and "2011" used in this article mean that the
349.11appropriations listed under them are available for the fiscal year ending June 30, 2010, or
349.12June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal
349.13year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal
349.14year ending June 30, 2009, are effective the day following final enactment.
350.1Receipts for Systems Projects.
350.2Appropriations and federal receipts for
350.3information systems projects for MAXIS,
350.4PRISM, MMIS, and SSIS must be deposited
350.5in the state system account authorized in
350.6Minnesota Statutes, section 256.014. Money
350.7appropriated for computer projects approved
350.8by the Minnesota Office of Enterprise
350.9Technology, funded by the legislature, and
350.10approved by the commissioner of finance,
350.11may be transferred from one project to
350.12another and from development to operations
350.13as the commissioner of human services
350.14considers necessary, except that any transfers
350.15to one project that exceed $1,000,000 or
350.16multiple transfers to one project that exceed
350.17$1,000,000 in total require the express
350.18approval of the legislature. The preceding
350.19requirement for legislative approval does not
350.20apply to transfers made to establish a project's
350.21initial operating budget each year; instead,
350.22the requirements of section 11, subdivision 2,
350.23of this article apply to those transfers. Any
350.24unexpended balance in the appropriation
350.25for these projects does not cancel but is
350.26available for ongoing development and
350.27operations. Any computer project with a
350.28total cost exceeding $1,000,000, including,
350.29but not limited to, a replacement for the
350.30proposed HealthMatch system, shall not be
350.31commenced without the express approval of
350.32the legislature.
350.33HealthMatch Systems Project. In fiscal
350.34year 2010, $3,054,000 shall be transferred
350.35from the HealthMatch account in the state
351.1systems account in the special revenue fund
351.2to the general fund.
351.3Nonfederal Share Transfers. The
351.4nonfederal share of activities for which
351.5federal administrative reimbursement is
351.6appropriated to the commissioner may be
351.7transferred to the special revenue fund.
351.8TANF Maintenance of Effort.
351.9(a) In order to meet the basic maintenance
351.10of effort (MOE) requirements of the TANF
351.11block grant specified under Code of Federal
351.12Regulations, title 45, section 263.1, the
351.13commissioner may only report nonfederal
351.14money expended for allowable activities
351.15listed in the following clauses as TANF/MOE
351.16expenditures:
351.17(1) MFIP cash, diversionary work program,
351.18and food assistance benefits under Minnesota
351.19Statutes, chapter 256J;
351.20(2) the child care assistance programs
351.21under Minnesota Statutes, sections 119B.03
351.22and 119B.05, and county child care
351.23administrative costs under Minnesota
351.24Statutes, section 119B.15;
351.25(3) state and county MFIP administrative
351.26costs under Minnesota Statutes, chapters
351.27256J and 256K;
351.28(4) state, county, and tribal MFIP
351.29employment services under Minnesota
351.30Statutes, chapters 256J and 256K;
351.31(5) expenditures made on behalf of
351.32noncitizen MFIP recipients who qualify
351.33for the medical assistance without federal
351.34financial participation program under
352.1Minnesota Statutes, section 256B.06,
352.2subdivision 4, paragraphs (d), (e), and (j);
352.3and
352.4(6) qualifying working family credit
352.5expenditures under Minnesota Statutes,
352.6section 290.0671.
352.7(b) The commissioner shall ensure that
352.8sufficient qualified nonfederal expenditures
352.9are made each year to meet the state's
352.10TANF/MOE requirements. For the activities
352.11listed in paragraph (a), clauses (2) to
352.12(6), the commissioner may only report
352.13expenditures that are excluded from the
352.14definition of assistance under Code of
352.15Federal Regulations, title 45, section 260.31.
352.16(c) For fiscal years beginning with state
352.17fiscal year 2003, the commissioner shall
352.18ensure that the maintenance of effort used
352.19by the commissioner of finance for the
352.20February and November forecasts required
352.21under Minnesota Statutes, section 16A.103,
352.22contains expenditures under paragraph (a),
352.23clause (1), equal to at least 16 percent of
352.24the total required under Code of Federal
352.25Regulations, title 45, section 263.1.
352.26(d) For the federal fiscal years beginning on
352.27or after October 1, 2007, the commissioner
352.28may not claim an amount of TANF/MOE in
352.29excess of the 75 percent standard in Code
352.30of Federal Regulations, title 45, section
352.31263.1(a)(2), except:
352.32(1) to the extent necessary to meet the 80
352.33percent standard under Code of Federal
352.34Regulations, title 45, section 263.1(a)(1),
352.35if it is determined by the commissioner
353.1that the state will not meet the TANF work
353.2participation target rate for the current year;
353.3(2) to provide any additional amounts
353.4under Code of Federal Regulations, title 45,
353.5section 264.5, that relate to replacement of
353.6TANF funds due to the operation of TANF
353.7penalties; and
353.8(3) to provide any additional amounts that
353.9may contribute to avoiding or reducing
353.10TANF work participation penalties through
353.11the operation of the excess MOE provisions
353.12of Code of Federal Regulations, title 45,
353.13section 261.43(a)(2).
353.14For the purposes of clauses (1) to (3),
353.15the commissioner may supplement the
353.16MOE claim with working family credit
353.17expenditures to the extent such expenditures
353.18or other qualified expenditures are otherwise
353.19available after considering the expenditures
353.20allowed in this section.
353.21(e) Minnesota Statutes, section 256.011,
353.22subdivision 3, which requires that federal
353.23grants or aids secured or obtained under that
353.24subdivision be used to reduce any direct
353.25appropriations provided by law, do not apply
353.26if the grants or aids are federal TANF funds.
353.27(f) Notwithstanding any contrary provision
353.28in this article, this provision expires June 30,
353.292013.
353.30Working Family Credit Expenditures as
353.31TANF/MOE. The commissioner may claim
353.32as TANF/MOE up to $6,707,000 per year of
353.33working family credit expenditures for fiscal
353.34year 2010 through fiscal year 2011.
354.1Working Family Credit Expenditures
354.2to be Claimed for TANF/MOE. The
354.3commissioner may count the following
354.4amounts of working family credit expenditure
354.5as TANF/MOE:
354.6(1) fiscal year 2010, $30,217,000;
354.7(2) fiscal year 2011, $55,596,000;
354.8(3) fiscal year 2012, $28,519,000; and
354.9(4) fiscal year 2013, $22,138,000.
354.10Notwithstanding any contrary provision in
354.11this article, this rider expires June 30, 2013.
354.12TANF Transfer to Federal Child Care
354.13and Development Fund. The following
354.14TANF fund amounts are appropriated to the
354.15commissioner for the purposes of MFIP and
354.16transition year child care under Minnesota
354.17Statutes, section 119B.05:
354.18(1) fiscal year 2010, $5,909,000;
354.19(2) fiscal year 2011, $9,808,000;
354.20(3) fiscal year 2012, $10,826,000; and
354.21(4) fiscal year 2013, $4,026,000.
354.22The commissioner shall authorize the
354.23transfer of sufficient TANF funds to the
354.24federal child care and development fund to
354.25meet this appropriation and shall ensure that
354.26all transferred funds are expended according
354.27to federal child care and development fund
354.28regulations.
354.29Food Stamps Employment and Training.
354.30(a) The commissioner shall apply for and
354.31claim the maximum allowable federal
354.32matching funds under United States Code,
355.1title 7, section 2025, paragraph (h), for
355.2state expenditures made on behalf of family
355.3stabilization services participants voluntarily
355.4engaged in food stamp employment and
355.5training activities, where appropriate.
355.6(b) Notwithstanding Minnesota Statutes,
355.7sections 256D.051, subdivisions 1a, 6b,
355.8and 6c, and 256J.626, federal food stamps
355.9employment and training funds received
355.10as reimbursement of MFIP consolidated
355.11fund grant expenditures for diversionary
355.12work program participants and child
355.13care assistance program expenditures for
355.14two-parent families must be deposited in the
355.15general fund. The amount of funds must be
355.16limited to $3,350,000 in fiscal year 2010
355.17and $4,440,000 in fiscal years 2011 through
355.182013, contingent on approval by the federal
355.19Food and Nutrition Service.
355.20(c) Consistent with the receipt of these federal
355.21funds, the commissioner may adjust the
355.22level of working family credit expenditures
355.23claimed as TANF maintenance of effort.
355.24Notwithstanding any contrary provision in
355.25this article, this rider expires June 30, 2013.
355.26ARRA Food Support Administration.
355.27The funds available for food support
355.28administration under the American Recovery
355.29and Reinvestment Act (ARRA) of 2009
355.30are appropriated to the commissioner
355.31to pay actual costs of implementing the
355.32food support benefit increases, increased
355.33eligibility determinations, and outreach. Of
355.34these funds, 20 percent shall be allocated
355.35to the commissioner and 80 percent shall
356.1be allocated to counties. The commissioner
356.2shall allocate the county portion based on
356.3caseload. Reimbursement shall be based on
356.4actual costs reported by counties through
356.5existing processes. Tribal reimbursement
356.6must be made from the state portion based
356.7on a caseload factor equivalent to that of a
356.8county.
356.9ARRA Food Support Benefit Increases.
356.10The funds provided for food support benefit
356.11increases under the Supplemental Nutrition
356.12Assistance Program provisions of the
356.13American Recovery and Reinvestment Act
356.14(ARRA) of 2009 must be used for benefit
356.15increases beginning July 1, 2009.
356.16Emergency Fund for the TANF Program.
356.17TANF Emergency Contingency funds
356.18available under the American Recovery
356.19and Reinvestment Act of 2009 (Public Law
356.20111-5) are appropriated to the commissioner.
356.21The commissioner must request TANF
356.22Emergency Contingency funds from the
356.23Secretary of the Department of Health
356.24and Human Services to the extent the
356.25commissioner meets or expects to meet the
356.26requirements of section 403(c) of the Social
356.27Security Act. The commissioner must seek
356.28to maximize such grants. The funds received
356.29must be used as appropriated. Each county
356.30must maintain the county's current level of
356.31emergency assistance funding under the
356.32MFIP consolidated fund and use the funds
356.33under this paragraph to supplement existing
356.34emergency assistance funding levels.
357.1The amounts that may be spent from the
357.2appropriation for each purpose are as follows:
357.19Lease Cost Reduction. Base level funding
357.20to the commissioner shall be reduced by
357.21$381,000 in fiscal year 2010, and $153,000
357.22in fiscal year 2011, to reflect a reduction in
357.23lease costs related to the Minnehaha Avenue
357.24building.
357.25Base Adjustment. The general fund base is
357.26increased by $153,000 in each of fiscal years
357.272012 and 2013.
358.6This appropriation is from the federal TANF
358.7fund.
358.10The amounts that may be spent from this
358.11appropriation for each purpose are as follows:
358.20MFIP Consolidated Fund. The MFIP
358.21consolidated fund TANF appropriation is
358.22reduced by $1,854,000 in fiscal year 2011
358.23and fiscal year 2012.
358.24Notwithstanding Minnesota Statutes, section
358.25256J.626, subdivision 8, paragraph (b), the
358.26commissioner shall reduce proportionately
358.27the reimbursement to counties for
358.28administrative expenses.
359.1Subsidized Employment Funding Through
359.2ARRA. The commissioner is authorized to
359.3apply for TANF emergency fund grants for
359.4subsidized employment activities. Growth
359.5in expenditures for subsidized employment
359.6within the supported work program and the
359.7MFIP consolidated fund over the amount
359.8expended in the calendar quarters in the
359.9TANF emergency fund base year shall be
359.10used to leverage the TANF emergency fund
359.11grants for subsidized employment and to
359.12fund supported work. The commissioner
359.13shall develop procedures to maximize
359.14reimbursement of these expenditures over the
359.15TANF emergency fund base year quarters,
359.16and may contract directly with employers
359.17and providers to maximize these TANF
359.18emergency fund grants.
359.19Supported Work. Of the TANF
359.20appropriation, $6,400,000 in fiscal year
359.212011 is to the commissioner for supported
359.22work for MFIP recipients and is available
359.23until expended. Supported work includes
359.24paid transitional work experience and
359.25a continuum of employment assistance,
359.26including outreach and recruitment,
359.27program orientation and intake, testing and
359.28assessment, job development and marketing,
359.29preworksite training, supported worksite
359.30experience, job coaching, and postplacement
359.31follow-up, in addition to extensive case
359.32management and referral services.
359.33Base Adjustment. The general fund base
359.34is reduced by $3,783,000 in each of fiscal
359.35years 2012 and 2013. The TANF fund base
360.1is increased by $9,704,000 in each of fiscal
360.2years 2012 and 2013.
360.3Integrated Services Program Funding.
360.4The TANF appropriation for integrated
360.5services program funding is $1,250,000 in
360.6fiscal year 2010 and $2,500,000 in fiscal year
360.72011.
360.8TANF Emergency Fund; Nonrecurrent
360.9Short-Term Benefits. TANF emergency
360.10contingency fund grants received due to
360.11increases in expenditures for nonrecurrent
360.12short-term benefits must be used to offset the
360.13increase in these expenditures for counties
360.14under the MFIP consolidated fund, under
360.15Minnesota Statutes, section 256J.626,
360.16and the diversionary work program. The
360.17commissioner shall develop procedures
360.18to maximize reimbursement of these
360.19expenditures over the TANF emergency fund
360.20base year quarters. Growth in expenditures
360.21for the diversionary work program over the
360.22amount expended in the calendar quarters in
360.23the TANF emergency fund base year shall be
360.24used to leverage these funds.
360.29ARRA Child Care Development Block
360.30Grant Funds. The funds available from the
360.31child care development block grant under
360.32ARRA must be used for MFIP child care to
360.33the extent that those funds are not earmarked
361.1for quality expansion or to improve the
361.2quality of infant and toddler care.
361.3Acceleration of ARRA Child Care and
361.4Development Fund Expenditure. The
361.5commissioner must liquidate all child care
361.6and development money available under
361.7the American Recovery and Reinvestment
361.8Act (ARRA) of 2009, Public Law 111-5,
361.9by September 30, 2010. In order to expend
361.10those funds by September 30, 2010, the
361.11commissioner may redesignate and expend
361.12the ARRA child care and development funds
361.13appropriated in fiscal year 2011 for purposes
361.14under this section for related purposes that
361.15will allow liquidation by September 30,
361.162010. Child care and development funds
361.17otherwise available to the commissioner
361.18for those related purposes shall be used to
361.19fund the purposes from which the ARRA
361.20child care and development funds had been
361.21redesignated.
361.24Base Adjustment. The general fund base is
361.25decreased by $260,000 in each of fiscal years
361.262012 and 2013.
361.27School Readiness Service Agreements.
361.28$261,000 in fiscal year 2010 and $261,000
361.29in fiscal year 2011 are from the federal
361.30child care development funds received from
361.31the American Recovery and Reinvestment
361.32Act of 2009, Public Law 111-5, to the
361.33commissioner of human services consistent
361.34with federal regulations for the purpose of
362.1school readiness service agreements under
362.2Minnesota Statutes, section 119B.231. This
362.3is a onetime appropriation. Any unexpended
362.4balance the first year is available in the
362.5second year.
362.6Child Care Development Fund
362.7Unexpended Balance. In addition to
362.8the amount provided in this section, the
362.9commissioner shall expend $5,244,000 in
362.10fiscal year 2010 from the federal child care
362.11development fund unexpended balance
362.12for basic sliding fee child care under
362.13Minnesota Statutes, section 119B.03. The
362.14commissioner shall ensure that all child
362.15care and development funds are expended
362.16according to the federal child care and
362.17development fund regulations.
362.18Basic Sliding Fee. $7,045,000 in fiscal year
362.192010 and $6,974,000 in fiscal year 2011 are
362.20from the federal child care development
362.21funds received from the American Recovery
362.22and Reinvestment Act of 2009, Public
362.23Law 111-5, to the commissioner of human
362.24services consistent with federal regulations
362.25for the purpose of basic sliding fee child care
362.26assistance under Minnesota Statutes, section
362.27119B.03. This is a onetime appropriation.
362.28Any unexpended balance the first year is
362.29available in the second year.
362.30Basic Sliding Fee Allocation for Calendar
362.31Year 2010. Notwithstanding Minnesota
362.32Statutes, section 119B.03, subdivision 6,
362.33in calendar year 2010, basic sliding fee
362.34funds shall be distributed according to
362.35this provision. Funds shall be allocated
363.1first in amounts equal to each county's
363.2guaranteed floor, according to Minnesota
363.3Statutes, section 119B.03, subdivision 8,
363.4with any remaining available funds allocated
363.5according to the following formula:
363.6(a) Up to one-fourth of the funds shall be
363.7allocated in proportion to the number of
363.8families participating in the transition year
363.9child care program as reported during and
363.10averaged over the most recent six months
363.11completed at the time of the notice of
363.12allocation. Funds in excess of the amount
363.13necessary to serve all families in this category
363.14shall be allocated according to paragraph (d).
363.15(b) Up to three-fourths of the funds shall
363.16be allocated in proportion to the average
363.17of each county's most recent six months of
363.18reported waiting list as defined in Minnesota
363.19Statutes, section 119B.03, subdivision 2, and
363.20the reinstatement list of those families whose
363.21assistance was terminated with the approval
363.22of the commissioner under Minnesota Rules,
363.23part 3400.0183, subpart 1. Funds in excess
363.24of the amount necessary to serve all families
363.25in this category shall be allocated according
363.26to paragraph (d).
363.27(c) The amount necessary to serve all families
363.28in paragraphs (a) and (b) shall be calculated
363.29based on the basic sliding fee average cost of
363.30care per family in the county with the highest
363.31cost in the most recently completed calendar
363.32year.
363.33(d) Funds in excess of the amount necessary
363.34to serve all families in paragraphs (a) and
363.35(b) shall be allocated in proportion to each
364.1county's total expenditures for the basic
364.2sliding fee child care program reported
364.3during the most recent fiscal year completed
364.4at the time of the notice of allocation. To
364.5the extent that funds are available, and
364.6notwithstanding Minnesota Statutes, section
364.7119B.03, subdivision 8, for the period
364.8January 1, 2011, to December 31, 2011, each
364.9county's guaranteed floor must be equal to its
364.10original calendar year 2010 allocation.
364.12Family, friends, and neighbor grants.
364.13$375,000 in fiscal year 2010 and $375,000
364.14in fiscal year 2011 are from the child
364.15care development fund required targeted
364.16quality funds for quality expansion and
364.17infant/toddler from the American Recovery
364.18and Reinvestment Act of 2009, Public
364.19Law 111-5, to the commissioner of human
364.20services for family, friends, and neighbor
364.21grants under Minnesota Statutes, section
364.22119B.232. This appropriation may be used
364.23on programs receiving family, friends, and
364.24neighbor grant funds as of June 30, 2009,
364.25or on new programs or projects. This is a
364.26onetime appropriation. Any unexpended
364.27balance the first year is available in the
364.28second year.
364.29Voluntary quality rating system training,
364.30coaching, consultation, and supports.
364.31$633,000 in fiscal year 2010 and $633,000
364.32in fiscal year 2011 are from the federal child
364.33care development fund required targeted
364.34quality funds for quality expansion and
364.35infant/toddler from the American Recovery
365.1and Reinvestment Act of 2009, Public
365.2Law 111-5, to the commissioner of human
365.3services consistent with federal regulations
365.4for the purpose of providing grants to provide
365.5statewide child-care provider training,
365.6coaching, consultation, and supports to
365.7prepare for the voluntary Minnesota quality
365.8rating system rating tool. This is a onetime
365.9appropriation. Any unexpended balance the
365.10first year is available in the second year.
365.11Voluntary quality rating system. $184,000
365.12in fiscal year 2010 and $1,200,000 in fiscal
365.13year 2011 are from the federal child care
365.14development fund required targeted funds for
365.15quality expansion and infant/toddler from the
365.16American Recovery and Reinvestment Act of
365.172009, Public Law 111-5, to the commissioner
365.18of human services consistent with federal
365.19regulations for the purpose of implementing
365.20the voluntary Parent Aware quality star
365.21rating system pilot in coordination with the
365.22Minnesota Early Learning Foundation. The
365.23appropriation for the first year is to complete
365.24and promote the voluntary Parent Aware
365.25quality rating system pilot program through
365.26June 30, 2010, and the appropriation for the
365.27second year is to continue the voluntary
365.28Minnesota quality rating system pilot
365.29through June 30, 2011. This is a onetime
365.30appropriation. Any unexpended balance the
365.31first year is available in the second year.
366.4Base Adjustment. The general fund base is
366.5decreased by $5,371,000 in fiscal year 2012
366.6and increased $8,737,000 in fiscal year 2013.
366.7Privatized Adoption Grants. Federal
366.8reimbursement for privatized adoption grant
366.9and foster care recruitment grant expenditures
366.10is appropriated to the commissioner for
366.11adoption grants and foster care and adoption
366.12administrative purposes.
366.13Adoption Assistance Incentive Grants.
366.14Federal funds available during fiscal year
366.152010 and fiscal year 2011 for the adoption
366.16incentive grants are appropriated to the
366.17commissioner for these purposes.
366.18Adoption Assistance and Relative Custody
366.19Assistance. The commissioner may transfer
366.20unencumbered appropriation balances for
366.21adoption assistance and relative custody
366.22assistance between fiscal years and between
366.23programs.
366.25Targeted Case Management Temporary
366.26Funding Adjustment. The commissioner
366.27shall recover from each county and tribe
366.28receiving a targeted case management
366.29temporary funding payment in fiscal year
366.302008 an amount equal to that payment. The
366.31commissioner shall recover one-half of the
366.32funds by February 1, 2010, and the remainder
366.33by February 1, 2011. At the commissioner's
367.1discretion and at the request of a county
367.2or tribe, the commissioner may revise
367.3the payment schedule, but full payment
367.4must not be delayed beyond May 1, 2011.
367.5The commissioner may use the recovery
367.6procedure under Minnesota Statutes, section
367.7256.017, to recover the funds. Recovered
367.8funds must be deposited into the general
367.9fund.
367.11General Assistance Standard. The
367.12commissioner shall set the monthly standard
367.13of assistance for general assistance units
367.14consisting of an adult recipient who is
367.15childless and unmarried or living apart
367.16from parents or a legal guardian at $203.
367.17The commissioner may reduce this amount
367.18according to Laws 1997, chapter 85, article
367.193, section 54.
367.20Emergency General Assistance. The
367.21amount appropriated for emergency general
367.22assistance funds is limited to no more
367.23than $7,889,812 in fiscal year 2010 and
367.24$7,889,812 in fiscal year 2011. Funds
367.25to counties must be allocated by the
367.26commissioner using the allocation method
367.27specified in Minnesota Statutes, section
367.28256D.06.
367.30Emergency Minnesota Supplemental
367.31Aid Funds. The amount appropriated for
367.32emergency Minnesota supplemental aid
367.33funds is limited to no more than $1,100,000
367.34in fiscal year 2010 and $1,100,000 in fiscal
368.1year 2011. Funds to counties must be
368.2allocated by the commissioner using the
368.3allocation method specified in Minnesota
368.4Statutes, section 256D.46.
368.6Group Residential Housing Costs
368.7Refinanced. (a) Effective July 1, 2011, the
368.8commissioner shall increase the home and
368.9community-based service rates and county
368.10allocations provided to programs for persons
368.11with disabilities established under section
368.121915(c) of the Social Security Act to the
368.13extent that these programs will be paying
368.14for the costs above the rate established
368.15in Minnesota Statutes, section 256I.05,
368.16subdivision 1.
368.17(b) For persons receiving services under
368.18Minnesota Statutes, section 245A.02, who
368.19reside in licensed adult foster care beds
368.20for which a difficulty of care payment
368.21was being made under Minnesota Statutes,
368.22section 256I.05, subdivision 1c, paragraph
368.23(b), counties may request an exception to
368.24the individual's service authorization not to
368.25exceed the difference between the client's
368.26monthly service expenditures plus the
368.27amount of the difficulty of care payment.
368.29Funding Usage. Up to 75 percent of a fiscal
368.30year's appropriation for children's mental
368.31health grants may be used to fund allocations
368.32in that portion of the fiscal year ending
368.33December 31.
369.3Fraud Prevention Grants. Of this
369.4appropriation, $379,000 in fiscal year 2010
369.5and $379,000 in fiscal year 2011 is to the
369.6commissioner for fraud prevention grants to
369.7counties.
369.8Homeless and Runaway Youth. $218,000
369.9in fiscal year 2010 is for the Runaway
369.10and Homeless Youth Act under Minnesota
369.11Statutes, section 256K.45. Funds shall be
369.12spent in each area of the continuum of care
369.13to ensure that programs are meeting the
369.14greatest need. Any unexpended balance in
369.15the first year is available in the second year.
369.16Beginning July 1, 2011, the base is increased
369.17by $119,000 each year.
369.18ARRA Homeless Youth Funds. To the
369.19extent permitted under federal law, the
369.20commissioner shall designate $2,500,000
369.21of the Homeless Prevention and Rapid
369.22Re-Housing Program funds provided under
369.23the American Recovery and Reinvestment
369.24Act of 2009, Public Law 111-5, for agencies
369.25providing homelessness prevention and rapid
369.26rehousing services to youth.
369.27Supportive Housing Services. $1,500,000
369.28each year is for supportive services under
369.29Minnesota Statutes, section 256K.26. This is
369.30a onetime appropriation. Beginning in fiscal
369.31year 2012, the base is increased by $68,000
369.32per year.
369.33Community Action Grants. Community
369.34action grants are reduced one time by
370.1$1,764,000 each year. This reduction is due
370.2to the availability of federal funds under the
370.3American Recovery and Reinvestment Act.
370.4Base Adjustment. The general fund base
370.5is increased by $773,000 in fiscal year 2012
370.6and $773,000 in fiscal year 2013.
370.7Federal ARRA Funds for Existing
370.8Programs. (a) Federal funds received by the
370.9commissioner for the emergency food and
370.10shelter program from the American Recovery
370.11and Reinvestment Act of 2009, Public
370.12Law 111-5, but not previously approved
370.13by the legislature are appropriated to the
370.14commissioner for the purposes of the grant
370.15program.
370.16(b) Federal funds received by the
370.17commissioner for the emergency shelter
370.18grant program including the Homelessness
370.19Prevention and Rapid Re-Housing
370.20Program from the American Recovery and
370.21Reinvestment Act of 2009, Public Law
370.22111-5, are appropriated to the commissioner
370.23for the purposes of the grant programs.
370.24(c) Federal funds received by the
370.25commissioner for the emergency food
370.26assistance program from the American
370.27Recovery and Reinvestment Act of 2009,
370.28Public Law 111-5, are appropriated to the
370.29commissioner for the purposes of the grant
370.30program.
370.31(d) Federal funds received by the
370.32commissioner for senior congregate meals
370.33and senior home-delivered meals from the
370.34American Recovery and Reinvestment Act
370.35of 2009, Public Law 111-5, are appropriated
371.1to the commissioner for the Minnesota Board
371.2on Aging, for purposes of the grant programs.
371.3(e) Federal funds received by the
371.4commissioner for the community services
371.5block grant program from the American
371.6Recovery and Reinvestment Act of 2009,
371.7Public Law 111-5, are appropriated to the
371.8commissioner for the purposes of the grant
371.9program.
371.10Long-Term Homeless Supportive
371.11Service Fund Appropriation. To the
371.12extent permitted under federal law, the
371.13commissioner shall designate $3,000,000
371.14of the Homelessness Prevention and Rapid
371.15Re-Housing Program funds provided under
371.16the American Recovery and Reinvestment
371.17Act of 2009, Public Law, 111-5, to the
371.18long-term homeless service fund under
371.19Minnesota Statutes, section 256K.26. This
371.20appropriation shall become available by July
371.211, 2009. This paragraph is effective the day
371.22following final enactment.
371.25The amounts that may be spent from the
371.26appropriation for each purpose are as follows:
372.1Base Adjustment. The federal TANF base
372.2is increased by $700,000 in each of fiscal
372.3years 2012 and 2013.
372.4School Readiness Service Agreements.
372.5$406,000 in fiscal year 2010 and $406,000
372.6in fiscal year 2011 are from the federal
372.7child care development funds received from
372.8the American Recovery and Reinvestment
372.9Act of 2009, Public Law 111-5, to the
372.10commissioner of human services consistent
372.11with federal regulations for the purpose of
372.12school readiness service agreements under
372.13Minnesota Statutes, section 119B.231. This
372.14is a onetime appropriation. Any unexpended
372.15balance the first year is available in the
372.16second year.
372.22Financial Institution Data Match and
372.23Payment of Fees. The commissioner is
372.24authorized to allocate up to $310,000 each
372.25year in fiscal years 2010 and 2011 from the
372.26PRISM special revenue account to make
372.27payments to financial institutions in exchange
372.28for performing data matches between account
372.29information held by financial institutions
372.30and the public authority's database of child
372.31support obligors as authorized by Minnesota
372.32Statutes, section 13B.06, subdivision 7.
373.1School Readiness Service Agreements.
373.2$106,000 in fiscal year 2010 and $241,000
373.3in fiscal year 2011 are from the federal
373.4child care development funds received from
373.5the American Recovery and Reinvestment
373.6Act of 2009, Public Law 111-5, to the
373.7commissioner of human services consistent
373.8with federal regulations for the purpose of
373.9school readiness service agreements under
373.10Minnesota Statutes, section 119B.231. This
373.11is a onetime appropriation.
373.12Use of Federal Stabilization Funds.
373.13$33,000,000 in fiscal year 2010 is
373.14appropriated from the fiscal stabilization
373.15account in the federal fund to the
373.16commissioner. This appropriation must not
373.17be used for any activity or service for which
373.18federal reimbursement is claimed. This is a
373.19onetime appropriation.
373.21The amounts that may be spent from this
373.22appropriation for each purpose are as follows:
373.24This appropriation is from the health care
373.25access fund.
373.28Medical Education Research Costs
373.29(MERC). Of these funds, the commissioner
373.30of human services shall transfer $38,000,000
373.31in fiscal year 2010 to the medical education
373.32research fund. These funds must restore the
373.33fiscal year 2009 unallotment of the transfers
374.1under Minnesota Statutes, section 256B.69,
374.2subdivision 5c, paragraph (a), for the July 1,
374.32008, through June 30, 2009, period.
374.4Newborn Screening Fee. Of the general
374.5fund appropriation, $34,000 in fiscal
374.6year 2011 is to the commissioner for the
374.7hospital reimbursement increase described
374.8under Minnesota Statutes, section 256.969,
374.9subdivision 28.
374.10Local Share Payment Modification
374.11Required for ARRA Compliance.
374.12Effective from July 1, 2009, to December
374.1331, 2010, Hennepin County's monthly
374.14contribution to the nonfederal share of
374.15medical assistance costs must be reduced
374.16to the percentage required on September
374.171, 2008, to meet federal requirements for
374.18enhanced federal match under the American
374.19Reinvestment and Recovery Act (ARRA)
374.20of 2009. Notwithstanding the requirements
374.21of Minnesota Statutes, section 256B.19,
374.22subdivision 1c, paragraph (d), for the period
374.23beginning July 1, 2009, to December 31,
374.242010, Hennepin County's monthly payment
374.25under that provision is reduced to $434,688.
374.26Capitation Payments. Effective from
374.27July 1, 2009, to December 31, 2010,
374.28notwithstanding the provisions of Minnesota
374.29Statutes 2008, section 256B.19, subdivision
374.301c, paragraph (c), the commissioner shall
374.31increase capitation payments made to the
374.32Metropolitan Health Plan under Minnesota
374.33Statutes 2008, section 256B.69, by
374.34$6,800,000 to recognize higher than average
375.1medical education costs. The increased
375.2amount includes federal matching funds.
375.3Use of Savings. Any savings derived
375.4from implementation of the prohibition in
375.5Minnesota Statutes, section 256B.032, on the
375.6enrollment of low-quality, high-cost health
375.7care providers as vendors of state health care
375.8program services shall be used to offset on a
375.9pro rata basis the reimbursement reductions
375.10for basic care services in Minnesota Statutes,
375.11section 256B.766.
375.14Minnesota Disability Health Options.
375.15Notwithstanding Minnesota Statutes, section
375.16256B.69, subdivision 5a, paragraph (b), for
375.17the period beginning July 1, 2009, to June
375.1830, 2011, the monthly enrollment of persons
375.19receiving home and community-based
375.20waivered services under Minnesota
375.21Disability Health Options shall not exceed
375.221,000. If the budget neutrality provision
375.23in Minnesota Statutes, section 256B.69,
375.24subdivision 23, paragraph (f), is reached
375.25prior to June 30, 2013, the commissioner may
375.26waive this monthly enrollment requirement.
375.27Hospital Fee-for-Service Payment Delay.
375.28Payments from the Medicaid Management
375.29Information System that would otherwise
375.30have been made for inpatient hospital
375.31services for Minnesota health care program
375.32enrollees must be delayed as follows: for
375.33fiscal year 2011, payments in the month of
375.34June equal to $15,937,000 must be included
376.1in the first payment of fiscal year 2012 and
376.2for fiscal year 2013, payments in the month
376.3of June equal to $6,666,000 must be included
376.4in the first payment of fiscal year 2014. The
376.5provisions of Minnesota Statutes, section
376.616A.124, do not apply to these delayed
376.7payments. Notwithstanding any contrary
376.8provision in this article, this paragraph
376.9expires December 31, 2014.
376.10Nonhospital Fee-for-Service Payment
376.11Delay. Payments from the Medicaid
376.12Management Information System that would
376.13otherwise have been made for nonhospital
376.14acute care services for Minnesota health
376.15care program enrollees must be delayed as
376.16follows: payments in the month of June equal
376.17to $23,438,000 for fiscal year 2011 must be
376.18included in the first payment for fiscal year
376.192012, and payments in the month of June
376.20equal to $27,156,000 for fiscal year 2013
376.21must be included in the first payment for
376.22fiscal year 2014. This payment delay must
376.23not include nursing facilities, intermediate
376.24care facilities for persons with developmental
376.25disabilities, home and community-based
376.26services, prepaid health plans, personal care
376.27provider organizations, and home health
376.28agencies. The provisions of Minnesota
376.29Statutes, section 16A.124, do not apply to
376.30these delayed payments. Notwithstanding
376.31any contrary provision in this article, this
376.32paragraph expires December 31, 2014.
377.4Base Adjustment. The health care access
377.5fund base is reduced to $190,000 in each of
377.6fiscal years 2012 and 2013.
377.8The amounts that may be spent from the
377.9appropriation for each purpose are as follows:
377.18Base Adjustment. The health care access
377.19fund base is increased by $1,006,000 in
377.20fiscal year 2012 and $1,781,000 in fiscal year
377.212013. The general fund base is decreased by
377.22$237,000 in fiscal year 2012 and $237,000 in
377.23fiscal year 2013.
377.25The amounts that may be spent from the
377.26appropriation for each purpose are as follows:
378.4Base Adjustment. The general fund base is
378.5increased by $5,751,000 in fiscal year 2012
378.6and $6,705,000 in fiscal year 2013.
378.7Information and Assistance
378.8Reimbursement. Federal administrative
378.9reimbursement obtained from information
378.10and assistance services provided by the
378.11Senior LinkAge or Disability Linkage lines
378.12to people who are identified as eligible for
378.13medical assistance shall be appropriated to
378.14the commissioner for this activity.
378.15Community Service Development Grant
378.16Reduction. Funding for community service
378.17development grants must be reduced by
378.18$251,000 for fiscal year 2010; $266,000 in
378.19fiscal year 2011; $25,000 in fiscal year 2012;
378.20and $25,000 in fiscal year 2013. Base level
378.21funding shall be restored in fiscal year 2014.
378.22Senior Nutrition Use of Federal Funds.
378.23For fiscal year 2010, general fund grants
378.24for home-delivered meals and congregate
378.25dining shall be reduced by $500,000. The
378.26commissioner must replace these general
378.27fund reductions with equal amounts from
378.28federal funding for senior nutrition from the
378.29American Recovery and Reinvestment Act
378.30of 2009.
379.1Base Adjustment. The general fund base is
379.2decreased by $3,598,000 in fiscal year 2012
379.3and $3,470,000 in fiscal year 2013.
379.4Alternative Care Transfer. Any money
379.5allocated to the alternative care program that
379.6is not spent for the purposes indicated does
379.7not cancel but must be transferred to the
379.8medical assistance account.
379.13Manage Growth in TBI and CADI
379.14Waivers. During the fiscal years beginning
379.15on July 1, 2009, and July 1, 2010, the
379.16commissioner shall allocate money for home
379.17and community-based waiver programs
379.18under Minnesota Statutes, section 256B.49,
379.19to ensure a reduction in state spending that is
379.20equivalent to limiting the caseload growth of
379.21the TBI waiver to 12.5 allocations per month
379.22each year of the biennium and the CADI
379.23waiver to 95 allocations per month each year
379.24of the biennium. Limits do not apply: (1)
379.25when there is an approved plan for nursing
379.26facility bed closures for individuals under
379.27age 65 who require relocation due to the
379.28bed closure; (2) to fiscal year 2009 waiver
379.29allocations delayed due to unallotment; or (3)
379.30to transfers authorized by the commissioner
379.31from the personal care assistance program
379.32of individuals having a home care rating
379.33of "CS," "MT," or "HL." Priorities for the
379.34allocation of funds must be for individuals
380.1anticipated to be discharged from institutional
380.2settings or who are at imminent risk of a
380.3placement in an institutional setting.
380.4Manage Growth in DD Waiver. The
380.5commissioner shall manage the growth in
380.6the DD waiver by limiting the allocations
380.7included in the February 2009 forecast to 15
380.8additional diversion allocations each month
380.9for the calendar years that begin on January
380.101, 2010, and January 1, 2011. Additional
380.11allocations must be made available for
380.12transfers authorized by the commissioner
380.13from the personal care program of individuals
380.14having a home care rating of "CS," "MT,"
380.15or "HL."
380.16Adjustment to Lead Agency Waiver
380.17Allocations. Prior to the availability of the
380.18alternative license defined in Minnesota
380.19Statutes, section 245A.11, subdivision 8,
380.20the commissioner shall reduce lead agency
380.21waiver allocations for the purposes of
380.22implementing a moratorium on corporate
380.23foster care.
380.24Alternatives to Personal Care Assistance
380.25Services. Base level funding of $3,237,000
380.26in fiscal year 2012 and $4,856,000 in
380.27fiscal year 2013 is to implement alternative
380.28services to personal care assistance services
380.29for persons with mental health and other
380.30behavioral challenges who can benefit
380.31from other services that more appropriately
380.32meet their needs and assist them in living
380.33independently in the community. These
380.34services may include, but not be limited to, a
380.351915(i) state plan option.
381.6Funding Usage. Up to 75 percent of a fiscal
381.7year's appropriation for adult mental health
381.8grants may be used to fund allocations in that
381.9portion of the fiscal year ending December
381.1031.
381.13Payments for Substance Abuse Treatment.
381.14For services provided during fiscal years
381.152010 and 2011, county-negotiated rates and
381.16provider claims to the consolidated chemical
381.17dependency fund must not exceed rates
381.18charged for these services on January 1, 2009.
381.19For services provided in fiscal years 2012
381.20and 2013, statewide average rates under the
381.21new rate methodology to be developed under
381.22Minnesota Statutes, section 254B.12, must
381.23not exceed the average rates charged for these
381.24services on January 1, 2009, plus $3,787,000
381.25for fiscal year 2012 and $5,023,000 for fiscal
381.26year 2013. Notwithstanding any provision
381.27to the contrary in this article, this provision
381.28expires on June 30, 2013.
381.29Chemical Dependency Special Revenue
381.30Account. For fiscal year 2010, $750,000
381.31must be transferred from the consolidated
382.1chemical dependency treatment fund
382.2administrative account and deposited into the
382.3general fund.
382.4County CD Share of MA Costs for
382.5ARRA Compliance. Notwithstanding the
382.6provisions of Minnesota Statutes, chapter
382.7254B, for chemical dependency services
382.8provided during the period July 1, 2009,
382.9to December 31, 2010, and reimbursed by
382.10medical assistance at the enhanced federal
382.11matching rate provided under the American
382.12Recovery and Reinvestment Act of 2009, the
382.13county share is 30 percent of the nonfederal
382.14share.
382.17Base Adjustment. The general fund base is
382.18decreased by $3,000 in each of fiscal years
382.192012 and 2013.
382.21Base Adjustment. The general fund base is
382.22increased by $7,028,000 in fiscal year 2012
382.23and increased by $8,243,000 in fiscal year
382.242013.
382.25Technology Grants. $650,000 in fiscal
382.26year 2010 and $1,000,000 in fiscal year
382.272011 are for technology grants, case
382.28consultation, evaluation, and consumer
382.29information grants related to developing and
382.30supporting alternatives to shift-staff foster
382.31care residential service models.
382.32Other Continuing Care Grants; HIV
382.33Grants. Money appropriated for the HIV
383.1drug and insurance grant program in fiscal
383.2year 2010 may be used in either year of the
383.3biennium.
383.10Quality Assurance Commission. Effective
383.11July 1, 2009, state funding for the quality
383.12assurance commission under Minnesota
383.13Statutes, section 256B.0951, is canceled.
383.14County Maintenance of Effort. $350,000 in
383.15fiscal year 2010 is from the general fund for
383.16the State-County Results Accountability and
383.17Service Delivery Reform under Minnesota
383.18Statutes, chapter 402A.
383.19Base Adjustment. The general fund base is
383.20decreased $2,697,000 in fiscal year 2012 and
383.21$2,791,000 in fiscal year 2013.
383.23The amounts that may be spent from the
383.24appropriation for each purpose are as follows:
383.25Transfer Authority Related to
383.26State-Operated Services. Money
383.27appropriated to finance state-operated
383.28services may be transferred between the
383.29fiscal years of the biennium with the approval
383.30of the commissioner of finance.
383.31County Past Due Receivables. The
383.32commissioner is authorized to withhold
384.1county federal administrative reimbursement
384.2when the county of financial responsibility
384.3for cost-of-care payments due the state
384.4under Minnesota Statutes, section 246.54
384.5or 253B.045, is 90 days past due. The
384.6commissioner shall deposit the withheld
384.7federal administrative earnings for the county
384.8into the general fund to settle the claims with
384.9the county of financial responsibility. The
384.10process for withholding funds is governed by
384.11Minnesota Statutes, section 256.017.
384.12Forecast and Census Data. The
384.13commissioner shall include census data and
384.14fiscal projections for state-operated services
384.15and Minnesota sex offender services with the
384.16November and February budget forecasts.
384.17Notwithstanding any contrary provision in
384.18this article, this paragraph shall not expire.
384.20Appropriation Limitation. No part of
384.21the appropriation in this article to the
384.22commissioner for mental health treatment
384.23services provided by state-operated services
384.24shall be used for the Minnesota sex offender
384.25program.
384.26Community Behavioral Health Hospitals.
384.27Under Minnesota Statutes, section 246.51,
384.28subdivision 1, a determination order for the
384.29clients served in a community behavioral
384.30health hospital operated by the commissioner
384.31of human services is only required when
384.32a client's third-party coverage has been
384.33exhausted.
385.1Base Adjustment. The general fund base is
385.2decreased by $500,000 for fiscal year 2012
385.3and by $500,000 for fiscal year 2013.
385.8Use of Federal Stabilization Funds. Of
385.9this appropriation, $26,495,000 in fiscal year
385.102010 is from the fiscal stabilization account
385.11in the federal fund to the commissioner.
385.12This appropriation must not be used for
385.13any activity or service for which federal
385.14reimbursement is claimed. This is a onetime
385.15appropriation.
385.21Minnesota Security Hospital. For the
385.22purposes of enhancing the safety of
385.23the public, improving supervision, and
385.24enhancing community-based mental health
385.25treatment, state-operated services may
385.26establish additional community capacity
385.27for providing treatment and supervision
385.28of clients who have been ordered into a
385.29less restrictive alternative of care from the
385.30state-operated services transitional services
386.1program consistent with Minnesota Statutes,
386.2section 246.014.
386.3Use of Federal Stabilization Funds.
386.4$83,505,000 in fiscal year 2010 is
386.5appropriated from the fiscal stabilization
386.6account in the federal fund to the
386.7commissioner. This appropriation must not
386.8be used for any activity or service for which
386.9federal reimbursement is claimed. This is a
386.10onetime appropriation.
386.28Newborn Screening Fee. Of the general
386.29fund appropriation, $300,000 in fiscal year
386.302011 is to the commissioner for the purpose
387.1of providing support services to families as
387.2required under Minnesota Statutes, section
387.3144.966, subdivision 3a. $74,000 of this
387.4appropriation in fiscal year 2011 and $51,000
387.5of this appropriation in subsequent fiscal
387.6years may be used by the commissioner
387.7for administrative costs associated with
387.8increasing the fee, contract administration,
387.9program oversight, and provide follow-up to
387.10families who need assistance beyond those
387.11available through the contractor.
387.12Support Services for Families With
387.13Children Who are Deaf or Have Hearing
387.14Loss. Of the general fund amount, $16,000
387.15in fiscal year 2010 and $284,000 in fiscal
387.16year 2011 is for support services to families
387.17with children who are deaf or have hearing
387.18loss. Of this amount, in fiscal year 2011,
387.19$223,000 is for grants and the balance is for
387.20administrative costs. Base funding in fiscal
387.21years 2012 and 2013 is $300,000 each year.
387.22Of this amount, $241,000 each year is for
387.23grants and the balance is for administrative
387.24costs.
387.25Funding Usage. Up to 75 percent of the
387.26fiscal year 2012 appropriation for local public
387.27health grants may be used to fund calendar
387.28year 2011 allocations for this program. The
387.29general fund reduction of $5,193,000 in
387.30fiscal year 2011 for local public health grants
387.31is onetime and the base funding for local
387.32public health grants for fiscal year 2012 is
387.33increased by $5,193,000.
387.34Colorectal Screening. $88,000 in fiscal year
387.352010 and $62,000 in fiscal year 2011 are
388.1for grants to the Hennepin County Medical
388.2Center and MeritCare Bemidji for colorectal
388.3screening demonstration projects.
388.4Feasibility Pilot Project for Cancer
388.5Surveillance. Of the general fund
388.6appropriation for fiscal year 2010, $100,000
388.7is to the commissioner to provide grant
388.8funding to cover the cost of one full-time
388.9equivalent position at the Hennepin County
388.10Medical Center to carry out the feasibility
388.11pilot project.
388.12American Recovery and Reinvestment
388.13Act Funds. Federal funds received by the
388.14commissioner for WIC program management
388.15information systems from the American
388.16Recovery and Reinvestment Act of 2009,
388.17Public Law 111-5, are appropriated to the
388.18commissioner for the purpose of the grant.
388.19TANF Appropriations. (1) $1,156,000 of
388.20the TANF funds are appropriated each year to
388.21the commissioner for family planning grants
388.22under Minnesota Statutes, section 145.925.
388.23(2) $3,579,000 of the TANF funds are
388.24appropriated each year to the commissioner
388.25for home visiting and nutritional services
388.26listed under Minnesota Statutes, section
388.27145.882, subdivision 7, clauses (6) and (7).
388.28Funds must be distributed to community
388.29health boards according to Minnesota
388.30Statutes, section 145A.131, subdivision 1.
388.31(3) $2,000,000 of the TANF funds are
388.32appropriated each year to the commissioner
388.33for decreasing racial and ethnic disparities
388.34in infant mortality rates under Minnesota
388.35Statutes, section 145.928, subdivision 7.
389.1(4) $4,998,000 of the TANF funds are
389.2appropriated each year to the commissioner
389.3for the family home visiting grant program
389.4according to Minnesota Statutes, section
389.5145A.17. $4,000,000 of the funding must
389.6be distributed to community health boards
389.7according to Minnesota Statutes, section
389.8145A.131, subdivision 1. $998,000 of
389.9the funding must be distributed to tribal
389.10governments based on Minnesota Statutes,
389.11section 145A.14, subdivision 2a. The
389.12commissioner may use five percent of
389.13the funds appropriated each fiscal year to
389.14conduct the ongoing evaluations required
389.15under Minnesota Statutes, section 145A.17,
389.16subdivision 7, and may use ten percent of
389.17the funds appropriated each fiscal year to
389.18provide training and technical assistance as
389.19required under Minnesota Statutes, section
389.20145A.17, subdivisions 4 and 5.
389.21Base Adjustment. The general fund base
389.22is increased by $10,302,000 for fiscal year
389.232012 and increased by $5,109,000 for fiscal
389.24year 2013. The health care access fund base
389.25is reduced to $1,719,000 for both fiscal years
389.262012 and 2013.
389.27TANF Carryforward. Any unexpended
389.28balance of the TANF appropriation in the
389.29first year of the biennium does not cancel but
389.30is available for the second year.
390.4Community-Based Health Care
390.5Demonstration Project. Notwithstanding
390.6the provisions of Laws 2007, chapter 147,
390.7article 19, section 3, subdivision 6, paragraph
390.8(e), base level funding to the commissioner
390.9for the demonstration project grant described
390.10in Minnesota Statutes, section 62Q.80,
390.11subdivision 1a, shall be zero for fiscal years
390.122011 and 2012.
390.13Medical Education and Research Cost
390.14Federal Compliance. Notwithstanding
390.15Laws 2008, chapter 363, article 18, section
390.164, subdivision 3, the base level funding
390.17for the commissioner to distribute to the
390.18Mayo Clinic for transitional funding while
390.19federal compliance changes are made to the
390.20medical education and research cost funding
390.21distribution formula shall be $0 for fiscal
390.22years 2010 and 2011.
390.23Autism Clinical Research. The
390.24commissioner, in partnership with a
390.25Minnesota research institution, shall apply
390.26for funds available for research grants under
390.27the American Recovery and Reinvestment
390.28Act (ARRA) of 2009 in order to expand
390.29research and treatment of autism spectrum
390.30disorders.
390.31Health Information Technology. (a) Of
390.32the health care access fund appropriation,
390.33$4,000,000 is to fund the revolving loan
390.34account under Minnesota Statutes, section
391.162J.496. This appropriation must not be
391.2expended unless it is matched with federal
391.3funding under the federal Health Information
391.4Technology for Economic and Clinical
391.5Health (HITECH) Act. This appropriation
391.6must not be included in the agency's base
391.7budget for the fiscal year beginning July 1,
391.82012.
391.9(b) On or before June 30, 2013, $1,200,000
391.10shall be transferred from the revolving loan
391.11account under Minnesota Statutes, section
391.1262J.496, to the health care access fund.
391.13This is a onetime transfer and must not be
391.14included in the agency's base budget for the
391.15fiscal year beginning July 1, 2014.
391.16Base Adjustment. The general fund
391.17base is $8,243,000 in fiscal year 2012 and
391.18$8,243,000 in fiscal year 2013. The health
391.19care access fund base is $10,950,000 in fiscal
391.20year 2012 and $6,816,000 in fiscal year 2013.
391.26Base Adjustment. The general fund base is
391.27reduced by $50,000 in each of fiscal years
391.282012 and 2013.
391.29Health Protection Appropriations. (a)
391.30$163,000 each year is for the lead abatement
391.31grant program.
391.32(b) $100,000 each year is for emergency
391.33preparedness and response activities.
392.1(c) $50,000 each year is for tuberculosis
392.2prevention and control. This is a onetime
392.3appropriation.
392.4American Recovery and Reinvestment
392.5Act Funds. Federal funds received
392.6by the commissioner for immunization
392.7operations from the American Recovery
392.8and Reinvestment Act of 2009, Public Law
392.9111-5, are appropriated to the commissioner
392.10for the purposes of the grant.
392.14This appropriation is from the state
392.15government special revenue fund.
392.16Transfer. In fiscal year 2010, $6,000,000
392.17shall be transferred from the state government
392.18special revenue fund to the general fund.
392.19The amounts that may be spent for each
392.20purpose are specified in the following
392.21subdivisions.
393.3Administrative Services Unit - Operating
393.4Costs. Of this appropriation, $524,000
393.5in fiscal year 2010 and $526,000 in
393.6fiscal year 2011 are for operating costs
393.7of the administrative services unit. The
393.8administrative services unit may receive
393.9and expend reimbursements for services
393.10performed by other agencies.
393.11Administrative Services Unit - Retirement
393.12Costs. Of this appropriation in fiscal year
393.132010, $201,000 is for onetime retirement
393.14costs in the health-related boards. This
393.15funding may be transferred to the health
393.16boards incurring those costs for their
393.17payment. These funds are available either
393.18year of the biennium.
393.19Administrative Services Unit - Volunteer
393.20Health Care Provider Program. Of this
393.21appropriation, $79,000 in fiscal year 2010
393.22and $89,000 in fiscal year 2011 are to pay
393.23for medical professional liability coverage
393.24required under Minnesota Statutes, section
393.25214.40.
393.26Administrative Services Unit - Contested
393.27Cases and Other Legal Proceedings. Of
393.28this appropriation, $200,000 in fiscal year
393.292010 and $200,000 in fiscal year 2011
393.30are for costs of contested case hearings
393.31and other unanticipated costs of legal
393.32proceedings involving health-related
393.33boards funded under this section. Upon
393.34certification of a health-related board to the
394.1administrative services unit that the costs
394.2will be incurred and that there is insufficient
394.3money available to pay for the costs out of
394.4money currently available to that board, the
394.5administrative services unit is authorized
394.6to transfer money from this appropriation
394.7to the board for payment of those costs
394.8with the approval of the commissioner of
394.9finance. This appropriation does not cancel.
394.10Any unencumbered and unspent balances
394.11remain available for these expenditures in
394.12subsequent fiscal years.
394.29Longevity Award and Incentive Program.
394.30Of the general fund appropriation, $700,000
395.1in fiscal year 2010 and $700,000 in fiscal year
395.22011 are to the board for the Cooper/Sams
395.3volunteer ambulance program, under
395.4Minnesota Statutes, section 144E.40.
395.5Transfer. In fiscal year 2010, $6,182,000
395.6is transferred from the Cooper/Sams
395.7volunteer ambulance trust, established under
395.8Minnesota Statutes, section 144E.42, to the
395.9general fund.
395.10Health Professional Services Program.
395.11$704,000 in fiscal year 2010 and $704,000 in
395.12fiscal year 2011 from the state government
395.13special revenue fund are for the health
395.14professional services program.
395.15Comprehensive Advanced Life-Support
395.16Educational (CALS) Program. $100,000 in
395.17the first year from the Cooper/Sams volunteer
395.18ambulance trust is for the comprehensive
395.19advanced life-support educational (CALS)
395.20program established under Minnesota
395.21Statutes, section 144E.37. This appropriation
395.22is to extend availability and affordability
395.23of the CALS program for rural emergency
395.24medical personnel and to assist hospital staff
395.25in attaining the credentialing levels necessary
395.26for implementation of the statewide trauma
395.27system.
395.30Veterans Paramedic Apprenticeship
395.31Program. Of this appropriation, $200,000
395.32in the first year is from the Cooper/Sams
395.33volunteer ambulance trust for transfer
395.34to the commissioner of veterans affairs
396.1for a grant to the Minnesota Ambulance
396.2Association to implement a veterans
396.3paramedic apprenticeship program to
396.4reintegrate returning military medics into
396.5Minnesota's workforce in the field of
396.6paramedic and emergency services, thereby
396.7guaranteeing returning military medics
396.8gainful employment with livable wages and
396.9benefits. This appropriation is available until
396.10expended.
396.12Medical Response Unit Reimbursement
396.13Pilot Program. (a) $250,000 in the first
396.14year is from the Cooper/Sams volunteer
396.15ambulance trust for a transfer to the
396.16Department of Public Safety for a medical
396.17response unit reimbursement pilot program.
396.18Of this appropriation, $75,000 is for
396.19administrative costs to the Department of
396.20Public Safety, including providing contract
396.21staff support and technical assistance to the
396.22pilot program partners if necessary.
396.23(b) Of the amount in paragraph (a), $175,000
396.24is to be used to provide a predetermined
396.25reimbursement amount to the participating
396.26medical response units. The Department
396.27of Public Safety or its contract designee
396.28will develop an agreement with the medical
396.29response units outlining reimbursement and
396.30program requirements to include HIPAA
396.31compliance while participating in the pilot
396.32program.
397.5 Sec. 12. Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended
397.6by Laws 2008, chapter 277, article 5, section 1; and Laws 2008, chapter 363, article
397.718, section 7, is amended to read:
397.10The amounts that may be spent from this
397.11appropriation for each purpose are as follows:
397.20TANF Prior Appropriation Cancellation.
397.21Notwithstanding Laws 2001, First Special
397.22Session chapter 9, article 17, section
397.232, subdivision 11, paragraph (b), any
397.24unexpended TANF funds appropriated to the
397.25commissioner to contract with the Board of
397.26Trustees of Minnesota State Colleges and
397.27Universities, to provide tuition waivers to
397.28employees of health care and human service
398.1providers that are members of qualifying
398.2consortia operating under Minnesota
398.3Statutes, sections116L.10 to
116L.15 , must
398.4cancel at the end of fiscal year 2007.
398.5MFIP Pilot Program. Of the TANF
398.6appropriation, $100,000 in fiscal year 2008
398.7and $750,000 in fiscal year 2009 are for a
398.8grant to the Stearns-Benton Employment and
398.9Training Council for the Workforce U pilot
398.10program. Base level funding for this program
398.11shall be $750,000 in 2010 and $0 in 2011.
398.12Supported Work. (1) Of the TANF
398.13appropriation, $5,468,000 in fiscal year 2008
398.14is for supported work for MFIP participants,
398.15to be allocated to counties and tribes based
398.16on the criteria under clauses (2) and (3), and
398.17is available until expended. Paid transitional
398.18work experience and other supported
398.19employment under this rider provides
398.20a continuum of employment assistance,
398.21including outreach and recruitment,
398.22program orientation and intake, testing and
398.23assessment, job development and marketing,
398.24preworksite training, supported worksite
398.25experience, job coaching, and postplacement
398.26follow-up, in addition to extensive case
398.27management and referral services. * (The
398.28preceding text "and $7,291,000 in fiscal
398.29year 2009" was indicated as vetoed by the
398.30governor.)
398.31(2) A county or tribe is eligible to receive an
398.32allocation under this rider if:
398.33(i) the county or tribe is not meeting the
398.34federal work participation rate;
399.1(ii) the county or tribe has participants who
399.2are required to perform work activities under
399.3Minnesota Statutes, chapter 256J, but are not
399.4meeting hourly work requirements; and
399.5(iii) the county or tribe has assessed
399.6participants who have completed six weeks
399.7of job search or are required to perform
399.8work activities and are not meeting the
399.9hourly requirements, and the county or tribe
399.10has determined that the participant would
399.11benefit from working in a supported work
399.12environment.
399.13(3) A county or tribe may also be eligible for
399.14funds in order to contract for supplemental
399.15hours of paid work at the participant's child's
399.16place of education, child care location, or the
399.17child's physical or mental health treatment
399.18facility or office. This grant to counties and
399.19tribes is specifically for MFIP participants
399.20who need to work up to five hours more
399.21per week in order to meet the hourly work
399.22requirement, and the participant's employer
399.23cannot or will not offer more hours to the
399.24participant.
399.25Work Study. Of the TANF appropriation,
399.26$750,000 each year are to the commissioner
399.27to contract with the Minnesota Office of
399.28Higher Education for the biennium beginning
399.29July 1, 2007, for work study grants under
399.30Minnesota Statutes, section136A.233 ,
399.31specifically for low-income individuals who
399.32receive assistance under Minnesota Statutes,
399.33chapter 256J, and for grants to opportunities
399.34industrialization centers. * (The preceding
399.35text beginning "Work Study. Of the TANF
400.1appropriation," was indicated as vetoed
400.2by the governor.)
400.3Integrated Service Projects. $2,500,000
400.4in fiscal year 2008 and $2,500,000 in fiscal
400.5year 2009 are appropriated from the TANF
400.6fund to the commissioner to continue to
400.7fund the existing integrated services projects
400.8for MFIP families, and if funding allows,
400.9additional similar projects.
400.10Base Adjustment. The TANF base for fiscal
400.11year 2010 is $115,902,000 and for fiscal year
400.122011 is $115,152,000.
400.18Base Adjustment. The general fund base
400.19is $44,881,000 for fiscal year 2010 and
400.20$44,852,000 for fiscal year 2011.
400.21At-Home Infant Care Program. No
400.22funding shall be allocated to or spent on
400.23the at-home infant care program under
400.24Minnesota Statutes, section119B.035 .
400.27Prekindergarten Exploratory Projects. Of
400.28the general fund appropriation, $2,000,000
400.29the first year and $4,000,000 the second
401.1year are for grants to the city of St. Paul,
401.2Hennepin County, and Blue Earth County to
401.3establish scholarship demonstration projects
401.4to be conducted in partnership with the
401.5Minnesota Early Learning Foundation to
401.6promote children's school readiness. This
401.7appropriation is available until June 30, 2009.
401.8Child Care Services Grants. Of this
401.9appropriation, $250,000 each year are for
401.10the purpose of providing child care services
401.11grants under Minnesota Statutes, section
401.12119B.21, subdivision 5
. This appropriation
401.13is for the 2008-2009 biennium only, and does
401.14not increase the base funding.
401.15Early Childhood Professional
401.16Development System. Of this appropriation,
401.17$250,000 each year are for purposes of the
401.18early childhood professional development
401.19system, which increases the quality and
401.20continuum of professional development
401.21opportunities for child care practitioners.
401.22This appropriation is for the 2008-2009
401.23biennium only, and does not increase the
401.24base funding.
401.25Base Adjustment. The general fund base
401.26is $1,515,000 for each of fiscal years 2010
401.27and 2011.
401.30Child Support Enforcement. $7,333,000
401.31for fiscal year 2008 is to make grants to
401.32counties for child support enforcement
401.33programs to make up for the loss under the
402.12005 federal Deficit Reduction Act of federal
402.2matching funds for federal incentive funds
402.3passed on to the counties by the state.
402.4This appropriation is available until June 30,
402.52009.
402.11Grants for Programs Serving Young
402.12Parents. Of the TANF fund appropriation,
402.13$140,000 each year is for a grant to a program
402.14or programs that provide comprehensive
402.15services through a private, nonprofit agency
402.16to young parents in Hennepin County who
402.17have dropped out of school and are receiving
402.18public assistance. The program administrator
402.19shall report annually to the commissioner on
402.20skills development, education, job training,
402.21and job placement outcomes for program
402.22participants.
402.23County Allocations for Rate Increases.
402.24County Children and Community Services
402.25Act allocations shall be increased by
402.26$197,000 effective October 1, 2007, and
402.27$696,000 effective October 1, 2008, to help
402.28counties pay for the rate adjustments to
402.29day training and habilitation providers for
402.30participants paid by county social service
402.31funds. Notwithstanding the provisions of
402.32Minnesota Statutes, section256M.40 , the
402.33allocation to a county shall be based on
403.1the county's proportion of social services
403.2spending for day training and habilitation
403.3services as determined in the most recent
403.4social services expenditure and grant
403.5reconciliation report.
403.6Privatized Adoption Grants. Federal
403.7reimbursement for privatized adoption grant
403.8and foster care recruitment grant expenditures
403.9is appropriated to the commissioner for
403.10adoption grants and foster care and adoption
403.11administrative purposes.
403.12Adoption Assistance Incentive Grants.
403.13Federal funds available during fiscal year
403.142008 and fiscal year 2009 for the adoption
403.15incentive grants are appropriated to the
403.16commissioner for these purposes.
403.17Adoption Assistance and Relative Custody
403.18Assistance. The commissioner may transfer
403.19unencumbered appropriation balances for
403.20adoption assistance and relative custody
403.21assistance between fiscal years and between
403.22programs.
403.23Children's Mental Health Grants. Of the
403.24general fund appropriation, $5,913,000 in
403.25fiscal year 2008 and $6,825,000 in fiscal year
403.262009 are for children's mental health grants.
403.27The purpose of these grants is to increase and
403.28maintain the state's children's mental health
403.29service capacity, especially for school-based
403.30mental health services. The commissioner
403.31shall require grantees to utilize all available
403.32third party reimbursement sources as a
403.33condition of using state grant funds. At
403.34least 15 percent of these funds shall be
403.35used to encourage efficiencies through early
404.1intervention services. At least another 15
404.2percent shall be used to provide respite care
404.3services for children with severe emotional
404.4disturbance at risk of out-of-home placement.
404.5Mental Health Crisis Services. Of the
404.6general fund appropriation, $2,528,000 in
404.7fiscal year 2008 and $2,850,000 in fiscal year
404.82009 are for statewide funding of children's
404.9mental health crisis services. Providers must
404.10utilize all available funding streams.
404.11Children's Mental Health Evidence-Based
404.12and Best Practices. Of the general fund
404.13appropriation, $375,000 in fiscal year 2008
404.14and $750,000 in fiscal year 2009 are for
404.15children's mental health evidence-based and
404.16best practices including, but not limited
404.17to: Adolescent Integrated Dual Diagnosis
404.18Treatment services; school-based mental
404.19health services; co-location of mental
404.20health and physical health care, and; the
404.21use of technological resources to better
404.22inform diagnosis and development of
404.23treatment plan development by mental
404.24health professionals. The commissioner
404.25shall require grantees to utilize all available
404.26third-party reimbursement sources as a
404.27condition of using state grant funds.
404.28Culturally Specific Mental Health
404.29Treatment Grants. Of the general fund
404.30appropriation, $75,000 in fiscal year 2008
404.31and $300,000 in fiscal year 2009 are for
404.32children's mental health grants to support
404.33increased availability of mental health
404.34services for persons from cultural and
404.35ethnic minorities within the state. The
405.1commissioner shall use at least 20 percent
405.2of these funds to help members of cultural
405.3and ethnic minority communities to become
405.4qualified mental health professionals and
405.5practitioners. The commissioner shall assist
405.6grantees to meet third-party credentialing
405.7requirements and require them to utilize all
405.8available third-party reimbursement sources
405.9as a condition of using state grant funds.
405.10Mental Health Services for Children with
405.11Special Treatment Needs. Of the general
405.12fund appropriation, $50,000 in fiscal year
405.132008 and $200,000 in fiscal year 2009 are
405.14for children's mental health grants to support
405.15increased availability of mental health
405.16services for children with special treatment
405.17needs. These shall include, but not be limited
405.18to: victims of trauma, including children
405.19subjected to abuse or neglect, veterans and
405.20their families, and refugee populations;
405.21persons with complex treatment needs, such
405.22as eating disorders; and those with low
405.23incidence disorders.
405.24MFIP and Children's Mental Health
405.25Pilot Project. Of the TANF appropriation,
405.26$100,000 in fiscal year 2008 and $200,000
405.27in fiscal year 2009 are to fund the MFIP
405.28and children's mental health pilot project.
405.29Of these amounts, up to $100,000 may be
405.30expended on evaluation of this pilot.
405.31Prenatal Alcohol or Drug Use. Of the
405.32general fund appropriation, $75,000each
405.33year is to award grants beginning July 1,
405.342007, to programs that provide services
405.35under Minnesota Statutes, section
254A.171,
406.1in Pine, Kanabec, and Carlton Counties.
406.2the second year is for a grant to A Circle
406.3of Women for program services. This
406.4appropriation shall become part of the base
406.5appropriation.
406.6Base Adjustment. The general fund base
406.7is $62,572,000 in fiscal year 2010 and
406.8$62,575,000 in fiscal year 2011.
406.11Base Adjustment. The general fund base
406.12is $69,274,000 in each of fiscal years 2010
406.13and 2011.
406.14Targeted Case Management Temporary
406.15Funding. (a) Of the general fund
406.16appropriation, $32,667,000 in fiscal year
406.172008 is transferred to the targeted case
406.18management contingency reserve account in
406.19the general fund to be allocated to counties
406.20and tribes affected by reductions in targeted
406.21case management federal Medicaid revenue
406.22as a result of the provisions in the federal
406.23Deficit Reduction Act of 2005, Public Law
406.24109-171.
406.25(b) Contingent upon (1) publication by the
406.26federal Centers for Medicare and Medicaid
406.27Services of final regulations implementing
406.28the targeted case management provisions
406.29of the federal Deficit Reduction Act of
406.302005, Public Law 109-171, or (2) the
406.31issuance of a finding by the Centers for
406.32Medicare and Medicaid Services of federal
406.33Medicaid overpayments for targeted case
407.1management expenditures, up to $32,667,000
407.2is appropriated to the commissioner of human
407.3services. Prior to distribution of funds, the
407.4commissioner shall estimate and certify the
407.5amount by which the federal regulations or
407.6federal disallowance will reduce targeted
407.7case management Medicaid revenue over the
407.82008-2009 biennium.
407.9(c) Within 60 days of a contingency described
407.10in paragraph (b), the commissioner shall
407.11distribute the grants proportionate to each
407.12affected county or tribe's targeted case
407.13management federal earnings for calendar
407.14year 2005, not to exceed the lower of (1) the
407.15amount of the estimated reduction in federal
407.16revenue or (2) $32,667,000.
407.17(d) These funds are available in either year of
407.18the biennium. Counties and tribes shall use
407.19these funds to pay for social service-related
407.20costs, but the funds are not subject to
407.21provisions of the Children and Community
407.22Services Act grant under Minnesota Statutes,
407.23chapter 256M.
407.24(e) This appropriation shall be available to
407.25pay counties and tribes for expenses incurred
407.26on or after July 1, 2007. The appropriation
407.27shall be available until expended.
407.30General Assistance Standard. The
407.31commissioner shall set the monthly standard
407.32of assistance for general assistance units
407.33consisting of an adult recipient who is
408.1childless and unmarried or living apart
408.2from parents or a legal guardian at $203.
408.3The commissioner may reduce this amount
408.4according to Laws 1997, chapter 85, article
408.53, section 54.
408.6Emergency General Assistance. The
408.7amount appropriated for emergency general
408.8assistance funds is limited to no more
408.9than $7,889,812 in fiscal year 2008 and
408.10$7,889,812 in fiscal year 2009. Funds
408.11to counties must be allocated by the
408.12commissioner using the allocation method
408.13specified in Minnesota Statutes, section
408.14256D.06
.
408.17Emergency Minnesota Supplemental
408.18Aid Funds. The amount appropriated for
408.19emergency Minnesota supplemental aid
408.20funds is limited to no more than $1,100,000
408.21in fiscal year 2008 and $1,100,000 in fiscal
408.22year 2009. Funds to counties must be
408.23allocated by the commissioner using the
408.24allocation method specified in Minnesota
408.25Statutes, section256D.46 .
408.28People Incorporated. Of the general fund
408.29appropriation, $460,000 each year is to
408.30augment community support and mental
408.31health services provided to individuals
409.1residing in facilities under Minnesota
409.2Statutes, section256I.05, subdivision 1m .
409.7Base Adjustment. The general fund base
409.8shall be $16,033,000 in fiscal year 2010 and
409.9$15,533,000 in fiscal year 2011. The TANF
409.10base shall be $1,500,000 in fiscal year 2010
409.11and $1,181,000 in fiscal year 2011.
409.12Homeless and Runaway Youth. Of the
409.13general fund appropriation, $500,000 each
409.14year are for the Runaway and Homeless
409.15Youth Act under Minnesota Statutes, section
409.16256K.45
. Funds shall be spent in each area
409.17of the continuum of care to ensure that
409.18programs are meeting the greatest need. This
409.19is a onetime appropriation.
409.20Long-Term Homelessness. Of the general
409.21fund appropriation, $2,000,000 in fiscal year
409.222008 is for implementation of programs
409.23to address long-term homelessness and is
409.24available in either year of the biennium. This
409.25is a onetime appropriation.
409.26Minnesota Community Action Grants. (a)
409.27Of the general fund appropriation, $250,000
409.28each year is for the purposes of Minnesota
409.29community action grants under Minnesota
409.30Statutes, sections256E.30 to
256E.32 . This
409.31is a onetime appropriation.
409.32(b) Of the TANF appropriation, $1,500,000
409.33each year is for community action agencies
410.1for auto repairs, auto loans, and auto
410.2purchase grants to individuals who are
410.3eligible to receive benefits under Minnesota
410.4Statutes, chapter 256J, or who have lost
410.5eligibility for benefits under Minnesota
410.6Statutes, chapter 256J, due to earnings in the
410.7prior 12 months. Base level funding for this
410.8activity shall be $1,500,000 in fiscal year
410.92010 and $1,181,000 in fiscal year 2011. *
410.10(The preceding text beginning "(b) Of the
410.11TANF appropriation," was indicated as
410.12vetoed by the governor.)
410.13(c) Money appropriated under paragraphs (a)
410.14and (b) that is not spent in the first year does
410.15not cancel but is available for the second
410.16year.
410.17EFFECTIVE DATE.This section is effective the day following final enactment.
410.18 Sec. 13. EMERGENCY SERVICES SHELTER GRANTS FROM AMERICAN
410.19RECOVERY AND REINVESTMENT ACT.
410.20 (a) To the extent permitted under federal law, the commissioner of human services,
410.21when determining the uses of the emergency services shelter grants provided under the
410.22American Recovery and Reinvestment Act, shall give priority to programs that serve
410.23the following:
410.24 (1) homeless youth;
410.25 (2) American Indian women who are victims of trafficking;
410.26 (3) high-risk adult males considered to be very likely to enter or reenter state or
410.27county correctional programs, or chemical and mental health programs;
410.28 (4) battered women; and
410.29 (5) families affected by foreclosure.
410.30(b) Paragraph (a) does not supersede use of ARRA funds as otherwise provided
410.31in this act.
410.32 Sec. 14. TRANSFERS.
410.33 Subdivision 1. Grants. The commissioner of human services, with the approval
410.34of the commissioner of finance, and after notification of the chairs of the relevant senate
411.1budget division and house of representatives finance division committee, may transfer
411.2unencumbered appropriation balances for the biennium ending June 30, 2011, within
411.3fiscal years among the MFIP, general assistance, general assistance medical care, medical
411.4assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section
411.5119B.05, Minnesota supplemental aid, and group residential housing programs, and the
411.6entitlement portion of the chemical dependency consolidated treatment fund, and between
411.7fiscal years of the biennium.
411.8 Subd. 2. Administration. Positions, salary money, and nonsalary administrative
411.9money may be transferred within the Departments of Human Services and Health as the
411.10commissioners consider necessary, with the advance approval of the commissioner of
411.11finance. The commissioner shall inform the chairs of the relevant house and senate health
411.12committees quarterly about transfers made under this provision.
411.13 Sec. 15. 2007 AND 2008 APPROPRIATION AMENDMENTS.
411.14(a) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4,
411.15paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF
411.16fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph
411.17is effective retroactively from July 1, 2008.
411.18(b) The appropriation for patient incentive programs under Laws 2007, chapter 147,
411.19article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective
411.20retroactively from July 1, 2007.
411.21(c) The onetime general fund base reduction for Child Care Development Grants
411.22under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is
411.23increased by $4,000. This paragraph is effective retroactively from July 1, 2008.
411.24(d) The base for Children Services Grants under Laws 2008, chapter 363, article 18,
411.25section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year
411.262010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008.
411.27(e) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the
411.28general fund base adjustment for Children and Community Services Grants under Laws
411.292008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by
411.30$98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively
411.31from July 1, 2008.
411.32(f) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article
411.3318, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010.
411.34This paragraph is effective retroactively from July 1, 2008.
412.1 Sec. 16. INDIRECT COSTS NOT TO FUND PROGRAMS.
412.2The commissioners of health and human services shall not use indirect cost
412.3allocations to pay for the operational costs of any program for which they are responsible.
412.4 Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
412.5 All uncodified language contained in this article expires on June 30, 2011, unless a
412.6different expiration date is explicit.
412.7 Sec. 18. EFFECTIVE DATE.
412.8 The provisions in this article are effective July 1, 2009, unless a different effective
412.9date is specified."
412.10Delete the title and insert:
412.12relating to state government; making changes to health and human services;
412.13amending provisions related to licensing, the Minnesota family investment
412.14program, child care, adult supports; fraud prevention, state-operated services,
412.15the Minnesota sex offender program, the Department of Health, health care
412.16programs, chemical and mental health; continuing care programs, and public
412.17health; establishing the State-County Results, Accountability, and Service
412.18Delivery Redesign; making technical changes; making forecast adjustments;
412.19requiring reports; establishing and increasing fees; appropriating money;
412.20amending Minnesota Statutes 2008, sections 60A.092, subdivision 2; 62D.03,
412.21subdivision 4; 62D.05, subdivision 3; 62J.495; 62J.496; 62J.497, subdivisions
412.221, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision
412.232; 119B.09, subdivision 7; 119B.13, subdivision 6; 119B.21, subdivisions 5,
412.2410; 119B.231, subdivisions 2, 3, 4; 144.0724, subdivisions 2, 4, 8, by adding
412.25subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision
412.261a; 144.125, subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3;
412.27144.9501, subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions
412.281g, 4; 144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by
412.29adding a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions;
412.30144.98, subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision
412.311; 144A.073, by adding a subdivision; 144A.44, subdivision 2; 144A.46,
412.32subdivision 1; 145A.17, by adding a subdivision; 148.6445, by adding a
412.33subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5;
412.34152.126, subdivisions 1, 2, 6; 153A.17; 157.15, by adding a subdivision; 157.16;
412.35157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, subdivision
412.361; 245.4871, subdivision 27; 245.488, subdivision 1; 245A.03, by adding a
412.37subdivision; 245A.10, subdivisions 2, 3; 245A.11, subdivision 2a, by adding
412.38subdivisions; 245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04,
412.39subdivisions 1, 3; 245C.05, subdivision 4, by adding a subdivision; 245C.08,
412.40subdivision 2; 245C.10, subdivision 3, by adding subdivisions; 245C.17, by
412.41adding a subdivision; 245C.20; 245C.21, subdivision 1a; 245C.23, subdivision 2;
412.42246.50, subdivision 5, by adding subdivisions; 246.51, by adding subdivisions;
412.43246.511; 246.52; 246.54, subdivision 2; 246B.01, by adding subdivisions;
412.44252.025, subdivision 7; 252.46, by adding a subdivision; 252.50, subdivision 1;
412.45254A.02, by adding a subdivision; 254A.16, by adding a subdivision; 254B.03,
412.46subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision 1; 254B.09,
412.47subdivision 2; 256.01, subdivision 2b, by adding subdivisions; 256.045,
412.48subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions 2, 6; 256.969,
412.49subdivisions 2b, 3a, by adding subdivisions; 256.975, subdivision 7; 256.983,
413.1subdivision 1; 256B.04, subdivision 16; 256B.055, subdivisions 7, 12; 256B.056,
413.2subdivisions 3c, 3d; 256B.057, by adding a subdivision; 256B.0575; 256B.0595,
413.3subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2;
413.4256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions
413.55, 8; 256B.0625, subdivisions 3, 3c, 6a, 7, 9, 11, 13, 13e, 13h, 17, 17a, 19a,
413.619c, 26, 42, 47, by adding subdivisions; 256B.0641, subdivision 3; 256B.0651;
413.7256B.0652; 256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657,
413.8subdivisions 2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision;
413.9256B.0911, subdivisions 1, 1a, 3, 3a, 3b, 3c, 4a, 5, 6, 7, by adding subdivisions;
413.10256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h, 5, by adding a
413.11subdivision; 256B.0916, subdivision 2; 256B.0917, by adding a subdivision;
413.12256B.092, subdivision 8a, by adding subdivisions; 256B.0943, subdivisions 1,
413.1312; 256B.0944, by adding a subdivision; 256B.0947, subdivision 1; 256B.15,
413.14subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37,
413.15subdivisions 1, 5; 256B.434, subdivision 4, by adding a subdivision; 256B.437,
413.16subdivision 6; 256B.441, subdivisions 55, 58, by adding a subdivision; 256B.49,
413.17subdivisions 12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision
413.184a; 256B.5011, subdivision 2; 256B.5012, by adding a subdivision; 256B.69,
413.19subdivisions 5a, 5c, 5f, 23; 256B.76, subdivision 1; 256D.03, subdivision 4;
413.20256D.44, subdivision 5; 256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05,
413.21subdivisions 1a, 7c; 256J.08, subdivision 73a; 256J.24, subdivision 5; 256J.425,
413.22subdivisions 2, 3; 256J.45, subdivision 3; 256J.49, subdivisions 1, 4; 256J.521,
413.23subdivision 2; 256J.545; 256J.561, subdivisions 2, 3; 256J.57, subdivision
413.241; 256J.575, subdivisions 3, 4, 6, 7; 256J.621; 256J.626, subdivision 7;
413.25256J.95, subdivisions 3, 11, 12, 13; 256L.03, by adding a subdivision; 256L.04,
413.26subdivisions 1, 7a, 10a, by adding a subdivision; 256L.05, subdivisions 1, 3, 3a,
413.27by adding a subdivision; 256L.07, subdivisions 1, 2, 3, by adding a subdivision;
413.28256L.11, subdivision 1; 256L.15, subdivisions 2, 3; 256L.17, subdivisions 3, 5;
413.29259.67, by adding a subdivision; 270A.09, by adding a subdivision; 327.14,
413.30by adding a subdivision; 327.15; 327.16; 327.20, subdivision 1, by adding a
413.31subdivision; 501B.89, by adding a subdivision; 519.05; 604A.33, subdivision
413.321; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, subdivisions
413.336, 13, 21; Laws 2003, First Special Session chapter 14, article 13C, section
413.342, subdivision 1, as amended; Laws 2007, chapter 147, article 19, section 3,
413.35subdivision 4, as amended; proposing coding for new law in Minnesota Statutes,
413.36chapters 62Q; 246B; 254B; 256; 256B; proposing coding for new law as
413.37Minnesota Statutes, chapter 402A; repealing Minnesota Statutes 2008, sections
413.38103I.112; 144.9501, subdivision 17b; 148D.180, subdivision 8; 245C.11,
413.39subdivisions 1, 2; 246.51, subdivision 1; 246.53, subdivision 3; 256.962,
413.40subdivision 7; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6,
413.417, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision
413.425a; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256I.06, subdivision
413.439; 256L.17, subdivision 6; 327.14, subdivisions 5, 6; Minnesota Rules, parts
413.444626.2015, subpart 9; 9555.6125, subpart 4, item B."
We request the adoption of this report and repassage of the bill.House Conferees: (Signed) Thomas Huntley, Paul Thissen, Larry Hosch, Karen Clark, Jim AbelerSenate Conferees: (Signed) Linda Berglin, Tony Lourey, Kathy Sheran, Julie Rosen, Yvonne Prettner Solon
1.3relating to state government; establishing the health and human services budget;
1.4making changes to licensing; Minnesota family investment program, children,
1.5and adult supports; child support; the Department of Health; health care
1.6programs; making technical changes; chemical and mental health; continuing
1.7care programs; establishing the State-County Results, Accountability, and
1.8Service Delivery Redesign; public health; health-related fees; making forecast
1.9adjustments; creating work groups and pilot projects; requiring reports;
1.10decreasing provider reimbursements; increasing fees; appropriating money to
1.11various state agencies for health and human services provisions;amending
1.12Minnesota Statutes 2008, sections 62J.495; 62J.496; 62J.497, subdivisions
1.131, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision 2;
1.14125A.744, subdivision 3; 144.0724, subdivisions 2, 4, 8, by adding subdivisions;
1.15144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision 1a; 144.125,
1.16subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3; 144.9501,
1.17subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions 1g, 4;
1.18144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by adding
1.19a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98,
1.20subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.073, by
1.21adding a subdivision; 144A.44, subdivision 2; 144A.46, subdivision 1; 148.108;
1.22148.6445, by adding a subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180,
1.23subdivisions 1, 2, 3, 5; 153A.17; 156.015; 157.15, by adding a subdivision;
1.24157.16; 157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470,
1.25subdivision 1; 245.4871, subdivision 27; 245.488, subdivision 1; 245.4885,
1.26subdivision 1; 245A.03, by adding a subdivision; 245A.10, subdivisions 2, 3,
1.274, 5, by adding subdivisions; 245A.11, subdivision 2a, by adding a subdivision;
1.28245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04, subdivisions 1,
1.293; 245C.05, subdivision 4; 245C.08, subdivision 2; 245C.10, subdivision 3,
1.30by adding subdivisions; 245C.17, by adding a subdivision; 245C.20; 245C.21,
1.31subdivision 1a; 245C.23, subdivision 2; 246.50, subdivision 5, by adding
1.32subdivisions; 246.51, by adding subdivisions; 246.511; 246.52; 246B.01, by
1.33adding subdivisions; 252.46, by adding a subdivision; 252.50, subdivision
1.341; 254A.02, by adding a subdivision; 254A.16, by adding a subdivision;
1.35254B.03, subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision
1.361; 254B.09, subdivision 2; 256.01, subdivision 2b, by adding subdivisions;
1.37256.045, subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions
1.382, 6; 256.963, by adding a subdivision; 256.969, subdivision 3a; 256.975,
1.39subdivision 7; 256.983, subdivision 1; 256B.04, subdivision 16; 256B.055,
1.40subdivisions 7, 12; 256B.056, subdivisions 3, 3b, 3c, by adding a subdivision;
1.41256B.057, subdivisions 3, 9, by adding a subdivision; 256B.0575; 256B.0595,
1.42subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2;
2.1256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions
2.25, 8; 256B.0625, subdivisions 3c, 7, 8, 8a, 9, 13e, 17, 19a, 19c, 26, 41, 42, 47;
2.3256B.0631, subdivision 1; 256B.0641, subdivision 3; 256B.0651; 256B.0652;
2.4256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657, subdivisions
2.52, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision; 256B.0911,
2.6subdivisions 1, 1a, 3, 3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913,
2.7subdivision 4; 256B.0915, subdivisions 3e, 3h, 5, by adding a subdivision;
2.8256B.0916, subdivision 2; 256B.0917, by adding a subdivision; 256B.092,
2.9subdivision 8a, by adding subdivisions; 256B.0943, subdivision 1; 256B.0944,
2.10by adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision
2.111; 256B.15, subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.37,
2.12subdivisions 1, 5; 256B.434, by adding a subdivision; 256B.437, subdivision 6;
2.13256B.441, subdivisions 48, 55, by adding subdivisions; 256B.49, subdivisions
2.1412, 13, 14, 17, by adding subdivisions; 256B.501, subdivision 4a; 256B.5011,
2.15subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, subdivision
2.161; 256B.69, subdivisions 5a, 5c, 5f; 256B.76, subdivisions 1, 4, by adding
2.17a subdivision; 256B.761; 256D.024, by adding a subdivision; 256D.03,
2.18subdivision 4; 256D.051, subdivision 2a; 256D.0515; 256D.06, subdivision
2.192; 256D.09, subdivision 6; 256D.44, subdivision 5; 256D.49, subdivision 3;
2.20256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05, subdivisions 1a, 7c;
2.21256J.08, subdivision 73a; 256J.20, subdivision 3; 256J.24, subdivisions 5a,
2.2210; 256J.26, by adding a subdivision; 256J.37, subdivision 3a, by adding a
2.23subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3; 256J.49, subdivision
2.2413; 256J.575, subdivisions 3, 6, 7; 256J.621; 256J.626, subdivision 6; 256J.751,
2.25by adding a subdivision; 256J.95, subdivision 12; 256L.04, subdivision 10a,
2.26by adding a subdivision; 256L.05, subdivision 1, by adding subdivisions;
2.27256L.11, subdivisions 1, 7; 256L.12, subdivision 9; 256L.17, subdivision 3;
2.28259.67, by adding a subdivision; 270A.09, by adding a subdivision; 295.52,
2.29by adding a subdivision; 327.14, by adding a subdivision; 327.15; 327.16;
2.30327.20, subdivision 1, by adding a subdivision; 393.07, subdivision 10; 501B.89,
2.31by adding a subdivision; 518A.53, subdivisions 1, 4, 10; 519.05; 604A.33,
2.32subdivision 1; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572,
2.33subdivisions 6, 13, 21; Laws 2003, First Special Session chapter 14, article
2.3413C, section 2, subdivision 1, as amended; Laws 2007, chapter 147, article
2.3519, section 3, subdivision 4, as amended; proposing coding for new law in
2.36Minnesota Statutes, chapters 62A; 62Q; 156; 246B; 254B; 256; 256B; proposing
2.37coding for new law as Minnesota Statutes, chapter 402A; repealing Minnesota
2.38Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b; 148D.180,
2.39subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.962, subdivision
2.407; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10,
2.4111, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision 5a; 256B.19,
2.42subdivision 1d; 256B.431, subdivision 23; 256D.46; 256I.06, subdivision 9;
2.43256J.626, subdivision 7; 327.14, subdivisions 5, 6; Laws 1988, chapter 689,
2.44section 251; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts
2.451, 3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5,
2.466; 9555.6125, subpart 4, item B.
2.47May 10, 2009
2.48The Honorable Margaret Anderson Kelliher
2.49Speaker of the House of Representatives
2.50The Honorable James P. Metzen
2.51President of the Senate
2.52We, the undersigned conferees for H. F. No. 1362 report that we have agreed upon
2.53the items in dispute and recommend as follows:
3.1That the Senate recede from its amendment and that H. F. No. 1362 be further
3.2amended as follows:
3.3Delete everything after the enacting clause and insert:
3.6 Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to
3.7read:
3.8 Subd. 2. County fees for background studies and licensing inspections. (a) For
3.9purposes of family and group family child care licensing under this chapter, a county
3.10agency may charge a fee to an applicant or license holder to recover the actual cost of
3.11background studies, but in any case not to exceed $100 annually. A county agency may
3.12also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
3.13license or $100 for a two-year license.
3.14 (b) A county agency may charge a fee to a legal nonlicensed child care provider or
3.15applicant for authorization to recover the actual cost of background studies completed
3.16under section
3.17 (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
3.18 (1) in cases of financial hardship;
3.19 (2) if the county has a shortage of providers in the county's area;
3.20 (3) for new providers; or
3.21 (4) for providers who have attained at least 16 hours of training before seeking
3.22initial licensure.
3.23 (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
3.24an installment basis for up to one year. If the provider is receiving child care assistance
3.25payments from the state, the provider may have the fees under paragraph (a) or (b)
3.26deducted from the child care assistance payments for up to one year and the state shall
3.27reimburse the county for the county fees collected in this manner.
3.28 (e) For purposes of adult foster care and child foster care licensing under this
3.29chapter, a county agency may charge a fee to a corporate applicant or corporate license
3.30holder to recover
3.31
3.32licensing inspections, not to exceed $500 annually.
3.33 (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
3.34following circumstances:
3.35(1) in cases of financial hardship;
4.1(2) if the county has a shortage of providers in the county's area; or
4.2(3) for new providers.
4.3 Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
4.4 Subd. 3. Application fee for initial license or certification. (a) For fees required
4.5under subdivision 1, an applicant for an initial license or certification issued by the
4.6commissioner shall submit a $500 application fee with each new application required
4.7under this subdivision. The application fee shall not be prorated, is nonrefundable, and
4.8is in lieu of the annual license or certification fee that expires on December 31. The
4.9commissioner shall not process an application until the application fee is paid.
4.10(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license
4.11to provide services at a specific location.
4.12(1) For a license to provide
4.13persons with developmental disabilities
4.14applicant shall submit an application for each county in which the
4.15be provided. Upon licensure, the license holder may provide services to persons in that
4.16county plus no more than three persons at any one time in each of up to ten additional
4.17counties. A license holder in one county may not provide services under the home and
4.18community-based waiver for persons with developmental disabilities to more than three
4.19people in a second county without holding a separate license for that second county.
4.20Applicants or licensees providing services under this clause to not more than three persons
4.21remain subject to the inspection fees established in section 245A.10, subdivision 2, for
4.22each location. The license issued by the commissioner must state the name of each
4.23additional county where services are being provided to persons with developmental
4.24disabilities. A license holder must notify the commissioner before making any changes
4.25that would alter the license information listed under section 245A.04, subdivision 7,
4.26paragraph (a), including any additional counties where persons with developmental
4.27disabilities are being served.
4.28(2) For a license to provide supported employment, crisis respite, or
4.29semi-independent living services to persons with developmental disabilities
4.30
4.31services statewide.
4.32(3) For a license to provide independent living assistance for youth under section
4.34 Sec. 3. Minnesota Statutes 2008, section 245A.11, subdivision 2a, is amended to read:
5.1 Subd. 2a. Adult foster care license capacity. The commissioner shall issue adult
5.2foster care licenses with a maximum licensed capacity of four beds, including nonstaff
5.3roomers and boarders, except that the commissioner may issue a license with a capacity of
5.4five beds, including roomers and boarders, according to paragraphs (a) to (e).
5.5(a) An adult foster care license holder may have a maximum license capacity of five
5.6if all persons in care are age 55 or over and do not have a serious and persistent mental
5.7illness or a developmental disability.
5.8(b) The commissioner may grant variances to paragraph (a) to allow a foster care
5.9provider with a licensed capacity of five persons to admit an individual under the age of 55
5.10if the variance complies with section
5.11is recommended by the county in which the licensed foster care provider is located.
5.12(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth
5.13bed for emergency crisis services for a person with serious and persistent mental illness
5.14or a developmental disability, regardless of age, if the variance complies with section
5.16which the licensed foster care provider is located.
5.17(d)
5.18that impacts providers of adult foster care services, the commissioner may issue an adult
5.19foster care license with a capacity of five adults if the fifth bed does not increase the
5.20overall statewide capacity of licensed adult foster care beds in homes that are not the
5.21primary residence of the license holder, over the licensed capacity in such homes on July
5.221, 2009, as identified in a plan submitted to the commissioner by the county, when the
5.23capacity is recommended by the county licensing agency of the county in which the
5.24facility is located and if the recommendation verifies that:
5.25(1) the facility meets the physical environment requirements in the adult foster
5.26care licensing rule;
5.27(2) the five-bed living arrangement is specified for each resident in the resident's:
5.28(i) individualized plan of care;
5.29(ii) individual service plan under section
5.30(iii) individual resident placement agreement under Minnesota Rules, part
5.319555.5105, subpart 19, if required;
5.32(3) the license holder obtains written and signed informed consent from each
5.33resident or resident's legal representative documenting the resident's informed choice to
5.34living in the home and that the resident's refusal to consent would not have resulted in
5.35service termination; and
5.36(4) the facility was licensed for adult foster care before March 1,
6.1(e) The commissioner shall not issue a new adult foster care license under paragraph
6.2(d) after June 30,
6.3care license issued under paragraph (d) before June 30,
6.4capacity of five adults if the license holder continues to comply with the requirements in
6.5paragraph (d).
6.6EFFECTIVE DATE.This section is effective July 1, 2009.
6.7 Sec. 4. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
6.8to read:
6.9 Subd. 7a. Alternate overnight supervision technology; adult foster care license.
6.10 (a) The commissioner may grant an applicant or license holder an adult foster care license
6.11for a residence that does not have a caregiver in the residence during normal sleeping
6.12hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
6.13monitoring technology to alert the license holder when an incident occurs that may
6.14jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
6.15holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
6.16to 9555.6265, and the requirements under this subdivision. The license printed by the
6.17commissioner must state in bold and large font:
6.18 (1) that the facility is under electronic monitoring; and
6.19 (2) the telephone number of the county's common entry point for making reports of
6.20suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
6.21(b) Applications for a license under this section must be submitted directly to
6.22the Department of Human Services licensing division. The licensing division must
6.23immediately notify the host county and lead county contract agency and the host county
6.24licensing agency. The licensing division must collaborate with the county licensing
6.25agency in the review of the application and the licensing of the program.
6.26 (c) Before a license is issued by the commissioner, and for the duration of the
6.27license, the applicant or license holder must establish, maintain, and document the
6.28implementation of written policies and procedures addressing the requirements in
6.29paragraphs (d) through (f).
6.30 (d) The applicant or license holder must have policies and procedures that:
6.31 (1) establish characteristics of target populations that will be admitted into the home,
6.32and characteristics of populations that will not be accepted into the home;
6.33 (2) explain the discharge process when a foster care recipient requires overnight
6.34supervision or other services that cannot be provided by the license holder due to the
6.35limited hours that the license holder is on-site;
7.1 (3) describe the types of events to which the program will respond with a physical
7.2presence when those events occur in the home during time when staff are not on-site, and
7.3how the license holder's response plan meets the requirements in paragraph (e), clause
7.4(1) or (2);
7.5 (4) establish a process for documenting a review of the implementation and
7.6effectiveness of the response protocol for the response required under paragraph (e),
7.7clause (1) or (2). The documentation must include:
7.8 (i) a description of the triggering incident;
7.9 (ii) the date and time of the triggering incident;
7.10 (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
7.11 (iv) whether the response met the resident's needs;
7.12 (v) whether the existing policies and response protocols were followed; and
7.13 (vi) whether the existing policies and protocols are adequate or need modification.
7.14 When no physical presence response is completed for a three-month period, the
7.15license holder's written policies and procedures must require a physical presence response
7.16drill be to conducted for which the effectiveness of the response protocol under paragraph
7.17(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
7.18 (5) establish that emergency and nonemergency phone numbers are posted in a
7.19prominent location in a common area of the home where they can be easily observed by a
7.20person responding to an incident who is not otherwise affiliated with the home.
7.21 (e) The license holder must document and include in the license application which
7.22response alternative under clause (1) or (2) is in place for responding to situations that
7.23present a serious risk to the health, safety, or rights of people receiving foster care services
7.24in the home:
7.25 (1) response alternative (1) requires only the technology to provide an electronic
7.26notification or alert to the license holder that an event is underway that requires a response.
7.27Under this alternative, no more than ten minutes will pass before the license holder will be
7.28physically present on-site to respond to the situation; or
7.29 (2) response alternative (2) requires the electronic notification and alert system
7.30under alternative (1), but more than ten minutes may pass before the license holder is
7.31present on-site to respond to the situation. Under alternative (2), all of the following
7.32conditions are met:
7.33 (i) the license holder has a written description of the interactive technological
7.34applications that will assist the licenser holder in communicating with and assessing the
7.35needs related to care, health, and safety of the foster care recipients. This interactive
7.36technology must permit the license holder to remotely assess the well being of the foster
8.1care recipient without requiring the initiation of the foster care recipient. Requiring the
8.2foster care recipient to initiate a telephone call does not meet this requirement;
8.3(ii) the license holder documents how the remote license holder is qualified and
8.4capable of meeting the needs of the foster care recipients and assessing foster care
8.5recipients' needs under item (i) during the absence of the license holder on-site;
8.6(iii) the license holder maintains written procedures to dispatch emergency response
8.7personnel to the site in the event of an identified emergency; and
8.8 (iv) each foster care recipient's individualized plan of care, individual service plan
8.9under section 256B.092, subdivision 1b, if required, or individual resident placement
8.10agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
8.11maximum response time, which may be greater than ten minutes, for the license holder
8.12to be on-site for that foster care recipient.
8.13 (f) All placement agreements, individual service agreements, and plans applicable
8.14to the foster care recipient must clearly state that the adult foster care license category is
8.15a program without the presence of a caregiver in the residence during normal sleeping
8.16hours; the protocols in place for responding to situations that present a serious risk to
8.17health, safety, or rights of foster care recipients under paragraph (e), clause (1) or (2); and a
8.18signed informed consent from each foster care recipient or the person's legal representative
8.19documenting the person's or legal representative's agreement with placement in the
8.20program. If electronic monitoring technology is used in the home, the informed consent
8.21form must also explain the following:
8.22 (1) how any electronic monitoring is incorporated into the alternative supervision
8.23system;
8.24 (2) the backup system for any electronic monitoring in times of electrical outages or
8.25other equipment malfunctions;
8.26 (3) how the license holder is trained on the use of the technology;
8.27 (4) the event types and license holder response times established under paragraph (e);
8.28 (5) how the license holder protects the foster care recipient's privacy related to
8.29electronic monitoring and related to any electronically recorded data generated by the
8.30monitoring system. A foster care recipient may not be removed from a program under
8.31this subdivision for failure to consent to electronic monitoring. The consent form must
8.32explain where and how the electronically recorded data is stored, with whom it will be
8.33shared, and how long it is retained; and
8.34 (6) the risks and benefits of the alternative overnight supervision system.
9.1 The written explanations under clauses (1) to (6) may be accomplished through
9.2cross-references to other policies and procedures as long as they are explained to the
9.3person giving consent, and the person giving consent is offered a copy.
9.4(g) Nothing in this section requires the applicant or license holder to develop or
9.5maintain separate or duplicative polices, procedures, documentation, consent forms, or
9.6individual plans that may be required for other licensing standards, if the requirements of
9.7this section are incorporated into those documents.
9.8(h) The commissioner may grant variances to the requirements of this section
9.9according to section 245A.04, subdivision 9.
9.10(i) For the purposes of paragraphs (d) through (h), license holder has the meaning
9.11under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
9.12contractors affiliated with the license holder.
9.13(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
9.14remotely determine what action the license holder needs to take to protect the well-being
9.15of the foster care recipient.
9.16 Sec. 5. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
9.17to read:
9.18 Subd. 8b. Adult foster care data privacy and security. (a) An adult foster
9.19care license holder who creates, collects, records, maintains, stores, or discloses any
9.20individually identifiable recipient data, whether in an electronic or any other format,
9.21must comply with the privacy and security provisions of applicable privacy laws and
9.22regulations, including:
9.23(1) the federal Health Insurance Portability and Accountability Act of 1996
9.24(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
9.25title 45, part 160, and subparts A and E of part 164; and
9.26(2) the Minnesota Government Data Practices Act as codified in chapter 13.
9.27(b) For purposes of licensure, the license holder shall be monitored for compliance
9.28with the following data privacy and security provisions:
9.29(1) the license holder must control access to data on foster care recipients according
9.30to the definitions of public and private data on individuals under section 13.02;
9.31classification of the data on individuals as private under section 13.46, subdivision 2;
9.32and control over the collection, storage, use, access, protection, and contracting related
9.33to data according to section 13.05, in which the license holder is assigned the duties
9.34of a government entity;
10.1(2) the license holder must provide each foster care recipient with a notice that
10.2meets the requirements under section 13.04, in which the license holder is assigned the
10.3duties of the government entity, and that meets the requirements of Code of Federal
10.4Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of
10.5the data, and to whom and why it may be disclosed pursuant to law. The notice must
10.6inform the recipient that the license holder uses electronic monitoring and, if applicable,
10.7that recording technology is used;
10.8(3) the license holder must not install monitoring cameras in bathrooms;
10.9(4) electronic monitoring cameras must not be concealed from the foster care
10.10recipients; and
10.11(5) electronic video and audio recordings of foster care recipients shall not be stored
10.12by the license holder for more than five days.
10.13(c) The commissioner shall develop, and make available to license holders and
10.14county licensing workers, a checklist of the data privacy provisions to be monitored
10.15for purposes of licensure.
10.16 Sec. 6. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:
10.17 Subdivision 1. Delegation of authority to agencies. (a) County agencies and
10.18private agencies that have been designated or licensed by the commissioner to perform
10.19licensing functions and activities under section
10.20
10.21recommend denial of applicants under section
10.22variances, and recommend a conditional license under section
10.23suspending or revoking a license or issuing a fine under section
10.24with rules and directives of the commissioner governing those functions and with this
10.25section. The following variances are excluded from the delegation of variance authority
10.26and may be issued only by the commissioner:
10.27 (1) dual licensure of family child care and child foster care, dual licensure of child
10.28and adult foster care, and adult foster care and family child care;
10.29 (2) adult foster care maximum capacity;
10.30 (3) adult foster care minimum age requirement;
10.31 (4) child foster care maximum age requirement;
10.32 (5) variances regarding disqualified individuals except that county agencies may
10.33issue variances under section
10.34is responsible for conducting a consolidated reconsideration according to sections
11.1and
11.2and a disqualification based on serious or recurring maltreatment; and
11.3 (6) the required presence of a caregiver in the adult foster care residence during
11.4normal sleeping hours.
11.5 (b) County agencies must report information about disqualification reconsiderations
11.6under sections
11.7granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
11.8prescribed by the commissioner.
11.9 (c) For family day care programs, the commissioner may authorize licensing reviews
11.10every two years after a licensee has had at least one annual review.
11.11 (d) For family adult day services programs, the commissioner may authorize
11.12licensing reviews every two years after a licensee has had at least one annual review.
11.13 (e) A license issued under this section may be issued for up to two years.
11.14 Sec. 7. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:
11.15 Subd. 3. Recommendations to commissioner. The county or private agency
11.16shall not make recommendations to the commissioner regarding licensure without first
11.17conducting an inspection, and for
11.18child care, a background study of the applicant under chapter 245C. The county or private
11.19agency must forward its recommendation to the commissioner regarding the appropriate
11.20licensing action within 20 working days of receipt of a completed application.
11.21 Sec. 8. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
11.22 Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
11.23background study of an individual required to be studied under section
11.24subdivision 1
11.25 (b) The commissioner shall conduct a background study of an individual required to
11.26be studied under section
11.27
11.28 (c) The commissioner is not required to conduct a study of an individual at the time
11.29of reapplication for a license if the individual's background study was completed by the
11.30commissioner of human services for an adult foster care license holder that is also:
11.31 (1) registered under chapter 144D; or
11.32 (2) licensed to provide home and community-based services to people with
11.33disabilities at the foster care location and the license holder does not reside in the foster
11.34care residence; and
12.1 (3) the following conditions are met:
12.2 (i) a study of the individual was conducted either at the time of initial licensure or
12.3when the individual became affiliated with the license holder;
12.4 (ii) the individual has been continuously affiliated with the license holder since
12.5the last study was conducted; and
12.6 (iii) the last study of the individual was conducted on or after October 1, 1995.
12.7 (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
12.8conduct a study of an individual required to be studied under section
12.9time of reapplication for a child foster care license. The county or private agency shall
12.10collect and forward to the commissioner the information required under section
12.11subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
12.12study conducted by the commissioner of human services under this paragraph must
12.13include a review of the information required under section
12.14paragraph (a), clauses (1) to (5), 3, and 4.
12.15 (e) The commissioner of human services shall conduct a background study of an
12.16individual specified under section
12.17to (6), who is newly affiliated with a child foster care license holder. The county or
12.18private agency shall collect and forward to the commissioner the information required
12.19under section
12.20commissioner of human services under this paragraph must include a review of the
12.21information required under section
12.22 (f) From January 1, 2010, to December 31, 2012, unless otherwise specified in
12.23paragraph (c), the commissioner shall conduct a study of an individual required to be
12.24studied under section 245C.03 at the time of reapplication for an adult foster care or family
12.25adult day services license: (1) the county shall collect and forward to the commissioner
12.26the information required under section 245C.05, subdivision 1, paragraphs (a) and (b),
12.27and subdivision 5, paragraphs (a) and (b), for background studies conducted by the
12.28commissioner for adult foster care and family adult day services when the license holder
12.29resides in the adult foster care or family adult day services residence; (2) the license
12.30holder shall collect and forward to the commissioner the information required under
12.31section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs (a) and (b),
12.32for background studies conducted by the commissioner for adult foster care when the
12.33license holder does not reside in the adult foster care residence; and (3) the background
12.34study conducted by the commissioner under this paragraph must include a review of the
12.35information required under section 245C.08, subdivision 1, paragraph (a), clauses (1)
12.36to (5), and subdivisions 3 and 4.
13.1(g) The commissioner shall conduct a background study of an individual specified
13.2under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
13.3affiliated with an adult foster care or family adult day services license holder: (1) the
13.4county shall collect and forward to the commissioner the information required under
13.5section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
13.6and (b), for background studies conducted by the commissioner for adult foster care
13.7and family adult day services when the license holder resides in the adult foster care or
13.8family adult day services residence; (2) the license holder shall collect and forward to the
13.9commissioner the information required under section 245C.05, subdivisions 1, paragraphs
13.10(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the
13.11commissioner for adult foster care when the license holder does not reside in the adult
13.12foster care residence; and (3) the background study conducted by the commissioner under
13.13this paragraph must include a review of the information required under section 245C.08,
13.14subdivision 1, paragraph (a), and subdivisions 3 and 4.
13.15 (h) Applicants for licensure, license holders, and other entities as provided in this
13.16chapter must submit completed background study forms to the commissioner before
13.17individuals specified in section
13.18contact in any licensed program.
13.19
13.20considered to be continuously affiliated upon the license holder's receipt from the
13.21commissioner of health or human services of the physician's background study results.
13.22 Sec. 9. Minnesota Statutes 2008, section 245C.05, is amended by adding a subdivision
13.23to read:
13.24 Subd. 2b. County agency to collect and forward information to the
13.25commissioner. For background studies related to adult foster care and family adult
13.26day services when the license holder resides in the adult foster care or family adult
13.27day services residence, the county agency must collect the information required under
13.28subdivision 1 and forward it to the commissioner.
13.29 Sec. 10. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:
13.30 Subd. 4. Electronic transmission. For background studies conducted by the
13.31Department of Human Services, the commissioner shall implement a system for the
13.32electronic transmission of:
13.33 (1) background study information to the commissioner;
13.34 (2) background study results to the license holder;
14.1 (3) background study results to county and private agencies for background studies
14.2conducted by the commissioner for child foster care; and
14.3(4) background study results to county agencies for background studies conducted
14.4by the commissioner for adult foster care and family adult day services.
14.5 Sec. 11. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:
14.6 Subd. 2. Background studies conducted by a county agency. (a) For a background
14.7study conducted by a county agency for
14.8family child care services, the commissioner shall review:
14.9 (1) information from the county agency's record of substantiated maltreatment
14.10of adults and the maltreatment of minors;
14.11 (2) information from juvenile courts as required in subdivision 4 for individuals
14.12listed in section
14.13 (3) information from the Bureau of Criminal Apprehension.
14.14 (b) If the individual has resided in the county for less than five years, the study shall
14.15include the records specified under paragraph (a) for the previous county or counties of
14.16residence for the past five years.
14.17 (c) Notwithstanding expungement by a court, the county agency may consider
14.18information obtained under paragraph (a), clause (3), unless the commissioner received
14.19notice of the petition for expungement and the court order for expungement is directed
14.20specifically to the commissioner.
14.21 Sec. 12. Minnesota Statutes 2008, section 245C.10, is amended by adding a
14.22subdivision to read:
14.23 Subd. 5. Adult foster care services. The commissioner shall recover the cost of
14.24background studies required under section 245C.03, subdivision 1, for the purposes of
14.25adult foster care and family adult day services licensing, through a fee of no more than
14.26$20 per study charged to the license holder. The fees collected under this subdivision are
14.27appropriated to the commissioner for the purpose of conducting background studies.
14.28 Sec. 13. Minnesota Statutes 2008, section 245C.10, is amended by adding a
14.29subdivision to read:
14.30 Subd. 8. Private agencies. The commissioner shall recover the cost of conducting
14.31background studies under section 245C.33 for studies initiated by private agencies for the
14.32purpose of adoption through a fee of no more than $70 per study charged to the private
15.1agency. The fees collected under this subdivision are appropriated to the commissioner for
15.2the purpose of conducting background studies.
15.3 Sec. 14. Minnesota Statutes 2008, section 245C.17, is amended by adding a
15.4subdivision to read:
15.5 Subd. 6. Notice to county agency. For studies on individuals related to a license
15.6to provide adult foster care and family adult day services, the commissioner shall also
15.7provide a notice of the background study results to the county agency that initiated the
15.8background study.
15.9 Sec. 15. Minnesota Statutes 2008, section 245C.20, is amended to read:
15.10245C.20 LICENSE HOLDER RECORD KEEPING.
15.11A licensed program shall document the date the program initiates a background
15.12study under this chapter in the program's personnel files. When a background study is
15.13completed under this chapter, a licensed program shall maintain a notice that the study
15.14was undertaken and completed in the program's personnel files. Except when background
15.15studies are initiated through the commissioner's online system, if a licensed program
15.16has not received a response from the commissioner under section
15.17days of initiation of the background study request, the licensed program must contact the
15.18
15.19a license holder initiates a background study under the commissioner's online system, but
15.20the background study subject's name does not appear in the list of active or recent studies
15.21initiated by that license holder, the license holder must either contact the human services
15.22licensing division or resubmit the background study information online for that individual.
15.23 Sec. 16. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:
15.24 Subd. 1a. Submission of reconsideration request
15.25For disqualifications related to studies conducted by county agencies for family child care,
15.26and for disqualifications related to studies conducted by the commissioner for child foster
15.27care, adult foster care, and family adult day services, the individual shall submit the request
15.28for reconsideration to the county
15.29 (b) For disqualifications related to studies conducted by the commissioner for child
15.30foster care, the individual shall submit the request for reconsideration to the private agency
15.31that initiated the background study.
16.1(c) A reconsideration request shall be submitted within 30 days of the individual's
16.2receipt of the disqualification notice or the time frames specified in subdivision 2,
16.3whichever time frame is shorter.
16.4
16.5reconsideration and provide the commissioner with a recommendation whether to set aside
16.6the individual's disqualification.
16.7 Sec. 17. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:
16.8 Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
16.9commissioner shall notify the license holder of the disqualification and order the license
16.10holder to immediately remove the individual from any position allowing direct contact
16.11with persons receiving services from the license holder if:
16.12 (1) the individual studied does not submit a timely request for reconsideration
16.13under section
16.14 (2) the individual submits a timely request for reconsideration, but the commissioner
16.15does not set aside the disqualification for that license holder under section
16.16 (3) an individual who has a right to request a hearing under sections
16.18not request a hearing within the specified time; or
16.19 (4) an individual submitted a timely request for a hearing under sections
16.20and
16.21disqualification under section
16.22 (b) If the commissioner does not set aside the disqualification under section
16.23and the license holder was previously ordered under section
16.24remove the disqualified individual from direct contact with persons receiving services or
16.25to ensure that the individual is under continuous, direct supervision when providing direct
16.26contact services, the order remains in effect pending the outcome of a hearing under
16.27sections
16.28 (c) For background studies related to child foster care, the commissioner shall
16.29also notify the county or private agency that initiated the study of the results of the
16.30reconsideration.
16.31(d) For background studies related to adult foster care and family adult day services,
16.32the commissioner shall also notify the county that initiated the study of the results of
16.33the reconsideration.
17.1 Sec. 18. Minnesota Statutes 2008, section 256B.092, is amended by adding a
17.2subdivision to read:
17.3 Subd. 5b. Revised per diem based on legislated rate reduction. Notwithstanding
17.4section 252.28, subdivision 3, paragraph (d), if the 2009 legislature adopts a rate reduction
17.5that impacts payment to providers of adult foster care services, the commissioner may
17.6issue adult foster care licenses that permit a capacity of five adults. The application for a
17.7five-bed license must meet the requirements of section 245A.11, subdivision 2a. Prior to
17.8admission of the fifth recipient of adult foster care services, the county must negotiate a
17.9revised per diem rate for room and board and waiver services that reflects the legislated
17.10rate reduction and results in an overall average per diem reduction for all foster care
17.11recipients in that home. The revised per diem must allow the provider to maintain, as
17.12much as possible, the level of services or enhanced services provided in the residence,
17.13while mitigating the losses of the legislated rate reduction.
17.14EFFECTIVE DATE.This section is effective July 1, 2009.
17.15 Sec. 19. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
17.16 Subd. 17. Cost of services and supports. (a) The commissioner shall ensure
17.17that the average per capita expenditures estimated in any fiscal year for home and
17.18community-based waiver recipients does not exceed the average per capita expenditures
17.19that would have been made to provide institutional services for recipients in the absence
17.20of the waiver.
17.21(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
17.22need-based methods for allocating to local agencies the home and community-based
17.23waivered service resources available to support recipients with disabilities in need of
17.24the level of care provided in a nursing facility or a hospital. The commissioner shall
17.25allocate resources to single counties and county partnerships in a manner that reflects
17.26consideration of:
17.27(1) an incentive-based payment process for achieving outcomes;
17.28(2) the need for a state-level risk pool;
17.29(3) the need for retention of management responsibility at the state agency level; and
17.30(4) a phase-in strategy as appropriate.
17.31(c) Until the allocation methods described in paragraph (b) are implemented, the
17.32annual allowable reimbursement level of home and community-based waiver services
17.33shall be the greater of:
18.1(1) the statewide average payment amount which the recipient is assigned under the
18.2waiver reimbursement system in place on June 30, 2001, modified by the percentage of
18.3any provider rate increase appropriated for home and community-based services; or
18.4(2) an amount approved by the commissioner based on the recipient's extraordinary
18.5needs that cannot be met within the current allowable reimbursement level. The
18.6increased reimbursement level must be necessary to allow the recipient to be discharged
18.7from an institution or to prevent imminent placement in an institution. The additional
18.8reimbursement may be used to secure environmental modifications; assistive technology
18.9and equipment; and increased costs for supervision, training, and support services
18.10necessary to address the recipient's extraordinary needs. The commissioner may approve
18.11an increased reimbursement level for up to one year of the recipient's relocation from an
18.12institution or up to six months of a determination that a current waiver recipient is at
18.13imminent risk of being placed in an institution.
18.14(d) Beginning July 1, 2001, medically necessary private duty nursing services will be
18.15authorized under this section as complex and regular care according to sections
18.16and
18.17nurse or licensed practical nurse services under any home and community-based waiver as
18.18of January 1, 2001, shall not be reduced.
18.19(e) Notwithstanding section 252.28, subdivision 3, paragraph (d), if the 2009
18.20legislature adopts a rate reduction that impacts payment to providers of adult foster care
18.21services, the commissioner may issue adult foster care licenses that permit a capacity of
18.22five adults. The application for a five-bed license must meet the requirements of section
18.23245A.11, subdivision 2a. Prior to admission of the fifth recipient of adult foster care
18.24services, the county must negotiate a revised per diem rate for room and board and waiver
18.25services that reflects the legislated rate reduction and results in an overall average per
18.26diem reduction for all foster care recipients in that home. The revised per diem must allow
18.27the provider to maintain, as much as possible, the level of services or enhanced services
18.28provided in the residence, while mitigating the losses of the legislated rate reduction.
18.29EFFECTIVE DATE.This section is effective July 1, 2009.
18.30 Sec. 20. WAIVER.
18.31By December 1, 2009, the commissioner shall request all federal approvals and
18.32waiver amendments to the disability home and community-based waivers to allow properly
18.33licensed adult foster care homes to provide residential services for up to five individuals.
18.34EFFECTIVE DATE.This section is effective July 1, 2009.
19.1 Sec. 21. REPEALER.
19.2(a) Minnesota Statutes 2008, section 245C.11, subdivisions 1 and 2, are repealed.
19.3(b) Minnesota Statutes 2008, section 256B.092, subdivision 5a, is repealed effective
19.4July 1, 2009.
19.5(c) Minnesota Rules, part 9555.6125, subpart 4, item B, is repealed.
19.8 Section 1. Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:
19.9 Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child
19.10care assistance under this chapter is the later of the date the application was signed; the
19.11beginning date of employment, education, or training; the date the infant is born for
19.12applicants to the at-home infant care program; or the date a determination has been made
19.13that the applicant is a participant in employment and training services under Minnesota
19.14Rules, part 3400.0080, or chapter 256J.
19.15 (b) Payment ceases for a family under the at-home infant child care program when a
19.16family has used a total of 12 months of assistance as specified under section
19.17Payment of child care assistance for employed persons on MFIP is effective the date of
19.18employment or the date of MFIP eligibility, whichever is later. Payment of child care
19.19assistance for MFIP or DWP participants in employment and training services is effective
19.20the date of commencement of the services or the date of MFIP or DWP eligibility,
19.21whichever is later. Payment of child care assistance for transition year child care must be
19.22made retroactive to the date of eligibility for transition year child care.
19.23(c) Notwithstanding paragraph (b), payment of child care assistance for participants
19.24eligible under section 119B.05 may only be made retroactive for a maximum of six
19.25months from the date of application for child care assistance.
19.26EFFECTIVE DATE.This section is effective October 1, 2009.
19.27 Sec. 2. Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:
19.28 Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments
19.29to the child care provider or pay the parent directly for eligible child care expenses.
19.30(b) If payments for child care assistance are made to providers, the provider shall
19.31bill the county for services provided within ten days of the end of the service period. If
19.32bills are submitted within ten days of the end of the service period, a county or the state
19.33shall issue payment to the provider of child care under the child care fund within 30 days
20.1of receiving a bill from the provider. Counties or the state may establish policies that
20.2make payments on a more frequent basis.
20.3(c)
20.4billing form for an eligible family, the bill must be submitted within 60 days of the last
20.5date of service on the bill. A county may pay a bill submitted more than 60 days after
20.6the last date of service if the provider shows good cause why the bill was not submitted
20.7within 60 days. Good cause must be defined in the county's child care fund plan under
20.8section
20.9error. A county may not pay any bill submitted more than a year after the last date of
20.10service on the bill.
20.11(d) If a provider provided care for a time period without receiving an authorization
20.12of care and a billing form for an eligible family, payment of child care assistance may only
20.13be made retroactively for a maximum of six months from the date the provider is issued
20.14an authorization of care and billing form.
20.15(e) A county may stop payment issued to a provider or may refuse to pay a bill
20.16submitted by a provider if:
20.17(1) the provider admits to intentionally giving the county materially false information
20.18on the provider's billing forms; or
20.19(2) a county finds by a preponderance of the evidence that the provider intentionally
20.20gave the county materially false information on the provider's billing forms.
20.21
20.22under section
20.23being in compliance with this subdivision, the payments must be made in compliance
20.24with section
20.25EFFECTIVE DATE.This section is effective October 1, 2009.
20.26 Sec. 3. Minnesota Statutes 2008, section 119B.21, subdivision 5, is amended to read:
20.27 Subd. 5. Child care services grants. (a) A child care resource and referral program
20.28designated under section
20.29for:
20.30 (1) creating new licensed child care facilities and expanding existing facilities,
20.31including, but not limited to, supplies, equipment, facility renovation, and remodeling;
20.32 (2) improving licensed child care facility programs;
20.33 (3) staff training and development services including, but not limited to, in-service
20.34training, curriculum development, accreditation, certification, consulting, resource
21.1centers, program and resource materials, supporting effective teacher-child interactions,
21.2child-focused teaching, and content-driven classroom instruction;
21.3 (4) interim financing;
21.4 (5) capacity building through the purchase of appropriate technology to create,
21.5enhance, and maintain business management systems;
21.6 (6) emergency assistance for child care programs;
21.7 (7) new programs or projects for the creation, expansion, or improvement of
21.8programs that serve ethnic immigrant and refugee communities; and
21.9 (8) targeted recruitment initiatives to expand and build the capacity of the child
21.10care system and to improve the quality of care provided by legal nonlicensed child care
21.11providers.
21.12 (b) A child care resource and referral program designated under section
21.13subdivision 1a
21.14 (1) licensed providers;
21.15 (2) providers in the process of being licensed;
21.16 (3) corporations or public agencies that develop or provide child care services;
21.17 (4) school-age care programs;
21.18 (5) legal nonlicensed or family, friend, and neighbor care providers; or
21.19 (6) any combination of clauses (1) to (5).
21.20 (c) A recipient of a child care services grant for facility improvements, interim
21.21financing, or staff training and development must provide a 25 percent local match.
21.22(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly
21.23awarded for activities that improve provider quality, including activities under paragraph
21.24(a), clauses (1) to (3) and (7).
21.25 Sec. 4. Minnesota Statutes 2008, section 119B.21, subdivision 10, is amended to read:
21.26 Subd. 10. Family child care technical assistance grants. (a) A child care resource
21.27and referral organization designated under section
21.28technical assistance grants of up to $1,000. These grants may be used for:
21.29 (1) facility improvements, including, but not limited to, improvements to meet
21.30licensing requirements;
21.31 (2) improvements to expand a child care facility or program;
21.32 (3) toys, materials, and equipment to improve the learning environment;
21.33 (4) technology and software to create, enhance, and maintain business management
21.34systems;
21.35 (5) start-up costs;
22.1 (6) staff training and development; and
22.2 (7) other uses approved by the commissioner.
22.3 (b) A child care resource and referral program may award family child care technical
22.4assistance grants to:
22.5 (1) licensed family child care providers;
22.6 (2) child care providers in the process of becoming licensed; or
22.7 (3) legal nonlicensed or family, friend, and neighbor care providers.
22.8 (c) A local match is not required for a family child care technical assistance grant.
22.9(d) Beginning July 1, 2009, grants under this subdivision shall be increasingly
22.10awarded for activities that improve provider quality, including activities under paragraph
22.11(a), clauses (1), (3), and (6).
22.12 Sec. 5. Minnesota Statutes 2008, section 119B.231, subdivision 2, is amended to read:
22.13 Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall
22.14apply to the commissioner or have been chosen as an SRSA provider prior to June 30,
22.152009, and have complied with all requirements of the SRSA agreement. Priority for funds
22.16is given to providers who had agreements prior to June 30, 2009. If sufficient funds are
22.17available, the commissioner shall make applications available to additional providers. To
22.18be eligible to apply for an SRSA, a provider shall:
22.19 (1) be eligible for child care assistance payments under chapter 119B;
22.20 (2) have at least 25 percent of the children enrolled with the provider subsidized
22.21through the child care assistance program;
22.22 (3) provide full-time, full-year child care services; and
22.23 (4)
22.24
22.25obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system.
22.26 (b) The commissioner may waive the 25 percent requirement in paragraph (a),
22.27clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity
22.28of types of care provided by SRSA providers.
22.29 (c) An eligible provider who would like to enter into an SRSA with the commissioner
22.30shall submit an SRSA application. To determine whether to enter into an SRSA with a
22.31provider, the commissioner shall evaluate the following factors:
22.32 (1) the
22.33Aware rating score;
22.34
22.35
23.1
23.2
23.3
23.4
23.5
23.6
23.7 Sec. 6. Minnesota Statutes 2008, section 119B.231, subdivision 3, is amended to read:
23.8 Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA
23.9provider for their children shall:
23.10 (1) be eligible to receive child care assistance under any provision in chapter 119B
23.11except section
23.12 (2) be in an authorized activity for an average of at least 35 hours per week when
23.13initial eligibility is determined; and
23.14 (3) include a child who has not yet entered kindergarten.
23.15 (b) A family who is determined to be eligible to choose an SRSA provider remains
23.16eligible to be paid at a higher rate through the SRSA provider when the following
23.17conditions exist:
23.18 (1) the child attends child care with the SRSA provider a minimum of 25 hours per
23.19week, on average;
23.20 (2) the family has a child who has not yet entered kindergarten; and
23.21 (3) the family maintains eligibility under chapter 119B except section
23.22 (c)
23.23family's authorized activities to an average of less than 35 hours per week does not result
23.24in ineligibility for the SRSA rate. A family must continue to maintain eligibility under this
23.25chapter and be in an authorized activity.
23.26 (d) A family that moves between counties but continues to use the same SRSA
23.27provider shall continue to receive SRSA funding for the increased payments.
23.28 Sec. 7. Minnesota Statutes 2008, section 119B.231, subdivision 4, is amended to read:
23.29 Subd. 4. Requirements of providers. An SRSA must include assessment,
23.30evaluation, and reporting requirements that promote the goals of improved school
23.31readiness and movement toward appropriate child development milestones. A provider
23.32who enters into an SRSA shall comply with all SRSA requirements, including the
23.33assessment, evaluation, and reporting requirements in the SRSA. Providers who have been
23.34selected previously for SRSAs must begin the process to obtain a rating using Parent
24.1Aware according to timelines established by the commissioner. If the initial Parent Aware
24.2rating is less than three stars, the provider must submit a plan to improve the rating. If
24.3a 3 or 4 star rating is not obtained within established timelines, the commissioner may
24.4consider continuation of the agreement, depending upon the progress made and other
24.5factors. Providers who apply and are selected for a new SRSA agreement on or after July
24.61, 2009, must have a level 3 or 4 star rating under the voluntary Parent Aware quality
24.7rating system at the time the SRSA agreement is signed.
24.8 Sec. 8. Minnesota Statutes 2008, section 145A.17, is amended by adding a subdivision
24.9to read:
24.10 Subd. 4a. Home visitors as MFIP employment and training service providers.
24.11The county social service agency and the local public health department may mutually
24.12agree to utilize home visitors under this section as MFIP employment and training service
24.13providers under section 256J.49, subdivision 4, for MFIP participants who are: (1) ill or
24.14incapacitated under section 256J.425, subdivision 2; or (2) minor caregivers under section
24.15256J.54. The county social service agency and the local public health department may
24.16also mutually agree to utilize home visitors to provide outreach to MFIP families who are
24.17being sanctioned or who have been terminated from MFIP due to the 60-month time limit.
24.18 Sec. 9. Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:
24.19 Subd. 3. State agency hearings. (a) State agency hearings are available for the
24.20following:
24.21 (1) any person applying for, receiving or having received public assistance, medical
24.22care, or a program of social services granted by the state agency or a county agency or
24.23the federal Food Stamp Act whose application for assistance is denied, not acted upon
24.24with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
24.25claimed to have been incorrectly paid;
24.26 (2) any patient or relative aggrieved by an order of the commissioner under section
24.28 (3) a party aggrieved by a ruling of a prepaid health plan;
24.29 (4) except as provided under chapter 245C, any individual or facility determined by
24.30a lead agency to have maltreated a vulnerable adult under section
24.31exercised their right to administrative reconsideration under section
24.32 (5) any person whose claim for foster care payment according to a placement of the
24.33child resulting from a child protection assessment under section
24.34acted upon with reasonable promptness, regardless of funding source;
25.1 (6) any person to whom a right of appeal according to this section is given by other
25.2provision of law;
25.3 (7) an applicant aggrieved by an adverse decision to an application for a hardship
25.4waiver under section
25.5 (8) an applicant aggrieved by an adverse decision to an application or redetermination
25.6for a Medicare Part D prescription drug subsidy under section
25.7 (9) except as provided under chapter 245A, an individual or facility determined
25.8to have maltreated a minor under section
25.9exercised the right to administrative reconsideration under section
25.10 (10) except as provided under chapter 245C, an individual disqualified under sections
25.12of the evidence that the individual has committed an act or acts that meet the definition
25.13of any of the crimes listed in section
25.14reports required under section
25.15regarding a maltreatment determination under clause (4) or (9) and a disqualification under
25.16this clause in which the basis for a disqualification is serious or recurring maltreatment,
25.17which has not been set aside under sections
25.18into a single fair hearing. In such cases, the scope of review by the human services referee
25.19shall include both the maltreatment determination and the disqualification. The failure to
25.20exercise the right to an administrative reconsideration shall not be a bar to a hearing under
25.21this section if federal law provides an individual the right to a hearing to dispute a finding
25.22of maltreatment. Individuals and organizations specified in this section may contest the
25.23specified action, decision, or final disposition before the state agency by submitting a
25.24written request for a hearing to the state agency within 30 days after receiving written
25.25notice of the action, decision, or final disposition, or within 90 days of such written notice
25.26if the applicant, recipient, patient, or relative shows good cause why the request was not
25.27submitted within the 30-day time limit
25.28 (11) any person with an outstanding debt resulting from receipt of public assistance,
25.29medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
25.30Department of Human Services or a county agency. The scope of the appeal is the validity
25.31of the claimant agency's intention to request a setoff of a refund under chapter 270A
25.32against the debt.
25.33 (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
25.34(10), is the only administrative appeal to the final agency determination specifically,
25.35including a challenge to the accuracy and completeness of data under section
25.36Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
26.1that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
26.2homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
26.3contested case proceeding under the provisions of chapter 14. Hearings requested under
26.4paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
26.5July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
26.6only available when there is no juvenile court or adult criminal action pending. If such
26.7action is filed in either court while an administrative review is pending, the administrative
26.8review must be suspended until the judicial actions are completed. If the juvenile court
26.9action or criminal charge is dismissed or the criminal action overturned, the matter may be
26.10considered in an administrative hearing.
26.11 (c) For purposes of this section, bargaining unit grievance procedures are not an
26.12administrative appeal.
26.13 (d) The scope of hearings involving claims to foster care payments under paragraph
26.14(a), clause (5), shall be limited to the issue of whether the county is legally responsible
26.15for a child's placement under court order or voluntary placement agreement and, if so,
26.16the correct amount of foster care payment to be made on the child's behalf and shall not
26.17include review of the propriety of the county's child protection determination or child
26.18placement decision.
26.19 (e) A vendor of medical care as defined in section
26.20vendor under contract with a county agency to provide social services is not a party and
26.21may not request a hearing under this section, except if assisting a recipient as provided in
26.22subdivision 4.
26.23 (f) An applicant or recipient is not entitled to receive social services beyond the
26.24services prescribed under chapter 256M or other social services the person is eligible
26.25for under state law.
26.26 (g) The commissioner may summarily affirm the county or state agency's proposed
26.27action without a hearing when the sole issue is an automatic change due to a change in
26.28state or federal law.
26.29 Sec. 10. Minnesota Statutes 2008, section 256.983, subdivision 1, is amended to read:
26.30 Subdivision 1. Programs established. Within the limits of available appropriations,
26.31the commissioner of human services shall require the maintenance of budget neutral
26.32fraud prevention investigation programs in the counties participating in the fraud
26.33prevention investigation project established under this section. If funds are sufficient,
26.34the commissioner may also extend fraud prevention investigation programs to other
26.35counties provided the expansion is budget neutral to the state. Under any expansion, the
27.1commissioner has the final authority in decisions regarding the creation and realignment
27.2of individual county or regional operations.
27.3 Sec. 11. Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:
27.4 Subd. 7. Countable income. "Countable income" means all income received by an
27.5applicant or recipient less any applicable exclusions or disregards. For a recipient of any
27.6cash benefit from the SSI program, countable income means the SSI benefit limit in effect
27.7at the time the person is in a GRH
27.8needs allowance. If the SSI limit has been reduced for a person due to events occurring
27.9prior to the persons entering the GRH setting, countable income means actual income less
27.10any applicable exclusions and disregards.
27.11EFFECTIVE DATE.This section is effective April 1, 2010.
27.12 Sec. 12. Minnesota Statutes 2008, section 256I.05, subdivision 7c, is amended to read:
27.13 Subd. 7c. Demonstration project. The commissioner is authorized to pursue the
27.14expansion of a demonstration project under federal food stamp regulation for the purpose
27.15of gaining additional federal reimbursement of food and nutritional costs currently paid by
27.16the state group residential housing program. The commissioner shall seek approval no
27.17later than
27.18revenue to the general fund.
27.19 Sec. 13. Minnesota Statutes 2008, section 256J.24, subdivision 5, is amended to read:
27.20 Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
27.21on the number of persons in the assistance unit eligible for both food and cash assistance
27.22unless the restrictions in subdivision 6 on the birth of a child apply. The following table
27.23represents the transitional standards effective
| 27.24 |
Number of Eligible People |
Transitional Standard |
Cash Portion |
Food Portion |
28.8standard for an assistance unit sizes 1 to 10 including a breakdown of the cash and food
28.9portions.
28.10EFFECTIVE DATE.This section is effective retroactively from April 1, 2009.
28.11 Sec. 14. Minnesota Statutes 2008, section 256J.425, subdivision 2, is amended to read:
28.12 Subd. 2. Ill or incapacitated. (a) An assistance unit subject to the time limit in
28.13section
28.14extension if the participant who reached the time limit belongs to any of the following
28.15groups:
28.16(1) participants who are suffering from an illness, injury, or incapacity which
28.17has been certified by a qualified professional when the illness, injury, or incapacity is
28.18expected to continue for more than 30 days and
28.19
28.20employment. These participants must follow the treatment recommendations of the
28.21qualified professional certifying the illness, injury, or incapacity;
28.22(2) participants whose presence in the home is required as a caregiver because of
28.23the illness, injury, or incapacity of another member in the assistance unit, a relative in the
28.24household, or a foster child in the household when the illness or incapacity and the need
28.25for a person to provide assistance in the home has been certified by a qualified professional
28.26and is expected to continue for more than 30 days; or
28.27(3) caregivers with a child or an adult in the household who meets the disability or
28.28medical criteria for home care services under section
28.29(c), or a home and community-based waiver services program under chapter 256B, or
28.30meets the criteria for severe emotional disturbance under section
28.316
28.32paragraph (c). Caregivers in this category are presumed to be prevented from obtaining
28.33or retaining employment.
29.1(b) An assistance unit receiving assistance under a hardship extension under this
29.2subdivision may continue to receive assistance as long as the participant meets the criteria
29.3in paragraph (a), clause (1), (2), or (3).
29.4 Sec. 15. Minnesota Statutes 2008, section 256J.425, subdivision 3, is amended to read:
29.5 Subd. 3. Hard-to-employ participants. (a) An assistance unit subject to the time
29.6limit in section
29.7a hardship extension if the participant who reached the time limit belongs to any of the
29.8following groups:
29.9(1) a person who is diagnosed by a licensed physician, psychological practitioner,
29.10or other qualified professional, as developmentally disabled or mentally ill, and
29.11
29.12condition severely limits the person's ability to obtain or maintain suitable employment;
29.13(2) a person who:
29.14(i) has been assessed by a vocational specialist or the county agency to be
29.15unemployable for purposes of this subdivision; or
29.16(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
29.17agency to be employable, but
29.18
29.19maintain suitable employment. The determination of IQ level must be made by a qualified
29.20professional. In the case of a non-English-speaking person: (A) the determination must
29.21be made by a qualified professional with experience conducting culturally appropriate
29.22assessments, whenever possible; (B) the county may accept reports that identify an
29.23IQ range as opposed to a specific score; (C) these reports must include a statement of
29.24confidence in the results;
29.25(3) a person who is determined by a qualified professional to be learning disabled,
29.26and the
29.27maintain suitable employment. For purposes of the initial approval of a learning disability
29.28extension, the determination must have been made or confirmed within the previous 12
29.29months. In the case of a non-English-speaking person: (i) the determination must be made
29.30by a qualified professional with experience conducting culturally appropriate assessments,
29.31whenever possible; and (ii) these reports must include a statement of confidence in the
29.32results. If a rehabilitation plan for a participant extended as learning disabled is developed
29.33or approved by the county agency, the plan must be incorporated into the employment
29.34plan. However, a rehabilitation plan does not replace the requirement to develop and
29.35comply with an employment plan under section
30.1(4) a person who has been granted a family violence waiver, and who is complying
30.2with an employment plan under section
30.3(b) For purposes of this section, "severely limits the person's ability to obtain or
30.4maintain suitable employment" means that a qualified professional has determined that the
30.5person's condition prevents the person from working 20 or more hours per week.
30.6 Sec. 16. Minnesota Statutes 2008, section 256J.49, subdivision 1, is amended to read:
30.7 Subdivision 1. Scope. The terms used in sections
30.8the meanings given them in this section.
30.9 Sec. 17. Minnesota Statutes 2008, section 256J.49, subdivision 4, is amended to read:
30.10 Subd. 4. Employment and training service provider. "Employment and training
30.11service provider" means:
30.12(1) a public, private, or nonprofit agency with which a county has contracted to
30.13provide employment and training services and which is included in the county's service
30.14agreement submitted under section
30.15(2) a county agency, if the county has opted to provide employment and training
30.16services and the county has indicated that fact in the service agreement submitted under
30.17section
30.18(3) a local public health department under section 145A.17, subdivision 3a, that a
30.19county has designated to provide employment and training services and is included in the
30.20county's service agreement submitted under section 256J.626, subdivision 4.
30.21Notwithstanding section
30.22meeting this definition may deliver employment and training services under this chapter.
30.23 Sec. 18. Minnesota Statutes 2008, section 256J.521, subdivision 2, is amended to read:
30.24 Subd. 2. Employment plan; contents. (a) Based on the assessment under
30.25subdivision 1, the job counselor and the participant must develop an employment plan
30.26that includes participation in activities and hours that meet the requirements of section
30.28participant the most direct path to unsubsidized employment and any subsequent steps that
30.29support long-term economic stability. The employment plan should be developed using
30.30the highest level of activity appropriate for the participant. Activities must be chosen from
30.31clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
30.32preference for activities, priority must be given for activities related to a family violence
30.33waiver when developing the employment plan. The employment plan must also list the
31.1specific steps the participant will take to obtain employment, including steps necessary
31.2for the participant to progress from one level of activity to another, and a timetable for
31.3completion of each step. Levels of activity include:
31.4 (1) unsubsidized employment;
31.5 (2) job search;
31.6 (3) subsidized employment or unpaid work experience;
31.7 (4) unsubsidized employment and job readiness education or job skills training;
31.8 (5) unsubsidized employment or unpaid work experience and activities related to
31.9a family violence waiver or preemployment needs; and
31.10 (6) activities related to a family violence waiver or preemployment needs.
31.11 (b) Participants who are determined to possess sufficient skills such that the
31.12participant is likely to succeed in obtaining unsubsidized employment must job search at
31.13least 30 hours per week for up to six weeks and accept any offer of suitable employment.
31.14The remaining hours necessary to meet the requirements of section
31.151
31.16subdivision 13
31.17whether the job search is supervised or unsupervised; (2) support services that will
31.18be provided; and (3) how frequently the participant must report to the job counselor.
31.19Participants who are unable to find suitable employment after six weeks must meet
31.20with the job counselor to determine whether other activities in paragraph (a) should be
31.21incorporated into the employment plan. Job search activities which are continued after six
31.22weeks must be structured and supervised.
31.23 (c)
31.24
31.25
31.26
31.27
31.28
31.29
31.30employment that will not be overcome during six weeks of job search under paragraph (b)
31.31must work with the job counselor to develop an employment plan that addresses those
31.32barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6).
31.33The employment plan must include enough hours to meet the participation requirements
31.34in section
31.35is noted in the participant's file.
32.1
32.2indicate agreement on the contents.
32.3
32.4activities in the plan, or voluntarily quitting suitable employment without good cause, will
32.5result in the imposition of a sanction under section
32.6
32.7employment because the participant is not eligible for holiday pay and the participant's
32.8place of employment is closed for a holiday, the job counselor shall not impose a sanction
32.9or increase the hours of participation in any other activity, including paid employment, to
32.10offset the hours that were missed due to the holiday.
32.11
32.12whether activities and hourly requirements should be revised. The job counselor is
32.13encouraged to allow participants who are participating in at least 20 hours of work
32.14activities to also participate in education and training activities in order to meet the federal
32.15hourly participation rates.
32.16 Sec. 19. Minnesota Statutes 2008, section 256J.545, is amended to read:
32.17256J.545 FAMILY VIOLENCE WAIVER CRITERIA.
32.18 (a) In order to qualify for a family violence waiver, an individual must provide
32.19documentation of past or current family violence which may prevent the individual from
32.20participating in certain employment activities.
32.21 (b) The following items may be considered acceptable documentation or verification
32.22of family violence:
32.23 (1) police, government agency, or court records;
32.24 (2) a statement from a battered women's shelter staff with knowledge of the
32.25circumstances
32.26 (3) a statement from a sexual assault or domestic violence advocate with knowledge
32.27of the circumstances
32.28 (4) a statement from professionals from whom the applicant or recipient has sought
32.29assistance for the abuse.
32.30 (c) A claim of family violence may also be documented by a sworn statement from
32.31the applicant or participant and a sworn statement from any other person with knowledge
32.32of the circumstances or credible evidence that supports the client's statement.
32.33 Sec. 20. Minnesota Statutes 2008, section 256J.561, subdivision 2, is amended to read:
33.1 Subd. 2. Participation requirements. (a) All MFIP caregivers, except caregivers
33.2who meet the criteria in subdivision 3, must
33.3individualized employment plan that identifies the activities the participant is required to
33.4participate in and the required hours of participation.
33.5
33.6
33.7
33.8
33.9
33.10
33.11
33.12
33.13
33.14
33.15
33.16
33.17
33.18
33.19
33.20
33.21
33.22
33.23
33.24
33.25
33.26
33.27
33.28
33.29
33.30
33.31
33.32
33.33
33.34
33.35
33.36
34.1(b) Participants who meet the eligibility requirements in section 256J.575,
34.2subdivision 3, must develop a family stabilization services plan that meets the
34.3requirements in section 256J.575, subdivision 5.
34.4(c) Minor caregivers and caregivers who are less than age 20 who have not
34.5completed high school or obtained a GED must develop an education plan that meets the
34.6requirements in section 256J.54.
34.7(d) Participants with a family violence waiver must develop an employment plan
34.8that meets the requirements in section 256J.521, which cover the provisions in section
34.9256J.575, subdivision 5.
34.10(e) All other participants must develop an employment plan that meets the
34.11requirements of section
34.12as defined in section
34.13minimum, the number of participation hours required under section
34.14 Sec. 21. Minnesota Statutes 2008, section 256J.561, subdivision 3, is amended to read:
34.15 Subd. 3. Child under 12
34.16natural born child who is less than 12
34.17subdivision is not required to participate in employment services until the child reaches
34.1812
34.19have already used this provision or the previously allowed child under age one exemption.
34.20However, an assistance unit that has an approved child under age one exemption at the
34.21time this provision becomes effective may continue to use that exemption until the child
34.22reaches one year of age.
34.23(b) The provision in paragraph (a) ends the first full month after the child reaches
34.2412
34.25In a two-parent household, only one parent shall be allowed to use this provision. The
34.26participant and job counselor must meet within ten days after the child reaches 12
34.27months of age to revise the participant's employment plan.
34.28EFFECTIVE DATE.This section is effective March 1, 2010.
34.29 Sec. 22. Minnesota Statutes 2008, section 256J.57, subdivision 1, is amended to read:
34.30 Subdivision 1. Good cause for failure to comply. The county agency shall not
34.31impose the sanction under section
34.32cause for failing to comply with the requirements of sections
34.33cause exists when:
34.34(1) appropriate child care is not available;
35.1(2) the job does not meet the definition of suitable employment;
35.2(3) the participant is ill or injured;
35.3(4) a member of the assistance unit, a relative in the household, or a foster child in
35.4the household is ill and needs care by the participant that prevents the participant from
35.5complying with the employment plan;
35.6(5) the participant is unable to secure necessary transportation;
35.7(6) the participant is in an emergency situation that prevents compliance with the
35.8employment plan;
35.9(7) the schedule of compliance with the employment plan conflicts with judicial
35.10proceedings;
35.11(8) a mandatory MFIP meeting is scheduled during a time that conflicts with a
35.12judicial proceeding or a meeting related to a juvenile court matter, or a participant's work
35.13schedule;
35.14(9) the participant is already participating in acceptable work activities;
35.15(10) the employment plan requires an educational program for a caregiver under age
35.1620, but the educational program is not available;
35.17(11) activities identified in the employment plan are not available;
35.18(12) the participant is willing to accept suitable employment, but suitable
35.19employment is not available;
35.20(13) the participant documents other verifiable impediments to compliance with the
35.21employment plan beyond the participant's control; or
35.22(14) the documentation needed to determine if a participant is eligible for family
35.23stabilization services is not available, but there is information that the participant may
35.24qualify and the participant is cooperating with the county or employment service provider's
35.25efforts to obtain the documentation necessary to determine eligibility.
35.26The job counselor shall work with the participant to reschedule mandatory meetings
35.27for individuals who fall under clauses (1), (3), (4), (5), (6), (7), and (8).
35.28 Sec. 23. Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:
35.29 Subd. 3. Eligibility. (a) The following MFIP
35.30participants are eligible for the services under this section:
35.31 (1) a participant who meets the requirements for or has been granted a hardship
35.32extension under section
35.33the participant to have reached or be approaching 60 months of eligibility for this section
35.34to apply;
36.1 (2) a participant who is applying for Supplemental Security Income or Social
36.2Security disability insurance;
36.3 (3) a participant who is a noncitizen who has been in the United States for 12 or
36.4fewer months; and
36.5(4) a participant who is age 60 or older.
36.6 (b) Families must meet all other eligibility requirements for MFIP established in
36.7this chapter. Families are eligible for financial assistance to the same extent as if they
36.8were participating in MFIP.
36.9 (c) A participant under paragraph (a), clause (3), must be provided with English as a
36.10second language opportunities and skills training for up to 12 months. After 12 months,
36.11the case manager and participant must determine whether the participant should continue
36.12with English as a second language classes or skills training, or both, and continue to
36.13receive family stabilization services.
36.14(d) If a county agency or employment services provider has information that
36.15an MFIP participant may meet the eligibility criteria set forth in this subdivision, the
36.16county agency or employment services provider must assist the participant in obtaining
36.17the documentation necessary to determine eligibility. Until necessary documentation is
36.18obtained, the participant must be treated as an eligible participant under subdivisions 5 to 7.
36.19EFFECTIVE DATE.This section is effective July 1, 2009, except the amendment
36.20to paragraph (a) striking "or diversionary work program (DWP)" is effective March 1,
36.212010.
36.22 Sec. 24. Minnesota Statutes 2008, section 256J.575, subdivision 4, is amended to read:
36.23 Subd. 4. Universal participation. All caregivers must participate in family
36.24stabilization services as defined in subdivision 2, except for caregivers exempt under
36.25section 256J.561, subdivision 3.
36.26EFFECTIVE DATE.This section is effective March 1, 2010.
36.27 Sec. 25. Minnesota Statutes 2008, section 256J.575, subdivision 6, is amended to read:
36.28 Subd. 6. Cooperation with services requirements. (a)
36.29who is eligible for family stabilization services under this section shall comply with
36.30paragraphs (b) to (d).
36.31 (b) Participants shall engage in family stabilization plan services for the appropriate
36.32number of hours per week that the activities are scheduled and available, unless good
36.33cause exists for not doing so, as defined in section
36.34number of hours must be based on the participant's plan.
37.1 (c) The case manager shall review the participant's progress toward the goals in the
37.2family stabilization plan every six months to determine whether conditions have changed,
37.3including whether revisions to the plan are needed.
37.4 (d) A participant's requirement to comply with any or all family stabilization plan
37.5requirements under this subdivision is excused when the case management services,
37.6training and educational services, or family support services identified in the participant's
37.7family stabilization plan are unavailable for reasons beyond the control of the participant,
37.8including when money appropriated is not sufficient to provide the services.
37.9 Sec. 26. Minnesota Statutes 2008, section 256J.575, subdivision 7, is amended to read:
37.10 Subd. 7. Sanctions. (a) The county agency or employment services provider must
37.11follow the requirements of this subdivision at the time the county agency or employment
37.12services provider has information that an MFIP recipient may meet the eligibility criteria
37.13in subdivision 3.
37.14(b) The financial assistance grant of a participating family is reduced according to
37.15section
37.16to comply with the family stabilization plan requirements in this subdivision, unless
37.17compliance has been excused under subdivision 6, paragraph (d).
37.18
37.19nature of the underlying family circumstances that act as barriers to both employment and
37.20full compliance with program requirements, there must be a review by the county agency
37.21prior to imposing a sanction to determine whether the plan was appropriated to the needs
37.22of the participant and family
37.23health or medical professional confirming that the participant in all ways had the ability to
37.24comply with the plan
37.25
37.26services provider shall review the participant's case to determine if the family stabilization
37.27plan is still appropriate and meet with the participant face-to-face.
37.28
37.29participant of the right to bring an advocate to the face-to-face meeting.
37.30 During the face-to-face meeting, the county agency shall:
37.31 (1) determine whether the continued noncompliance can be explained and mitigated
37.32by providing a needed family stabilization service, as defined in subdivision 2, paragraph
37.33(d);
37.34 (2) determine whether the participant qualifies for a good cause exception under
37.35section
38.1determine if the participant qualifies for a good cause exemption under section
38.2subdivision 10;
38.3 (3) determine whether activities in the family stabilization plan are appropriate
38.4based on the family's circumstances;
38.5 (4) explain the consequences of continuing noncompliance;
38.6 (5) identify other resources that may be available to the participant to meet the
38.7needs of the family; and
38.8 (6) inform the participant of the right to appeal under section
38.9 If the lack of an identified activity or service can explain the noncompliance, the
38.10county shall work with the participant to provide the identified activity.
38.11 (d) If the participant fails to come to the face-to-face meeting, the case manager or a
38.12designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
38.13the county agency shall send the participant a written notice that includes the information
38.14under paragraph (c).
38.15 (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
38.16of a sanction, the county agency shall provide a notice of intent to sanction under section
38.19 (f) Section
38.20by this subdivision.
38.21 Sec. 27. Minnesota Statutes 2008, section 256J.621, is amended to read:
38.22256J.621 WORK PARTICIPATION CASH BENEFITS.
38.23 (a) Effective October 1, 2009, upon exiting the diversionary work program (DWP)
38.24or upon terminating the Minnesota family investment program with earnings, a participant
38.25who is employed may be eligible for work participation cash benefits of
38.26month to assist in meeting the family's basic needs as the participant continues to move
38.27toward self-sufficiency.
38.28 (b) To be eligible for work participation cash benefits, the participant shall not
38.29receive MFIP or diversionary work program assistance during the month and the
38.30participant or participants must meet the following work requirements:
38.31 (1) if the participant is a single caregiver and has a child under six years of age, the
38.32participant must be employed at least 87 hours per month;
38.33 (2) if the participant is a single caregiver and does not have a child under six years of
38.34age, the participant must be employed at least 130 hours per month; or
39.1 (3) if the household is a two-parent family, at least one of the parents must be
39.2employed an average of at least 130 hours per month.
39.3 Whenever a participant exits the diversionary work program or is terminated from
39.4MFIP and meets the other criteria in this section, work participation cash benefits are
39.5available for up to 24 consecutive months.
39.6 (c) Expenditures on the program are maintenance of effort state funds under
39.7a separate state program for participants under paragraph (b), clauses (1) and (2).
39.8Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
39.9funds. Months in which a participant receives work participation cash benefits under this
39.10section do not count toward the participant's MFIP 60-month time limit.
39.11 Sec. 28. Minnesota Statutes 2008, section 256J.626, subdivision 7, is amended to read:
39.12 Subd. 7. Performance base funds. (a) For the purpose of this section, the following
39.13terms have the meanings given.
39.14(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
39.15TANF and separate state program caseload has fallen relative to federal fiscal year 2005
39.16based on caseload data from October 1 to September 30.
39.17(2) "TANF participation rate target" means a 50 percent participation rate reduced by
39.18the CRC for the previous year.
39.19(b) For calendar year
39.20allocated 95 percent of their initial calendar year allocation. Counties and tribes will be
39.21allocated additional funds based on performance as follows:
39.22 (1) a county or tribe that achieves
39.23or a five percentage point improvement over the previous year's TANF participation rate
39.24under section
39.25months for the most recent year for which the measurements are available, will receive an
39.26additional allocation equal to 2.5 percent of its initial allocation;
39.27 (2) a county or tribe that performs within or above its range of expected performance
39.28on the annualized three-year self-support index under section
39.29clause (6), will receive an additional allocation equal to 2.5 percent of its initial allocation;
39.30and
39.31 (3) a county or tribe that does not achieve
39.32target or a five percentage point improvement over the previous year's TANF participation
39.33rate under section
39.34months for the most recent year for which the measurements are available, will not
40.1receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
40.2improvement plan with the commissioner; or
40.3 (4) a county or tribe that does not perform within or above its range of expected
40.4performance on the annualized three-year self-support index under section
40.5subdivision 2
40.6of its initial allocation until after negotiating a multiyear improvement plan with the
40.7commissioner.
40.8
40.9a federally approved tribal TANF program in which the state and tribe have in place
40.10a contract under section
40.11follows:
40.12 (1) a tribe that achieves the participation rate approved in its federal TANF plan
40.13using the average of 12 consecutive months for the most recent year for which the
40.14measurements are available, will receive an additional allocation equal to 2.5 percent of
40.15its initial allocation; and
40.16 (2) a tribe that performs within or above its range of expected performance on the
40.17annualized three-year self-support index under section
40.18will receive an additional allocation equal to 2.5 percent of its initial allocation; or
40.19 (3) a tribe that does not achieve the participation rate approved in its federal TANF
40.20plan using the average of 12 consecutive months for the most recent year for which the
40.21measurements are available, will not receive an additional allocation equal to 2.5 percent
40.22of its initial allocation until after negotiating a multiyear improvement plan with the
40.23commissioner; or
40.24 (4) a tribe that does not perform within or above its range of expected performance
40.25on the annualized three-year self-support index under section
40.262
40.27negotiating a multiyear improvement plan with the commissioner.
40.28
40.29in paragraph
40.30subdivision 5.
40.31
40.32paragraph
40.33unobligated and available from the innovation projects through the end of the current
40.34biennium.
40.35 (2) If after the application of clause (1) funds remain insufficient to meet county
40.36and tribal allocations under paragraph
41.1reduce the allocation of each county and tribe with respect to their maximum allocation
41.2available under paragraph
41.3 Sec. 29. Minnesota Statutes 2008, section 256J.95, subdivision 3, is amended to read:
41.4 Subd. 3. Eligibility for diversionary work program. (a) Except for the categories
41.5of family units listed below, all family units who apply for cash benefits and who
41.6meet MFIP eligibility as required in sections
41.7participate in the diversionary work program. Family units that are not eligible for the
41.8diversionary work program include:
41.9 (1) child only cases;
41.10 (2) a single-parent family unit that includes a child under 12
41.11A parent is eligible for this exception once in a parent's lifetime and is not eligible if
41.12the parent has already used the previously allowed child under age one exemption from
41.13MFIP employment services;
41.14 (3) a minor parent without a high school diploma or its equivalent;
41.15 (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
41.16who chooses to have an employment plan with an education option;
41.17 (5) a caregiver age 60 or over;
41.18 (6) family units with a caregiver who received DWP benefits in the 12 months prior
41.19to the month the family applied for DWP, except as provided in paragraph (c);
41.20 (7) family units with a caregiver who received MFIP within the 12 months prior to
41.21the month the family unit applied for DWP;
41.22 (8) a family unit with a caregiver who received 60 or more months of TANF
41.23assistance;
41.24 (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
41.25fraud; and
41.26 (10) refugees and asylees as defined in Code of Federal Regulations, title 45, part
41.27400, subpart d, section
41.28the date of application for family cash assistance.
41.29 (b) A two-parent family must participate in DWP unless both caregivers meet the
41.30criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
41.31includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), (9), or (10).
41.32 (c) Once DWP eligibility is determined, the four months run consecutively. If a
41.33participant leaves the program for any reason and reapplies during the four-month period,
41.34the county must redetermine eligibility for DWP.
41.35EFFECTIVE DATE.This section is effective March 1, 2010.
42.1 Sec. 30. Minnesota Statutes 2008, section 256J.95, subdivision 11, is amended to read:
42.2 Subd. 11. Universal participation required. (a) All DWP caregivers, except
42.3caregivers who meet the criteria in paragraph (d), are required to participate in DWP
42.4employment services. Except as specified in paragraphs (b) and (c), employment plans
42.5under DWP must, at a minimum, meet the requirements in section
42.6(b) A caregiver who is a member of a two-parent family that is required to participate
42.7in DWP who would otherwise be ineligible for DWP under subdivision 3 may be allowed
42.8to develop an employment plan under section
42.9may contain alternate activities and reduced hours.
42.10(c) A participant who is a victim of family violence shall be allowed to develop an
42.11employment plan under section
42.12be documented by the applicant or participant by providing a sworn statement which is
42.13supported by collateral documentation in section
42.14(d) One parent in a two-parent family unit that has a natural born child under 12
42.15
42.16
42.18section
42.19(e) The provision in paragraph (d) ends the first full month after the child reaches 12
42.20
42.21two-parent household, only one parent shall be allowed to use this category.
42.22(f) The participant and job counselor must meet within ten working days after the
42.23child reaches 12
42.24employment plan for a family unit that has a child under 12
42.25already used the exclusion in section
42.26age one exemption under section
42.27recognize the caregiving needs of the parent.
42.28EFFECTIVE DATE.This section is effective March 1, 2010.
42.29 Sec. 31. Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:
42.30 Subd. 12. Conversion or referral to MFIP. (a) If at any time during the DWP
42.31application process or during the four-month DWP eligibility period, it is determined that
42.32a participant is unlikely to benefit from the diversionary work program, the county shall
42.33convert or refer the participant to MFIP as specified in paragraph (d). Participants who are
42.34determined to be unlikely to benefit from the diversionary work program must develop
42.35and sign an employment plan.
43.1
43.2
43.3(b) A participant who
43.4subdivision 3, must be considered to be unlikely to benefit from DWP, provided the
43.5necessary documentation is available to support the determination.
43.6
43.7
43.8
43.9
43.10
43.11
43.12
43.13
43.14
43.15
43.16
43.17
43.18(c) In a two-parent family unit,
43.19to be unlikely to benefit from the diversionary work program
43.20
43.21(d) A participant who is determined to be unlikely to benefit from the diversionary
43.22work program shall be converted to MFIP and, if the determination was made within 30
43.23days of the initial application for benefits, no additional application form is required.
43.24A participant who is determined to be unlikely to benefit from the diversionary work
43.25program shall be referred to MFIP and, if the determination is made more than 30
43.26days after the initial application, the participant must submit a program change request
43.27form. The county agency shall process the program change request form by the first of
43.28the following month to ensure that no gap in benefits is due to delayed action by the
43.29county agency. In processing the program change request form, the county must follow
43.30section
43.31verification of the information in the case file from the DWP application unless the
43.32information in the case file is inaccurate, questionable, or no longer current.
43.33(e) The county shall not request a combined application form for a participant who
43.34has exhausted the four months of the diversionary work program, has continued need for
43.35cash and food assistance, and has completed, signed, and submitted a program change
43.36request form within 30 days of the fourth month of the diversionary work program. The
44.1county must process the program change request according to section
44.21
44.3in the case file unless the information is inaccurate, questionable, or no longer current.
44.4When a participant does not request MFIP within 30 days of the diversionary work
44.5program benefits being exhausted, a new combined application form must be completed
44.6for any subsequent request for MFIP.
44.7EFFECTIVE DATE.This section is effective March 1, 2010.
44.8 Sec. 32. Minnesota Statutes 2008, section 256J.95, subdivision 13, is amended to read:
44.9 Subd. 13. Immediate referral to employment services. Within one working day of
44.10determination that the applicant is eligible for the diversionary work program, but before
44.11benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to
44.12employment services. The referral to the DWP employment services must be in writing
44.13and must contain the following information:
44.14(1) notification that, as part of the application process, applicants are required to
44.15develop an employment plan or the DWP application will be denied;
44.16(2) the employment services provider name and phone number;
44.17(3)
44.18
44.19child care, transportation, and other work-related aid; and
44.20
44.21including, but not limited to, the grounds for good cause, the consequences of refusing or
44.22failing to participate fully with program requirements, and the appeal process.
44.23 Sec. 33. Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
44.24to read:
44.25 Subd. 3b. Extension; adoption finalized after age 16. A child who has attained the
44.26age of 16 prior to finalization of their adoption is eligible for extension of the adoption
44.27assistance agreement to the date the child attains age 21 if the child is:
44.28 (1) completing a secondary education program or a program leading to an equivalent
44.29credential;
44.30 (2) enrolled in an institution which provides postsecondary or vocational education;
44.31 (3) participating in a program or activity designed to promote or remove barriers to
44.32employment;
44.33 (4) employed for at least 80 hours per month; or
45.1 (5) incapable of doing any of the activities described in clauses (1) to (4) due to a
45.2medical condition which incapability is supported by regularly updated information in
45.3the case plan of the child.
45.4EFFECTIVE DATE.This section is effective October 1, 2010.
45.5 Sec. 34. Minnesota Statutes 2008, section 270A.09, is amended by adding a
45.6subdivision to read:
45.7 Subd. 1b. Department of Human Services claims. Notwithstanding subdivision 1,
45.8any debtor contesting a setoff claim by the Department of Human Services or a county
45.9agency whose claim relates to a debt resulting from receipt of public assistance, medical
45.10care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as
45.11an appeal under sections 256.045 and 256.0451.
45.12 Sec. 35. AMERICAN INDIAN CHILD WELFARE PROJECTS.
45.13Notwithstanding Minnesota Statutes, section 16A.28, the commissioner of human
45.14services shall extend payment of state fiscal year 2009 funds in state fiscal year 2010
45.15to tribes participating in the American Indian child welfare projects under Minnesota
45.16Statutes, section 256.01, subdivision 14b. Future extensions of payment for a tribe
45.17participating in the Indian child welfare projects under Minnesota Statutes, section 256.01,
45.18subdivision 14b, must be granted according to the commissioner's authority under
45.19Minnesota Statutes, section 16A.28.
45.20 Sec. 36. REPEALER.
45.21Minnesota Statutes 2008, section 256I.06, subdivision 9, is repealed.
45.24 Section 1. Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:
45.25 Subd. 5. Cost of care. "Cost of care" means the commissioner's charge for services
45.26provided to any person admitted to a state facility.
45.27For purposes of this subdivision, "charge for services" means the
45.28
45.29
45.30
45.31
45.32
46.1
46.2usual and customary fee shall be established in a manner required to appropriately bill
46.3services to all payers and shall include the costs related to the operations of any program
46.4offered by the state.
46.5 Sec. 2. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
46.6to read:
46.7 Subd. 10. State-operated community-based program. "State-operated
46.8community-based program" means any program operated in the community including
46.9community behavioral health hospitals, crisis centers, residential facilities, outpatient
46.10services, and other community-based services developed and operated by the state and
46.11under the commissioner's control.
46.12 Sec. 3. Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
46.13to read:
46.14 Subd. 11. Health plan company. "Health plan company" has the meaning given it
46.15in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in
46.16section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating
46.17in county-based purchasing according to section 256B.692, and a children's mental health
46.18collaborative under contract to provide medical assistance for individuals enrolled in
46.19the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to
46.20245.495.
46.21 Sec. 4. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
46.22to read:
46.23 Subd. 1a. Clients in state-operated community-based programs; determination.
46.24The commissioner shall determine available health plan coverage from a health plan
46.25company for services provided to clients admitted to a state-operated community-based
46.26program. If the health plan coverage requires a co-pay or deductible, or if there is no
46.27available health plan coverage, the commissioner shall determine or redetermine, what
46.28part of the noncovered cost of care, if any, the client is able to pay. If the client is unable to
46.29pay the uncovered cost of care, the commissioner shall determine the client's relatives'
46.30ability to pay. The client and relatives shall provide to the commissioner documents and
46.31proof necessary to determine the client and relatives' ability to pay. Failure to provide the
46.32commissioner with sufficient information to determine ability to pay may make the client
46.33or relatives liable for the full cost of care until the time when sufficient information is
47.1provided. If it is determined that the responsible party does not have the ability to pay,
47.2the commissioner shall waive payment of the portion that exceeds ability to pay under
47.3the determination.
47.4 Sec. 5. Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
47.5to read:
47.6 Subd. 1b. Clients served by regional treatment centers or nursing homes;
47.7determination. The commissioner shall determine or redetermine, if necessary, what part
47.8of the cost of care, if any, a client served in regional treatment centers or nursing homes
47.9operated by state-operated services, is able to pay. If the client is unable to pay the full cost
47.10of care, the commissioner shall determine if the client's relatives have the ability to pay.
47.11The client and relatives shall provide to the commissioner documents and proof necessary
47.12to determine the client and relatives' ability to pay. Failure to provide the commissioner
47.13with sufficient information to determine ability to pay may make the client or relatives
47.14liable for the full cost of care until the time when sufficient information is provided. No
47.15parent shall be liable for the cost of care given a client at a regional treatment center after
47.16the client has reached the age of 18 years.
47.17 Sec. 6. Minnesota Statutes 2008, section 246.511, is amended to read:
47.18246.511 RELATIVE RESPONSIBILITY.
47.19Except for chemical dependency services paid for with funds provided under chapter
47.20254B, a client's relatives shall not, pursuant to the commissioner's authority under section
47.22services provided in a community-based service, the noncovered cost of care as determined
47.23under the ability to pay determination; and (2) for services provided at a regional treatment
47.24center operated by state-operated services, 20 percent of the cost of care, unless they
47.25reside outside the state. Parents of children in state facilities shall have their responsibility
47.26to pay determined according to section
47.27chapter 254B if the cost of care is paid under chapter 254B. The commissioner may
47.28accept voluntary payments in excess of
47.29full payment of the full per capita cost of care in state facilities for clients whose parent,
47.30parents, spouse, guardian, or conservator do not reside in Minnesota.
47.31 Sec. 7. Minnesota Statutes 2008, section 246.52, is amended to read:
47.32246.52 PAYMENT FOR CARE; ORDER; ACTION.
48.1The commissioner shall issue an order to the client or the guardian of the estate, if
48.2there be one, and relatives determined able to pay requiring them to pay
48.3state of Minnesota the amounts so determined the total of which shall not exceed the full
48.4cost of care. Such order shall specifically state the commissioner's determination and shall
48.5be conclusive unless appealed from as herein provided. When a client or relative fails to
48.6pay the amount due hereunder the attorney general, upon request of the commissioner,
48.7may institute, or direct the appropriate county attorney to institute, civil action to recover
48.8such amount.
48.9 Sec. 8. Minnesota Statutes 2008, section 246.54, subdivision 2, is amended to read:
48.10 Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
48.11Minnesota Security Hospital
48.12extended treatment options program. For services at these facilities, a county's payment
48.13shall be made from the county's own sources of revenue and payments shall be paid as
48.14follows: payments to the state from the county shall equal ten percent of the cost of care,
48.15as determined by the commissioner, for each day, or the portion thereof, that the client
48.16spends at the facility. If payments received by the state under sections
48.17exceed 90 percent of the cost of care, the county shall be responsible for paying the state
48.18only the remaining amount. The county shall not be entitled to reimbursement from the
48.19client, the client's estate, or from the client's relatives, except as provided in section
48.20 (b) Regardless of the facility to which the client is committed, subdivision 1 does
48.21not apply to the following individuals:
48.22 (1) clients who are committed as mentally ill and dangerous under section
48.23subdivision 17;
48.24 (2) clients who are committed as sexual psychopathic personalities under section
48.26 (3) clients who are committed as sexually dangerous persons under section
48.27subdivision 18c.
48.28 For each of the individuals in clauses (1) to (3), the payment by the county to the state
48.29shall equal ten percent of the cost of care for each day as determined by the commissioner.
48.30 Sec. 9. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
48.31to read:
48.32 Subd. 1a. Client. "Client" means a person who is admitted to the Minnesota sex
48.33offender program or subject to a court hold order under section 253B.185 for the purpose
49.1of assessment, diagnosis, care, treatment, supervision, or other services provided by the
49.2Minnesota sex offender program.
49.3 Sec. 10. Minnesota Statutes 2008, section 246B.01, is amended by adding a
49.4subdivision to read:
49.5 Subd. 1b. Client's county. "Client's county" means the county of the client's
49.6legal settlement for poor relief purposes at the time of commitment. If the client has no
49.7legal settlement for poor relief in this state, it means the county of commitment, except
49.8that when a client with no legal settlement for poor relief is committed while serving a
49.9sentence at a penal institution, it means the county from which the client was sentenced.
49.10 Sec. 11. Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
49.11to read:
49.12 Subd. 2a. Cost of care. "Cost of care" means the commissioner's charge for housing
49.13and treatment services provided to any person admitted to the Minnesota sex offender
49.14program.
49.15For purposes of this subdivision, "charge for housing and treatment services" means
49.16the cost of services, treatment, maintenance, bonds issued for capital improvements,
49.17depreciation of buildings and equipment, and indirect costs related to the operation of
49.18state facilities. The commissioner may determine the charge for services on an anticipated
49.19average per diem basis as an all-inclusive charge per facility.
49.20 Sec. 12. Minnesota Statutes 2008, section 246B.01, is amended by adding a
49.21subdivision to read:
49.22 Subd. 2b. Local social services agency. "Local social services agency" means the
49.23local social services agency of the client's county as defined in subdivision 1b and of the
49.24county of commitment, and any other local social services agency possessing information
49.25regarding, or requested by the commissioner to investigate, the financial circumstances
49.26of a client.
49.27 Sec. 13. [246B.07] PAYMENT FOR CARE AND TREATMENT:
49.28DETERMINATION.
49.29 Subdivision 1. Procedures. The commissioner shall determine or redetermine, if
49.30necessary, what amount of the cost of care, if any, the client is able to pay. The client shall
49.31provide to the commissioner documents and proof necessary to determine the ability to
49.32pay. Failure to provide the commissioner with sufficient information to determine ability
50.1to pay may make the client liable for the full cost of care until the time when sufficient
50.2information is provided.
50.3 Subd. 2. Rules. The commissioner shall use the standards in section 246.51,
50.4subdivision 2, to determine the client's liability for the care provided by the Minnesota sex
50.5offender program.
50.6 Subd. 3. Applicability. The commissioner may recover, under sections 246B.07 to
50.7246B.10, the cost of any care provided by the Minnesota sex offender program.
50.8 Sec. 14. [246B.08] PAYMENT FOR CARE; ORDER; ACTION.
50.9The commissioner shall issue an order to the client or the guardian of the estate, if
50.10there is one, requiring the client or guardian to pay to the state the amounts determined, the
50.11total of which must not exceed the full cost of care. The order must specifically state the
50.12commissioner's determination and must be conclusive, unless appealed. If a client fails to
50.13pay the amount due, the attorney general, upon request of the commissioner, may institute,
50.14or direct the appropriate county attorney to institute a civil action to recover the amount.
50.15 Sec. 15. [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
50.16 Subdivision 1. Client's estate. Upon the death of a client, or a former client, the
50.17total cost of care provided to the client, less the amount actually paid toward the cost of
50.18care by the client, must be filed by the commissioner as a claim against the estate of the
50.19client with the court having jurisdiction to probate the estate, and all proceeds collected
50.20by the state in the case must be divided between the state and county in proportion to
50.21the cost of care each has borne.
50.22 Subd. 2. Preferred status. An estate claim in subdivision 1 must be considered an
50.23expense of the last illness for purposes of section 524.3-805.
50.24If the commissioner determines that the property or estate of a client is not more
50.25than needed to care for and maintain the spouse and minor or dependent children of a
50.26deceased client, the commissioner has the power to compromise the claim of the state in a
50.27manner deemed just and proper.
50.28 Subd. 3. Exception from statute of limitations. Any statute of limitations that
50.29limits the commissioner in recovering the cost of care obligation incurred by a client or
50.30former client must not apply to any claim against an estate made under this section to
50.31recover cost of care.
50.32 Sec. 16. [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.
51.1The client's county shall pay to the state a portion of the cost of care provided in
51.2the Minnesota sex offender program to a client who has legally settled in that county. A
51.3county's payment must be made from the county's own sources of revenue and payments
51.4must equal ten percent of the cost of care, as determined by the commissioner, for each
51.5day or portion of a day, that the client spends at the facility. If payments received by the
51.6state under this chapter exceed 90 percent of the cost of care, the county is responsible
51.7for paying the state the remaining amount. The county is not entitled to reimbursement
51.8from the client, the client's estate, or from the client's relatives, except as provided in
51.9section 246B.07.
51.10 Sec. 17. Minnesota Statutes 2008, section 252.025, subdivision 7, is amended to read:
51.11 Subd. 7. Minnesota extended treatment options. The commissioner shall develop
51.12by July 1, 1997, the Minnesota extended treatment options to serve Minnesotans who have
51.13developmental disabilities and exhibit severe behaviors which present a risk to public
51.14safety. This program is statewide and must provide specialized residential services in
51.15Cambridge and an array of
51.16sufficient levels of care and a sufficient number of specialists to ensure that individuals
51.17referred to the program receive the appropriate care. The individuals working in the
51.18community-based services under this section are state employees supervised by the
51.19commissioner of human services. No layoffs shall occur as a result of restructuring
51.20under this section.
51.21 Sec. 18. REQUIRING THE DEVELOPMENT OF COMMUNITY-BASED
51.22MENTAL HEALTH SERVICES FOR PATIENTS COMMITTED TO THE
51.23ANOKA-METRO REGIONAL TREATMENT CENTER.
51.24In consultation with community partners, the commissioner of human services
51.25shall develop an array of community-based services to transform the current services
51.26now provided to patients at the Anoka-Metro Regional Treatment Center. The
51.27community-based services may be provided in facilities with 16 or fewer beds, and must
51.28provide the appropriate level of care for the patients being admitted to the facilities. The
51.29planning for this transition must be completed by October 1, 2009, with an initial report
51.30to the committee chairs of health and human services by November 30, 2009, and a
51.31semiannual report on progress until the transition is completed. The commissioner of
51.32human services shall solicit interest from stakeholders and potential community partners.
51.33The individuals working in the community-based services facilities under this section are
52.1state employees supervised by the commissioner of human services. No layoffs shall
52.2occur as a result of restructuring under this section.
52.3 Sec. 19. REPEALER.
52.4Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision
52.53, are repealed.
52.8 Section 1. Minnesota Statutes 2008, section 62J.495, is amended to read:
52.962J.495 HEALTH INFORMATION TECHNOLOGY AND
52.10INFRASTRUCTURE.
52.11 Subdivision 1. Implementation. By January 1, 2015, all hospitals and health care
52.12providers must have in place an interoperable electronic health records system within their
52.13hospital system or clinical practice setting. The commissioner of health, in consultation
52.14with the e-Health
52.15shall develop a statewide plan to meet this goal, including uniform standards to be used
52.16for the interoperable system for sharing and synchronizing patient data across systems.
52.17The standards must be compatible with federal efforts. The uniform standards must be
52.18developed by January 1, 2009,
52.19
52.20commissioner shall include an update on standards development as part of an annual
52.21report to the legislature.
52.22 Subd. 1a. Definitions. (a) "Certified electronic health record technology" means an
52.23electronic health record that is certified pursuant to section 3001(c)(5) of the HITECH
52.24Act to meet the standards and implementation specifications adopted under section 3004
52.25as applicable.
52.26(b) "Commissioner" means the commissioner of health.
52.27(c) "Pharmaceutical electronic data intermediary" means any entity that provides
52.28the infrastructure to connect computer systems or other electronic devices utilized
52.29by prescribing practitioners with those used by pharmacies, health plans, third party
52.30administrators, and pharmacy benefit manager in order to facilitate the secure transmission
52.31of electronic prescriptions, refill authorization requests, communications, and other
52.32prescription-related information between such entities.
52.33(d) "HITECH Act" means the Health Information Technology for Economic and
52.34Clinical Health Act in division A, title XIII and division B, title IV of the American
53.1Recovery and Reinvestment Act of 2009, including federal regulations adopted under
53.2that act.
53.3(e) "Interoperable electronic health record" means an electronic health record that
53.4securely exchanges health information with another electronic health record system that
53.5meets national requirements for certification under the HITECH Act.
53.6(f) "Qualified electronic health record" means an electronic record of health-related
53.7information on an individual that includes patient demographic and clinical health
53.8information and has the capacity to:
53.9(1) provide clinical decision support;
53.10(2) support physician order entry;
53.11(3) capture and query information relevant to health care quality; and
53.12(4) exchange electronic health information with, and integrate such information
53.13from, other sources.
53.14 Subd. 2. E-Health
53.15Committee. (a) The commissioner shall establish
53.16
53.17commissioner on the following matters:
53.18 (1) assessment of the adoption and effective use of health information technology by
53.19the state, licensed health care providers and facilities, and local public health agencies;
53.20 (2) recommendations for implementing a statewide interoperable health information
53.21infrastructure, to include estimates of necessary resources, and for determining standards
53.22for
53.23requirements, and maintenance of the security and confidentiality of individual patient
53.24data;
53.25 (3) recommendations for encouraging use of innovative health care applications
53.26using information technology and systems to improve patient care and reduce the cost
53.27of care, including applications relating to disease management and personal health
53.28management that enable remote monitoring of patients' conditions, especially those with
53.29chronic conditions; and
53.30 (4) other related issues as requested by the commissioner.
53.31 (b) The members of the e-Health
53.32Advisory Committee shall include the commissioners, or commissioners' designees, of
53.33health, human services, administration, and commerce and additional members to be
53.34appointed by the commissioner to include persons representing Minnesota's local public
53.35health agencies, licensed hospitals and other licensed facilities and providers, private
53.36purchasers, the medical and nursing professions, health insurers and health plans, the
54.1state quality improvement organization, academic and research institutions, consumer
54.2advisory organizations with an interest and expertise in health information technology, and
54.3other stakeholders as identified by the
54.4
54.5(g) of the HITECH Act.
54.6 (c) The commissioner shall prepare and issue an annual report not later than January
54.730 of each year outlining progress to date in implementing a statewide health information
54.8infrastructure and recommending
54.9to continue the promotion of adoption and effective use of health information technology.
54.10(d) Notwithstanding section
54.11 Subd. 3. Interoperable electronic health record requirements.
54.12requirements of subdivision 1, hospitals and health care providers must meet the following
54.13criteria when implementing an interoperable electronic health records system within their
54.14hospital system or clinical practice setting.
54.15(a) The electronic health record must be a qualified electronic health record.
54.16 (b) The electronic health record must be certified by the
54.17
54.18pursuant to the HITECH Act. This criterion only applies to hospitals and health care
54.19providers
54.20
54.21electronic health record product for the provider's particular practice setting is available.
54.22This criterion shall be considered met if a hospital or health care provider is using an
54.23electronic health records system that has been certified within the last three years, even if a
54.24more current version of the system has been certified within the three-year period.
54.25(c) The electronic health record must meet the standards established according to
54.26section 3004 of the HITECH Act as applicable.
54.27(d) The electronic health record must have the ability to generate information on
54.28clinical quality measures and other measures reported under sections 4101, 4102, and
54.294201 of the HITECH Act.
54.30
54.31
54.32requirements of section
54.33 Subd. 4. Coordination with national HIT activities. (a) The commissioner,
54.34in consultation with the e-Health Advisory Committee, shall update the statewide
54.35implementation plan required under subdivision 2 and released June 2008, to be consistent
54.36with the updated Federal HIT Strategic Plan released by the Office of the National
55.1Coordinator in accordance with section 3001 of the HITECH Act. The statewide plan
55.2shall meet the requirements for a plan required under section 3013 of the HITECH Act.
55.3(b) The commissioner, in consultation with the e-Health Advisory Committee, shall
55.4work to ensure coordination between state, regional, and national efforts to support and
55.5accelerate efforts to effectively use health information technology to improve the quality
55.6and coordination of health care and continuity of patient care among health care providers,
55.7to reduce medical errors, to improve population health, to reduce health disparities, and
55.8to reduce chronic disease. The commissioner's coordination efforts shall include but not
55.9be limited to:
55.10(1) assisting in the development and support of health information technology
55.11regional extension centers established under section 3012(c) of the HITECH Act to
55.12provide technical assistance and disseminate best practices; and
55.13(2) providing supplemental information to the best practices gathered by regional
55.14centers to ensure that the information is relayed in a meaningful way to the Minnesota
55.15health care community.
55.16(c) The commissioner, in consultation with the e-Health Advisory Committee, shall
55.17monitor national activity related to health information technology and shall coordinate
55.18statewide input on policy development. The commissioner shall coordinate statewide
55.19responses to proposed federal health information technology regulations in order to ensure
55.20that the needs of the Minnesota health care community are adequately and efficiently
55.21addressed in the proposed regulations. The commissioner's responses may include, but
55.22are not limited to:
55.23(1) reviewing and evaluating any standard, implementation specification, or
55.24certification criteria proposed by the national HIT standards committee;
55.25(2) reviewing and evaluating policy proposed by the national HIT policy
55.26committee relating to the implementation of a nationwide health information technology
55.27infrastructure;
55.28(3) monitoring and responding to activity related to the development of quality
55.29measures and other measures as required by section 4101 of the HITECH Act. Any
55.30response related to quality measures shall consider and address the quality efforts required
55.31under chapter 62U; and
55.32(4) monitoring and responding to national activity related to privacy, security, and
55.33data stewardship of electronic health information and individually identifiable health
55.34information.
55.35(d) To the extent that the state is either required or allowed to apply, or designate an
55.36entity to apply for or carry out activities and programs under section 3013 of the HITECH
56.1Act, the commissioner of health, in consultation with the e-Health Advisory Committee
56.2and the commissioner of human services, shall be the lead applicant or sole designating
56.3authority. The commissioner shall make such designations consistent with the goals and
56.4objectives of sections 62J.495 to 62J.497, and sections 62J.50 to 62J.61.
56.5(e) The commissioner of human services shall apply for funding necessary to
56.6administer the incentive payments to providers authorized under title IV of the American
56.7Recovery and Reinvestment Act.
56.8(f) The commissioner shall include in the report to the legislature information on the
56.9activities of this subdivision and provide recommendations on any relevant policy changes
56.10that should be considered in Minnesota.
56.11 Subd. 5. Collection of data for assessment and eligibility determination. (a)
56.12The commissioner of health, in consultation with the commissioner of human services,
56.13may require providers, dispensers, group purchasers, and pharmaceutical electronic data
56.14intermediaries to submit data in a form and manner specified by the commissioner to
56.15assess the status of adoption, effective use, and interoperability of electronic health
56.16records for the purpose of:
56.17(1) demonstrating Minnesota's progress on goals established by the Office of the
56.18National Coordinator to accelerate the adoption and effective use of health information
56.19technology established under the HITECH Act;
56.20(2) assisting the Center for Medicare and Medicaid Services and Department of
56.21Human Services in determining eligibility of health care professionals and hospitals
56.22to receive federal incentives for the adoption and effective use of health information
56.23technology under the HITECH Act or other federal incentive programs;
56.24(3) assisting the Office of the National Coordinator in completing required
56.25assessments of the impact of the implementation and effective use of health information
56.26technology in achieving goals identified in the national strategic plan, and completing
56.27studies required by the HITECH Act;
56.28(4) providing the data necessary to assist the Office of the National Coordinator in
56.29conducting evaluations of regional extension centers as required by the HITECH Act; and
56.30(5) other purposes as necessary to support the implementation of the HITECH Act.
56.31(b) The commissioner shall coordinate with the commissioner of human services
56.32and other state agencies in the collection of data required under this section to:
56.33(1) avoid duplicative reporting requirements;
56.34(2) maximize efficiencies in the development of reports on state activities as
56.35required by HITECH; and
57.1(3) determine health professional and hospital eligibility for incentives available
57.2under the HITECH Act.
57.3(c) The commissioner must not collect data or publish analyses that identify, or could
57.4potentially identify, individual patients. The commissioner must not collect individual
57.5data in identified or de-identified form.
57.6 Sec. 2. Minnesota Statutes 2008, section 62J.496, is amended to read:
57.762J.496 ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
57.8ACCOUNT AND LOAN PROGRAM.
57.9 Subdivision 1. Account establishment. (a) An account is established to:
57.10
57.11
57.12
57.13
57.14(1) finance the purchase of certified electronic health records or qualified electronic
57.15health records as defined in section 62J.495, subdivision 1a;
57.16(2) enhance the utilization of electronic health record technology, which may include
57.17costs associated with upgrading the technology to meet the criteria necessary to be a
57.18certified electronic health record or a qualified electronic health record;
57.19(3) train personnel in the use of electronic health record technology; and
57.20(4) improve the secure electronic exchange of health information.
57.21(b) Amounts deposited in the account, including any grant funds obtained through
57.22federal or other sources, loan repayments, and interest earned on the amounts shall be
57.23used only for awarding loans or loan guarantees, as a source of reserve and security for
57.24leveraged loans, or for the administration of the account.
57.25(c) The commissioner may accept contributions to the account from private sector
57.26entities subject to the following provisions:
57.27(1) the contributing entity may not specify the recipient or recipients of any loan
57.28issued under this subdivision;
57.29(2) the commissioner shall make public the identity of any private contributor to the
57.30loan fund, as well as the amount of the contribution provided; and
57.31(3) the commissioner may issue letters of commendation or make other awards that
57.32have no financial value to any such entity.
57.33A contributing entity may not specify that the recipient or recipients of any loan use
57.34specific products or services, nor may the contributing entity imply that a contribution is
57.35an endorsement of any specific product or service.
58.1(d) The commissioner may use the loan funds to reimburse private sector entities
58.2for any contribution made to the loan fund. Reimbursement to private entities may not
58.3exceed the principle amount contributed to the loan fund.
58.4(e) The commissioner may use funds deposited in the account to guarantee, or
58.5purchase insurance for, a local obligation if the guarantee or purchase would improve
58.6credit market access or reduce the interest rate applicable to the obligation involved.
58.7(f) The commissioner may use funds deposited in the account as a source of revenue
58.8or security for the payment of principal and interest on revenue or bonds issued by the
58.9state if the proceeds of the sale of the bonds will be deposited into the loan fund.
58.10 Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
58.11(1) federally qualified health centers;
58.12
58.13
58.14
58.15to 144.56;
58.16
58.17
58.18
58.19(4) individual or small group physician practices that are focused primarily on
58.20primary care;
58.21
58.22(6) local public health departments as defined in chapter 145A; and
58.23
58.24commissioner for which interoperable electronic health record capability would improve
58.25quality of care, patient safety, or community health.
58.26 (b) The commissioner shall administer the loan fund to prioritize support and
58.27assistance to:
58.28(1) critical access hospitals;
58.29(2) federally qualified health centers;
58.30(3) entities that serve uninsured, underinsured, and medically underserved
58.31individuals, regardless of whether such area is urban or rural; and
58.32(4) individual or small group practices that are primarily focused on primary care.
58.33
58.34submit a loan application to the commissioner of health on forms prescribed by the
58.35commissioner. The application must include, at a minimum:
59.1 (1) the amount of the loan requested and a description of the purpose or project
59.2for which the loan proceeds will be used;
59.3 (2) a quote from a vendor;
59.4 (3) a description of the health care entities and other groups participating in the
59.5project;
59.6 (4) evidence of financial stability and a demonstrated ability to repay the loan; and
59.7 (5) a description of how the system to be financed
59.8plans in the future to
59.9groups located in the same geographical area;
59.10(6) a plan on how the certified electronic health record technology will be maintained
59.11and supported over time; and
59.12(7) any other requirements for applications included or developed pursuant to
59.13section 3014 of the HITECH Act.
59.14 Subd. 3. Loans. (a) The commissioner of health may make a no interest loan or
59.15low interest loan to a provider or provider group who is eligible under subdivision 2
59.16
59.17
59.18loan principal must not exceed
59.19loan, if imposed, shall not exceed the current market interest rate. The commissioner of
59.20health has discretion over the size, interest rate, and number of loans made. Nothing in
59.21this section shall require the commissioner to make a loan to an eligible borrower under
59.22subdivision 2.
59.23 (b) The commissioner of health may prescribe forms and establish an application
59.24process and, notwithstanding section
59.25application fee to cover the cost of administering the loan program. Any application
59.26fees imposed and collected under the electronic health records system revolving account
59.27and loan program in this section are appropriated to the commissioner of health for the
59.28duration of the loan program. The commissioner may apply for and use all federal funds
59.29available through the HITECH Act to administer the loan program.
59.30 (c) For loans approved prior to July 1, 2009, the borrower must begin repaying the
59.31principal no later than two years from the date of the loan. Loans must be amortized no
59.32later than six years from the date of the loan.
59.33(d) For loans granted on January 1, 2010, or thereafter, the borrower must begin
59.34repaying the principle no later than one year from the date of the loan. Loans must be
59.35amortized no later than six years after the date of the loan.
60.1
60.2to the account.
60.3(f) The loan agreement shall include the assurances that borrower meets requirements
60.4included or developed pursuant to section 3014 of the HITECH Act. The requirements
60.5shall include, but are not limited to:
60.6(1) submitting reports on quality measures in compliance with regulations adopted
60.7by the federal government;
60.8(2) demonstrating that any certified electronic health record technology purchased,
60.9improved, or otherwise financially supported by this loan program is used to exchange
60.10health information in a manner that, in accordance with law and standards applicable to
60.11the exchange of information, improves the quality of health care;
60.12(3) including a plan on how the borrower intends to maintain and support the
60.13certified electronic health record technology over time and the resources expected to be
60.14used to maintain and support the technology purchased with the loan; and
60.15(4) complying with other requirements the secretary may require to use loans funds
60.16under the HITECH Act.
60.17 Subd. 4. Data classification. Data collected by the commissioner of health on the
60.18application to determine eligibility under subdivision 2 and to monitor borrowers' default
60.19risk or collect payments owed under subdivision 3 are (1) private data on individuals as
60.20defined in section
60.22are public data.
60.23 Sec. 3. Minnesota Statutes 2008, section 62J.497, subdivision 1, is amended to read:
60.24 Subdivision 1. Definitions. For the purposes of this section, the following terms
60.25have the meanings given.
60.26(a) "Backward compatible" means that the newer version of a data transmission
60.27standard would retain, at a minimum, the full functionality of the versions previously
60.28adopted, and would permit the successful completion of the applicable transactions with
60.29entities that continue to use the older versions.
60.30
60.31subdivision
60.32substance to a patient by a licensed health care professional.
60.33
60.34substance, pursuant to a valid prescription.
61.1
61.2title 45, part
61.3
61.4or prescription-related information between a prescriber, dispenser, pharmacy benefit
61.5manager, or group purchaser, either directly or through an intermediary, including
61.6an e-prescribing network. E-prescribing includes, but is not limited to, two-way
61.7transmissions between the point of care and the dispenser and two-way transmissions
61.8related to eligibility, formulary, and medication history information.
61.9
61.10e-prescribing.
61.11
61.12
61.13organization known as Health Level Seven.
61.14
61.15Code of Federal Regulations, title 45, part
61.16
61.17
61.18Prescription Drug Programs Formulary and Benefits Standard, Implementation Guide,
61.19Version 1, Release 0, October 2005.
61.20
61.21Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard, Implementation
61.22Guide Version 8, Release 1 (Version 8.1), October 2005, or the most recent standard
61.23adopted by the Centers for Medicare and Medicaid Services for e-prescribing under
61.24Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and
61.25regulations adopted under it. The standards shall be implemented according to the Centers
61.26for Medicare and Medicaid Services schedule for compliance. Subsequently released
61.27versions of the NCPDP SCRIPT Standard may be used, provided that the new version
61.28of the standard is backward compatible to the current version adopted by the Centers for
61.29Medicare and Medicaid Services.
61.30
61.31
61.32
61.33than a veterinarian, as defined in section 151.01, subdivision 23.
61.34
61.35drug benefits, medication history, or related health or drug information.
62.1
62.2subdivision 8.
62.3 Sec. 4. Minnesota Statutes 2008, section 62J.497, subdivision 2, is amended to read:
62.4 Subd. 2. Requirements for electronic prescribing. (a) Effective January 1, 2011,
62.5all providers, group purchasers, prescribers, and dispensers must establish
62.6and use an electronic prescription drug program
62.7with the applicable standards in this section for transmitting, directly or through an
62.8intermediary, prescriptions and prescription-related information using electronic media.
62.9 (b)
62.10
62.11this section are conducted, they must be done electronically using the standards described
62.12in this section. Nothing in this section requires providers, group purchasers, prescribers,
62.13or dispensers to electronically conduct transactions that are expressly prohibited by other
62.14sections or federal law.
62.15 (c) Providers, group purchasers, prescribers, and dispensers must use either HL7
62.16messages or the NCPDP SCRIPT Standard to transmit prescriptions or prescription-related
62.17information internally when the sender and the recipient are part of the same legal entity. If
62.18an entity sends prescriptions outside the entity, it must use the NCPDP SCRIPT Standard
62.19or other applicable standards required by this section. Any pharmacy within an entity
62.20must be able to receive electronic prescription transmittals from outside the entity using
62.21the adopted NCPDP SCRIPT Standard. This exemption does not supersede any Health
62.22Insurance Portability and Accountability Act (HIPAA) requirement that may require the
62.23use of a HIPAA transaction standard within an organization.
62.24
62.25
62.26
62.27
62.28
62.29 Sec. 5. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision
62.30to read:
62.31 Subd. 4. Development and use of uniform formulary exception form. (a) The
62.32commissioner of health, in consultation with the Minnesota Administrative Uniformity
62.33Committee, shall develop by July 1, 2009, or six weeks after enactment of this subdivision,
62.34whichever is later, a uniform formulary exception form that allows health care providers
63.1to request exceptions from group purchaser formularies using a uniform form. Upon
63.2development of the form, all health care providers must submit requests for formulary
63.3exceptions using the uniform form, and all group purchasers must accept this form from
63.4health care providers.
63.5 (b) No later than January 1, 2011, the uniform formulary exception form must be
63.6accessible and submitted by health care providers, and accepted and processed by group
63.7purchasers, through secure electronic transmissions. Facsimile shall not be considered
63.8secure electronic transmissions.
63.9 Sec. 6. Minnesota Statutes 2008, section 62J.497, is amended by adding a subdivision
63.10to read:
63.11 Subd. 5. Electronic drug prior authorization standardization and transmission.
63.12 (a) The commissioner of health, in consultation with the Minnesota e-Health Advisory
63.13Committee and the Minnesota Administrative Uniformity Committee, shall, by February
63.1415, 2010, identify an outline on how best to standardize drug prior authorization request
63.15transactions between providers and group purchasers with the goal of maximizing
63.16administrative simplification and efficiency in preparation for electronic transmissions.
63.17 (b) No later than January 1, 2011, drug prior authorization requests must be
63.18accessible and submitted by health care providers, and accepted and processed by group
63.19purchasers, electronically through secure electronic transmissions. Facsimile shall not be
63.20considered electronic transmission.
63.21 Sec. 7. [62Q.676] MEDICATION THERAPY MANAGEMENT.
63.22 A pharmacy benefit manager that provides prescription drug services must make
63.23available medication therapy management services for enrollees taking four or more
63.24prescriptions to treat or prevent two or more chronic medical conditions. For purposes
63.25of this section, "medication therapy management" means the provision of the following
63.26pharmaceutical care services by, or under the supervision of, a licensed pharmacist to
63.27optimize the therapeutic outcomes of the patient's medications:
63.28 (1) performing a comprehensive medication review to identify, resolve, and prevent
63.29medication-related problems, including adverse drug events;
63.30 (2) communicating essential information to the patient's other primary care
63.31providers; and
63.32 (3) providing verbal education and training designed to enhance patient
63.33understanding and appropriate use of the patient's medications.
64.1 Nothing in this section shall be construed to expand or modify the scope of practice
64.2of the pharmacist as defined in section 151.01, subdivision 27.
64.3 Sec. 8. Minnesota Statutes 2008, section 144.122, is amended to read:
64.4144.122 LICENSE, PERMIT, AND SURVEY FEES.
64.5 (a) The state commissioner of health, by rule, may prescribe procedures and fees
64.6for filing with the commissioner as prescribed by statute and for the issuance of original
64.7and renewal permits, licenses, registrations, and certifications issued under authority of
64.8the commissioner. The expiration dates of the various licenses, permits, registrations,
64.9and certifications as prescribed by the rules shall be plainly marked thereon. Fees may
64.10include application and examination fees and a penalty fee for renewal applications
64.11submitted after the expiration date of the previously issued permit, license, registration,
64.12and certification. The commissioner may also prescribe, by rule, reduced fees for permits,
64.13licenses, registrations, and certifications when the application therefor is submitted
64.14during the last three months of the permit, license, registration, or certification period.
64.15Fees proposed to be prescribed in the rules shall be first approved by the Department of
64.16Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
64.17in an amount so that the total fees collected by the commissioner will, where practical,
64.18approximate the cost to the commissioner in administering the program. All fees collected
64.19shall be deposited in the state treasury and credited to the state government special revenue
64.20fund unless otherwise specifically appropriated by law for specific purposes.
64.21 (b) The commissioner may charge a fee for voluntary certification of medical
64.22laboratories and environmental laboratories, and for environmental and medical laboratory
64.23services provided by the department, without complying with paragraph (a) or chapter 14.
64.24Fees charged for environment and medical laboratory services provided by the department
64.25must be approximately equal to the costs of providing the services.
64.26 (c) The commissioner may develop a schedule of fees for diagnostic evaluations
64.27conducted at clinics held by the services for children with disabilities program. All
64.28receipts generated by the program are annually appropriated to the commissioner for use
64.29in the maternal and child health program.
64.30 (d) The commissioner shall set license fees for hospitals and nursing homes that are
64.31not boarding care homes at the following levels:
65.7 The commissioner shall set license fees for outpatient surgical centers, boarding care
65.8homes, and supervised living facilities at the following levels:
| 65.9 |
Outpatient surgical centers |
|
| 65.10 |
Boarding care homes |
$183 plus $91 per bed |
| 65.11 |
Supervised living facilities |
$183 plus $91 per bed. |
65.13applicants the following fees to cover the cost of any initial certification surveys required
65.14to determine a provider's eligibility to participate in the Medicare or Medicaid program:
66.1 These fees shall be submitted at the time of the application for federal certification
66.2and shall not be refunded. All fees collected after the date that the imposition of fees is not
66.3prohibited by federal law shall be deposited in the state treasury and credited to the state
66.4government special revenue fund.
66.5 Sec. 9. Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:
66.6 Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
66.7subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified
66.8birth, stillbirth, or death record, and for a certification that the record cannot be found.
66.9The local or state registrar shall forward this amount to the commissioner of finance to
66.10be deposited into the state government special revenue fund. This surcharge shall not be
66.11charged under those circumstances in which no fee for a birth, stillbirth, or death record is
66.12permitted under subdivision 1, paragraph (a).
66.13(b) Effective August 1, 2005,
66.14
66.15 Sec. 10. Minnesota Statutes 2008, section 148.6445, is amended by adding a
66.16subdivision to read:
66.17 Subd. 2a. Duplicate license fee. The fee for a duplicate license is $25.
66.20 Section 1. Minnesota Statutes 2008, section 60A.092, subdivision 2, is amended to
66.21read:
66.22 Subd. 2. Licensed assuming insurer. Reinsurance is ceded to an assuming insurer
66.23if the assuming insurer is licensed to transact insurance or reinsurance in this state. For
66.24purposes of reinsuring any health risk, an insurer is defined under section 62A.63.
66.25 Sec. 2. Minnesota Statutes 2008, section 62D.03, subdivision 4, is amended to read:
66.26 Subd. 4. Application requirements. Each application for a certificate of authority
66.27shall be verified by an officer or authorized representative of the applicant, and shall be
66.28in a form prescribed by the commissioner of health. Each application shall include the
66.29following:
66.30(a) a copy of the basic organizational document, if any, of the applicant and of
66.31each major participating entity; such as the articles of incorporation, or other applicable
66.32documents, and all amendments thereto;
67.1(b) a copy of the bylaws, rules and regulations, or similar document, if any, and all
67.2amendments thereto which regulate the conduct of the affairs of the applicant and of
67.3each major participating entity;
67.4(c) a list of the names, addresses, and official positions of the following:
67.5(1) all members of the board of directors, or governing body of the local government
67.6unit, and the principal officers and shareholders of the applicant organization; and
67.7(2) all members of the board of directors, or governing body of the local government
67.8unit, and the principal officers of the major participating entity and each shareholder
67.9beneficially owning more than ten percent of any voting stock of the major participating
67.10entity;
67.11The commissioner may by rule identify persons included in the term "principal
67.12officers";
67.13(d) a full disclosure of the extent and nature of any contract or financial arrangements
67.14between the following:
67.15(1) the health maintenance organization and the persons listed in clause (c)(1);
67.16(2) the health maintenance organization and the persons listed in clause (c)(2);
67.17(3) each major participating entity and the persons listed in clause (c)(1) concerning
67.18any financial relationship with the health maintenance organization; and
67.19(4) each major participating entity and the persons listed in clause (c)(2) concerning
67.20any financial relationship with the health maintenance organization;
67.21(e) the name and address of each participating entity and the agreed upon duration of
67.22each contract or agreement;
67.23(f) a copy of the form of each contract binding the participating entities and the
67.24health maintenance organization. Contractual provisions shall be consistent with the
67.25purposes of sections
67.26contract, the manner in which payment for services is determined, the nature and extent
67.27of responsibilities to be retained by the health maintenance organization, the nature and
67.28extent of risk sharing permissible, and contractual termination provisions;
67.29(g) a copy of each contract binding major participating entities and the health
67.30maintenance organization. Contract information filed with the commissioner shall be
67.31confidential and subject to the provisions of section
67.32the request of the health maintenance organization.
67.33Upon initial filing of each contract, the health maintenance organization shall file
67.34a separate document detailing the projected annual expenses to the major participating
67.35entity in performing the contract and the projected annual revenues received by the entity
67.36from the health maintenance organization for such performance. The commissioner
68.1shall disapprove any contract with a major participating entity if the contract will result
68.2in an unreasonable expense under section
68.3disapprove a contract within 30 days of filing.
68.4Within 120 days of the anniversary of the implementation of each contract, the
68.5health maintenance organization shall file a document detailing the actual expenses
68.6incurred and reported by the major participating entity in performing the contract in the
68.7preceding year and the actual revenues received from the health maintenance organization
68.8by the entity in payment for the performance;
68.9(h) a statement generally describing the health maintenance organization, its health
68.10maintenance contracts and separate health service contracts, facilities, and personnel,
68.11including a statement describing the manner in which the applicant proposes to provide
68.12enrollees with comprehensive health maintenance services and separate health services;
68.13(i) a copy of the form of each evidence of coverage to be issued to the enrollees;
68.14(j) a copy of the form of each individual or group health maintenance contract
68.15and each separate health service contract which is to be issued to enrollees or their
68.16representatives;
68.17(k) financial statements showing the applicant's assets, liabilities, and sources of
68.18financial support. If the applicant's financial affairs are audited by independent certified
68.19public accountants, a copy of the applicant's most recent certified financial statement
68.20may be deemed to satisfy this requirement;
68.21(l) a description of the proposed method of marketing the plan, a schedule of
68.22proposed charges, and a financial plan which includes a three-year projection of the
68.23expenses and income and other sources of future capital;
68.24(m) a statement reasonably describing the geographic area or areas to be served and
68.25the type or types of enrollees to be served;
68.26(n) a description of the complaint procedures to be utilized as required under section
68.28(o) a description of the procedures and programs to be implemented to meet the
68.29requirements of section
68.30quality of health care provided to enrollees;
68.31(p) a description of the mechanism by which enrollees will be afforded an
68.32opportunity to participate in matters of policy and operation under section
68.33(q) a copy of any agreement between the health maintenance organization and
68.34an insurer
68.35maintenance organization, regarding reinsurance, stop-loss coverage, insolvency
69.1coverage, or any other type of coverage for potential costs of health services, as authorized
69.2in sections
69.3(r) a copy of the conflict of interest policy which applies to all members of the board
69.4of directors and the principal officers of the health maintenance organization, as described
69.5in section
69.6organizations shall also file a conflict of interest policy with the commissioner within 60
69.7days after August 1, 1990, or at a later date if approved by the commissioner;
69.8(s) a copy of the statement that describes the health maintenance organization's prior
69.9authorization administrative procedures; and
69.10(t) other information as the commissioner of health may reasonably require to be
69.11provided.
69.12 Sec. 3. Minnesota Statutes 2008, section 62D.05, subdivision 3, is amended to read:
69.13 Subd. 3. Contracts; health services. A health maintenance organization may
69.14contract with providers of health care services to render the services the health maintenance
69.15organization has promised to provide under the terms of its health maintenance contracts,
69.16may, subject to section
69.17or other separate health service contracts, may, subject to the limitations of section
69.19 nonprofit health service plan corporations or other health maintenance organizations,
69.20for insurance, indemnity or reimbursement of its cost of providing health care services
69.21for enrollees or against the risks incurred by the health maintenance organization, may
69.22contract with insurance companies and nonprofit health service plan corporations for
69.23insolvency insurance coverage, and may contract with insurance companies and nonprofit
69.24health service plan corporations to insure or cover the enrollees' costs and expenses in the
69.25health maintenance organization, including the customary prepayment amount and any
69.26co-payment obligations, and may contract to provide reinsurance or insolvency insurance
69.27coverage to health insurers or nonprofit health service plan corporations.
69.28 Sec. 4. Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:
69.29 Subd. 7. Transfers from the commissioner of human services.
69.30
69.31
69.32
69.33
69.34clauses (1) to (4), $21,714,000 shall be distributed as follows:
70.1(1) $2,157,000 shall be distributed by the commissioner to the University of
70.2Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
70.3(2) $1,035,360 shall be distributed by the commissioner to the Hennepin County
70.4Medical Center for clinical medical education;
70.5(3) $17,400,000 shall be distributed by the commissioner to the University of
70.6Minnesota Board of Regents for purposes of medial education;
70.7(4) $1,121,640 shall be distributed by the commissioner to clinical medical education
70.8dental innovation grants in accordance with subdivision 7a; and
70.9(5) the remainder of the amount transferred according to section 256B.69,
70.10subdivision 5c, clauses (1) to (4), shall be distributed by the commissioner annually to
70.11clinical medical education programs that meet the qualifications of subdivision 3 based on
70.12the formula in subdivision 4, paragraph (a).
70.13
70.14
70.15
70.16
70.17
70.18
70.19
70.20
70.21
70.22
70.23
70.24
70.25
70.26
70.27
70.28 Sec. 5. Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:
70.29 Subd. 2b. Performance payments.
70.30implement a pay-for-performance system to provide performance payments to eligible
70.31medical groups and clinics that demonstrate optimum care in serving individuals
70.32with chronic diseases who are enrolled in health care programs administered by the
70.33commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any
70.34federal matching money that is made available through the medical assistance program
70.35for managed care oversight contracted through vendors, including consumer surveys,
71.1studies, and external quality reviews as required by the federal Balanced Budget Act of
71.21997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
71.3quality review. Any federal money received for managed care oversight is appropriated
71.4to the commissioner for this purpose. The commissioner may expend the federal money
71.5received in either year of the biennium.
71.6
71.7
71.8
71.9
71.10
71.11
71.12
71.13 Sec. 6. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
71.14to read:
71.15 Subd. 18a. Public Assistance Reporting Information System. (a) Effective
71.16October 1, 2009, the commissioner shall comply with the federal requirements in Public
71.17Law 110-379 in implementing the Public Assistance Reporting Information System
71.18(PARIS) to determine eligibility for all individuals applying for:
71.19(1) health care benefits under chapters 256B, 256D, and 256L; and
71.20(2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition
71.21assistance program.
71.22(b) The commissioner shall determine eligibility under paragraph (a) by performing
71.23data matches, including matching with medical assistance, cash, child care, and
71.24supplemental assistance programs operated by other states.
71.25EFFECTIVE DATE.This section is effective October 1, 2009.
71.26 Sec. 7. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
71.27to read:
71.28 Subd. 18b. Protections for American Indians. Effective February 18, 2009, the
71.29commissioner shall comply with the federal requirements in the American Recovery and
71.30Reinvestment Act of 2009, Public Law 111-5, section 5006, regarding American Indians.
71.31 Sec. 8. Minnesota Statutes 2008, section 256.962, subdivision 2, is amended to read:
72.1 Subd. 2. Outreach grants. (a) The commissioner shall award grants to public and
72.2private organizations, regional collaboratives, and regional health care outreach centers
72.3for outreach activities, including, but not limited to:
72.4 (1) providing information, applications, and assistance in obtaining coverage
72.5through Minnesota public health care programs;
72.6 (2) collaborating with public and private entities such as hospitals, providers, health
72.7plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
72.8develop outreach activities and partnerships to ensure the distribution of information
72.9and applications and provide assistance in obtaining coverage through Minnesota health
72.10care programs;
72.11 (3) providing or collaborating with public and private entities to provide multilingual
72.12and culturally specific information and assistance to applicants in areas of high
72.13uninsurance in the state or populations with high rates of uninsurance; and
72.14(4) targeting geographic areas with high rates of (i) eligible but unenrolled children,
72.15including children who reside in rural areas, or (ii) racial and ethnic minorities and health
72.16disparity populations.
72.17 (b) The commissioner shall ensure that all outreach materials are available in
72.18languages other than English.
72.19 (c) The commissioner shall establish an outreach trainer program to provide
72.20training to designated individuals from the community and public and private entities on
72.21application assistance in order for these individuals to provide training to others in the
72.22community on an as-needed basis.
72.23 Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:
72.24 Subd. 6. School districts and charter schools. (a) At the beginning of each school
72.25year, a school district or charter school shall provide information to each student on the
72.26availability of health care coverage through the Minnesota health care programs and how
72.27to obtain an application for the Minnesota health care programs.
72.28 (b)
72.29
72.30
72.31
72.32information on application assistance are available at early childhood education sites and
72.33public schools located within the district's jurisdiction.
72.34
72.35assistance and follow-up services with families who have indicated an interest in receiving
73.1information or an application for the Minnesota health care program. A district is eligible
73.2for the application assistance bonus described in subdivision 5.
73.3
73.4school district or charter school shall provide on
73.5how to obtain an application and application assistance.
73.6 Sec. 10. [256.964] DENTAL CARE PILOT PROJECTS.
73.7The commissioner shall authorize pilot projects to reduce the total cost to the state
73.8for dental services provided to enrollees of the state public health care programs by
73.9reducing hospital emergency room costs for preventable or nonemergency dental services.
73.10As part of the project, a community dental clinic or dental provider, in collaboration with a
73.11hospital emergency room, shall provide urgent care dental services as an alternative to the
73.12hospital emergency room for nonemergency dental care. The project participants shall
73.13establish a process to divert a patient presenting at the emergency room for nonemergency
73.14dental care to the dental community clinic or to an appropriate dental provider. The
73.15commissioner may establish special payment rates for urgent care services provided and
73.16may change or waive existing payment policies in order to adequately reimburse providers
73.17for providing cost-effective alternative services in an outpatient or urgent care setting.
73.18The commissioner may establish a project in conjunction with the initiative authorized
73.19under section 256.963.
73.20 Sec. 11. Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:
73.21 Subd. 2b. Operating payment rates. In determining operating payment rates for
73.22admissions occurring on or after the rate year beginning January 1, 1991, and every two
73.23years after, or more frequently as determined by the commissioner, the commissioner
73.24shall obtain operating data from an updated base year and establish operating payment
73.25rates per admission for each hospital based on the cost-finding methods and allowable
73.26costs of the Medicare program in effect during the base year. Rates under the general
73.27assistance medical care, medical assistance, and MinnesotaCare programs shall not be
73.28rebased to more current data on January 1, 1997, January 1, 2005,
73.29months of the rebased period beginning January 1, 2009, and for the first three months of
73.30the rebased period beginning January 1, 2011. From April 1, 2011, to March 31, 2012,
73.31rates shall be rebased at 39.2 percent of the full value of the rebasing percentage change.
73.32Effective April 1, 2012, rates shall be rebased at full value. The base year operating
73.33payment rate per admission is standardized by the case mix index and adjusted by the
73.34hospital cost index, relative values, and disproportionate population adjustment. The
74.1cost and charge data used to establish operating rates shall only reflect inpatient services
74.2covered by medical assistance and shall not include property cost information and costs
74.3recognized in outlier payments.
74.4 Sec. 12. Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:
74.5 Subd. 3a. Payments. (a) Acute care hospital billings under the medical
74.6assistance program must not be submitted until the recipient is discharged. However,
74.7the commissioner shall establish monthly interim payments for inpatient hospitals that
74.8have individual patient lengths of stay over 30 days regardless of diagnostic category.
74.9Except as provided in section
74.10of mental illness shall be reimbursed based on diagnostic classifications. Individual
74.11hospital payments established under this section and sections
74.13the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
74.14inpatient services paid for the same period of time to the hospital. This payment limitation
74.15shall be calculated separately for medical assistance and general assistance medical
74.16care services. The limitation on general assistance medical care shall be effective for
74.17admissions occurring on or after July 1, 1991. Services that have rates established under
74.18subdivision 11 or 12, must be limited separately from other services. After consulting with
74.19the affected hospitals, the commissioner may consider related hospitals one entity and
74.20may merge the payment rates while maintaining separate provider numbers. The operating
74.21and property base rates per admission or per day shall be derived from the best Medicare
74.22and claims data available when rates are established. The commissioner shall determine
74.23the best Medicare and claims data, taking into consideration variables of recency of the
74.24data, audit disposition, settlement status, and the ability to set rates in a timely manner.
74.25The commissioner shall notify hospitals of payment rates by December 1 of the year
74.26preceding the rate year. The rate setting data must reflect the admissions data used to
74.27establish relative values. Base year changes from 1981 to the base year established for the
74.28rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
74.29to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
74.301. The commissioner may adjust base year cost, relative value, and case mix index data
74.31to exclude the costs of services that have been discontinued by the October 1 of the year
74.32preceding the rate year or that are paid separately from inpatient services. Inpatient stays
74.33that encompass portions of two or more rate years shall have payments established based
74.34on payment rates in effect at the time of admission unless the date of admission preceded
74.35the rate year in effect by six months or more. In this case, operating payment rates for
75.1services rendered during the rate year in effect and established based on the date of
75.2admission shall be adjusted to the rate year in effect by the hospital cost index.
75.3 (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
75.4payment, before third-party liability and spenddown, made to hospitals for inpatient
75.5services is reduced by .5 percent from the current statutory rates.
75.6 (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
75.7admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
75.8before third-party liability and spenddown, is reduced five percent from the current
75.9statutory rates. Mental health services within diagnosis related groups 424 to 432, and
75.10facilities defined under subdivision 16 are excluded from this paragraph.
75.11 (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
75.12fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
75.13inpatient services before third-party liability and spenddown, is reduced 6.0 percent
75.14from the current statutory rates. Mental health services within diagnosis related groups
75.15424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
75.16Notwithstanding section
75.17assistance does not include general assistance medical care. Payments made to managed
75.18care plans shall be reduced for services provided on or after January 1, 2006, to reflect
75.19this reduction.
75.20 (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
75.21fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
75.22to hospitals for inpatient services before third-party liability and spenddown, is reduced
75.233.46 percent from the current statutory rates. Mental health services with diagnosis related
75.24groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
75.25paragraph. Payments made to managed care plans shall be reduced for services provided
75.26on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
75.27 (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
75.28fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
75.29to hospitals for inpatient services before third-party liability and spenddown, is reduced
75.301.9 percent from the current statutory rates. Mental health services with diagnosis related
75.31groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
75.32paragraph. Payments made to managed care plans shall be reduced for services provided
75.33on or after July 1, 2009, through June 30, 2010, to reflect this reduction.
75.34 (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
75.35for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
75.36inpatient services before third-party liability and spenddown, is reduced 1.79 percent
76.1from the current statutory rates. Mental health services with diagnosis related groups
76.2424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
76.3Payments made to managed care plans shall be reduced for services provided on or after
76.4July 1, 2010, to reflect this reduction.
76.5(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
76.6payment for fee-for-service admissions occurring on or after July 1, 2009, made to
76.7hospitals for inpatient services before third-party liability and spenddown, is reduced
76.8one percent from the current statutory rates. Facilities defined under subdivision 16 are
76.9excluded from this paragraph. Payments made to managed care plans shall be reduced for
76.10services provided on or after October 1, 2009, to reflect this reduction.
76.11 Sec. 13. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
76.12to read:
76.13 Subd. 3b. Nonpayment for hospital-acquired conditions and for certain
76.14treatments. (a) The commissioner must not make medical assistance payments to a
76.15hospital for any costs of care that result from a condition listed in paragraph (c), if the
76.16condition was hospital acquired.
76.17 (b) For purposes of this subdivision, a condition is hospital acquired if it is not
76.18identified by the hospital as present on admission. For purposes of this subdivision,
76.19medical assistance includes general assistance medical care and MinnesotaCare.
76.20(c) The prohibition in paragraph (a) applies to payment for each hospital-acquired
76.21condition listed in this paragraph that is represented by an ICD-9-CM diagnosis code and
76.22is designated as a complicating condition or a major complicating condition:
76.23(1) foreign object retained after surgery (ICD-9-CM codes 998.4 or 998.7);
76.24(2) air embolism (ICD-9-CM code 999.1);
76.25(3) blood incompatibility (ICD-9-CM code 999.6);
76.26(4) pressure ulcers stage III or IV (ICD-9-CM codes 707.23 or 707.24);
76.27(5) falls and trauma, including fracture, dislocation, intracranial injury, crushing
76.28injury, burn, and electric shock (ICD-9-CM codes with these ranges on the complicating
76.29condition and major complicating condition list: 800-829; 830-839; 850-854; 925-929;
76.30940-949; and 991-994);
76.31(6) catheter-associated urinary tract infection (ICD-9-CM code 996.64);
76.32(7) vascular catheter-associated infection (ICD-9-CM code 999.31);
76.33(8) manifestations of poor glycemic control (ICD-9-CM codes 249.10; 249.11;
76.34249.20; 249.21; 250.10; 250.11; 250.12; 250.13; 250.20; 250.21; 250.22; 250.23; and
76.35251.0);
77.1(9) surgical site infection (ICD-9-CM codes 996.67 or 998.59) following certain
77.2orthopedic procedures (procedure codes 81.01; 81.02; 81.03; 81.04; 81.05; 81.06; 81.07;
77.381.08; 81.23; 81.24; 81.31; 81.32; 81.33; 81.34; 81.35; 81.36; 81.37; 81.38; 81.83; and
77.481.85);
77.5(10) surgical site infection (ICD-9-CM code 998.59) following bariatric surgery
77.6(procedure codes 44.38; 44.39; or 44.95) for a principal diagnosis of morbid obesity
77.7(ICD-9-CM code 278.01);
77.8(11) surgical site infection, mediastinitis (ICD-9-CM code 519.2) following coronary
77.9artery bypass graft (procedure codes 36.10 to 36.19); and
77.10(12) deep vein thrombosis (ICD-9-CM codes 453.40 to 453.42) or pulmonary
77.11embolism (ICD-9-CM codes 415.11 or 415.91) following total knee replacement
77.12(procedure code 81.54) or hip replacement (procedure codes 00.85 to 00.87 or 81.51
77.13to 81.52).
77.14(d) The prohibition in paragraph (a) applies to any additional payments that result
77.15from a hospital-acquired condition listed in paragraph (c), including, but not limited to,
77.16additional treatment or procedures, readmission to the facility after discharge, increased
77.17length of stay, change to a higher diagnostic category, or transfer to another hospital. In
77.18the event of a transfer to another hospital, the hospital where the condition listed under
77.19paragraph (c) was acquired is responsible for any costs incurred at the hospital to which
77.20the patient is transferred.
77.21(e) A hospital shall not bill a recipient of services for any payment disallowed under
77.22this subdivision.
77.23 Sec. 14. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
77.24to read:
77.25 Subd. 28. Temporary rate increase for qualifying hospitals. For the period
77.26from April 1, 2009, to September 30, 2010, for each hospital with a medical assistance
77.27utilization rate equal to or greater than 25 percent during the base year, the commissioner
77.28shall provide an equal percentage rate increase for each medical assistance admission. The
77.29commissioner shall estimate the percentage rate increase using as the state share of the
77.30increase the amount available under section 256B.199, paragraph (d). The commissioner
77.31shall settle up payments to qualifying hospitals based on actual payments under that
77.32section and actual hospital admissions.
77.33EFFECTIVE DATE.This section is effective the day following final enactment.
78.1 Sec. 15. Minnesota Statutes 2008, section 256.969, is amended by adding a subdivision
78.2to read:
78.3 Subd. 29. Reimbursement for the fee increase for the early hearing detection
78.4and intervention program. For services provided on or after July 1, 2010, in addition to
78.5any other payment under this section, the commissioner shall reimburse hospitals for the
78.6increase in the fee for the early hearing detection and intervention program described in
78.7section 144.125, subdivision 1, paid by the hospital for public program recipients.
78.8 Sec. 16. [256B.032] ELIGIBLE VENDORS OF MEDICAL CARE.
78.9(a) Effective January 1, 2011, the commissioner shall establish performance
78.10thresholds for health care providers included in the provider peer grouping system
78.11developed by the commissioner of health under section 62U.04. The thresholds shall be
78.12set at the 10th percentile of the combined cost and quality measure used for provider peer
78.13grouping, and separate thresholds shall be set for hospital and physician services.
78.14(b) Beginning January 1, 2012, any health care provider with a combined cost and
78.15quality score below the threshold set in paragraph (a) shall be prohibited from enrolling
78.16as a vendor of medical care in the medical assistance, general assistance medical care,
78.17or MinnesotaCare programs, and shall not be eligible for direct payments under those
78.18programs or for payments made by managed care plans under their contracts with the
78.19commissioner under section 256B.69 or 256L.12. A health care provider that is prohibited
78.20from enrolling as a vendor or receiving payments under this paragraph may reenroll
78.21effective January 1 of any subsequent year if the provider's most recent combined cost and
78.22quality score exceeds the threshold established in paragraph (a).
78.23(c) Notwithstanding paragraph (b), a provider may continue to participate as a vendor
78.24or as part of a managed care plan provider network if the commissioner determines that a
78.25contract with the provider is necessary to ensure adequate access to health care services.
78.26(d) By January 15, 2013, the commissioner shall report to the legislature on the
78.27impact of this section. The commissioner's report shall include information on:
78.28(1) the providers falling below the thresholds as of January 1, 2012;
78.29(2) the volume of services and cost of care provided to enrollees in the medical
78.30assistance, general assistance medical care, or MinnesotaCare programs in the 12 months
78.31prior to January 1, 2012, by providers falling below the thresholds;
78.32(3) providers who fell below the thresholds but continued to be eligible vendors
78.33under paragraph (c);
78.34(4) the estimated cost savings achieved by not contracting with providers who do
78.35not meet the performance thresholds; and
79.1(5) recommendations for increasing the threshold levels of performance over time.
79.2 Sec. 17. Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to
79.3read:
79.4 Subd. 3c. Asset limitations for families and children. A household of two or more
79.5persons must not own more than $20,000 in total net assets, and a household of one
79.6person must not own more than $10,000 in total net assets. In addition to these maximum
79.7amounts, an eligible individual or family may accrue interest on these amounts, but they
79.8must be reduced to the maximum at the time of an eligibility redetermination. The value of
79.9assets that are not considered in determining eligibility for medical assistance for families
79.10and children is the value of those assets excluded under the AFDC state plan as of July 16,
79.111996, as required by the Personal Responsibility and Work Opportunity Reconciliation
79.12Act of 1996 (PRWORA), Public Law 104-193, with the following exceptions:
79.13(1) household goods and personal effects are not considered;
79.14(2) capital and operating assets of a trade or business up to $200,000 are not
79.15considered, except that a bank account that contains personal income or assets, or is used to
79.16pay personal expenses, is not considered a capital or operating asset of a trade or business;
79.17(3) one motor vehicle is excluded for each person of legal driving age who is
79.18employed or seeking employment;
79.19(4) one burial plot and all other burial expenses equal to the supplemental security
79.20income program asset limit are not considered for each individual;
79.21(5) court-ordered settlements up to $10,000 are not considered;
79.22(6) individual retirement accounts and funds are not considered; and
79.23(7) assets owned by children are not considered.
79.24The assets specified in clause (2) must be disclosed to the local agency at the time of
79.25application and at the time of an eligibility redetermination, and must be verified upon
79.26request of the local agency.
79.27EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
79.28approval, whichever is later.
79.29 Sec. 18. Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to
79.30read:
79.31 Subd. 3d. Reduction of excess assets. Assets in excess of the limits in subdivisions
79.323 to 3c may be reduced to allowable limits as follows:
79.33(a) Assets may be reduced in any of the three calendar months before the month
79.34of application in which the applicant seeks coverage by
80.1
80.2
80.3
80.4period for which the applicant seeks eligibility, starting with the oldest bill. After assets
80.5are reduced to allowable limits, eligibility begins with the next dollar of MA-covered
80.6health services incurred in the retroactive period. Applicants reducing assets under this
80.7subdivision who also have excess income shall first spend excess assets to pay health
80.8service bills and may meet the income spenddown on remaining bills.
80.9(b) Assets may be reduced beginning the month of application by
80.10
80.11Minnesota Rules, part 9505.0090, subpart 2, that would otherwise be paid by medical
80.12assistance
80.13next dollar of medical assistance covered health services incurred in the period. Applicants
80.14reducing assets under this subdivision who also have excess income shall first spend excess
80.15assets to pay health service bills and may meet the income spenddown on remaining bills.
80.16
80.17
80.18EFFECTIVE DATE.This section is effective January 1, 2011.
80.19 Sec. 19. Minnesota Statutes 2008, section 256B.057, is amended by adding a
80.20subdivision to read:
80.21 Subd. 11. Treatment for colorectal cancer. (a) Medical assistance shall be paid for
80.22an individual who:
80.23(1) has been screened for colorectal cancer by the colorectal cancer prevention
80.24demonstration project;
80.25(2) according to the individual's treating health professional, needs treatment for
80.26colorectal cancer;
80.27(3) meets income eligibility guidelines for the colorectal cancer prevention
80.28demonstration project;
80.29(4) is under the age of 65; and
80.30(5) is not otherwise eligible for medical assistance or covered under creditable
80.31coverage as defined under United States Code, title 42, section 300gg(a).
80.32(b) Medical assistance provided under this subdivision shall be limited to services
80.33provided during the period that the individual receives treatment for colorectal cancer.
81.1(c) An individual meeting the criteria in paragraph (a) is eligible for medical
81.2assistance without meeting the eligibility criteria relating to income and assets in section
81.3256B.056, subdivisions 1a to 5b.
81.4(d) This subdivision expires December 31, 2010.
81.5 Sec. 20. Minnesota Statutes 2008, section 256B.0575, is amended to read:
81.6256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
81.7PERSONS.
81.8 Subdivision 1. Income deductions. When an institutionalized person is determined
81.9eligible for medical assistance, the income that exceeds the deductions in paragraphs (a)
81.10and (b) must be applied to the cost of institutional care.
81.11(a) The following amounts must be deducted from the institutionalized person's
81.12income in the following order:
81.13(1) the personal needs allowance under section
81.14does not have a spouse or child, or a surviving spouse of a veteran having no child, the
81.15amount of an improved pension received from the veteran's administration not exceeding
81.16$90 per month;
81.17(2) the personal allowance for disabled individuals under section
81.18(3) if the institutionalized person has a legally appointed guardian or conservator,
81.19five percent of the recipient's gross monthly income up to $100 as reimbursement for
81.20guardianship or conservatorship services;
81.21(4) a monthly income allowance determined under section
81.222
81.23community spouse;
81.24(5) a monthly allowance for children under age 18 which, together with the net
81.25income of the children, would provide income equal to the medical assistance standard
81.26for families and children according to section
81.27that includes only the minor children. This deduction applies only if the children do not
81.28live with the community spouse and only to the extent that the deduction is not included
81.29in the personal needs allowance under section
81.30garnished under a court order;
81.31(6) a monthly family allowance for other family members, equal to one-third of the
81.32difference between 122 percent of the federal poverty guidelines and the monthly income
81.33for that family member;
82.1(7) reparations payments made by the Federal Republic of Germany and reparations
82.2payments made by the Netherlands for victims of Nazi persecution between 1940 and
82.31945;
82.4(8) all other exclusions from income for institutionalized persons as mandated by
82.5federal law; and
82.6(9) amounts for reasonable expenses, as specified in subdivision 2, incurred for
82.7necessary medical or remedial care for the institutionalized person that are recognized
82.8under state law, not medical assistance covered expenses, and
82.9payment by a third party.
82.10
82.11
82.12
82.13
82.14For purposes of clause (6), "other family member" means a person who resides
82.15with the community spouse and who is a minor or dependent child, dependent parent, or
82.16dependent sibling of either spouse. "Dependent" means a person who could be claimed as
82.17a dependent for federal income tax purposes under the Internal Revenue Code.
82.18(b) Income shall be allocated to an institutionalized person for a period of up to three
82.19calendar months, in an amount equal to the medical assistance standard for a family
82.20size of one if:
82.21(1) a physician certifies that the person is expected to reside in the long-term care
82.22facility for three calendar months or less;
82.23(2) if the person has expenses of maintaining a residence in the community; and
82.24(3) if one of the following circumstances apply:
82.25(i) the person was not living together with a spouse or a family member as defined in
82.26paragraph (a) when the person entered a long-term care facility; or
82.27(ii) the person and the person's spouse become institutionalized on the same date, in
82.28which case the allocation shall be applied to the income of one of the spouses.
82.29For purposes of this paragraph, a person is determined to be residing in a licensed nursing
82.30home, regional treatment center, or medical institution if the person is expected to remain
82.31for a period of one full calendar month or more.
82.32 Subd. 2. Reasonable expenses. For the purposes of subdivision 1, paragraph (a),
82.33clause (9), reasonable expenses are limited to expenses that have not been previously used
82.34as a deduction from income and were not:
82.35 (1) for long-term care expenses incurred during a period of ineligibility as defined in
82.36section 256B.0595, subdivision 2;
83.1 (2) incurred more than three months before the month of application associated with
83.2the current period of eligibility;
83.3 (3) for expenses incurred by a recipient that are duplicative of services that are
83.4covered under chapter 256B; or
83.5 (4) nursing facility expenses incurred without a timely assessment as required under
83.6section 256B.0911.
83.7 Sec. 21. Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to
83.8read:
83.9 Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before
83.10August 10, 1993, if an institutionalized person or the institutionalized person's spouse has
83.11given away, sold, or disposed of, for less than fair market value, any asset or interest
83.12therein, except assets other than the homestead that are excluded under the supplemental
83.13security program, within 30 months before or any time after the date of institutionalization
83.14if the person has been determined eligible for medical assistance, or within 30 months
83.15before or any time after the date of the first approved application for medical assistance
83.16if the person has not yet been determined eligible for medical assistance, the person is
83.17ineligible for long-term care services for the period of time determined under subdivision
83.182.
83.19 (b) Effective for transfers made after August 10, 1993, an institutionalized person, an
83.20institutionalized person's spouse, or any person, court, or administrative body with legal
83.21authority to act in place of, on behalf of, at the direction of, or upon the request of the
83.22institutionalized person or institutionalized person's spouse, may not give away, sell, or
83.23dispose of, for less than fair market value, any asset or interest therein, except assets other
83.24than the homestead that are excluded under the Supplemental Security Income program,
83.25for the purpose of establishing or maintaining medical assistance eligibility. This applies
83.26to all transfers, including those made by a community spouse after the month in which
83.27the institutionalized spouse is determined eligible for medical assistance. For purposes of
83.28determining eligibility for long-term care services, any transfer of such assets within 36
83.29months before or any time after an institutionalized person requests medical assistance
83.30payment of long-term care services, or 36 months before or any time after a medical
83.31assistance recipient becomes an institutionalized person, for less than fair market value
83.32may be considered. Any such transfer is presumed to have been made for the purpose
83.33of establishing or maintaining medical assistance eligibility and the institutionalized
83.34person is ineligible for long-term care services for the period of time determined under
83.35subdivision 2, unless the institutionalized person furnishes convincing evidence to
84.1establish that the transaction was exclusively for another purpose, or unless the transfer is
84.2permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a
84.3trust that are considered transfers of assets under federal law, or in the case of any other
84.4disposal of assets made on or after February 8, 2006, any transfers made within 60 months
84.5before or any time after an institutionalized person requests medical assistance payment of
84.6long-term care services and within 60 months before or any time after a medical assistance
84.7recipient becomes an institutionalized person, may be considered.
84.8 (c) This section applies to transfers, for less than fair market value, of income
84.9or assets, including assets that are considered income in the month received, such as
84.10inheritances, court settlements, and retroactive benefit payments or income to which the
84.11institutionalized person or the institutionalized person's spouse is entitled but does not
84.12receive due to action by the institutionalized person, the institutionalized person's spouse,
84.13or any person, court, or administrative body with legal authority to act in place of, on
84.14behalf of, at the direction of, or upon the request of the institutionalized person or the
84.15institutionalized person's spouse.
84.16 (d) This section applies to payments for care or personal services provided by a
84.17relative, unless the compensation was stipulated in a notarized, written agreement which
84.18was in existence when the service was performed, the care or services directly benefited
84.19the person, and the payments made represented reasonable compensation for the care
84.20or services provided. A notarized written agreement is not required if payment for the
84.21services was made within 60 days after the service was provided.
84.22 (e) This section applies to the portion of any asset or interest that an institutionalized
84.23person, an institutionalized person's spouse, or any person, court, or administrative body
84.24with legal authority to act in place of, on behalf of, at the direction of, or upon the request
84.25of the institutionalized person or the institutionalized person's spouse, transfers to any
84.26annuity that exceeds the value of the benefit likely to be returned to the institutionalized
84.27person or institutionalized person's spouse while alive, based on estimated life expectancy
84.28as determined according to the current actuarial tables published by the Office of the
84.29Chief Actuary of the Social Security Administration. The commissioner may adopt rules
84.30reducing life expectancies based on the need for long-term care. This section applies to an
84.31annuity purchased on or after March 1, 2002, that:
84.32 (1) is not purchased from an insurance company or financial institution that is
84.33subject to licensing or regulation by the Minnesota Department of Commerce or a similar
84.34regulatory agency of another state;
84.35 (2) does not pay out principal and interest in equal monthly installments; or
84.36 (3) does not begin payment at the earliest possible date after annuitization.
85.1 (f) Effective for transactions, including the purchase of an annuity, occurring on or
85.2after February 8, 2006, by or on behalf of an institutionalized person who has applied for
85.3or is receiving long-term care services or the institutionalized person's spouse shall be
85.4treated as the disposal of an asset for less than fair market value unless the department is
85.5named a preferred remainder beneficiary as described in section
85.611
85.7beneficiary shall result in the annuity being treated as a disposal of assets for less than
85.8fair market value. The amount of such transfer shall be the maximum amount the
85.9institutionalized person or the institutionalized person's spouse could receive from the
85.10annuity or similar financial instrument. Any change in the amount of the income or
85.11principal being withdrawn from the annuity or other similar financial instrument at the
85.12time of the most recent disclosure shall be deemed to be a transfer of assets for less than
85.13fair market value unless the institutionalized person or the institutionalized person's spouse
85.14demonstrates that the transaction was for fair market value. In the event a distribution
85.15of income or principal has been improperly distributed or disbursed from an annuity or
85.16other retirement planning instrument of an institutionalized person or the institutionalized
85.17person's spouse, a cause of action exists against the individual receiving the improper
85.18distribution for the cost of medical assistance services provided or the amount of the
85.19improper distribution, whichever is less.
85.20 (g) Effective for transactions, including the purchase of an annuity, occurring on
85.21or after February 8, 2006, by or on behalf of an institutionalized person applying for or
85.22receiving long-term care services shall be treated as a disposal of assets for less than fair
85.23market value unless it is:
85.24 (i) an annuity described in subsection (b) or (q) of section 408 of the Internal
85.25Revenue Code of 1986; or
85.26 (ii) purchased with proceeds from:
85.27 (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
85.28Internal Revenue Code;
85.29 (B) a simplified employee pension within the meaning of section 408(k) of the
85.30Internal Revenue Code; or
85.31 (C) a Roth IRA described in section 408A of the Internal Revenue Code; or
85.32 (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
85.33determined in accordance with actuarial publications of the Office of the Chief Actuary of
85.34the Social Security Administration; and provides for payments in equal amounts during
85.35the term of the annuity, with no deferral and no balloon payments made.
86.1 (h) For purposes of this section, long-term care services include services in a nursing
86.2facility, services that are eligible for payment according to section
86.32
86.4developmental disabilities, and home and community-based services provided pursuant
86.5to sections
86.6subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient
86.7in a nursing facility or in a swing bed, or intermediate care facility for persons with
86.8developmental disabilities or who is receiving home and community-based services under
86.9sections
86.10 (i) This section applies to funds used to purchase a promissory note, loan, or
86.11mortgage unless the note, loan, or mortgage:
86.12 (1) has a repayment term that is actuarially sound;
86.13 (2) provides for payments to be made in equal amounts during the term of the loan,
86.14with no deferral and no balloon payments made; and
86.15 (3) prohibits the cancellation of the balance upon the death of the lender.
86.16 In the case of a promissory note, loan, or mortgage that does not meet an exception
86.17in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
86.18balance due as of the date of the institutionalized person's request for medical assistance
86.19payment of long-term care services.
86.20 (j) This section applies to the purchase of a life estate interest in another person's
86.21home unless the purchaser resides in the home for a period of at least one year after the
86.22date of purchase.
86.23(k) This section applies to transfers into a pooled trust that qualifies under United
86.24States Code, title 42, section 1396p(d)(4)(C), by:
86.25(1) a person age 65 or older or the person's spouse; or
86.26(2) any person, court, or administrative body with legal authority to act in place
86.27of, on behalf of, at the direction of, or upon the request of a person age 65 or older or
86.28the person's spouse.
86.29 Sec. 22. Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to
86.30read:
86.31 Subd. 2. Period of ineligibility for long-term care services. (a) For any
86.32uncompensated transfer occurring on or before August 10, 1993, the number of months
86.33of ineligibility for long-term care services shall be the lesser of 30 months, or the
86.34uncompensated transfer amount divided by the average medical assistance rate for nursing
86.35facility services in the state in effect on the date of application. The amount used to
87.1calculate the average medical assistance payment rate shall be adjusted each July 1 to
87.2reflect payment rates for the previous calendar year. The period of ineligibility begins
87.3with the month in which the assets were transferred. If the transfer was not reported to
87.4the local agency at the time of application, and the applicant received long-term care
87.5services during what would have been the period of ineligibility if the transfer had been
87.6reported, a cause of action exists against the transferee for the cost of long-term care
87.7services provided during the period of ineligibility, or for the uncompensated amount of
87.8the transfer, whichever is less. The uncompensated transfer amount is the fair market
87.9value of the asset at the time it was given away, sold, or disposed of, less the amount of
87.10compensation received.
87.11 (b) For uncompensated transfers made after August 10, 1993, the number of months
87.12of ineligibility for long-term care services shall be the total uncompensated value of the
87.13resources transferred divided by the average medical assistance rate for nursing facility
87.14services in the state in effect on the date of application. The amount used to calculate
87.15the average medical assistance payment rate shall be adjusted each July 1 to reflect
87.16payment rates for the previous calendar year. The period of ineligibility begins with the
87.17first day of the month after the month in which the assets were transferred except that
87.18if one or more uncompensated transfers are made during a period of ineligibility, the
87.19total assets transferred during the ineligibility period shall be combined and a penalty
87.20period calculated to begin on the first day of the month after the month in which the first
87.21uncompensated transfer was made. If the transfer was reported to the local agency after
87.22the date that advance notice of a period of ineligibility that affects the next month could
87.23be provided to the recipient and the recipient received medical assistance services or the
87.24transfer was not reported to the local agency, and the applicant or recipient received
87.25medical assistance services during what would have been the period of ineligibility if
87.26the transfer had been reported, a cause of action exists against the transferee for that
87.27portion of long-term care services provided during the period of ineligibility, or for the
87.28uncompensated amount of the transfer, whichever is less. The uncompensated transfer
87.29amount is the fair market value of the asset at the time it was given away, sold, or disposed
87.30of, less the amount of compensation received. Effective for transfers made on or after
87.31March 1, 1996, involving persons who apply for medical assistance on or after April 13,
87.321996, no cause of action exists for a transfer unless:
87.33 (1) the transferee knew or should have known that the transfer was being made by a
87.34person who was a resident of a long-term care facility or was receiving that level of care in
87.35the community at the time of the transfer;
88.1 (2) the transferee knew or should have known that the transfer was being made to
88.2assist the person to qualify for or retain medical assistance eligibility; or
88.3 (3) the transferee actively solicited the transfer with intent to assist the person to
88.4qualify for or retain eligibility for medical assistance.
88.5 (c) For uncompensated transfers made on or after February 8, 2006, the period
88.6of ineligibility:
88.7 (1) for uncompensated transfers by or on behalf of individuals receiving medical
88.8assistance payment of long-term care services, begins the first day of the month following
88.9advance notice of the
88.10month that follows three full calendar months from the date of the report or discovery
88.11of the transfer; or
88.12 (2) for uncompensated transfers by individuals requesting medical assistance
88.13payment of long-term care services, begins the date on which the individual is eligible
88.14for medical assistance under the Medicaid state plan and would otherwise be receiving
88.15long-term care services based on an approved application for such care but for the
88.16
88.17transfer; and
88.18 (3) cannot begin during any other period of ineligibility.
88.19 (d) If a calculation of a
88.20payments for long-term care services shall be reduced in an amount equal to the fraction.
88.21 (e) In the case of multiple fractional transfers of assets in more than one month for
88.22less than fair market value on or after February 8, 2006, the period of ineligibility is
88.23calculated by treating the total, cumulative, uncompensated value of all assets transferred
88.24during all months on or after February 8, 2006, as one transfer.
88.25 (f) A period of ineligibility established under paragraph (c) may be eliminated if
88.26all of the assets transferred for less than fair market value used to calculate the period of
88.27ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned
88.28within 12 months after the date the period of ineligibility began. A period of ineligibility
88.29must not be adjusted if less than the full amount of the transferred assets or the full cash
88.30value of the transferred assets are returned.
88.31EFFECTIVE DATE.This section is effective for periods of ineligibility established
88.32on or after January 1, 2011.
88.33 Sec. 23. Minnesota Statutes 2008, section 256B.06, subdivision 4, is amended to read:
88.34 Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
88.35to citizens of the United States, qualified noncitizens as defined in this subdivision, and
89.1other persons residing lawfully in the United States. Citizens or nationals of the United
89.2States must cooperate in obtaining satisfactory documentary evidence of citizenship or
89.3nationality according to the requirements of the federal Deficit Reduction Act of 2005,
89.4Public Law 109-171.
89.5(b) "Qualified noncitizen" means a person who meets one of the following
89.6immigration criteria:
89.7(1) admitted for lawful permanent residence according to United States Code, title 8;
89.8(2) admitted to the United States as a refugee according to United States Code,
89.9title 8, section 1157;
89.10(3) granted asylum according to United States Code, title 8, section 1158;
89.11(4) granted withholding of deportation according to United States Code, title 8,
89.12section 1253(h);
89.13(5) paroled for a period of at least one year according to United States Code, title 8,
89.14section 1182(d)(5);
89.15(6) granted conditional entrant status according to United States Code, title 8,
89.16section 1153(a)(7);
89.17(7) determined to be a battered noncitizen by the United States Attorney General
89.18according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
89.19title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
89.20(8) is a child of a noncitizen determined to be a battered noncitizen by the United
89.21States Attorney General according to the Illegal Immigration Reform and Immigrant
89.22Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
89.23Public Law 104-200; or
89.24(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
89.25Law 96-422, the Refugee Education Assistance Act of 1980.
89.26(c) All qualified noncitizens who were residing in the United States before August
89.2722, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
89.28medical assistance with federal financial participation.
89.29(d) All qualified noncitizens who entered the United States on or after August 22,
89.301996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
89.31medical assistance with federal financial participation through November 30, 1996.
89.32Beginning December 1, 1996, qualified noncitizens who entered the United States
89.33on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
89.34chapter are eligible for medical assistance with federal participation for five years if they
89.35meet one of the following criteria:
90.1(i) refugees admitted to the United States according to United States Code, title 8,
90.2section 1157;
90.3(ii) persons granted asylum according to United States Code, title 8, section 1158;
90.4(iii) persons granted withholding of deportation according to United States Code,
90.5title 8, section 1253(h);
90.6(iv) veterans of the United States armed forces with an honorable discharge for
90.7a reason other than noncitizen status, their spouses and unmarried minor dependent
90.8children; or
90.9(v) persons on active duty in the United States armed forces, other than for training,
90.10their spouses and unmarried minor dependent children.
90.11Beginning December 1, 1996, qualified noncitizens who do not meet one of the
90.12criteria in items (i) to (v) are eligible for medical assistance without federal financial
90.13participation as described in paragraph (j).
90.14Notwithstanding paragraph (j), beginning July 1, 2010, children and pregnant
90.15women who are qualified noncitizens, as described in paragraph (b), are eligible for
90.16medical assistance with federal financial participation as provided by the federal Children's
90.17Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.
90.18(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b), who
90.19are lawfully present in the United States, as defined in Code of Federal Regulations, title
90.208, section
90.21eligible for medical assistance under clauses (1) to (3). These individuals must cooperate
90.22with the United States Citizenship and Immigration Services to pursue any applicable
90.23immigration status, including citizenship, that would qualify them for medical assistance
90.24with federal financial participation.
90.25(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
90.26for medical assistance with federal financial participation through December 31, 1996.
90.27(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
90.28medical assistance without federal financial participation as described in paragraph (j).
90.29(3) Beginning December 1, 1996, persons residing in the United States prior to
90.30August 22, 1996, who were not receiving medical assistance and persons who arrived on
90.31or after August 22, 1996, are eligible for medical assistance without federal financial
90.32participation as described in paragraph (j).
90.33(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
90.34are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this
90.35subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
90.36Code, title 8, section 1101(a)(15).
91.1(g) Payment shall also be made for care and services that are furnished to noncitizens,
91.2regardless of immigration status, who otherwise meet the eligibility requirements of
91.3this chapter, if such care and services are necessary for the treatment of an emergency
91.4medical condition, except for organ transplants and related care and services and routine
91.5prenatal care.
91.6(h) For purposes of this subdivision, the term "emergency medical condition" means
91.7a medical condition that meets the requirements of United States Code, title 42, section
91.81396b(v).
91.9(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
91.10nonimmigrants, or
91.11present as designated in paragraph (e) and who are not covered by a group health plan
91.12or health insurance coverage according to Code of Federal Regulations, title 42, section
91.13457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible
91.14for medical assistance through the period of pregnancy, including labor and delivery,
91.15and 60 days postpartum, to the extent federal funds are available under title XXI of the
91.16Social Security Act, and the state children's health insurance program
91.17
91.18(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
91.19lawfully residing in the United States as described in paragraph (e), who are ineligible
91.20for medical assistance with federal financial participation and who otherwise meet the
91.21eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
91.22assistance without federal financial participation. Qualified noncitizens as described
91.23in paragraph (d) are only eligible for medical assistance without federal financial
91.24participation for five years from their date of entry into the United States.
91.25(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation
91.26services from a nonprofit center established to serve victims of torture and are otherwise
91.27ineligible for medical assistance under this chapter are eligible for medical assistance
91.28without federal financial participation. These individuals are eligible only for the period
91.29during which they are receiving services from the center. Individuals eligible under this
91.30paragraph shall not be required to participate in prepaid medical assistance.
91.31EFFECTIVE DATE.This section is effective July 1, 2009.
91.32 Sec. 24. Minnesota Statutes 2008, section 256B.06, subdivision 5, is amended to read:
91.33 Subd. 5. Deeming of sponsor income and resources. When determining eligibility
91.34for any federal or state funded medical assistance under this section, the income
91.35and resources of all noncitizens shall be deemed to include their sponsors' income
92.1and resources as required under the Personal Responsibility and Work Opportunity
92.2Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
92.3subsequently set out in federal rules. This section is effective May 1, 1997. Beginning
92.4July 1, 2010, sponsor deeming does not apply to pregnant women and children who are
92.5qualified noncitizens, as described in section 256B.06, subdivision 4, paragraph (b).
92.6EFFECTIVE DATE.This section is effective July 1, 2010.
92.7 Sec. 25. Minnesota Statutes 2008, section 256B.0625, subdivision 3, is amended to
92.8read:
92.9 Subd. 3. Physicians' services. (a) Medical assistance covers physicians' services.
92.10(b) Rates paid for anesthesiology services provided by physicians shall be according
92.11to the formula utilized in the Medicare program and shall use a conversion factor "at
92.12percentile of calendar year set by legislature
92.13medical direction of a certified registered nurse anesthetist shall be the same as the rate
92.14paid to the certified registered nurse anesthetist under medical direction.
92.15 Sec. 26. Minnesota Statutes 2008, section 256B.0625, subdivision 3c, is amended to
92.16read:
92.17 Subd. 3c. Health Services Policy Committee. (a) The commissioner, after
92.18receiving recommendations from professional physician associations, professional
92.19associations representing licensed nonphysician health care professionals, and consumer
92.20groups, shall establish a 13-member Health Services Policy Committee, which consists of
92.2112 voting members and one nonvoting member. The Health Services Policy Committee
92.22shall advise the commissioner regarding health services pertaining to the administration
92.23of health care benefits covered under the medical assistance, general assistance medical
92.24care, and MinnesotaCare programs. The Health Services Policy Committee shall meet at
92.25least quarterly. The Health Services Policy Committee shall annually elect a physician
92.26chair from among its members, who shall work directly with the commissioner's medical
92.27director, to establish the agenda for each meeting. The Health Services Policy Committee
92.28shall also recommend criteria for verifying centers of excellence for specific aspects of
92.29medical care where a specific set of combined services, a volume of patients necessary to
92.30maintain a high level of competency, or a specific level of technical capacity is associated
92.31with improved health outcomes.
92.32(b) The commissioner shall establish a dental subcommittee to operate under the
92.33Health Services Policy Committee. The dental subcommittee consists of general dentists,
92.34dental specialists, safety net providers, dental hygienists, health plan company and
93.1county and public health representatives, health researchers, consumers, and a designee
93.2of the commissioner of health. The dental subcommittee shall advise the commissioner
93.3regarding:
93.4(1) the critical access dental program under section 256B.76, subdivision 4, including
93.5but not limited to criteria for designating and terminating critical access dental providers;
93.6(2) any changes to the critical access dental provider program necessary to comply
93.7with program expenditure limits;
93.8(3) dental coverage policy based on evidence, quality, continuity of care, and best
93.9practices;
93.10(4) the development of dental delivery models; and
93.11(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
93.12(c) The Health Services Policy Committee shall study approaches to making
93.13provider reimbursement under the medical assistance, MinnesotaCare, and general
93.14assistance medical care programs contingent on patient participation in a patient-centered
93.15decision-making process, and shall evaluate the impact of these approaches on health
93.16care quality, patient satisfaction, and health care costs. The committee shall present
93.17findings and recommendations to the commissioner and the legislative committees with
93.18jurisdiction over health care by January 15, 2010.
93.19(d) The Health Services Policy Committee shall monitor and track the practice
93.20patterns of physicians providing services to medical assistance, MinnesotaCare, and
93.21general assistance medical care enrollees under fee-for-service, managed care, and
93.22county-based purchasing. The committee shall focus on services or specialties for which
93.23there is a high variation in utilization across physicians, or which are associated with
93.24high medical costs. The commissioner, based upon the findings of the committee, shall
93.25regularly notify physicians whose practice patterns indicate higher than average utilization
93.26or costs. Managed care and county-based purchasing plans shall provide the committee
93.27with utilization and cost data necessary to implement this paragraph.
93.28 (e) The Health Services Policy Committee shall review caesarean section rates
93.29for the fee-for-service medical assistance population. The committee may develop best
93.30practices policies related to the minimization of caesarean sections, including but not
93.31limited to standards and guidelines for health care providers and health care facilities.
93.32 Sec. 27. Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to
93.33read:
94.1 Subd. 9. Dental services. (a) Medical assistance covers dental services.
94.2
94.3
94.4(b) Medical assistance dental coverage for nonpregnant adults is limited to the
94.5following services:
94.6(1) comprehensive exams, limited to once every five years;
94.7(2) periodic exams, limited to one per year;
94.8(3) limited exams;
94.9(4) bitewing x-rays, limited to one per year;
94.10(5) periapical x-rays;
94.11(6) panoramic x-rays, limited to one every five years, and only if provided in
94.12conjunction with a posterior extraction or scheduled outpatient facility procedure, or as
94.13medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology
94.14and trauma. Panoramic x-rays may be taken once every two years for patients who cannot
94.15cooperate for intraoral film due to a developmental disability or medical condition that
94.16does not allow for intraoral film placement;
94.17(7) prophylaxis, limited to one per year;
94.18(8) application of fluoride varnish, limited to one per year;
94.19(9) posterior fillings, all at the amalgam rate;
94.20(10) anterior fillings;
94.21(11) endodontics, limited to root canals on the anterior and premolars only;
94.22(12) removable prostheses, each dental arch limited to one every six years;
94.23(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
94.24abscesses;
94.25(14) palliative treatment and sedative fillings for relief of pain; and
94.26(15) full-mouth debridement, limited to one every five years.
94.27(c) In addition to the services specified in paragraph (b), medical assistance
94.28covers the following services for adults, if provided in an outpatient hospital setting or
94.29freestanding ambulatory surgical center as part of outpatient dental surgery:
94.30(1) periodontics, limited to periodontal scaling and root planing once every two
94.31years;
94.32(2) general anesthesia; and
94.33(3) full-mouth survey once every five years.
94.34(d) Medical assistance covers dental services for children that are medically
94.35necessary. The following guidelines apply:
94.36(1) posterior fillings are paid at the amalgam rate;
95.1(2) application of sealants once every five years per permanent molar; and
95.2(3) application of fluoride varnish once every six months.
95.3EFFECTIVE DATE.This section is effective January 1, 2010.
95.4 Sec. 28. Minnesota Statutes 2008, section 256B.0625, subdivision 11, is amended to
95.5read:
95.6 Subd. 11. Nurse anesthetist services. Medical assistance covers nurse anesthetist
95.7services. Rates paid for anesthesiology services provided by a certified registered nurse
95.8
95.9utilized in the Medicare program and shall use the conversion factor that is used by
95.10the Medicare program. Rates paid for anesthesiology services provided by a certified
95.11registered nurse anesthetist who is not directed by a physician shall be the same rate as
95.12paid under subdivision 3, paragraph (b).
95.13 Sec. 29. Minnesota Statutes 2008, section 256B.0625, subdivision 13, is amended to
95.14read:
95.15 Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs
95.16when specifically used to enhance fertility, if prescribed by a licensed practitioner and
95.17dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance
95.18program as a dispensing physician, or by a physician, physician assistant, or a nurse
95.19practitioner employed by or under contract with a community health board as defined in
95.20section
95.21(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
95.22unless authorized by the commissioner.
95.23(c) Medical assistance covers the following over-the-counter drugs when prescribed
95.24by a licensed practitioner or by a licensed pharmacist who meets standards established by
95.25the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen,
95.26family planning products, aspirin, insulin, products for the treatment of lice, vitamins for
95.27adults with documented vitamin deficiencies, vitamins for children under the age of seven
95.28and pregnant or nursing women, and any other over-the-counter drug identified by the
95.29commissioner, in consultation with the formulary committee, as necessary, appropriate,
95.30and cost-effective for the treatment of certain specified chronic diseases, conditions,
95.31or disorders, and this determination shall not be subject to the requirements of chapter
95.3214. A pharmacist may prescribe over-the-counter medications as provided under this
95.33paragraph for purposes of receiving reimbursement under Medicaid. When prescribing
95.34over-the-counter drugs under this paragraph, licensed pharmacists must consult with the
96.1recipient to determine necessity, provide drug counseling, review drug therapy for potential
96.2adverse interactions, and make referrals as needed to other health care professionals.
96.3(d) Effective January 1, 2006, medical assistance shall not cover drugs that
96.4are coverable under Medicare Part D as defined in the Medicare Prescription Drug,
96.5Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e),
96.6for individuals eligible for drug coverage as defined in the Medicare Prescription
96.7Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section
96.81860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the
96.9drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this
96.10subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code,
96.11title 42, section 1396r-8(d)(2)(E), shall not be covered.
96.12 Sec. 30. Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to
96.13read:
96.14 Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
96.15shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
96.16the maximum allowable cost set by the federal government or by the commissioner plus
96.17the fixed dispensing fee; or the usual and customary price charged to the public. The
96.18amount of payment basis must be reduced to reflect all discount amounts applied to the
96.19charge by any provider/insurer agreement or contract for submitted charges to medical
96.20assistance programs. The net submitted charge may not be greater than the patient liability
96.21for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
96.22for intravenous solutions which must be compounded by the pharmacist shall be $8 per
96.23bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
96.24nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
96.25nutritional products dispensed in quantities greater than one liter. Actual acquisition
96.26cost includes quantity and other special discounts except time and cash discounts.
96.27Effective July 1,
96.28commissioner, at average wholesale price minus
96.29cost of antihemophilic factor drugs shall be estimated at the average wholesale price
96.30minus 30 percent. The maximum allowable cost of a multisource drug may be set by the
96.31commissioner and it shall be comparable to, but no higher than, the maximum amount
96.32paid by other third-party payors in this state who have maximum allowable cost programs.
96.33Establishment of the amount of payment for drugs shall not be subject to the requirements
96.34of the Administrative Procedure Act.
97.1 (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
97.2to pharmacists for legend drug prescriptions dispensed to residents of long-term care
97.3facilities when a unit dose blister card system, approved by the department, is used. Under
97.4this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
97.5The National Drug Code (NDC) from the drug container used to fill the blister card must
97.6be identified on the claim to the department. The unit dose blister card containing the
97.7drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
97.8that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
97.9will be required to credit the department for the actual acquisition cost of all unused
97.10drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
97.11manufacturer's unopened package. The commissioner may permit the drug clozapine to be
97.12dispensed in a quantity that is less than a 30-day supply.
97.13 (c) Whenever a generically equivalent product is available, payment shall be on the
97.14basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost
97.15established by the commissioner.
97.16 (d) The basis for determining the amount of payment for drugs administered in an
97.17outpatient setting shall be the lower of the usual and customary cost submitted by the
97.18provider or the amount established for Medicare by the United States Department of
97.19Health and Human Services pursuant to title XVIII, section 1847a of the federal Social
97.20Security Act.
97.21 (e) The commissioner may negotiate lower reimbursement rates for specialty
97.22pharmacy products than the rates specified in paragraph (a). The commissioner may
97.23require individuals enrolled in the health care programs administered by the department
97.24to obtain specialty pharmacy products from providers with whom the commissioner has
97.25negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
97.26used by a small number of recipients or recipients with complex and chronic diseases
97.27that require expensive and challenging drug regimens. Examples of these conditions
97.28include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
97.29C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
97.30of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
97.31biotechnology drugs, high-cost therapies, and therapies that require complex care. The
97.32commissioner shall consult with the formulary committee to develop a list of specialty
97.33pharmacy products subject to this paragraph. In consulting with the formulary committee
97.34in developing this list, the commissioner shall take into consideration the population
97.35served by specialty pharmacy products, the current delivery system and standard of care in
98.1the state, and access to care issues. The commissioner shall have the discretion to adjust
98.2the reimbursement rate to prevent access to care issues.
98.3 Sec. 31. Minnesota Statutes 2008, section 256B.0625, subdivision 13h, is amended to
98.4read:
98.5 Subd. 13h. Medication therapy management services. (a) Medical assistance
98.6and general assistance medical care cover medication therapy management services for
98.7a recipient taking four or more prescriptions to treat or prevent two or more chronic
98.8medical conditions, or a recipient with a drug therapy problem that is identified or prior
98.9authorized by the commissioner that has resulted or is likely to result in significant
98.10nondrug program costs. The commissioner may cover medical therapy management
98.11services under MinnesotaCare if the commissioner determines this is cost-effective. For
98.12purposes of this subdivision, "medication therapy management" means the provision
98.13of the following pharmaceutical care services by a licensed pharmacist to optimize the
98.14therapeutic outcomes of the patient's medications:
98.15 (1) performing or obtaining necessary assessments of the patient's health status;
98.16 (2) formulating a medication treatment plan;
98.17 (3) monitoring and evaluating the patient's response to therapy, including safety
98.18and effectiveness;
98.19 (4) performing a comprehensive medication review to identify, resolve, and prevent
98.20medication-related problems, including adverse drug events;
98.21 (5) documenting the care delivered and communicating essential information to
98.22the patient's other primary care providers;
98.23 (6) providing verbal education and training designed to enhance patient
98.24understanding and appropriate use of the patient's medications;
98.25 (7) providing information, support services, and resources designed to enhance
98.26patient adherence with the patient's therapeutic regimens; and
98.27 (8) coordinating and integrating medication therapy management services within the
98.28broader health care management services being provided to the patient.
98.29Nothing in this subdivision shall be construed to expand or modify the scope of practice of
98.30the pharmacist as defined in section
98.31 (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
98.32must meet the following requirements:
98.33 (1) have a valid license issued under chapter 151;
98.34 (2) have graduated from an accredited college of pharmacy on or after May 1996, or
98.35completed a structured and comprehensive education program approved by the Board of
99.1Pharmacy and the American Council of Pharmaceutical Education for the provision and
99.2documentation of pharmaceutical care management services that has both clinical and
99.3didactic elements;
99.4 (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
99.5have developed a structured patient care process that is offered in a private or semiprivate
99.6patient care area that is separate from the commercial business that also occurs in the
99.7setting, or in home settings, excluding long-term care and group homes, if the service is
99.8ordered by the provider-directed care coordination team; and
99.9 (4) make use of an electronic patient record system that meets state standards.
99.10 (c) For purposes of reimbursement for medication therapy management services,
99.11the commissioner may enroll individual pharmacists as medical assistance and general
99.12assistance medical care providers. The commissioner may also establish contact
99.13requirements between the pharmacist and recipient, including limiting the number of
99.14reimbursable consultations per recipient.
99.15
99.16
99.17
99.18
99.19
99.20
99.21
99.22
99.23
99.24
99.25
99.26
99.27
99.28
99.29
99.30
99.31
99.32(d) The commissioner shall establish a pilot project for an intensive medication
99.33therapy management program for patients identified by the commissioner with multiple
99.34chronic conditions and a high number of medications who are at high risk of preventable
99.35hospitalizations, emergency room use, medication complications, and suboptimal
99.36treatment outcomes due to medication-related problems. For purposes of the pilot
100.1project, medication therapy management services may be provided in a patient's home
100.2or community setting, in addition to other authorized settings. The commissioner may
100.3waive existing payment policies and establish special payment rates for the pilot project.
100.4The pilot project must be designed to produce a net savings to the state compared to the
100.5estimated costs that would otherwise be incurred for similar patients without the program.
100.6 Sec. 32. Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to
100.7read:
100.8 Subd. 17. Transportation costs. (a) Medical assistance covers medical
100.9transportation costs incurred solely for obtaining emergency medical care or transportation
100.10costs incurred by eligible persons in obtaining emergency or nonemergency medical
100.11care when paid directly to an ambulance company, common carrier, or other recognized
100.12providers of transportation services. Medical transportation must be provided by:
100.13(1) an ambulance, as defined in section 144E.001, subdivision 2;
100.14(2) special transportation; or
100.15(3) common carrier including, but not limited to, bus, taxicab, other commercial
100.16carrier, or private automobile.
100.17(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
100.18part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
100.19would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
100.20transportation, or private automobile.
100.21The commissioner may use an order by the recipient's attending physician to certify that
100.22the recipient requires special transportation services. Special transportation
100.23providers shall perform driver-assisted
100.24Driver-assisted service includes passenger pickup at and return to the individual's
100.25residence or place of business, assistance with admittance of the individual to the medical
100.26facility, and assistance in passenger securement or in securing of wheelchairs or stretchers
100.27in the vehicle. Special transportation providers must obtain written documentation
100.28from the health care service provider who is serving the recipient being transported,
100.29identifying the time that the recipient arrived. Special transportation providers may not
100.30bill for separate base rates for the continuation of a trip beyond the original destination.
100.31Special transportation providers must take recipients to the nearest appropriate health
100.32care provider, using the most direct route
100.33assistance reimbursement rates for special transportation services are:
100.34(1) (i) $17 for the base rate and $1.35 per mile for special transportation services to
100.35eligible persons who need a wheelchair-accessible van;
101.1
101.2to eligible persons who do not need a wheelchair-accessible van; and
101.3
101.4for special transportation services to eligible persons who need a stretcher-accessible
101.5vehicle;
101.6(2) the base rates for special transportation services in areas defined under RUCA
101.7to be super rural shall be equal to the reimbursement rate established in clause (1) plus
101.811.3 percent; and
101.9(3) for special transportation services in areas defined under RUCA to be rural
101.10or super rural areas:
101.11(i) for a trip equal to 17 miles or less, mileage reimbursement shall be equal to 125
101.12percent of the respective mileage rate in clause (1); and
101.13(ii) for a trip between 18 and 50 miles, mileage reimbursement shall be equal to
101.14112.5 percent of the respective mileage rate in clause (1).
101.15(c) For purposes of reimbursement rates for special transportation services under
101.16paragraph (b), the zip code of the recipient's place of residence shall determine whether
101.17the urban, rural, or super rural reimbursement rate applies.
101.18(d) For purposes of this subdivision, "rural urban commuting area" or "RUCA"
101.19means a census-tract based classification system under which a geographical area is
101.20determined to be urban, rural, or super rural.
101.21 Sec. 33. Minnesota Statutes 2008, section 256B.0625, subdivision 17a, is amended to
101.22read:
101.23 Subd. 17a. Payment for ambulance services. Medical assistance covers
101.24ambulance services. Providers shall bill ambulance services according to Medicare
101.25criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective
101.26for services rendered on or after July 1, 2001, medical assistance payments for ambulance
101.27services shall be paid at the Medicare reimbursement rate or at the medical assistance
101.28payment rate in effect on July 1, 2000, whichever is greater.
101.29 Sec. 34. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
101.30subdivision to read:
101.31 Subd. 18b. Broker dispatching prohibition. The commissioner shall not use a
101.32broker or coordinator for any purpose related to transportation services under subdivision
101.3318.
102.1 Sec. 35. Minnesota Statutes 2008, section 256B.0625, is amended by adding a
102.2subdivision to read:
102.3 Subd. 25a. Prior authorization of diagnostic imaging services. (a) Effective
102.4January 1, 2010, the commissioner shall require prior authorization or decision support
102.5for the ordering providers at the time the service is ordered for the following outpatient
102.6diagnostic imaging services: computerized tomography (CT), magnetic resonance
102.7imaging (MRI), magnetic resonance angiography (MRA), positive emission tomography
102.8(PET), cardiac imaging and ultrasound diagnostic imaging.
102.9(b) Prior authorization under this subdivision is not required for diagnostic imaging
102.10services performed as part of a hospital emergency room visit, inpatient hospitalization, or
102.11if concurrent with or on the same day as an urgent care facility visit.
102.12(c) This subdivision does not apply to services provided to recipients who are
102.13enrolled in Medicare, the prepaid medical assistance program, the prepaid general
102.14assistance medical care program, or the MinnesotaCare program.
102.15(d) The commissioner may contract with a private entity to provide the prior
102.16authorization or decision support required under this subdivision. The contracting entity
102.17must incorporate clinical guidelines that are based on evidence-based medical literature, if
102.18available. By January 1, 2012, the contracting entity shall report to the commissioner the
102.19results of prior authorization or decision support.
102.20 Sec. 36. Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to
102.21read:
102.22 Subd. 26. Special education services. (a) Medical assistance covers medical
102.23services identified in a recipient's individualized education plan and covered under the
102.24medical assistance state plan. Covered services include occupational therapy, physical
102.25therapy, speech-language therapy, clinical psychological services, nursing services,
102.26school psychological services, school social work services, personal care assistants
102.27serving as management aides, assistive technology devices, transportation services,
102.28health assessments, and other services covered under the medical assistance state plan.
102.29Mental health services eligible for medical assistance reimbursement must be provided or
102.30coordinated through a children's mental health collaborative where a collaborative exists if
102.31the child is included in the collaborative operational target population. The provision or
102.32coordination of services does not require that the individual education plan be developed
102.33by the collaborative.
102.34The services may be provided by a Minnesota school district that is enrolled as a
102.35medical assistance provider or its subcontractor, and only if the services meet all the
103.1requirements otherwise applicable if the service had been provided by a provider other
103.2than a school district, in the following areas: medical necessity, physician's orders,
103.3documentation, personnel qualifications, and prior authorization requirements. The
103.4nonfederal share of costs for services provided under this subdivision is the responsibility
103.5of the local school district as provided in section
103.6individual education plan are eligible for medical assistance reimbursement only if those
103.7services meet criteria for federal financial participation under the Medicaid program.
103.8(b) Approval of health-related services for inclusion in the individual education plan
103.9does not require prior authorization for purposes of reimbursement under this chapter.
103.10The commissioner may require physician review and approval of the plan not more than
103.11once annually or upon any modification of the individual education plan that reflects a
103.12change in health-related services.
103.13(c) Services of a speech-language pathologist provided under this section are covered
103.14notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:
103.15(1) holds a masters degree in speech-language pathology;
103.16(2) is licensed by the Minnesota Board of Teaching as an educational
103.17speech-language pathologist; and
103.18(3) either has a certificate of clinical competence from the American Speech and
103.19Hearing Association, has completed the equivalent educational requirements and work
103.20experience necessary for the certificate or has completed the academic program and is
103.21acquiring supervised work experience to qualify for the certificate.
103.22(d) Medical assistance coverage for medically necessary services provided under
103.23other subdivisions in this section may not be denied solely on the basis that the same or
103.24similar services are covered under this subdivision.
103.25(e) The commissioner shall develop and implement package rates, bundled rates, or
103.26per diem rates for special education services under which separately covered services are
103.27grouped together and billed as a unit in order to reduce administrative complexity.
103.28(f) The commissioner shall develop a cost-based payment structure for payment
103.29of these services. The commissioner shall reimburse claims submitted based on an
103.30interim rate, and shall settle at a final rate once the department has determined it. The
103.31commissioner shall notify the school district of the final rate. The school district has 60
103.32days to appeal the final rate. To appeal the final rate, the school district shall file a written
103.33appeal request to the commissioner within 60 days of the date the final rate determination
103.34was mailed. The appeal request shall specify (1) the disputed items and (2) the name and
103.35address of the person to contact regarding the appeal.
104.1(g) Effective July 1, 2000, medical assistance services provided under an individual
104.2education plan or an individual family service plan by local school districts shall not count
104.3against medical assistance authorization thresholds for that child.
104.4(h) Nursing services as defined in section
104.5as an individual education plan health-related service, are eligible for medical assistance
104.6payment if they are otherwise a covered service under the medical assistance program.
104.7Medical assistance covers the administration of prescription medications by a licensed
104.8nurse who is employed by or under contract with a school district when the administration
104.9of medications is identified in the child's individualized education plan. The simple
104.10administration of medications alone is not covered under medical assistance when
104.11administered by a provider other than a school district or when it is not identified in the
104.12child's individualized education plan.
104.13 Sec. 37. Minnesota Statutes 2008, section 256B.08, is amended by adding a
104.14subdivision to read:
104.15 Subd. 4. Data from Social Security. The commissioner shall accept data from the
104.16Social Security Administration in accordance with United States Code, title 42, section
104.171396U-5(a).
104.18EFFECTIVE DATE.This section is effective January 1, 2010.
104.19 Sec. 38. Minnesota Statutes 2008, section 256B.15, subdivision 1, is amended to read:
104.20 Subdivision 1. Policy and applicability. (a) It is the policy of this state that
104.21individuals or couples, either or both of whom participate in the medical assistance
104.22program, use their own assets to pay their share of the total cost of their care during or
104.23after their enrollment in the program according to applicable federal law and the laws of
104.24this state. The following provisions apply:
104.25 (1) subdivisions 1c to 1k shall not apply to claims arising under this section which
104.26are presented under section
104.27 (2) the provisions of subdivisions 1c to 1k expanding the interests included in an
104.28estate for purposes of recovery under this section give effect to the provisions of United
104.29States Code, title 42, section 1396p, governing recoveries, but do not give rise to any
104.30express or implied liens in favor of any other parties not named in these provisions;
104.31 (3) the continuation of a recipient's life estate or joint tenancy interest in real
104.32property after the recipient's death for the purpose of recovering medical assistance under
104.33this section modifies common law principles holding that these interests terminate on
104.34the death of the holder;
105.1 (4) all laws, rules, and regulations governing or involved with a recovery of medical
105.2assistance shall be liberally construed to accomplish their intended purposes;
105.3 (5) a deceased recipient's life estate and joint tenancy interests continued under this
105.4section shall be owned by the remaindermen or surviving joint tenants as their interests
105.5may appear on the date of the recipient's death. They shall not be merged into the
105.6remainder interest or the interests of the surviving joint tenants by reason of ownership.
105.7They shall be subject to the provisions of this section. Any conveyance, transfer, sale,
105.8assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs,
105.9successors, and assigns shall be deemed to include all of their interest in the deceased
105.10recipient's life estate or joint tenancy interest continued under this section; and
105.11 (6) the provisions of subdivisions 1c to 1k continuing a recipient's joint tenancy
105.12interests in real property after the recipient's death do not apply to a homestead owned
105.13of record, on the date the recipient dies, by the recipient and the recipient's spouse as
105.14joint tenants with a right of survivorship. Homestead means the real property occupied
105.15by the surviving joint tenant spouse as their sole residence on the date the recipient dies
105.16and classified and taxed to the recipient and surviving joint tenant spouse as homestead
105.17property for property tax purposes in the calendar year in which the recipient dies. For
105.18purposes of this exemption, real property the recipient and their surviving joint tenant
105.19spouse purchase solely with the proceeds from the sale of their prior homestead, own
105.20of record as joint tenants, and qualify as homestead property under section
105.21the calendar year in which the recipient dies and prior to the recipient's death shall be
105.22deemed to be real property classified and taxed to the recipient and their surviving joint
105.23tenant spouse as homestead property in the calendar year in which the recipient dies.
105.24The surviving spouse, or any person with personal knowledge of the facts, may provide
105.25an affidavit describing the homestead property affected by this clause and stating facts
105.26showing compliance with this clause. The affidavit shall be prima facie evidence of the
105.27facts it states.
105.28 (b) For purposes of this section, "medical assistance" includes the medical assistance
105.29program under this chapter and the general assistance medical care program under chapter
105.30256D and alternative care for nonmedical assistance recipients under section
105.31 (c) For purposes of this section, beginning January 1, 2010, "medical assistance"
105.32does not include Medicare cost-sharing benefits in accordance with United States Code,
105.33title 42, section 1396p.
105.34 (d) All provisions in this subdivision, and subdivisions 1d, 1f, 1g, 1h, 1i, and 1j,
105.35related to the continuation of a recipient's life estate or joint tenancy interests in real
105.36property after the recipient's death for the purpose of recovering medical assistance, are
106.1effective only for life estates and joint tenancy interests established on or after August 1,
106.22003. For purposes of this paragraph, medical assistance does not include alternative care.
106.3 Sec. 39. Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:
106.4 Subd. 1a. Estates subject to claims. (a) If a person receives any medical assistance
106.5hereunder, on the person's death, if single, or on the death of the survivor of a married
106.6couple, either or both of whom received medical assistance, or as otherwise provided
106.7for in this section, the total amount paid for medical assistance rendered for the person
106.8and spouse shall be filed as a claim against the estate of the person or the estate of the
106.9surviving spouse in the court having jurisdiction to probate the estate or to issue a decree
106.10of descent according to sections
106.11(b) For the purposes of this section, the person's estate must consist of:
106.12(1) the person's probate estate;
106.13(2) all of the person's interests or proceeds of those interests in real property the
106.14person owned as a life tenant or as a joint tenant with a right of survivorship at the time of
106.15the person's death;
106.16(3) all of the person's interests or proceeds of those interests in securities the person
106.17owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time
106.18of the person's death, to the extent the interests or proceeds of those interests become part
106.19of the probate estate under section 524.6-307;
106.20(4) all of the person's interests in joint accounts, multiple-party accounts, and
106.21pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of
106.22those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the
106.23person's death to the extent the interests become part of the probate estate under section
106.24524.6-207; and
106.25(5) assets conveyed to a survivor, heir, or assign of the person through survivorship,
106.26living trust, or other arrangements.
106.27(c) For the purpose of this section and recovery in a surviving spouse's estate for
106.28medical assistance paid for a predeceased spouse, the estate must consist of all of the legal
106.29title and interests the deceased individual's predeceased spouse had in jointly owned or
106.30marital property at the time of the spouse's death, as defined in subdivision 2b, and the
106.31proceeds of those interests, that passed to the deceased individual or another individual, a
106.32survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy
106.33in common, survivorship, life estate, living trust, or other arrangement. A deceased
106.34recipient who, at death, owned the property jointly with the surviving spouse shall have
106.35an interest in the entire property.
107.1(d) For the purpose of recovery in a single person's estate or the estate of a survivor
107.2of a married couple, "other arrangement" includes any other means by which title to all or
107.3any part of the jointly owned or marital property or interest passed from the predeceased
107.4spouse to another including, but not limited to, transfers between spouses which are
107.5permitted, prohibited, or penalized for purposes of medical assistance.
107.6(e) A claim shall be filed if medical assistance was rendered for either or both
107.7persons under one of the following circumstances:
107.8
107.9
107.10services under this chapter, and, at the time of institutionalization or application for
107.11medical assistance, whichever is later, the person could not have reasonably been expected
107.12to be discharged and returned home, as certified in writing by the person's treating
107.13physician. For purposes of this section only, a "medical institution" means a skilled
107.14nursing facility, intermediate care facility, intermediate care facility for persons with
107.15developmental disabilities, nursing facility, or inpatient hospital; or
107.16
107.17256D.
107.18(f) The claim shall be considered an expense of the last illness of the decedent for the
107.19purpose of section
107.20county agency with a claim under this section must be a creditor under section 524.6-307.
107.21Any statute of limitations that purports to limit any county agency or the state agency,
107.22or both, to recover for medical assistance granted hereunder shall not apply to any claim
107.23made hereunder for reimbursement for any medical assistance granted hereunder. Notice
107.24of the claim shall be given to all heirs and devisees of the decedent whose identity can be
107.25ascertained with reasonable diligence. The notice must include procedures and instructions
107.26for making an application for a hardship waiver under subdivision 5; time frames for
107.27submitting an application and determination; and information regarding appeal rights and
107.28procedures. Counties are entitled to one-half of the nonfederal share of medical assistance
107.29collections from estates that are directly attributable to county effort. Counties are entitled
107.30to ten percent of the collections for alternative care directly attributable to county effort.
107.31 Sec. 40. Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:
107.32 Subd. 1h. Estates of specific persons receiving medical assistance. (a) For
107.33purposes of this section, paragraphs (b) to
107.34assistance for which a claim may be filed under this section and died single, or the
108.1surviving spouse of the couple and was not survived by any of the persons described
108.2in subdivisions 3 and 4.
108.3
108.4
108.5
108.6
108.7
108.8
108.9
108.10
108.11
108.12
108.13
108.14
108.15
108.16
108.17
108.18
108.19tenancy interest in real property not subject to a medical assistance lien under sections
108.21and shall continue as provided in this subdivision. The life estate in the person's estate
108.22shall be that portion of the interest in the real property subject to the life estate that is equal
108.23to the life estate percentage factor for the life estate as listed in the Life Estate Mortality
108.24Table of the health care program's manual for a person who was the age of the medical
108.25assistance recipient on the date of the person's death. The joint tenancy interest in real
108.26property in the estate shall be equal to the fractional interest the person would have owned
108.27in the jointly held interest in the property had they and the other owners held title to the
108.28property as tenants in common on the date the person died.
108.29
108.30or any interested party, may enter an order directing the remaindermen or surviving joint
108.31tenants and their spouses, if any, to sign all documents, take all actions, and otherwise
108.32fully cooperate with the personal representative and the court to liquidate the decedent's
108.33life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of
108.34those interests to the personal representative and provide for any legal and equitable
108.35sanctions as the court deems appropriate to enforce and carry out the order, including an
108.36award of reasonable attorney fees.
109.1
109.2or other documents necessary to convey the decedent's life estate or joint tenancy interest
109.3in the estate that are necessary to liquidate and reduce to cash the decedent's interest or
109.4for any other purposes.
109.5
109.6directly and immediately related to liquidating the decedent's life estate or joint tenancy
109.7interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation
109.8allocable to the decedent's interest and the net proceeds shall be turned over to the personal
109.9representative and applied to payment of the claim presented under this section.
109.10
109.11the estate is being probated to compel the remaindermen or surviving joint tenants to
109.12account for and deliver to the personal representative all or any part of the proceeds of any
109.13sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the
109.14decedent's life estate or joint tenancy interest in the decedent's estate, and do everything
109.15necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of
109.16the sale or other disposition over to the personal representative. The court may grant any
109.17legal or equitable relief including, but not limited to, ordering a partition of real estate
109.18under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy
109.19interest available to the estate for payment of a claim under this section.
109.20
109.21or proceeds of interests to pay an allowable claim under this section. The remaindermen
109.22or surviving joint tenants and their spouses, if any, may enter into a written agreement
109.23with the personal representative or the claimant to settle and satisfy obligations imposed at
109.24any time before or after a claim is filed.
109.25
109.26other owners, remaindermen, or surviving joint tenants with an affidavit terminating the
109.27decedent's estate's interest in real property the decedent owned as a life tenant or as a joint
109.28tenant with others, if the personal representative determines in good faith that neither the
109.29decedent nor any of the decedent's predeceased spouses received any medical assistance
109.30for which a claim could be filed under this section, or if the personal representative has
109.31filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as
109.32presented, or if there is a written agreement under paragraph
109.33allowed, has been paid in full or to the full extent of the assets the estate has available
109.34to pay it. The affidavit may be recorded in the office of the county recorder or filed in
109.35the Office of the Registrar of Titles for the county in which the real property is located.
109.36Except as provided in section
110.1shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a
110.2joint tenant with others. The affidavit shall:
110.3(1) be signed by the personal representative;
110.4(2) identify the decedent and the interest being terminated;
110.5(3) give recording information sufficient to identify the instrument that created the
110.6interest in real property being terminated;
110.7(4) legally describe the affected real property;
110.8(5) state that the personal representative has determined that neither the decedent
110.9nor any of the decedent's predeceased spouses received any medical assistance for which
110.10a claim could be filed under this section;
110.11(6) state that the decedent's estate has other assets sufficient to pay the claim, as
110.12presented, or that there is a written agreement between the personal representative and
110.13the claimant and the other owners or remaindermen or other joint tenants to satisfy the
110.14obligations imposed under this subdivision; and
110.15(7) state that the affidavit is being given to terminate the estate's interest under this
110.16subdivision, and any other contents as may be appropriate.
110.17The recorder or registrar of titles shall accept the affidavit for recording or filing. The
110.18affidavit shall be effective as provided in this section and shall constitute notice even if it
110.19does not include recording information sufficient to identify the instrument creating the
110.20interest it terminates. The affidavit shall be conclusive evidence of the stated facts.
110.21
110.22the holder's expense against an interest terminated under paragraph
110.23of the termination.
110.24
110.25prior to closing the estate, the personal representative shall deed the interest subject to the
110.26lien to the remaindermen or surviving joint tenants as their interests may appear. Upon
110.27recording or filing, the deed shall work a merger of the recipient's life estate or joint
110.28tenancy interest, subject to the lien, into the remainder interest or interest the decedent and
110.29others owned jointly. The lien shall attach to and run with the property to the extent of
110.30the decedent's interest at the time of the decedent's death.
110.31 Sec. 41. Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:
110.32 Subd. 2. Limitations on claims. The claim shall include only the total amount
110.33of medical assistance rendered after age 55 or during a period of institutionalization
110.34described in subdivision 1a,
110.35assistance medical care rendered, and shall not include interest. Claims that have been
111.1allowed but not paid shall bear interest according to section
111.2claim against the estate of a surviving spouse who did not receive medical assistance, for
111.3medical assistance rendered for the predeceased spouse, shall be payable from the full
111.4value of all of the predeceased spouse's assets and interests which are part of the surviving
111.5spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in
111.6the nonrecipient surviving spouse's estate is limited to the value of the assets of the estate
111.7that were marital property or jointly owned property at any time during the marriage. The
111.8claim is not payable from the value of assets or proceeds of assets in the estate attributable
111.9to a predeceased spouse whom the individual married after the death of the predeceased
111.10recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the
111.11estate which the nonrecipient decedent spouse acquired with assets which were not marital
111.12property or jointly owned property after the death of the predeceased recipient spouse.
111.13Claims for alternative care shall be net of all premiums paid under section
111.14subdivision 12
111.15after July 1, 2003. Claims against marital property shall be limited to claims against
111.16recipients who died on or after July 1, 2009.
111.17 Sec. 42. Minnesota Statutes 2008, section 256B.15, is amended by adding a
111.18subdivision to read:
111.19 Subd. 2b. Controlling provisions. (a) For purposes of this subdivision and
111.20subdivisions 1a and 2, paragraphs (b) to (d) apply.
111.21(b) At the time of death of a recipient spouse and solely for purpose of recovery of
111.22medical assistance benefits received, a predeceased recipient spouse shall have a legal
111.23title or interest in the undivided whole of all of the property which the recipient and the
111.24recipient's surviving spouse owned jointly or which was marital property at any time
111.25during their marriage regardless of the form of ownership and regardless of whether
111.26it was owned or titled in the names of one or both the recipient and the recipient's
111.27spouse. Title and interest in the property of a predeceased recipient spouse shall not end
111.28or extinguish upon the person's death and shall continue for the purpose of allowing
111.29recovery of medical assistance in the estate of the surviving spouse. Upon the death of
111.30the predeceased recipient spouse, title and interest in the predeceased spouse's property
111.31shall vest in the surviving spouse by operation of law and without the necessity for any
111.32probate or decree of descent proceedings and shall continue to exist after the death of the
111.33predeceased spouse and the surviving spouse to permit recovery of medical assistance.
111.34The recipient spouse and the surviving spouse of a deceased recipient spouse shall not
112.1encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of
112.2these interests before or upon death.
112.3(c) For purposes of this section, "marital property" includes any and all real or
112.4personal property of any kind or interests in such property the predeceased recipient
112.5spouse and their spouse, or either of them, owned at the time of their marriage to each
112.6other or acquired during their marriage regardless of whether it was owned or titled in
112.7the names of one or both of them. If either or both spouses of a married couple received
112.8medical assistance, all property owned during the marriage or which either or both spouses
112.9acquired during their marriage shall be presumed to be marital property for purposes of
112.10recovering medical assistance unless there is clear and convincing evidence to the contrary.
112.11(d) The agency responsible for the claim for medical assistance for a recipient spouse
112.12may, at its discretion, release specific real and personal property from the provisions of
112.13this section. The release shall extinguish the interest created under paragraph (b) in the
112.14land it describes upon filing or recording. The release need not be attested, certified, or
112.15acknowledged as a condition of filing or recording and shall be filed or recorded in the
112.16office of the county recorder or registrar of titles, as appropriate, in the county where the
112.17real property is located. The party to whom the release is given shall be responsible for
112.18paying all fees and costs necessary to record and file the release. If the property described
112.19in the release is registered property, the registrar of titles shall accept it for recording and
112.20shall record it on the certificate of title for each parcel of property described in the release.
112.21If the property described in the release is abstract property, the recorder shall accept it
112.22for filing and file it in the county's grantor-grantee indexes and any tract index the county
112.23maintains for each parcel of property described in the release.
112.24 Sec. 43. Minnesota Statutes 2008, section 256B.15, is amended by adding a
112.25subdivision to read:
112.26 Subd. 9. Commissioner's intervention. The commissioner shall be permitted to
112.27intervene as a party in any proceeding involving recovery of medical assistance upon
112.28filing a notice of intervention and serving such notice on the other parties.
112.29 Sec. 44. [256B.196] INTERGOVERNMENTAL TRANSFERS; HOSPITAL
112.30PAYMENTS.
112.31 Subdivision 1. Federal approval required. This section is contingent on federal
112.32approval of the intergovernmental transfers and payments authorized under this section.
112.33This section is also contingent on current payment by the government entities of the
112.34intergovernmental transfers under this section.
113.1 Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
113.2subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
113.3services upper payment limit for nonstate government hospitals. The commissioner shall
113.4then determine the amount of a supplemental payment to Hennepin County Medical
113.5Center and Regions Hospital for these services that would increase medical assistance
113.6spending in this category to the aggregate upper payment limit for all nonstate government
113.7hospitals in Minnesota. In making this determination, the commissioner shall allot the
113.8available increases between Hennepin County Medical Center and Regions Hospital
113.9based on the ratio of medical assistance fee-for-service outpatient hospital payments to
113.10the two facilities. The commissioner shall adjust this allotment as necessary based on
113.11federal approvals, the amount of intergovernmental transfers received from Hennepin and
113.12Ramsey Counties, and other factors, in order to maximize the additional total payments.
113.13The commissioner shall inform Hennepin County and Ramsey County of the periodic
113.14intergovernmental transfers necessary to match federal Medicaid payments available
113.15under this subdivision in order to make supplementary medical assistance payments to
113.16Hennepin County Medical Center and Regions Hospital equal to an amount that when
113.17combined with existing medical assistance payments to nonstate governmental hospitals
113.18would increase total payments to hospitals in this category for outpatient services to
113.19the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
113.20receipt of these periodic transfers, the commissioner shall make supplementary payments
113.21to Hennepin County Medical Center and Regions Hospital.
113.22(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
113.23determine an upper payment limit for physicians affiliated with Hennepin County Medical
113.24Center and with Regions Hospital. The upper payment limit shall be based on the average
113.25commercial rate or be determined using another method acceptable to the Centers for
113.26Medicare and Medicaid Services. The commissioner shall inform Hennepin County and
113.27Ramsey County of the periodic intergovernmental transfers necessary to match the federal
113.28Medicaid payments available under this subdivision in order to make supplementary
113.29payments to physicians affiliated with Hennepin County Medical Center and Regions
113.30Hospital equal to the difference between the established medical assistance payment for
113.31physician services and the upper payment limit. Upon receipt of these periodic transfers,
113.32the commissioner shall make supplementary payments to physicians of Hennepin Faculty
113.33Associates and HealthPartners.
113.34(c) Beginning January 1, 2010, Hennepin County and Ramsey County shall make
113.35monthly intergovernmental transfers to the commissioner in the following amounts:
113.36$133,333 by Hennepin County and $100,000 by Ramsey County. The commissioner shall
114.1increase the medical assistance capitation payments to Metropolitan Health Plan and
114.2HealthPartners by an amount equal to the annual value of the monthly transfers plus
114.3federal financial participation.
114.4(d) The commissioner shall inform Hennepin County and Ramsey County on an
114.5ongoing basis of the need for any changes needed in the intergovernmental transfers
114.6in order to continue the payments under paragraphs (a) to (c), at their maximum level,
114.7including increases in upper payment limits, changes in the federal Medicaid match, and
114.8other factors.
114.9(e) The payments in paragraphs (a) to (c) shall be implemented independently of
114.10each other, subject to federal approval and to the receipt of transfers under subdivision 3.
114.11 Subd. 3. Intergovernmental transfers. Based on the determination by the
114.12commissioner under subdivision 2, Hennepin County and Ramsey County shall make
114.13periodic intergovernmental transfers to the commissioner for the purposes of subdivision
114.142, paragraphs (a) to (c). All of the intergovernmental transfers made by Hennepin County
114.15shall be used to match federal payments to Hennepin County Medical Center under
114.16subdivision 2, paragraph (a); to physicians affiliated with Hennepin Faculty Associates
114.17under subdivision 2, paragraph (b); and to Metropolitan Health Plan under subdivision
114.182, paragraph (c). All of the intergovernmental transfers made by Ramsey County shall
114.19be used to match federal payments to Regions Hospital under subdivision 2, paragraph
114.20(a); to physicians affiliated with HealthPartners under subdivision 2, paragraph (b); and to
114.21HealthPartners under subdivision 2, paragraph (c).
114.22 Subd. 4. Adjustments permitted. (a) The commissioner may adjust the
114.23intergovernmental transfers under subdivision 3 and the payments under subdivision
114.242, based on the commissioner's determination of Medicare upper payment limits,
114.25hospital-specific charge limits, hospital-specific limitations on disproportionate share
114.26payments, medical inflation, actuarial certification, and cost-effectiveness for purposes
114.27of federal waivers. Any adjustments must be made on a proportional basis. The
114.28commissioner may make adjustments under this subdivision only after consultation
114.29with the affected counties and hospitals. All payments under subdivision 2 and all
114.30intergovernmental transfers under subdivision 3 are limited to amounts available after all
114.31other base rates, adjustments, and supplemental payments in chapter 256B are calculated.
114.32(b) The ratio of medical assistance payments specified in subdivision 2 to the
114.33voluntary intergovernmental transfers specified in subdivision 3 shall not be reduced
114.34except as provided under paragraph (a).
115.1 Subd. 5. Recession period. Each type of intergovernmental transfer in subdivision
115.22, paragraphs (a) to (d), for payment periods from October 1, 2008, through December
115.331, 2010, is voluntary on the part of Hennepin and Ramsey Counties, meaning that the
115.4transfer must be agreed to, in writing, by the counties prior to any payments being issued.
115.5One agreement on each type of transfer shall cover the entire recession period.
115.6 Sec. 45. Minnesota Statutes 2008, section 256B.199, is amended to read:
115.7256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
115.8 (a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
115.9for the expenditures in paragraphs (b) and (c).
115.10 (b) The commissioner shall apply for federal matching funds for certified public
115.11expenditures as follows:
115.12 (1) Hennepin County, Hennepin County Medical Center, Ramsey County, Regions
115.13Hospital, the University of Minnesota, and Fairview-University Medical Center shall
115.14report quarterly to the commissioner beginning June 1, 2007, payments made during the
115.15second previous quarter that may qualify for reimbursement under federal law;
115.16 (2) based on these reports, the commissioner shall apply for federal matching
115.17funds. These funds are appropriated to the commissioner for the payments under section
115.19 (3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
115.20the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
115.21hospital payment money expected to be available in the current federal fiscal year.
115.22 (c) The commissioner shall apply for federal matching funds for general assistance
115.23medical care expenditures as follows:
115.24 (1) for hospital services occurring on or after July 1, 2007, general assistance medical
115.25care expenditures for fee-for-service inpatient and outpatient hospital payments made by
115.26the department shall be used to apply for federal matching funds, except as limited below:
115.27 (i) only those general assistance medical care expenditures made to an individual
115.28hospital that would not cause the hospital to exceed its individual hospital limits under
115.29section 1923 of the Social Security Act may be considered; and
115.30 (ii) general assistance medical care expenditures may be considered only to the extent
115.31of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and
115.32 (2) all hospitals must provide any necessary expenditure, cost, and revenue
115.33information required by the commissioner as necessary for purposes of obtaining federal
115.34Medicaid matching funds for general assistance medical care expenditures.
116.1(d) For the period from April 1, 2009, to September 30, 2010, the commissioner shall
116.2apply for additional federal matching funds available as disproportionate share hospital
116.3payments under the American Recovery and Reinvestment Act of 2009. These funds shall
116.4be made available as the state share of payments under section 256.969, subdivision 28.
116.5The entities required to report certified public expenditures under paragraph (b), clause
116.6(1), shall report additional certified public expenditures as necessary under this paragraph.
116.7EFFECTIVE DATE.This section is effective the day following final enactment.
116.8 Sec. 46. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
116.9 Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
116.10and sections
116.11basis beginning January 1, 1996. Managed care contracts which were in effect on June
116.1230, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
116.13through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
116.14commissioner may issue separate contracts with requirements specific to services to
116.15medical assistance recipients age 65 and older.
116.16 (b) A prepaid health plan providing covered health services for eligible persons
116.17pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
116.18of its contract with the commissioner. Requirements applicable to managed care programs
116.19under chapters 256B, 256D, and 256L, established after the effective date of a contract
116.20with the commissioner take effect when the contract is next issued or renewed.
116.21 (c) Effective for services rendered on or after January 1, 2003, the commissioner shall
116.22withhold five percent of managed care plan payments under this section and county-based
116.23purchasing plan's payment rate under section 256B.692 for the prepaid medical assistance
116.24and general assistance medical care programs pending completion of performance targets.
116.25Each performance target must be quantifiable, objective, measurable, and reasonably
116.26attainable, except in the case of a performance target based on a federal or state law or rule.
116.27Criteria for assessment of each performance target must be outlined in writing prior to the
116.28contract effective date. The managed care plan must demonstrate, to the commissioner's
116.29satisfaction, that the data submitted regarding attainment of the performance target is
116.30accurate. The commissioner shall periodically change the administrative measures used
116.31as performance targets in order to improve plan performance across a broader range of
116.32administrative services. The performance targets must include measurement of plan
116.33efforts to contain spending on health care services and administrative activities. The
116.34commissioner may adopt plan-specific performance targets that take into account factors
116.35affecting only one plan, including characteristics of the plan's enrollee population. The
117.1withheld funds must be returned no sooner than July of the following year if performance
117.2targets in the contract are achieved. The commissioner may exclude special demonstration
117.3projects under subdivision 23.
117.4
117.5
117.6 (d)
117.731, 2009, the commissioner shall withhold three percent of managed care plan payments
117.8under this section and county-based purchasing plan payments under section 256B.692 for
117.9the prepaid medical assistance and general assistance medical care programs. The withheld
117.10funds must be returned no sooner than July 1 and no later than July 31 of the following
117.11year. The commissioner may exclude special demonstration projects under subdivision 23.
117.12
117.13
117.14
117.15requirements of paragraph (c).
117.16(e) Effective for services rendered on or after January 1, 2010, through December
117.1731, 2010, the commissioner shall withhold 3.5 percent of managed care plan payments
117.18under this section and county-based purchasing plan payments under section 256B.692
117.19for the prepaid medical assistance program. The withheld funds must be returned no
117.20sooner than July 1 and no later than July 31 of the following year. The commissioner may
117.21exclude special demonstration projects under subdivision 23.
117.22(f) Effective for services rendered on or after January 1, 2011, through December 31,
117.232011, the commissioner shall withhold four percent of managed care plan payments under
117.24this section and county-based purchasing plan payments under section 256B.692 for the
117.25prepaid medical assistance program. The withheld funds must be returned no sooner than
117.26July 1 and no later than July 31 of the following year. The commissioner may exclude
117.27special demonstration projects under subdivision 23.
117.28(g) Effective for services rendered on or after January 1, 2012, through December
117.2931, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
117.30under this section and county-based purchasing plan payments under section 256B.692
117.31for the prepaid medical assistance program. The withheld funds must be returned no
117.32sooner than July 1 and no later than July 31 of the following year. The commissioner may
117.33exclude special demonstration projects under subdivision 23.
117.34(h) Effective for services rendered on or after January 1, 2013, through December
117.3531, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
117.36under this section and county-based purchasing plan payments under section 256B.692
118.1for the prepaid medical assistance program. The withheld funds must be returned no
118.2sooner than July 1 and no later than July 31 of the following year. The commissioner may
118.3exclude special demonstration projects under subdivision 23.
118.4(i) Effective for services rendered on or after January 1, 2014, the commissioner
118.5shall withhold three percent of managed care plan payments under this section and
118.6county-based purchasing plan payments under section 256B.692 for the prepaid medical
118.7assistance and prepaid general assistance medical care programs. The withheld funds must
118.8be returned no sooner than July 1 and no later than July 31 of the following year. The
118.9commissioner may exclude special demonstration projects under subdivision 23.
118.10(j) A managed care plan or a county-based purchasing plan under section 256B.692
118.11may include as admitted assets under section 62D.044 any amount withheld under this
118.12section that is reasonably expected to be returned.
118.13 Sec. 47. Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:
118.14 Subd. 5c. Medical education and research fund. (a) Except as provided in
118.15paragraph (c), the commissioner of human services shall transfer each year to the medical
118.16education and research fund established under section
118.17(1) an amount equal to the reduction in the prepaid medical assistance and prepaid
118.18general assistance medical care payments as specified in this clause. Until January 1,
118.192002, the county medical assistance and general assistance medical care capitation base
118.20rate prior to plan specific adjustments and after the regional rate adjustments under section
118.22the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota
118.23counties; and after January 1, 2002, the county medical assistance and general assistance
118.24medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent
118.25for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent
118.26for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments
118.27and demonstration project payments operating under subdivision 23 are excluded from
118.28this reduction. The amount calculated under this clause shall not be adjusted for periods
118.29already paid due to subsequent changes to the capitation payments;
118.30(2) beginning July 1, 2003,
118.31under this section
118.32(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
118.33paid under this section; and
118.34(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
118.35under this section.
119.1(b) This subdivision shall be effective upon approval of a federal waiver which
119.2allows federal financial participation in the medical education and research fund. Effective
119.3July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4),
119.4shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first
119.5reduce the amounts otherwise required to be transferred under paragraph (a), clauses
119.6(2) to (4). Any excess following this reduction shall proportionally reduce the transfers
119.7under paragraph (a), clause (1).
119.8(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance
119.9medical care payments under paragraph (a), clause (1), shall be transferred to the general
119.10fund.
119.11(d) Beginning July 1, 2009, of the amounts in paragraph (a), the commissioner shall
119.12transfer $21,714,000 each fiscal year to the medical education and research fund. The
119.13balance of the transfers under paragraph (a) shall be transferred to the medical education
119.14and research fund no earlier than July 1 of the following fiscal year.
119.15 Sec. 48. Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:
119.16 Subd. 5f. Capitation rates. (a) Beginning July 1, 2002, the capitation rates paid
119.17under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the
119.18capitation rates paid under this section are increased by $4,700,000 per year.
119.19(b) Beginning July 1, 2009, the capitation rates paid under this section are increased
119.20each year by the lesser of $21,714,000 or an amount equal to the difference between the
119.21estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1),
119.22and the amount of the limit described in subdivision 5c, paragraph (b).
119.23 Sec. 49. Minnesota Statutes 2008, section 256B.69, subdivision 23, is amended to read:
119.24 Subd. 23. Alternative services; elderly and disabled persons. (a) The
119.25commissioner may implement demonstration projects to create alternative integrated
119.26delivery systems for acute and long-term care services to elderly persons and persons
119.27with disabilities as defined in section
119.28coordination, improve access to quality services, and mitigate future cost increases.
119.29The commissioner may seek federal authority to combine Medicare and Medicaid
119.30capitation payments for the purpose of such demonstrations and may contract with
119.31Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
119.32services shall be administered according to the terms and conditions of the federal contract
119.33and demonstration provisions. For the purpose of administering medical assistance funds,
119.34demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
120.1of Minnesota Rules, parts
120.2with the exceptions of parts
120.3items B and C, which do not apply to persons enrolling in demonstrations under this
120.4section. An initial open enrollment period may be provided. Persons who disenroll from
120.5demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
120.6to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
120.7the health plan's participation is subsequently terminated for any reason, the person shall
120.8be provided an opportunity to select a new health plan and shall have the right to change
120.9health plans within the first 60 days of enrollment in the second health plan. Persons
120.10required to participate in health plans under this section who fail to make a choice of
120.11health plan shall not be randomly assigned to health plans under these demonstrations.
120.12Notwithstanding section
120.13subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
120.14the commissioner may contract with managed care organizations, including counties, to
120.15serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
120.16disabled persons only. For persons with a primary diagnosis of developmental disability,
120.17serious and persistent mental illness, or serious emotional disturbance, the commissioner
120.18must ensure that the county authority has approved the demonstration and contracting
120.19design. Enrollment in these projects for persons with disabilities shall be voluntary. The
120.20commissioner shall not implement any demonstration project under this subdivision for
120.21persons with a primary diagnosis of developmental disabilities, serious and persistent
120.22mental illness, or serious emotional disturbance, without approval of the county board of
120.23the county in which the demonstration is being implemented.
120.24 (b) Notwithstanding chapter 245B, sections
120.25to
120.269525.1330, 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
120.27under this section projects for persons with developmental disabilities. The commissioner
120.28may capitate payments for ICF/MR services, waivered services for developmental
120.29disabilities, including case management services, day training and habilitation and
120.30alternative active treatment services, and other services as approved by the state and by the
120.31federal government. Case management and active treatment must be individualized and
120.32developed in accordance with a person-centered plan. Costs under these projects may not
120.33exceed costs that would have been incurred under fee-for-service. Beginning July 1, 2003,
120.34and until four years after the pilot project implementation date, subcontractor participation
120.35in the long-term care developmental disability pilot is limited to a nonprofit long-term
120.36care system providing ICF/MR services, home and community-based waiver services,
121.1and in-home services to no more than 120 consumers with developmental disabilities in
121.2Carver, Hennepin, and Scott Counties. The commissioner shall report to the legislature
121.3prior to expansion of the developmental disability pilot project. This paragraph expires
121.4four years after the implementation date of the pilot project.
121.5 (c) Before implementation of a demonstration project for disabled persons, the
121.6commissioner must provide information to appropriate committees of the house of
121.7representatives and senate and must involve representatives of affected disability groups
121.8in the design of the demonstration projects.
121.9 (d) A nursing facility reimbursed under the alternative reimbursement methodology
121.10in section
121.11provide services under paragraph (a). The commissioner shall amend the state plan and
121.12seek any federal waivers necessary to implement this paragraph.
121.13 (e) The commissioner, in consultation with the commissioners of commerce and
121.14health, may approve and implement programs for all-inclusive care for the elderly (PACE)
121.15according to federal laws and regulations governing that program and state laws or rules
121.16applicable to participating providers. The process for approval of these programs shall
121.17begin only after the commissioner receives grant money in an amount sufficient to cover
121.18the state share of the administrative and actuarial costs to implement the programs during
121.19state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
121.20account in the special revenue fund and are appropriated to the commissioner to be used
121.21solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
121.22not required to be licensed or certified as a health plan company as defined in section
121.24and found to be eligible for services under the elderly waiver or community alternatives
121.25for disabled individuals or who are already eligible for Medicaid but meet level of
121.26care criteria for receipt of waiver services may choose to enroll in the PACE program.
121.27Medicare and Medicaid services will be provided according to this subdivision and
121.28federal Medicare and Medicaid requirements governing PACE providers and programs.
121.29PACE enrollees will receive Medicaid home and community-based services through the
121.30PACE provider as an alternative to services for which they would otherwise be eligible
121.31through home and community-based waiver programs and Medicaid State Plan Services.
121.32The commissioner shall establish Medicaid rates for PACE providers that do not exceed
121.33costs that would have been incurred under fee-for-service or other relevant managed care
121.34programs operated by the state.
121.35 (f) The commissioner shall seek federal approval to expand the Minnesota disability
121.36health options (MnDHO) program established under this subdivision in stages, first to
122.1regional population centers outside the seven-county metro area and then to all areas of
122.2the state. Until July 1, 2009, expansion for MnDHO projects that include home and
122.3community-based services is limited to the two projects and service areas in effect on
122.4March 1, 2006. Enrollment in integrated MnDHO programs that include home and
122.5community-based services shall remain voluntary. Costs for home and community-based
122.6services included under MnDHO must not exceed costs that would have been incurred
122.7under the fee-for-service program. Notwithstanding whether expansion occurs under
122.8this paragraph, in determining MnDHO payment rates and risk adjustment methods for
122.9contract years starting in 2012, the commissioner must consider the methods used to
122.10determine county allocations for home and community-based program participants. If
122.11necessary to reduce MnDHO rates to comply with the provision regarding MnDHO costs
122.12for home and community-based services, the commissioner shall achieve the reduction by
122.13maintaining the base rate for contract years 2010 and 2011 for services provided under the
122.14community alternatives for disabled individuals waiver at the same level as for contract
122.15year 2009. The commissioner may apply other reductions to MnDHO rates to implement
122.16decreases in provider payment rates required by state law. In developing program
122.17specifications for expansion of integrated programs, the commissioner shall involve and
122.18consult the state-level stakeholder group established in subdivision 28, paragraph (d),
122.19including consultation on whether and how to include home and community-based waiver
122.20programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
122.21of the house of representatives and senate committees with jurisdiction over health and
122.22human services policy and finance by February 1, 2007.
122.23 (g) Notwithstanding section
122.24section are responsible for home care targeted case management and relocation targeted
122.25case management. Services must be provided according to the terms of the waivers and
122.26contracts approved by the federal government.
122.27 Sec. 50. [256B.756] REIMBURSEMENT RATES FOR BIRTHS.
122.28 Subdivision 1. Facility rate. (a) Notwithstanding section 256.969, effective for
122.29services provided on or after October 1, 2009, the facility payment rate for the following
122.30diagnosis-related groups, as they fall within the diagnostic categories: (1) 371 cesarean
122.31section without complicating diagnosis; (2) 372 vaginal delivery with complicating
122.32diagnosis; and (3) 373 vaginal delivery without complicating diagnosis, shall be calculated
122.33as provided in paragraph (b).
122.34(b) The commissioner shall calculate a single rate for all of the diagnostic related
122.35groups specified in paragraph (a) consistent with an increase in the proportion of births
123.1by vaginal delivery and a reduction in the percentage of births by cesarean section. The
123.2calculated single rate must be based on an expected increase in the number of vaginal
123.3births and expected reduction in the number of cesarean section such that the reduction
123.4in cesarean sections is less than or equal to one standard deviation below the average in
123.5the frequency of cesarean births for Minnesota health care program clients at hospitals
123.6performing greater than 50 deliveries per year.
123.7(c) The rates described in this subdivision do not include newborn care.
123.8 Subd. 2. Provider rate. Notwithstanding section 256B.76, effective for services
123.9provided on or after October 1, 2009, the payment rate for professional services related
123.10to labor, delivery, and antepartum and postpartum care when provided for any of the
123.11diagnostic categories identified in subdivision 1, paragraph (a), shall be calculated using
123.12the methodology specified in subdivision 1, paragraph (b).
123.13 Subd. 3. Health plans. Payments to managed care and county-based purchasing
123.14plans under sections 256B.69, 256B.692, or 256L.12 shall be reduced for services
123.15provided on or after October 1, 2009, to reflect the adjustments in subdivisions 1 and 2.
123.16 Subd. 4. Prior authorization. Prior authorization shall not be required before
123.17reimbursement is paid for a cesarean section delivery.
123.18 Sec. 51. Minnesota Statutes 2008, section 256B.76, subdivision 1, is amended to read:
123.19 Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
123.20or after October 1, 1992, the commissioner shall make payments for physician services
123.21as follows:
123.22 (1) payment for level one Centers for Medicare and Medicaid Services' common
123.23procedural coding system codes titled "office and other outpatient services," "preventive
123.24medicine new and established patient," "delivery, antepartum, and postpartum care,"
123.25"critical care," cesarean delivery and pharmacologic management provided to psychiatric
123.26patients, and level three codes for enhanced services for prenatal high risk, shall be paid
123.27at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
123.2830, 1992. If the rate on any procedure code within these categories is different than the
123.29rate that would have been paid under the methodology in section
123.30then the larger rate shall be paid;
123.31 (2) payments for all other services shall be paid at the lower of (i) submitted charges,
123.32or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
123.33 (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
123.34percentile of 1989, less the percent in aggregate necessary to equal the above increases
124.1except that payment rates for home health agency services shall be the rates in effect
124.2on September 30, 1992.
124.3 (b) Effective for services rendered on or after January 1, 2000, payment rates for
124.4physician and professional services shall be increased by three percent over the rates
124.5in effect on December 31, 1999, except for home health agency and family planning
124.6agency services. The increases in this paragraph shall be implemented January 1, 2000,
124.7for managed care.
124.8(c) Effective for services rendered on or after July 1, 2009, payment rates for
124.9physician and professional services shall be reduced by five percent over the rates in effect
124.10on June 30, 2009. This reduction does not apply to office or other outpatient services
124.11(procedure codes 99201 to 99215), preventive medicine services (procedure codes 99381
124.12to 99412) and family planning services billed by the following primary care specialties:
124.13general practice, internal medicine, pediatrics, geriatrics, family practice, or by an
124.14advanced practice registered nurse or physician assistant practicing in pediatrics, geriatrics,
124.15or family practice. This reduction does not apply to federally qualified health centers,
124.16rural health centers, and Indian health services. Effective October 1, 2009, payments
124.17made to managed care plans and county-based purchasing plans under sections 256B.69,
124.18256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.
124.19 Sec. 52. [256B.766] REIMBURSEMENT FOR BASIC CARE SERVICES.
124.20(a) Effective for services provided on or after July 1, 2009, total payments for basic
124.21care services, shall be reduced by three percent, prior to third-party liability and spenddown
124.22calculation. Payments made to managed care plans and county-based purchasing plans
124.23shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.
124.24(b) This section does not apply to physician and professional services, inpatient
124.25hospital services, family planning services, mental health services, dental services,
124.26prescription drugs, and medical transportation.
124.27 Sec. 53. Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:
124.28 Subd. 4. General assistance medical care; services. (a)(i) For a person who is
124.29eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
124.30care covers, except as provided in paragraph (c):
124.31 (1) inpatient hospital services;
124.32 (2) outpatient hospital services;
124.33 (3) services provided by Medicare certified rehabilitation agencies;
125.1 (4) prescription drugs and other products recommended through the process
125.2established in section
125.3 (5) equipment necessary to administer insulin and diagnostic supplies and equipment
125.4for diabetics to monitor blood sugar level;
125.5 (6) eyeglasses and eye examinations provided by a physician or optometrist;
125.6 (7) hearing aids;
125.7 (8) prosthetic devices;
125.8 (9) laboratory and X-ray services;
125.9 (10) physician's services;
125.10 (11) medical transportation except special transportation;
125.11 (12) chiropractic services as covered under the medical assistance program;
125.12 (13) podiatric services;
125.13 (14) dental services as covered under the medical assistance program;
125.14 (15) mental health services covered under chapter 256B;
125.15 (16) prescribed medications for persons who have been diagnosed as mentally ill as
125.16necessary to prevent more restrictive institutionalization;
125.17 (17) medical supplies and equipment, and Medicare premiums, coinsurance and
125.18deductible payments;
125.19 (18) medical equipment not specifically listed in this paragraph when the use of
125.20the equipment will prevent the need for costlier services that are reimbursable under
125.21this subdivision;
125.22 (19) services performed by a certified pediatric nurse practitioner, a certified family
125.23nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
125.24nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
125.25practitioner in independent practice, if (1) the service is otherwise covered under this
125.26chapter as a physician service, (2) the service provided on an inpatient basis is not included
125.27as part of the cost for inpatient services included in the operating payment rate, and (3) the
125.28service is within the scope of practice of the nurse practitioner's license as a registered
125.29nurse, as defined in section
125.30 (20) services of a certified public health nurse or a registered nurse practicing in
125.31a public health nursing clinic that is a department of, or that operates under the direct
125.32authority of, a unit of government, if the service is within the scope of practice of the
125.33public health nurse's license as a registered nurse, as defined in section
125.34 (21) telemedicine consultations, to the extent they are covered under section
126.1 (22) care coordination and patient education services provided by a community
126.2health worker according to section
126.3 (23) regardless of the number of employees that an enrolled health care provider
126.4may have, sign language interpreter services when provided by an enrolled health care
126.5provider during the course of providing a direct, person-to-person covered health care
126.6service to an enrolled recipient who has a hearing loss and uses interpreting services.
126.7 (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
126.8paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
126.9to inpatient hospital services, including physician services provided during the inpatient
126.10hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
126.11 (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
126.12subdivision.
126.13 (c) In order to contain costs, the commissioner of human services shall select
126.14vendors of medical care who can provide the most economical care consistent with high
126.15medical standards and shall where possible contract with organizations on a prepaid
126.16capitation basis to provide these services. The commissioner shall consider proposals by
126.17counties and vendors for prepaid health plans, competitive bidding programs, block grants,
126.18or other vendor payment mechanisms designed to provide services in an economical
126.19manner or to control utilization, with safeguards to ensure that necessary services are
126.20provided. Before implementing prepaid programs in counties with a county operated or
126.21affiliated public teaching hospital or a hospital or clinic operated by the University of
126.22Minnesota, the commissioner shall consider the risks the prepaid program creates for the
126.23hospital and allow the county or hospital the opportunity to participate in the program in a
126.24manner that reflects the risk of adverse selection and the nature of the patients served by
126.25the hospital, provided the terms of participation in the program are competitive with the
126.26terms of other participants considering the nature of the population served. Payment for
126.27services provided pursuant to this subdivision shall be as provided to medical assistance
126.28vendors of these services under sections
126.29payments made during fiscal year 1990 and later years, the commissioner shall consult
126.30with an independent actuary in establishing prepayment rates, but shall retain final control
126.31over the rate methodology.
126.32 (d) Effective January 1, 2008, drug coverage under general assistance medical
126.33care is limited to prescription drugs that:
126.34 (i) are covered under the medical assistance program as described in section
127.1 (ii) are provided by manufacturers that have fully executed general assistance
127.2medical care rebate agreements with the commissioner and comply with the agreements.
127.3Prescription drug coverage under general assistance medical care must conform to
127.4coverage under the medical assistance program according to section
127.5subdivisions 13 to 13g.
127.6 (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
127.7co-payments for services provided on or after October 1, 2003, and before January 1, 2009:
127.8 (1) $25 for eyeglasses;
127.9 (2) $25 for nonemergency visits to a hospital-based emergency room;
127.10 (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
127.11subject to a $12 per month maximum for prescription drug co-payments. No co-payments
127.12shall apply to antipsychotic drugs when used for the treatment of mental illness; and
127.13 (4) 50 percent coinsurance on restorative dental services.
127.14 (f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
127.15co-payments for services provided on or after January 1, 2009:
127.16 (1) $25 for nonemergency visits to a hospital-based emergency room; and
127.17 (2) $3 per brand-name drug prescription and $1 per generic drug prescription,
127.18subject to a $7 per month maximum for prescription drug co-payments. No co-payments
127.19shall apply to antipsychotic drugs when used for the treatment of mental illness.
127.20 (g) MS 2007 Supp [Expired]
127.21 (h) Effective January 1, 2009, co-payments shall be limited to one per day per
127.22provider for nonemergency visits to a hospital-based emergency room. Recipients of
127.23general assistance medical care are responsible for all co-payments in this subdivision.
127.24The general assistance medical care reimbursement to the provider shall be reduced by the
127.25amount of the co-payment, except that reimbursement for prescription drugs shall not be
127.26reduced once a recipient has reached the $7 per month maximum for prescription drug
127.27co-payments. The provider collects the co-payment from the recipient. Providers may not
127.28deny services to recipients who are unable to pay the co-payment.
127.29 (i) General assistance medical care reimbursement to fee-for-service providers
127.30and payments to managed care plans shall not be increased as a result of the removal of
127.31the co-payments effective January 1, 2009.
127.32 (j) Any county may, from its own resources, provide medical payments for which
127.33state payments are not made.
127.34 (k) Chemical dependency services that are reimbursed under chapter 254B must not
127.35be reimbursed under general assistance medical care.
128.1 (l) The maximum payment for new vendors enrolled in the general assistance
128.2medical care program after the base year shall be determined from the average usual and
128.3customary charge of the same vendor type enrolled in the base year.
128.4 (m) The conditions of payment for services under this subdivision are the same
128.5as the conditions specified in rules adopted under chapter 256B governing the medical
128.6assistance program, unless otherwise provided by statute or rule.
128.7 (n) Inpatient and outpatient payments shall be reduced by five percent, effective July
128.81, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
128.9and incorporated by reference in paragraph (l).
128.10 (o) Payments for all other health services except inpatient, outpatient, and pharmacy
128.11services shall be reduced by five percent, effective July 1, 2003.
128.12 (p) Payments to managed care plans shall be reduced by five percent for services
128.13provided on or after October 1, 2003.
128.14 (q) A hospital receiving a reduced payment as a result of this section may apply the
128.15unpaid balance toward satisfaction of the hospital's bad debts.
128.16 (r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for
128.17services provided on or after January 1, 2006. For purposes of this subdivision, a visit
128.18means an episode of service which is required because of a recipient's symptoms,
128.19diagnosis, or established illness, and which is delivered in an ambulatory setting by
128.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
128.21audiologist, optician, or optometrist.
128.22 (s) Payments to managed care plans shall not be increased as a result of the removal
128.23of the $3 nonpreventive visit co-payment effective January 1, 2006.
128.24 (t) Payments for mental health services added as covered benefits after December
128.2531, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).
128.26(u) Effective for services provided on or after July 1, 2009, total payment rates for
128.27basic care services shall be reduced by three percent, in accordance with section 256B.766.
128.28Payments made to managed care plans shall be reduced for services provided on or after
128.29October 1, 2009, to reflect this reduction.
128.30(v) Effective for services provided on or after July 1, 2009, payment rates for
128.31physician and professional services shall be reduced as described under section 256B.76,
128.32subdivision 1, paragraph (c). Payments made to managed care plans shall be reduced for
128.33services provided on or after October 1, 2009, to reflect this reduction.
128.34 Sec. 54. Minnesota Statutes 2008, section 256L.03, is amended by adding a subdivision
128.35to read:
129.1 Subd. 3b. Chiropractic services. MinnesotaCare covers the following chiropractic
129.2services: medically necessary exams, manual manipulation of the spine, and x-rays.
129.3EFFECTIVE DATE.This section is effective January 1, 2010.
129.4 Sec. 55. Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:
129.5 Subdivision 1. Families with children. (a) Families with children with family
129.6income equal to or less than 275 percent of the federal poverty guidelines for the
129.7applicable family size shall be eligible for MinnesotaCare according to this section. All
129.8other provisions of sections
129.9to enrollment under section
129.10 (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
129.11if the children are eligible. Children may be enrolled separately without enrollment by
129.12parents. However, if one parent in the household enrolls, both parents must enroll, unless
129.13other insurance is available. If one child from a family is enrolled, all children must
129.14be enrolled, unless other insurance is available. If one spouse in a household enrolls,
129.15the other spouse in the household must also enroll, unless other insurance is available.
129.16Families cannot choose to enroll only certain uninsured members.
129.17 (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
129.18to the MinnesotaCare program. These persons are no longer counted in the parental
129.19household and may apply as a separate household.
129.20 (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
129.21not eligible for MinnesotaCare if their gross income exceeds $57,500.
129.22 (e) Children formerly enrolled in medical assistance and automatically deemed
129.23eligible for MinnesotaCare according to section
129.24from the requirements of this section until renewal.
129.25(f) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
129.268, are exempt from the eligibility requirements of this subdivision.
129.27 Sec. 56. Minnesota Statutes 2008, section 256L.04, is amended by adding a subdivision
129.28to read:
129.29 Subd. 1b. Children with family income greater than 275 percent of federal
129.30poverty guidelines. Children with family income greater than 275 percent of federal
129.31poverty guidelines for the applicable family size shall be eligible for MinnesotaCare. All
129.32other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
129.33to enrollment under section 256L.07, shall apply unless otherwise specified.
130.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
130.2approval, whichever is later.
130.3 Sec. 57. Minnesota Statutes 2008, section 256L.04, subdivision 7a, is amended to read:
130.4 Subd. 7a. Ineligibility.
130.5established under this section may not enroll in the MinnesotaCare program.
130.6EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
130.7approval, whichever is later.
130.8 Sec. 58. Minnesota Statutes 2008, section 256L.04, subdivision 10a, is amended to
130.9read:
130.10 Subd. 10a. Sponsor's income and resources deemed available; documentation.
130.11When determining eligibility for any federal or state benefits under sections
130.13support as defined under United States Code, title 8, section 1183a, shall be deemed to
130.14include their sponsors' income and resources as defined in the Personal Responsibility
130.15and Work Opportunity Reconciliation Act of 1996, title IV, Public Law 104-193, sections
130.16421 and 422, and subsequently set out in federal rules. To be eligible for the program,
130.17noncitizens must provide documentation of their immigration status. Beginning July
130.181, 2010, or upon federal approval, whichever is later, sponsor deeming does not apply
130.19to pregnant women and children who are qualified noncitizens, as described in section
130.20256B.06, subdivision 4, paragraph (b).
130.21EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
130.22approval, whichever is later. The commissioner shall notify the revisor of statutes when
130.23federal approval has been obtained.
130.24 Sec. 59. Minnesota Statutes 2008, section 256L.05, subdivision 1, is amended to read:
130.25 Subdivision 1. Application assistance and information availability. (a)
130.26Applications and application assistance must be made available at provider offices, local
130.27human services agencies, school districts, public and private elementary schools in which
130.2825 percent or more of the students receive free or reduced price lunches, community health
130.29offices, Women, Infants and Children (WIC) program sites, Head Start program sites,
130.30public housing councils, crisis nurseries, child care centers, early childhood education
130.31and preschool program sites, legal aid offices, and libraries. These sites may accept
130.32applications and forward the forms to the commissioner or local county human services
131.1agencies that choose to participate as an enrollment site. Otherwise, applicants may apply
131.2directly to the commissioner or to participating local county human services agencies.
131.3(b) Application assistance must be available for applicants choosing to file an
131.4online application.
131.5 Sec. 60. Minnesota Statutes 2008, section 256L.05, is amended by adding a subdivision
131.6to read:
131.7 Subd. 1c. Open enrollment and streamlined application and enrollment
131.8process. (a) The commissioner and local agencies working in partnership must develop a
131.9streamlined and efficient application and enrollment process for medical assistance and
131.10MinnesotaCare enrollees that meets the criteria specified in this subdivision.
131.11(b) The commissioners of human services and education shall provide
131.12recommendations to the legislature by January 15, 2010, on the creation of an open
131.13enrollment process for medical assistance and MinnesotaCare that is coordinated with
131.14the public education system. The recommendations must:
131.15(1) be developed in consultation with medical assistance and MinnesotaCare
131.16enrollees and representatives from organizations that advocate on behalf of children and
131.17families, low-income persons and minority populations, counties, school administrators
131.18and nurses, health plans, and health care providers;
131.19 (2) be based on enrollment and renewal procedures best practices, including express
131.20lane eligibility as required under subdivision 1d;
131.21(3) simplify the enrollment and renewal processes wherever possible; and
131.22(4) establish a process:
131.23(i) to disseminate information on medical assistance and MinnesotaCare to all
131.24children in the public education system, including prekindergarten programs; and
131.25(ii) for the commissioner of human services to enroll children and other household
131.26members who are eligible.
131.27The commissioner of human services in coordination with the commissioner of
131.28education shall implement an open enrollment process by August 1, 2010, to be effective
131.29beginning with the 2010-2011 school year.
131.30(c) The commissioner and local agencies shall develop an online application process
131.31for medical assistance and MinnesotaCare.
131.32(d) The commissioner shall develop an application that is easily understandable
131.33and does not exceed four pages in length.
132.1(e) The commissioner of human services shall present to the legislature, by January
132.215, 2010, an implementation plan for the open enrollment period and online application
132.3process.
132.4EFFECTIVE DATE.This section is effective July 1, 2010, or upon federal
132.5approval, which must be requested by the commissioner, whichever is later.
132.6 Sec. 61. Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
132.7 Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
132.8first day of the month following the month in which eligibility is approved and the first
132.9premium payment has been received. As provided in section
132.10newborns is automatic from the date of birth and must be coordinated with other health
132.11coverage. The effective date of coverage for eligible newly adoptive children added to a
132.12family receiving covered health services is the month of placement. The effective date
132.13of coverage for other new members added to the family is the first day of the month
132.14following the month in which the change is reported. All eligibility criteria must be met
132.15by the family at the time the new family member is added. The income of the new family
132.16member is included with the family's gross income and the adjusted premium begins in
132.17the month the new family member is added.
132.18(b) The initial premium must be received by the last working day of the month for
132.19coverage to begin the first day of the following month.
132.20(c) Benefits are not available until the day following discharge if an enrollee is
132.21hospitalized on the first day of coverage.
132.22(d) Notwithstanding any other law to the contrary, benefits under sections
132.24person may have coverage and the commissioner shall use cost avoidance techniques to
132.25ensure coordination of any other health coverage for eligible persons. The commissioner
132.26shall identify eligible persons who may have coverage or benefits under other plans of
132.27insurance or who become eligible for medical assistance.
132.28(e) The effective date of coverage for single adults and households with no children
132.29formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
132.30according to section
132.31last day of general assistance medical care coverage.
132.32(f) The effective date of coverage for children eligible under section 256L.07,
132.33subdivision 8, is the first day of the month following the date of termination from foster
132.34care or release from a juvenile residential correctional facility.
133.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
133.2approval, whichever is later.
133.3 Sec. 62. Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:
133.4 Subd. 3a. Renewal of eligibility. (a) Beginning July 1, 2007, an enrollee's eligibility
133.5must be renewed every 12 months. The 12-month period begins in the month after the
133.6month the application is approved.
133.7 (b) Each new period of eligibility must take into account any changes in
133.8circumstances that impact eligibility and premium amount. An enrollee must provide all
133.9the information needed to redetermine eligibility by the first day of the month that ends
133.10the eligibility period. If there is no change in circumstances, the enrollee may renew
133.11eligibility at designated locations that include community clinics and health care providers'
133.12offices. The designated sites shall forward the renewal forms to the commissioner. The
133.13commissioner may establish criteria and timelines for sites to forward applications to the
133.14commissioner or county agencies. The premium for the new period of eligibility must be
133.15received as provided in section
133.16 (c) For single adults and households with no children formerly enrolled in general
133.17assistance medical care and enrolled in MinnesotaCare according to section
133.18subdivision 3
133.19application or renewal for general assistance medical care.
133.20 (d)
133.21renewal forms and related documentation necessary for verification of continued eligibility
133.22in a timely manner shall remain eligible for one additional month beyond the end of the
133.23current eligibility period before being disenrolled. The enrollee remains responsible for
133.24MinnesotaCare premiums for the additional month.
133.25(e) Children in families with family income equal to or below 275 percent of federal
133.26poverty guidelines who fail to submit renewal forms and related documentation necessary
133.27for verification of continued eligibility in a timely manner shall remain eligible for the
133.28program. The commissioner shall use the means described in subdivision 2 or any other
133.29means available to verify family income. If the commissioner determines that there has
133.30been a change in income in which premium payment is required to remain enrolled, the
133.31commissioner shall notify the family of the premium payment, and that the children
133.32will be disenrolled if the premium payment is not received effective the first day of the
133.33calendar month following the calendar month for which the premium is due.
133.34(f) For children enrolled in MinnesotaCare under section 256L.07, subdivision 8, the
133.35first period of renewal begins the month the enrollee turns 21 years of age.
134.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
134.2approval, whichever is later.
134.3 Sec. 63. Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:
134.4 Subdivision 1. General requirements. (a) Children enrolled in the original
134.5children's health plan as of September 30, 1992, children who enrolled in the
134.6MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
134.7article 4, section 17, and children who have family gross incomes that are equal to or
134.8less than
134.9the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
134.10long as they maintain continuous coverage in the MinnesotaCare program or medical
134.11assistance.
134.12
134.13
134.14
134.15
134.16
134.17whose income increases above 275 percent of the federal poverty guidelines, are no longer
134.18eligible for the program and shall be disenrolled by the commissioner. Beginning January
134.191, 2008, individuals enrolled in MinnesotaCare under section
134.207
134.21percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
134.22the program and shall be disenrolled by the commissioner. For persons disenrolled under
134.23this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
134.24following the month in which the commissioner determines that the income of a family or
134.25individual exceeds program income limits.
134.26 (b)
134.27if
134.29
134.30
134.31
134.32than 275 percent of federal poverty guidelines. The premium for children remaining
134.33eligible under this
134.34section
135.1 (c) Notwithstanding
135.2MinnesotaCare if gross household income exceeds $57,500 for the 12-month period
135.3of eligibility.
135.4EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
135.5approval, whichever is later.
135.6 Sec. 64. Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:
135.7 Subd. 2. Must not have access to employer-subsidized coverage. (a) To be
135.8eligible, a family or individual must not have access to subsidized health coverage through
135.9an employer and must not have had access to employer-subsidized coverage through
135.10a current employer for 18 months prior to application or reapplication. A family or
135.11individual whose employer-subsidized coverage is lost due to an employer terminating
135.12health care coverage as an employee benefit during the previous 18 months is not eligible.
135.13(b) This subdivision does not apply to a family or individual who was enrolled
135.14in MinnesotaCare within six months or less of reapplication and who no longer has
135.15employer-subsidized coverage due to the employer terminating health care coverage as an
135.16employee benefit. This subdivision does not apply to children with family gross incomes
135.17that are equal to or less than 200 percent of federal poverty guidelines.
135.18(c) For purposes of this requirement, subsidized health coverage means health
135.19coverage for which the employer pays at least 50 percent of the cost of coverage for
135.20the employee or dependent, or a higher percentage as specified by the commissioner.
135.21Children are eligible for employer-subsidized coverage through either parent, including
135.22the noncustodial parent. The commissioner must treat employer contributions to Internal
135.23Revenue Code Section 125 plans and any other employer benefits intended to pay
135.24health care costs as qualified employer subsidies toward the cost of health coverage for
135.25employees for purposes of this subdivision.
135.26EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
135.27approval, whichever is later.
135.28 Sec. 65. Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:
135.29 Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
135.30MinnesotaCare program must have no health coverage while enrolled
135.31
135.32greater than 200 percent of federal poverty guidelines, and adults, must have had no health
135.33coverage for at least four months prior to application and renewal. Children enrolled in the
135.34original children's health plan and children in families with income equal to or less than
136.1
136.2eligible if the coverage:
136.3(1) lacks two or more of the following:
136.4(i) basic hospital insurance;
136.5(ii) medical-surgical insurance;
136.6(iii) prescription drug coverage;
136.7(iv) dental coverage; or
136.8(v) vision coverage;
136.9(2) requires a deductible of $100 or more per person per year; or
136.10(3) lacks coverage because the child has exceeded the maximum coverage for a
136.11particular diagnosis or the policy excludes a particular diagnosis.
136.12The commissioner may change this eligibility criterion for sliding scale premiums
136.13in order to remain within the limits of available appropriations. The requirement of no
136.14health coverage does not apply to newborns.
136.15(b) Medical assistance, general assistance medical care, and the Civilian Health and
136.16Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under
136.17United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or
136.18health coverage for purposes of the four-month requirement described in this subdivision.
136.19(c) For purposes of this subdivision, an applicant or enrollee who is entitled to
136.20Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
136.21Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
136.22have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
136.23Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
136.24for MinnesotaCare.
136.25(d) Applicants who were recipients of medical assistance or general assistance
136.26medical care within one month of application must meet the provisions of this subdivision
136.27and subdivision 2.
136.28(e) Cost-effective health insurance that was paid for by medical assistance is not
136.29considered health coverage for purposes of the four-month requirement under this
136.30section, except if the insurance continued after medical assistance no longer considered it
136.31cost-effective or after medical assistance closed.
136.32EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
136.33approval, whichever is later.
136.34 Sec. 66. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
136.35to read:
137.1 Subd. 8. Automatic eligibility for certain children. Any child who was residing
137.2in foster care or a juvenile residential correctional facility on the child's 18th birthday is
137.3automatically deemed eligible for MinnesotaCare upon termination or release until the
137.4child reaches the age of 21, and is exempt from the requirements of this section and
137.5section 256L.15. To be enrolled under this section, a child must complete an initial
137.6application for MinnesotaCare. The commissioner shall contact individuals enrolled
137.7under this section annually to ensure the individual continues to reside in the state and is
137.8interested in continuing MinnesotaCare coverage.
137.9EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
137.10approval, whichever is later.
137.11 Sec. 67. Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:
137.12 Subdivision 1. Medical assistance rate to be used. (a) Payment to providers under
137.13sections
137.14medical assistance, except as provided in subdivisions 2 to 6.
137.15(b) Effective for services provided on or after July 1, 2009, total payments for basic
137.16care services shall be reduced by three percent, in accordance with section 256B.766.
137.17Payments made to managed care plans shall be reduced for services provided on or after
137.18October 1, 2009, to reflect this reduction.
137.19 Sec. 68. Minnesota Statutes 2008, section 256L.15, subdivision 2, is amended to read:
137.20 Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
137.21commissioner shall establish a sliding fee scale to determine the percentage of monthly
137.22gross individual or family income that households at different income levels must pay to
137.23obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
137.24on the enrollee's monthly gross individual or family income. The sliding fee scale must
137.25contain separate tables based on enrollment of one, two, or three or more persons. Until
137.26June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
137.27individual or family income for individuals or families with incomes below the limits for
137.28the medical assistance program for families and children in effect on January 1, 1999, and
137.29proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
137.308.8 percent. These percentages are matched to evenly spaced income steps ranging from
137.31the medical assistance income limit for families and children in effect on January 1, 1999,
137.32to 275 percent of the federal poverty guidelines for the applicable family size, up to a
137.33family size of five. The sliding fee scale for a family of five must be used for families of
137.34more than five. The sliding fee scale and percentages are not subject to the provisions of
138.1chapter 14. If a family or individual reports increased income after enrollment, premiums
138.2shall be adjusted at the time the change in income is reported.
138.3 (b) Children in families whose gross income is above 275 percent of the federal
138.4poverty guidelines shall pay the maximum premium. The maximum premium is defined
138.5as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
138.6cases paid the maximum premium, the total revenue would equal the total cost of
138.7MinnesotaCare medical coverage and administration. In this calculation, administrative
138.8costs shall be assumed to equal ten percent of the total. The costs of medical coverage
138.9for pregnant women and children under age two and the enrollees in these groups shall
138.10be excluded from the total. The maximum premium for two enrollees shall be twice the
138.11maximum premium for one, and the maximum premium for three or more enrollees shall
138.12be three times the maximum premium for one.
138.13 (c) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums according
138.14to the premium scale specified in paragraph (d) with the exception that children in families
138.15with income at or below
138.16
138.17means a monthly premium of $4.
138.18 (d) The following premium scale is established for individuals and families with
138.19gross family incomes of 300 percent of the federal poverty guidelines or less:
139.1EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
139.2approval, whichever is later.
139.3 Sec. 69. Minnesota Statutes 2008, section 256L.15, subdivision 3, is amended to read:
139.4 Subd. 3. Exceptions to sliding scale. Children in families with income at or below
139.5
139.6
139.7EFFECTIVE DATE.This section is effective July 1, 2009, or upon federal
139.8approval, whichever is later.
139.9 Sec. 70. Minnesota Statutes 2008, section 256L.17, subdivision 3, is amended to read:
139.10 Subd. 3. Documentation. (a) The commissioner of human services shall require
139.11individuals and families, at the time of application or renewal, to indicate on a
139.12form developed by the commissioner whether they satisfy the MinnesotaCare asset
139.13requirement.
139.14 (b) The commissioner may require individuals and families to provide any
139.15information the commissioner determines necessary to verify compliance with the asset
139.16requirement, if the commissioner determines that there is reason to believe that an
139.17individual or family has assets that exceed the program limit.
139.18 Sec. 71. Minnesota Statutes 2008, section 256L.17, subdivision 5, is amended to read:
139.19 Subd. 5. Exemption. This section does not apply to pregnant women or children.
139.20For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
139.21 Sec. 72. Minnesota Statutes 2008, section 501B.89, is amended by adding a
139.22subdivision to read:
139.23 Subd. 4. Annual filing requirement for supplemental needs trusts. (a) A trustee
139.24of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or
139.25(C), shall submit to the commissioner of human services, at the time of a beneficiary's
139.26request for medical assistance, the following information about the trust:
139.27(1) a copy of the trust instrument; and
139.28(2) an inventory of the beneficiary's trust account assets and the value of those assets.
139.29(b) A trustee of a trust under subdivision 3 and United States Code, title 42, section
139.301396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the
139.31commissioner of human services at least annually until the trust, or the beneficiary's
139.32interest in the trust, terminates. Accountings are due on the anniversary of the execution
140.1date of the trust unless another annual date is established by the terms of the trust. The
140.2accounting must include the following information for the accounting period:
140.3(1) an inventory of trust assets and the value of those assets at the beginning of the
140.4accounting period;
140.5(2) additions to the trust during the accounting period and the source of those
140.6additions;
140.7(3) itemized distributions from the trust during the accounting period, including the
140.8purpose of the distributions and to whom the distributions were made;
140.9(4) an inventory of trust assets and the value of those assets at the end of the
140.10accounting period; and
140.11(5) changes to the trust instrument during the accounting period.
140.12(c) For the purpose of paragraph (b), an accounting period is 12 months unless an
140.13accounting period of a different length is permitted by the commissioner.
140.14EFFECTIVE DATE.This section is effective for applications for medical
140.15assistance and renewals of medical assistance submitted on or after July 1, 2009.
140.16 Sec. 73. Minnesota Statutes 2008, section 519.05, is amended to read:
140.17519.05 LIABILITY OF HUSBAND AND WIFE.
140.18(a) A spouse is not liable to a creditor for any debts of the other spouse. Where
140.19husband and wife are living together, they shall be jointly and severally liable for
140.20necessary medical services that have been furnished to either spouse, including any claims
140.21arising under section 246.53, 256B.15, 256D.16, or 261.04, and necessary household
140.22articles and supplies furnished to and used by the family. Notwithstanding this paragraph,
140.23in a proceeding under chapter 518 the court may apportion such debt between the spouses.
140.24(b) Either spouse may close a credit card account or other unsecured consumer line
140.25of credit on which both spouses are contractually liable, by giving written notice to the
140.26creditor.
140.27 Sec. 74. Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision
140.281, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:
| 140.29 |
Subdivision 1.Total Appropriation |
$ |
3,848,049,000 |
$ |
4,135,780,000 |
||
141.7Federal Medicaid funds made available
141.8under title IV of the federal Jobs and Growth
141.9Tax Relief Reconciliation Act of 2003
141.10are appropriated to the commissioner of
141.11human services for use in the state's medical
141.12assistance and MinnesotaCare programs.
141.13The commissioners of human services and
141.14finance shall report to the legislative advisory
141.15committee on the additional federal Medicaid
141.16matching funds that will be available to the
141.17state.
141.18(b) Because of the availability of these funds,
141.19the following policies shall become effective:
141.20(1) medical assistance and MinnesotaCare
141.21eligibility and local financial participation
141.22changes provided for in this act may be
141.23implemented prior to September 2, 2003, or
141.24may be delayed as necessary to maximize
141.25the use of federal funds received under
141.26title IV of the Jobs and Growth Tax Relief
141.27Reconciliation Act of 2003;
141.28(2) the aggregate cap on the services
141.29identified in Minnesota Statutes, section
141.31be increased from $2,000 to $5,000. This
141.32increase shall expire at the end of fiscal year
141.332007. Funds may be transferred from the
142.1general fund to the health care access fund as
142.2necessary to implement this provision; and
142.3(3) the following payment shifts shall not be
142.4implemented:
142.5(i) MFIP payment shift found in subdivision
142.611;
142.7(ii) the county payment shift found in
142.8subdivision 1; and
142.9(iii) the delay in medical assistance
142.10and general assistance medical care
142.11fee-for-service payments found in
142.12subdivision 6.
142.13(c) Notwithstanding section 14, paragraphs
142.14(a) and (b) shall expire June 30, 2007.
142.15Receipts for Systems Projects.
142.16Appropriations and federal receipts for
142.17information system projects for MAXIS,
142.18PRISM, MMIS, and SSIS must be deposited
142.19in the state system account authorized in
142.20Minnesota Statutes, section
142.21appropriated for computer projects approved
142.22by the Minnesota office of technology,
142.23funded by the legislature, and approved
142.24by the commissioner of finance may be
142.25transferred from one project to another
142.26and from development to operations as the
142.27commissioner of human services considers
142.28necessary. Any unexpended balance in
142.29the appropriation for these projects does
142.30not cancel but is available for ongoing
142.31development and operations.
142.32Gifts. Notwithstanding Minnesota Statutes,
142.33chapter 7, the commissioner may accept
142.34on behalf of the state additional funding
143.1from sources other than state funds for the
143.2purpose of financing the cost of assistance
143.3program grants or nongrant administration.
143.4All additional funding is appropriated to the
143.5commissioner for use as designated by the
143.6grantor of funding.
143.7Systems Continuity. In the event of
143.8disruption of technical systems or computer
143.9operations, the commissioner may use
143.10available grant appropriations to ensure
143.11continuity of payments for maintaining the
143.12health, safety, and well-being of clients
143.13served by programs administered by the
143.14department of human services. Grant funds
143.15must be used in a manner consistent with the
143.16original intent of the appropriation.
143.17Nonfederal Share Transfers. The
143.18nonfederal share of activities for which
143.19federal administrative reimbursement is
143.20appropriated to the commissioner may be
143.21transferred to the special revenue fund.
143.22TANF Funds Appropriated to Other
143.23Entities. Any expenditures from the TANF
143.24block grant shall be expended in accordance
143.25with the requirements and limitations of part
143.26A of title IV of the Social Security Act, as
143.27amended, and any other applicable federal
143.28requirement or limitation. Prior to any
143.29expenditure of these funds, the commissioner
143.30shall assure that funds are expended in
143.31compliance with the requirements and
143.32limitations of federal law and that any
143.33reporting requirements of federal law are
143.34met. It shall be the responsibility of any entity
143.35to which these funds are appropriated to
144.1implement a memorandum of understanding
144.2with the commissioner that provides the
144.3necessary assurance of compliance prior to
144.4any expenditure of funds. The commissioner
144.5shall receipt TANF funds appropriated
144.6to other state agencies and coordinate all
144.7related interagency accounting transactions
144.8necessary to implement these appropriations.
144.9Unexpended TANF funds appropriated to
144.10any state, local, or nonprofit entity cancel
144.11at the end of the state fiscal year unless
144.12appropriating language permits otherwise.
144.13TANF Funds Transferred to Other Federal
144.14Grants. The commissioner must authorize
144.15transfers from TANF to other federal block
144.16grants so that funds are available to meet the
144.17annual expenditure needs as appropriated.
144.18Transfers may be authorized prior to the
144.19expenditure year with the agreement of the
144.20receiving entity. Transferred funds must be
144.21expended in the year for which the funds
144.22were appropriated unless appropriation
144.23language permits otherwise. In accelerating
144.24transfer authorizations, the commissioner
144.25must aim to preserve the future potential
144.26transfer capacity from TANF to other block
144.27grants.
144.28TANF Maintenance of Effort. (a) In
144.29order to meet the basic maintenance of
144.30effort (MOE) requirements of the TANF
144.31block grant specified under Code of Federal
144.32Regulations, title 45, section
144.33commissioner may only report nonfederal
144.34money expended for allowable activities
144.35listed in the following clauses as TANF/MOE
144.36expenditures:
145.1(1) MFIP cash, diversionary work program,
145.2and food assistance benefits under Minnesota
145.3Statutes, chapter 256J;
145.4(2) the child care assistance programs
145.5under Minnesota Statutes, sections
145.6and
145.7administrative costs under Minnesota
145.8Statutes, section
145.9(3) state and county MFIP administrative
145.10costs under Minnesota Statutes, chapters
145.11256J and 256K;
145.12(4) state, county, and tribal MFIP
145.13employment services under Minnesota
145.14Statutes, chapters 256J and 256K;
145.15(5) expenditures made on behalf of
145.16noncitizen MFIP recipients who qualify
145.17for the medical assistance without federal
145.18financial participation program under
145.19Minnesota Statutes, section
145.20subdivision 4
145.21and
145.22(6) qualifying working family credit
145.23expenditures under Minnesota Statutes,
145.24section
145.25(b) The commissioner shall ensure that
145.26sufficient qualified nonfederal expenditures
145.27are made each year to meet the state's
145.28TANF/MOE requirements. For the activities
145.29listed in paragraph (a), clauses (2) to
145.30(6), the commissioner may only report
145.31expenditures that are excluded from the
145.32definition of assistance under Code of
145.33Federal Regulations, title 45, section
146.1(c) By August 31 of each year, the
146.2commissioner shall make a preliminary
146.3calculation to determine the likelihood
146.4that the state will meet its annual federal
146.5work participation requirement under Code
146.6of Federal Regulations, title 45, sections
146.8caseload reduction credit under Code of
146.9Federal Regulations, title 45, section
146.10If the commissioner determines that the
146.11state will meet its federal work participation
146.12rate for the federal fiscal year ending that
146.13September, the commissioner may reduce the
146.14expenditure under paragraph (a), clause (1),
146.15to the extent allowed under Code of Federal
146.16Regulations, title 45, section 263.1(a)(2).
146.17(d) For fiscal years beginning with state
146.18fiscal year 2003, the commissioner shall
146.19assure that the maintenance of effort used
146.20by the commissioner of finance for the
146.21February and November forecasts required
146.22under Minnesota Statutes, section
146.23contains expenditures under paragraph (a),
146.24clause (1), equal to at least 25 percent of
146.25the total required under Code of Federal
146.26Regulations, title 45, section
146.27(e) If nonfederal expenditures for the
146.28programs and purposes listed in paragraph
146.29(a) are insufficient to meet the state's
146.30TANF/MOE requirements, the commissioner
146.31shall recommend additional allowable
146.32sources of nonfederal expenditures to the
146.33legislature, if the legislature is or will be in
146.34session to take action to specify additional
146.35sources of nonfederal expenditures for
146.36TANF/MOE before a federal penalty is
147.1imposed. The commissioner shall otherwise
147.2provide notice to the legislative commission
147.3on planning and fiscal policy under paragraph
147.4(g).
147.5(f) If the commissioner uses authority
147.6granted under section 11, or similar authority
147.7granted by a subsequent legislature, to
147.8meet the state's TANF/MOE requirement
147.9in a reporting period, the commissioner
147.10shall inform the chairs of the appropriate
147.11legislative committees about all transfers
147.12made under that authority for this purpose.
147.13(g) If the commissioner determines that
147.14nonfederal expenditures under paragraph
147.15(a) are insufficient to meet TANF/MOE
147.16expenditure requirements, and if the
147.17legislature is not or will not be in
147.18session to take timely action to avoid a
147.19federal penalty, the commissioner may
147.20report nonfederal expenditures from
147.21other allowable sources as TANF/MOE
147.22expenditures after the requirements of this
147.23paragraph are met. The commissioner
147.24may report nonfederal expenditures
147.25in addition to those specified under
147.26paragraph (a) as nonfederal TANF/MOE
147.27expenditures, but only ten days after the
147.28commissioner of finance has first submitted
147.29the commissioner's recommendations for
147.30additional allowable sources of nonfederal
147.31TANF/MOE expenditures to the members of
147.32the legislative commission on planning and
147.33fiscal policy for their review.
147.34(h) The commissioner of finance shall not
147.35incorporate any changes in federal TANF
148.1expenditures or nonfederal expenditures for
148.2TANF/MOE that may result from reporting
148.3additional allowable sources of nonfederal
148.4TANF/MOE expenditures under the interim
148.5procedures in paragraph (g) into the February
148.6or November forecasts required under
148.7Minnesota Statutes, section
148.8the commissioner of finance has approved
148.9the additional sources of expenditures under
148.10paragraph (g).
148.11(i) Minnesota Statutes, section
148.12subdivision 3
148.13grants or aids secured or obtained under that
148.14subdivision be used to reduce any direct
148.15appropriations provided by law, do not apply
148.16if the grants or aids are federal TANF funds.
148.17(j) Notwithstanding section 14, paragraph
148.18(a), clauses (1) to (6), and paragraphs (b) to
148.19(j) expire June 30, 2007.
148.20Working Family Credit Expenditures as
148.21TANF MOE. The commissioner may claim
148.22as TANF maintenance of effort up to the
148.23following amounts of working family credit
148.24expenditures for the following fiscal years:
148.25(1) fiscal year 2004, $7,013,000;
148.26(2) fiscal year 2005, $25,133,000;
148.27(3) fiscal year 2006, $6,942,000; and
148.28(4) fiscal year 2007, $6,707,000.
148.29Fiscal Year 2003 Appropriations
148.30Carryforward. Effective the day following
148.31final enactment, notwithstanding Minnesota
148.32Statutes, section
148.33the contrary, state agencies and constitutional
148.34offices may carry forward unexpended
149.1and unencumbered nongrant operating
149.2balances from fiscal year 2003 general fund
149.3appropriations into fiscal year 2004 to offset
149.4general budget reductions.
149.5Transfer of Grant Balances. Effective
149.6the day following final enactment, the
149.7commissioner of human services, with
149.8the approval of the commissioner of
149.9finance and after notification of the chair
149.10of the senate health, human services and
149.11corrections budget division and the chair
149.12of the house of representatives health
149.13and human services finance committee,
149.14may transfer unencumbered appropriation
149.15balances for the biennium ending June 30,
149.162003, in fiscal year 2003 among the MFIP,
149.17MFIP child care assistance under Minnesota
149.18Statutes, section
149.19general assistance medical care, medical
149.20assistance, Minnesota supplemental aid,
149.21and group residential housing programs,
149.22and the entitlement portion of the chemical
149.23dependency consolidated treatment fund, and
149.24between fiscal years of the biennium.
149.25TANF Appropriation Cancellation.
149.26Notwithstanding the provisions of Laws
149.272000, chapter 488, article 1, section 16,
149.28any prior appropriations of TANF funds
149.29to the department of trade and economic
149.30development or to the job skills partnership
149.31board or any transfers of TANF funds from
149.32another agency to the department of trade
149.33and economic development or to the job
149.34skills partnership board are not available
149.35until expended, and if unobligated as of June
150.130, 2003, these appropriations or transfers
150.2shall cancel to the TANF fund.
150.3Shift County Payment. The commissioner
150.4shall make up to 100 percent of the
150.5calendar year 2005 payments to counties for
150.6developmental disabilities semi-independent
150.7living services grants, developmental
150.8disabilities family support grants, and
150.9adult mental health grants from fiscal year
150.102006 appropriations. This is a onetime
150.11payment shift. Calendar year 2006 and future
150.12payments for these grants are not affected by
150.13this shift. This provision expires June 30,
150.142006.
150.15Capitation Rate Increase. Of the health care
150.16access fund appropriations to the University
150.17of Minnesota in the higher education
150.18omnibus appropriation bill,
150.19
150.20
150.21
150.22July 1, 2003, and thereafter, $2,157,000 each
150.23year shall be transferred to the commissioner
150.24for purposes of Minnesota Statutes, section
150.26section 14, this provision shall not expire.
150.27 Sec. 75. ASTHMA COVERAGE DEMONSTRATION PROJECT.
150.28 Subdivision 1. Medical assistance coverage. The commissioner of human services
150.29shall establish a demonstration project to provide additional medical assistance coverage
150.30for a maximum of 200 American Indian children in Minneapolis, St. Paul, and Duluth
150.31who are burdened by health disparities associated with the cumulative health impact of
150.32toxic environmental exposures. Under this demonstration project, the additional medical
150.33assistance coverage for this population must include, but is not limited to, the following
150.34durable medical equipment: high efficiency particulate air (HEPA) cleaners, HEPA
150.35vacuum cleaners, allergy bed and pillow encasements, high filtration filters for forced air
151.1gas furnaces, and dehumidifiers with medical tubing to connect the appliance to a floor
151.2drain, if the listed item is medically necessary to reduce asthma symptoms. Provision
151.3of these items must be preceded by a home environmental assessment for triggers of
151.4asthma and in-home asthma education on the proper medical management of asthma by a
151.5Certified Asthma Educator or public health nurse with asthma management training.
151.6 Subd. 2. Report. (a) Two years following implementation of the medical assistance
151.7coverage demonstration project established under this section, the commissioner of health,
151.8in collaboration with the Department of Human Services, must report to the legislature
151.9on the number of asthma-related hospital admittances that occurred in the population of
151.10children described in subdivision 1, before and after implementation of the demonstration
151.11project, and whether the demonstration project had an impact on asthma-related school
151.12absenteeism for this population of children.
151.13(b) The commissioner of health must seek nonstate funding to conduct this report.
151.14The reporting requirement is contingent upon the availability of nonstate funds.
151.15 Sec. 76. CLAIMS AND UTILIZATION DATA.
151.16The commissioner of human services, in consultation with the Health Services
151.17Policy Committee, shall develop and provide to the legislature by December 15, 2009, a
151.18methodology and any draft legislation necessary to allow for the release, upon request, of
151.19summary data as defined in Minnesota Statutes, section 13.02, subdivision 19, on claims
151.20and utilization for medical assistance, general assistance medical care, and MinnesotaCare
151.21enrollees at no charge to the University of Minnesota Medical School, the Mayo Medical
151.22School, Northwestern Health Sciences University, the Institute for Clinical Systems
151.23Improvement, and other research institutions, to conduct analyses of health care outcomes
151.24and treatment effectiveness, provided the research institutions do not release private or
151.25nonpublic data, or data for which dissemination is prohibited by law.
151.26 Sec. 77. ADMINISTRATION OF PUBLICLY FUNDED HEALTH CARE
151.27PROGRAMS.
151.28(a) The commissioner of human services, in cooperation with the representatives
151.29of county human services agencies and with input from organizations that advocate on
151.30behalf of families and children, shall develop a plan that, to the extent feasible, seeks to
151.31align standards, income and asset methodologies, and procedures for families and children
151.32under medical assistance and MinnesotaCare. The commissioner shall evaluate the impact
151.33of different approaches toward alignment on the number of potential medical assistance
151.34and MinnesotaCare enrollees who are families and children, and on administrative, health
152.1care, and other costs to the state. The commissioner shall present recommendations to the
152.2legislative committees with jurisdiction over health care by September 15, 2010.
152.3(b) The commissioner shall report in detail to the chair of the Health Care and
152.4Human Services Finance Committee of the house of representatives and to the chair of
152.5the Health and Human Services Division of the Finance Committee of the senate, prior
152.6to entering into any contracts involving counties for streamlined electronic enrollment
152.7and eligibility determinations for publicly funded health care programs, if such contracts
152.8would require payment from either the general fund, or the health care access fund, as
152.9described in Minnesota Statutes, sections 295.58 and 297I.05.
152.10 Sec. 78. COBRA PREMIUM STATE SUBSIDY.
152.11 Subdivision 1. Eligibility. (a) An individual and the individual's qualified
152.12beneficiaries shall be eligible for a state premium subsidy equal to 35 percent of the
152.13premiums the individual is required to pay for the continuation of health care coverage
152.14under COBRA, if the individual and the individual's qualified beneficiaries:
152.15(1) are eligible for the 65 percent COBRA continuation premium subsidy for health
152.16care coverage under the American Recovery and Reinvestment Act of 2009;
152.17(2) elect COBRA continuation health care coverage; and
152.18(3) are eligible for medical assistance under Minnesota Statutes, chapter 256B;
152.19general assistance medical care under Minnesota Statutes, section 256D.03; or
152.20MinnesotaCare under Minnesota Statutes, chapter 256L, except for the four-month barrier
152.21requirement under Minnesota Statutes, section 256L.07, subdivision 3.
152.22(b) Eligibility for the state subsidy shall continue for as long as the individual
152.23remains eligible for the COBRA premium subsidies provided under the American
152.24Recovery and Reinvestment Act of 2009.
152.25 Subd. 2. Subsidy. (a) The commissioner of human services shall pay 35 percent of
152.26the COBRA premiums that the individual must pay for continuation health care coverage
152.27for the individual and the individual's qualified beneficiaries, if the individual and the
152.28individual's qualified beneficiaries meet the requirements in subdivision 1.
152.29(b) The state subsidy payment required under this section shall be made directly to
152.30the entity to which the individual is required to make COBRA premium payments.
152.31(c) If any eligible individual has paid either the full amount of the COBRA premiums
152.32or 35 percent of the COBRA premiums before the date of enactment of this section, the
152.33individual is not entitled to a reimbursement of any premium paid.
152.34 Subd. 3. Notification. (a) All employers and plan administrators who are required to
152.35provide notice to all qualified individuals under the American Recovery and Reinvestment
153.1Act of 2009 must include information to qualified individuals residing in Minnesota of
153.2the availability of the state subsidy available under this section. The notice shall include
153.3the eligibility requirements for the state subsidy and that the individual must apply to the
153.4commissioner of human services to receive the state subsidy.
153.5(b) The commissioner of employment and economic development must inform an
153.6applicant for unemployment benefits of the availability of a state subsidy if the applicant
153.7elects COBRA continuation coverage and the applicant meets the eligibility requirements
153.8of this section.
153.9 Subd. 4. Exemption. Any individual who receives a state subsidy under this
153.10section is exempt from the four-month requirement under Minnesota Statutes, section
153.11256L.07, subdivision 3, if the individual or the individual's qualified beneficiaries apply
153.12for MinnesotaCare after the individual no longer receives COBRA continuation coverage.
153.13 Subd. 5. Expiration. This section expires December 31, 2010.
153.14 Sec. 79. FEDERAL APPROVAL.
153.15The commissioner of human services shall resubmit for federal approval the
153.16elimination of depreciation for self-employed farmers in determining income eligibility
153.17for MinnesotaCare passed in Laws 2007, chapter 147, article 5, section 19.
153.18 Sec. 80. REPEALER.
153.19Minnesota Statutes 2008, sections 256.962, subdivision 7; and 256L.17, subdivision
153.206, are repealed.
153.23 Section 1. Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to
153.24read:
153.25 Subdivision 1. License required. (a) A home care provider may not operate in the
153.26state without a current license issued by the commissioner of health. A home care provider
153.27may hold a separate license for each class of home care licensure.
153.28 (b) Within ten days after receiving an application for a license, the commissioner
153.29shall acknowledge receipt of the application in writing. The acknowledgment must
153.30indicate whether the application appears to be complete or whether additional information
153.31is required before the application will be considered complete. Within 90 days after
153.32receiving a complete application, the commissioner shall either grant or deny the license.
153.33If an applicant is not granted or denied a license within 90 days after submitting a
154.1complete application, the license must be deemed granted. An applicant whose license has
154.2been deemed granted must provide written notice to the commissioner before providing a
154.3home care service.
154.4 (c) Each application for a home care provider license, or for a renewal of a license,
154.5shall be accompanied by a fee to be set by the commissioner under section
154.6 (d) The commissioner of health, in consultation with the commissioner of human
154.7services, shall provide recommendations to the legislature by February 15, 2009, for
154.8provider standards for personal care assistant services as described in section
154.9256B.0659.
154.10 Sec. 2. Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:
154.11 Subd. 9. Employee. "Employee" means any person who performs services for
154.12another for hire including the following:
154.13(1) an alien;
154.14(2) a minor;
154.15(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and
154.16peace officer while engaged in the enforcement of peace or in the pursuit or capture of a
154.17person charged with or suspected of crime;
154.18(4) a person requested or commanded to aid an officer in arresting or retaking a
154.19person who has escaped from lawful custody, or in executing legal process, in which
154.20cases, for purposes of calculating compensation under this chapter, the daily wage of the
154.21person shall be the prevailing wage for similar services performed by paid employees;
154.22(5) a county assessor;
154.23(6) an elected or appointed official of the state, or of a county, city, town, school
154.24district, or governmental subdivision in the state. An officer of a political subdivision
154.25elected or appointed for a regular term of office, or to complete the unexpired portion of a
154.26regular term, shall be included only after the governing body of the political subdivision
154.27has adopted an ordinance or resolution to that effect;
154.28(7) an executive officer of a corporation, except those executive officers excluded
154.29by section
154.30(8) a voluntary uncompensated worker, other than an inmate, rendering services in
154.31state institutions under the commissioners of human services and corrections similar to
154.32those of officers and employees of the institutions, and whose services have been accepted
154.33or contracted for by the commissioner of human services or corrections as authorized by
154.34law. In the event of injury or death of the worker, the daily wage of the worker, for the
154.35purpose of calculating compensation under this chapter, shall be the usual wage paid at
155.1the time of the injury or death for similar services in institutions where the services are
155.2performed by paid employees;
155.3(9) a voluntary uncompensated worker engaged in emergency management as
155.4defined in section
155.5(i) registered with the state or any political subdivision of it, according to the
155.6procedures set forth in the state or political subdivision emergency operations plan; and
155.7(ii) acting under the direction and control of, and within the scope of duties approved
155.8by, the state or political subdivision.
155.9The daily wage of the worker, for the purpose of calculating compensation under this
155.10chapter, shall be the usual wage paid at the time of the injury or death for similar services
155.11performed by paid employees;
155.12(10) a voluntary uncompensated worker participating in a program established by a
155.13local social services agency. For purposes of this clause, "local social services agency"
155.14means any agency established under section
155.15worker, the wage of the worker, for the purpose of calculating compensation under this
155.16chapter, shall be the usual wage paid in the county at the time of the injury or death for
155.17similar services performed by paid employees working a normal day and week;
155.18(11) a voluntary uncompensated worker accepted by the commissioner of natural
155.19resources who is rendering services as a volunteer pursuant to section
155.20wage of the worker for the purpose of calculating compensation under this chapter, shall
155.21be the usual wage paid at the time of injury or death for similar services performed by
155.22paid employees;
155.23(12) a voluntary uncompensated worker in the building and construction industry
155.24who renders services for joint labor-management nonprofit community service projects.
155.25The daily wage of the worker for the purpose of calculating compensation under this
155.26chapter shall be the usual wage paid at the time of injury or death for similar services
155.27performed by paid employees;
155.28(13) a member of the military forces, as defined in section
155.29active service, as defined in section
155.30for the purpose of calculating compensation under this chapter shall be based on the
155.31member's usual earnings in civil life. If there is no evidence of previous occupation or
155.32earning, the trier of fact shall consider the member's earnings as a member of the military
155.33forces;
155.34(14) a voluntary uncompensated worker, accepted by the director of the Minnesota
155.35Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily
155.36wage of the worker, for the purposes of calculating compensation under this chapter,
156.1shall be the usual wage paid at the time of injury or death for similar services performed
156.2by paid employees;
156.3(15) a voluntary uncompensated worker, other than a student, who renders services
156.4at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the
156.5Blind, and whose services have been accepted or contracted for by the commissioner of
156.6education, as authorized by law. In the event of injury or death of the worker, the daily
156.7wage of the worker, for the purpose of calculating compensation under this chapter, shall
156.8be the usual wage paid at the time of the injury or death for similar services performed in
156.9institutions by paid employees;
156.10(16) a voluntary uncompensated worker, other than a resident of the veterans home,
156.11who renders services at a Minnesota veterans home, and whose services have been
156.12accepted or contracted for by the commissioner of veterans affairs, as authorized by law.
156.13In the event of injury or death of the worker, the daily wage of the worker, for the purpose
156.14of calculating compensation under this chapter, shall be the usual wage paid at the time of
156.15the injury or death for similar services performed in institutions by paid employees;
156.16(17) a worker performing services under section
156.17recipient in the home of the recipient or in the community under section
156.18subdivision 19a
156.19section
156.20workers' compensation insurance, the employer of the worker is as designated in law
156.21by the commissioner of the Department of Human Services, notwithstanding any other
156.22law to the contrary;
156.23(18) students enrolled in and regularly attending the Medical School of the
156.24University of Minnesota in the graduate school program or the postgraduate program. The
156.25students shall not be considered employees for any other purpose. In the event of the
156.26student's injury or death, the weekly wage of the student for the purpose of calculating
156.27compensation under this chapter, shall be the annualized educational stipend awarded to
156.28the student, divided by 52 weeks. The institution in which the student is enrolled shall
156.29be considered the "employer" for the limited purpose of determining responsibility for
156.30paying benefits under this chapter;
156.31(19) a faculty member of the University of Minnesota employed for an academic
156.32year is also an employee for the period between that academic year and the succeeding
156.33academic year if:
156.34(a) the member has a contract or reasonable assurance of a contract from the
156.35University of Minnesota for the succeeding academic year; and
157.1(b) the personal injury for which compensation is sought arises out of and in the
157.2course of activities related to the faculty member's employment by the University of
157.3Minnesota;
157.4(20) a worker who performs volunteer ambulance driver or attendant services is an
157.5employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other
157.6entity for which the worker performs the services. The daily wage of the worker for the
157.7purpose of calculating compensation under this chapter shall be the usual wage paid at the
157.8time of injury or death for similar services performed by paid employees;
157.9(21) a voluntary uncompensated worker, accepted by the commissioner of
157.10administration, rendering services as a volunteer at the Department of Administration. In
157.11the event of injury or death of the worker, the daily wage of the worker, for the purpose of
157.12calculating compensation under this chapter, shall be the usual wage paid at the time of the
157.13injury or death for similar services performed in institutions by paid employees;
157.14(22) a voluntary uncompensated worker rendering service directly to the Pollution
157.15Control Agency. The daily wage of the worker for the purpose of calculating compensation
157.16payable under this chapter is the usual going wage paid at the time of injury or death for
157.17similar services if the services are performed by paid employees;
157.18(23) a voluntary uncompensated worker while volunteering services as a first
157.19responder or as a member of a law enforcement assistance organization while acting
157.20under the supervision and authority of a political subdivision. The daily wage of the
157.21worker for the purpose of calculating compensation payable under this chapter is the
157.22usual going wage paid at the time of injury or death for similar services if the services
157.23are performed by paid employees;
157.24(24) a voluntary uncompensated member of the civil air patrol rendering service on
157.25the request and under the authority of the state or any of its political subdivisions. The
157.26daily wage of the member for the purposes of calculating compensation payable under this
157.27chapter is the usual going wage paid at the time of injury or death for similar services if
157.28the services are performed by paid employees; and
157.29(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in
157.30sections
157.31conducted by the commissioner of health. The daily wage of the volunteer for the purposes
157.32of calculating compensation payable under this chapter is established in section
157.33A person who qualifies under this clause and who may also qualify under another clause
157.34of this subdivision shall receive benefits in accordance with this clause.
157.35If it is difficult to determine the daily wage as provided in this subdivision, the trier
157.36of fact may determine the wage upon which the compensation is payable.
158.1 Sec. 3. Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:
158.2 Subd. 2. Personal care provider organizations. The commissioner shall conduct
158.3background studies on any individual required under sections
158.4to
158.5 Sec. 4. Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:
158.6 Subd. 3. Personal care provider organizations. (a) The commissioner shall
158.7conduct a background study of an individual required to be studied under section
158.8subdivision 2
158.9
158.10(b) Organizations required to initiate background studies under sections
158.11
158.12subdivision 2
158.13before those individuals begin a position allowing direct contact with persons served
158.14by the organization.
158.15 Sec. 5. Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:
158.16 Subd. 3. Personal care provider organizations. The commissioner shall recover
158.17the cost of background studies initiated by a personal care provider organization under
158.18sections
158.19more than $20 per study charged to the organization responsible for submitting the
158.20background study form. The fees collected under this subdivision are appropriated to the
158.21commissioner for the purpose of conducting background studies.
158.22 Sec. 6. Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:
158.23 Subd. 16. Personal care services. (a) Notwithstanding any contrary language in
158.24this paragraph, the commissioner of human services and the commissioner of health shall
158.25jointly promulgate rules to be applied to the licensure of personal care services provided
158.26under the medical assistance program. The rules shall consider standards for personal care
158.27services that are based on the World Institute on Disability's recommendations regarding
158.28personal care services. These rules shall at a minimum consider the standards and
158.29requirements adopted by the commissioner of health under section
158.30commissioner of human services determines are applicable to the provision of personal
158.31care services, in addition to other standards or modifications which the commissioner of
158.32human services determines are appropriate.
159.1The commissioner of human services shall establish an advisory group including
159.2personal care consumers and providers to provide advice regarding which standards or
159.3modifications should be adopted. The advisory group membership must include not less
159.4than 15 members, of which at least 60 percent must be consumers of personal care services
159.5and representatives of recipients with various disabilities and diagnoses and ages. At least
159.651 percent of the members of the advisory group must be recipients of personal care.
159.7The commissioner of human services may contract with the commissioner of health
159.8to enforce the jointly promulgated licensure rules for personal care service providers.
159.9Prior to final promulgation of the joint rule the commissioner of human services
159.10shall report preliminary findings along with any comments of the advisory group and a
159.11plan for monitoring and enforcement by the Department of Health to the legislature by
159.12February 15, 1992.
159.13Limits on the extent of personal care services that may be provided to an individual
159.14must be based on the cost-effectiveness of the services in relation to the costs of inpatient
159.15hospital care, nursing home care, and other available types of care. The rules must
159.16provide, at a minimum:
159.17(1) that agencies be selected to contract with or employ and train staff to provide and
159.18supervise the provision of personal care services;
159.19(2) that agencies employ or contract with a qualified applicant that a qualified
159.20recipient proposes to the agency as the recipient's choice of assistant;
159.21(3) that agencies bill the medical assistance program for a personal care service
159.22by a personal care assistant and supervision by a qualified professional supervising the
159.23personal care assistant unless the recipient selects the fiscal agent option under section
159.25(4) that agencies establish a grievance mechanism; and
159.26(5) that agencies have a quality assurance program.
159.27(b) The commissioner may waive the requirement for the provision of personal care
159.28services through an agency in a particular county, when there are less than two agencies
159.29providing services in that county and shall waive the requirement for personal care
159.30assistants required to join an agency for the first time during 1993 when personal care
159.31services are provided under a relative hardship waiver under Minnesota Statutes 1992,
159.32section
159.33providing personal care services have refused to employ or contract with the independent
159.34personal care assistant.
159.35 Sec. 7. Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:
160.1 Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the
160.2person is under age 19 and qualifies as a disabled individual under United States Code,
160.3title 42, section 1382c(a), and would be eligible for medical assistance under the state
160.4plan if residing in a medical institution, and the child requires a level of care provided in
160.5a hospital, nursing facility, or intermediate care facility for persons with developmental
160.6disabilities, for whom home care is appropriate, provided that the cost to medical
160.7assistance under this section is not more than the amount that medical assistance would pay
160.8for if the child resides in an institution. After the child is determined to be eligible under
160.9this section, the commissioner shall review the child's disability under United States Code,
160.10title 42, section 1382c(a) and level of care defined under this section no more often than
160.11annually and may elect, based on the recommendation of health care professionals under
160.12contract with the state medical review team, to extend the review of disability and level of
160.13care up to a maximum of four years. The commissioner's decision on the frequency of
160.14continuing review of disability and level of care is not subject to administrative appeal
160.15under section
160.16enrollee six months prior to the date the recertification of disability is due. Nothing in this
160.17subdivision shall be construed as affecting other redeterminations of medical assistance
160.18eligibility under this chapter and annual cost-effective reviews under this section.
160.19 (b) For purposes of this subdivision, "hospital" means an institution as defined
160.20in section
160.214640.3600, and licensed pursuant to sections
160.22subdivision, a child requires a level of care provided in a hospital if the child is determined
160.23by the commissioner to need an extensive array of health services, including mental health
160.24services, for an undetermined period of time, whose health condition requires frequent
160.25monitoring and treatment by a health care professional or by a person supervised by a
160.26health care professional, who would reside in a hospital or require frequent hospitalization
160.27if these services were not provided, and the daily care needs are more complex than
160.28a nursing facility level of care.
160.29 A child with serious emotional disturbance requires a level of care provided in a
160.30hospital if the commissioner determines that the individual requires 24-hour supervision
160.31because the person exhibits recurrent or frequent suicidal or homicidal ideation or
160.32behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that
160.33may become life threatening, recurrent or frequent severe socially unacceptable behavior
160.34associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing
160.35and chronic developmental problems requiring continuous skilled observation, or severe
161.1disabling symptoms for which office-centered outpatient treatment is not adequate, and
161.2which overall severely impact the individual's ability to function.
161.3 (c) For purposes of this subdivision, "nursing facility" means a facility which
161.4provides nursing care as defined in section
161.5sections
161.6treatment; is in need of special treatments provided or supervised by a licensed nurse; or
161.7has unpredictable episodes of active disease processes requiring immediate judgment
161.8by a licensed nurse. For purposes of this subdivision, a child requires the level of care
161.9provided in a nursing facility if the child is determined by the commissioner to meet
161.10the requirements of the preadmission screening assessment document under section
161.12
161.13and under
161.14 (d) For purposes of this subdivision, "intermediate care facility for persons with
161.15developmental disabilities" or "ICF/MR" means a program licensed to provide services to
161.16persons with developmental disabilities under section
161.17physical plant licensed as a supervised living facility under chapter 144, which together
161.18are certified by the Minnesota Department of Health as meeting the standards in Code of
161.19Federal Regulations, title 42, part 483, for an intermediate care facility which provides
161.20services for persons with developmental disabilities who require 24-hour supervision
161.21and active treatment for medical, behavioral, or habilitation needs. For purposes of this
161.22subdivision, a child requires a level of care provided in an ICF/MR if the commissioner
161.23finds that the child has a developmental disability in accordance with section
161.24is in need of a 24-hour plan of care and active treatment similar to persons with
161.25developmental disabilities, and there is a reasonable indication that the child will need
161.26ICF/MR services.
161.27 (e) For purposes of this subdivision, a person requires the level of care provided
161.28in a nursing facility if the person requires 24-hour monitoring or supervision and a plan
161.29of mental health treatment because of specific symptoms or functional impairments
161.30associated with a serious mental illness or disorder diagnosis, which meet severity criteria
161.31for mental health established by the commissioner and published in March 1997 as
161.32the Minnesota Mental Health Level of Care for Children and Adolescents with Severe
161.33Emotional Disorders.
161.34 (f) The determination of the level of care needed by the child shall be made by
161.35the commissioner based on information supplied to the commissioner by the parent or
161.36guardian, the child's physician or physicians, and other professionals as requested by the
162.1commissioner. The commissioner shall establish a screening team to conduct the level of
162.2care determinations according to this subdivision.
162.3 (g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
162.4must assess the case to determine whether:
162.5 (1) the child qualifies as a disabled individual under United States Code, title 42,
162.6section 1382c(a), and would be eligible for medical assistance if residing in a medical
162.7institution; and
162.8 (2) the cost of medical assistance services for the child, if eligible under this
162.9subdivision, would not be more than the cost to medical assistance if the child resides in a
162.10medical institution to be determined as follows:
162.11 (i) for a child who requires a level of care provided in an ICF/MR, the cost of
162.12care for the child in an institution shall be determined using the average payment rate
162.13established for the regional treatment centers that are certified as ICF's/MR;
162.14 (ii) for a child who requires a level of care provided in an inpatient hospital setting
162.15according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
162.16Rules, part 9505.3520, items F and G; and
162.17 (iii) for a child who requires a level of care provided in a nursing facility according
162.18to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota
162.19Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to
162.20reflect rates which would be paid for children under age 16. The commissioner may
162.21authorize an amount up to the amount medical assistance would pay for a child referred to
162.22the commissioner by the preadmission screening team under section
162.23 (h) Children eligible for medical assistance services under section
162.24subdivision 12
162.25subdivision prior to January 1, 1996. Children found to be ineligible may not be removed
162.26from the program until January 1, 1996.
162.27 Sec. 8. Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:
162.28 Subd. 2. Targeted case management; definitions. For purposes of subdivisions 3
162.29to 10, the following terms have the meanings given them:
162.30 (1) "home care service recipients" means those individuals receiving the following
162.31services under sections
162.32home health aide visits, private duty nursing, personal care assistants, or therapies
162.33provided through a home health agency;
163.1 (2) "home care targeted case management" means the provision of targeted case
163.2management services for the purpose of assisting home care service recipients to gain
163.3access to needed services and supports so that they may remain in the community;
163.4 (3) "institutions" means hospitals, consistent with Code of Federal Regulations, title
163.542, section
163.7disabilities;
163.8 (4) "relocation targeted case management" includes the provision of both county
163.9targeted case management and public or private vendor service coordination services
163.10for the purpose of assisting recipients to gain access to needed services and supports if
163.11they choose to move from an institution to the community. Relocation targeted case
163.12management may be provided during the lesser of:
163.13 (i) the last 180 consecutive days of an eligible recipient's institutional stay; or
163.14 (ii) the limits and conditions which apply to federal Medicaid funding for this
163.15service; and
163.16 (5) "targeted case management" means case management services provided to help
163.17recipients gain access to needed medical, social, educational, and other services and
163.18supports.
163.19 Sec. 9. Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to read:
163.20 Subd. 3. Assessment and prior authorization process. Effective January 1, 1996,
163.21for purposes of providing informed choice, coordinating of local planning decisions, and
163.22streamlining administrative requirements, the assessment and prior authorization process
163.23for persons receiving both home care and home and community-based waivered services
163.24for persons with developmental disabilities shall meet the requirements of sections
163.26(a) Upon request for home care services and subsequent assessment by the public
163.27health nurse under sections
163.28the public health nurse shall participate in the screening process, as appropriate, and,
163.29if home care services are determined to be necessary, participate in the development
163.30of a service plan coordinating the need for home care and home and community-based
163.31waivered services with the assigned county case manager, the recipient of services, and
163.32the recipient's legal representative, if any.
163.33(b) The public health nurse shall give prior authorization for home care services
163.34to the extent that home care services are:
163.35(1) medically necessary;
164.1(2) chosen by the recipient and their legal representative, if any, from the array of
164.2home care and home and community-based waivered services available;
164.3(3) coordinated with other services to be received by the recipient as described
164.4in the service plan; and
164.5(4) provided within the county's reimbursement limits for home care and home and
164.6community-based waivered services for persons with developmental disabilities.
164.7(c) If the public health agency is or may be the provider of home care services to the
164.8recipient, the public health agency shall provide the commissioner of human services with
164.9a written plan that specifies how the assessment and prior authorization process will be
164.10held separate and distinct from the provision of services.
164.11 Sec. 10. Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to
164.12read:
164.13 Subd. 2. Eligibility. (a) The self-directed supports option is available to a person
164.14who:
164.15 (1) is a recipient of medical assistance as determined under sections
164.17 (2) is eligible for personal care assistant services under section
164.18256B.0659;
164.19 (3) lives in the person's own apartment or home, which is not owned, operated, or
164.20controlled by a provider of services not related by blood or marriage;
164.21 (4) has the ability to hire, fire, supervise, establish staff compensation for, and
164.22manage the individuals providing services, and to choose and obtain items, related
164.23services, and supports as described in the participant's plan. If the recipient is not able to
164.24carry out these functions but has a legal guardian or parent to carry them out, the guardian
164.25or parent may fulfill these functions on behalf of the recipient; and
164.26 (5) has not been excluded or disenrolled by the commissioner.
164.27 (b) The commissioner may disenroll or exclude recipients, including guardians and
164.28parents, under the following circumstances:
164.29 (1) recipients who have been restricted by the Primary Care Utilization Review
164.30Committee may be excluded for a specified time period;
164.31 (2) recipients who exit the self-directed supports option during the recipient's
164.32service plan year shall not access the self-directed supports option for the remainder of
164.33that service plan year; and
164.34 (3) when the department determines that the recipient cannot manage recipient
164.35responsibilities under the program.
165.1 Sec. 11. Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to
165.2read:
165.3 Subd. 6. Services covered. (a) Services covered under the self-directed supports
165.4option include:
165.5 (1) personal care assistant services under section
165.6 (2) items, related services, and supports, including assistive technology, that increase
165.7independence or substitute for human assistance to the extent expenditures would
165.8otherwise be used for human assistance.
165.9 (b) Items, supports, and related services purchased under this option shall not be
165.10considered home care services for the purposes of section
165.11 Sec. 12. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to
165.12read:
165.13 Subd. 8. Self-directed budget requirements. The budget for the provision of the
165.14self-directed service option shall be equal to the greater of either:
165.15 (1) the annual amount of personal care assistant services under section
165.16256B.0659 that the recipient has used in the most recent 12-month period; or
165.17 (2) the amount determined using the consumer support grant methodology under
165.18section
165.19and nonfederal share of the average service costs.
165.20 Sec. 13. Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:
165.21 Subd. 17. Cost of services and supports. (a) The commissioner shall ensure
165.22that the average per capita expenditures estimated in any fiscal year for home and
165.23community-based waiver recipients does not exceed the average per capita expenditures
165.24that would have been made to provide institutional services for recipients in the absence
165.25of the waiver.
165.26(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
165.27need-based methods for allocating to local agencies the home and community-based
165.28waivered service resources available to support recipients with disabilities in need of
165.29the level of care provided in a nursing facility or a hospital. The commissioner shall
165.30allocate resources to single counties and county partnerships in a manner that reflects
165.31consideration of:
165.32(1) an incentive-based payment process for achieving outcomes;
165.33(2) the need for a state-level risk pool;
165.34(3) the need for retention of management responsibility at the state agency level; and
166.1(4) a phase-in strategy as appropriate.
166.2(c) Until the allocation methods described in paragraph (b) are implemented, the
166.3annual allowable reimbursement level of home and community-based waiver services
166.4shall be the greater of:
166.5(1) the statewide average payment amount which the recipient is assigned under the
166.6waiver reimbursement system in place on June 30, 2001, modified by the percentage of
166.7any provider rate increase appropriated for home and community-based services; or
166.8(2) an amount approved by the commissioner based on the recipient's extraordinary
166.9needs that cannot be met within the current allowable reimbursement level. The
166.10increased reimbursement level must be necessary to allow the recipient to be discharged
166.11from an institution or to prevent imminent placement in an institution. The additional
166.12reimbursement may be used to secure environmental modifications; assistive technology
166.13and equipment; and increased costs for supervision, training, and support services
166.14necessary to address the recipient's extraordinary needs. The commissioner may approve
166.15an increased reimbursement level for up to one year of the recipient's relocation from an
166.16institution or up to six months of a determination that a current waiver recipient is at
166.17imminent risk of being placed in an institution.
166.18(d) Beginning July 1, 2001, medically necessary private duty nursing services
166.19will be authorized under this section as complex and regular care according to sections
166.21commissioner for registered nurse or licensed practical nurse services under any home and
166.22community-based waiver as of January 1, 2001, shall not be reduced.
166.23 Sec. 14. Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to
166.24read:
166.25 Subd. 4a. Inclusion of home care costs in waiver rates. The commissioner
166.26shall adjust the limits of the established average daily reimbursement rates for waivered
166.27services to include the cost of home care services that may be provided to waivered
166.28services recipients. This adjustment must be used to maintain or increase services and
166.29shall not be used by county agencies for inflation increases for waivered services vendors.
166.30Home care services referenced in this section are those listed in section
166.31subdivision 2
166.32the provisions of this subdivision apply only to the combined average, daily costs of
166.33waivered and home care services and do not change home care limitations under sections
167.1receiving home care as of June 30, 1992, shall not have the amount of their services
167.2reduced as a result of this section.
167.3 Sec. 15. Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:
167.4 Subd. 6. Excluded time. "Excluded time" means:
167.5(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter
167.6other than an emergency shelter, halfway house, foster home, semi-independent living
167.7domicile or services program, residential facility offering care, board and lodging facility
167.8or other institution for the hospitalization or care of human beings, as defined in section
167.10or correctional facility; or any facility based on an emergency hold under sections
167.12(b) any period an applicant spends on a placement basis in a training and habilitation
167.13program, including a rehabilitation facility or work or employment program as defined
167.14in section
167.16section
167.17habilitation programs and assisted living services; and
167.18(c) any placement for a person with an indeterminate commitment, including
167.19independent living.
167.20 Sec. 16. Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:
167.21 Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section
167.23for other services necessary to provide room and board provided by the group residence
167.24if the residence is licensed by or registered by the Department of Health, or licensed by
167.25the Department of Human Services to provide services in addition to room and board,
167.26and if the provider of services is not also concurrently receiving funding for services for
167.27a recipient under a home and community-based waiver under title XIX of the Social
167.28Security Act; or funding from the medical assistance program under section
167.29
167.30in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000.
167.31If funding is available for other necessary services through a home and community-based
167.32waiver, or personal care services under section
167.33then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided
167.34in law, in no case may the supplementary service rate exceed $426.37. The registration
168.1and licensure requirement does not apply to establishments which are exempt from state
168.2licensure because they are located on Indian reservations and for which the tribe has
168.3prescribed health and safety requirements. Service payments under this section may be
168.4prohibited under rules to prevent the supplanting of federal funds with state funds. The
168.5commissioner shall pursue the feasibility of obtaining the approval of the Secretary of
168.6Health and Human Services to provide home and community-based waiver services under
168.7title XIX of the Social Security Act for residents who are not eligible for an existing home
168.8and community-based waiver due to a primary diagnosis of mental illness or chemical
168.9dependency and shall apply for a waiver if it is determined to be cost-effective.
168.10(b) The commissioner is authorized to make cost-neutral transfers from the GRH
168.11fund for beds under this section to other funding programs administered by the department
168.12after consultation with the county or counties in which the affected beds are located.
168.13The commissioner may also make cost-neutral transfers from the GRH fund to county
168.14human service agencies for beds permanently removed from the GRH census under a plan
168.15submitted by the county agency and approved by the commissioner. The commissioner
168.16shall report the amount of any transfers under this provision annually to the legislature.
168.17(c) The provisions of paragraph (b) do not apply to a facility that has its
168.18reimbursement rate established under section
168.19 Sec. 17. Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:
168.20 Subd. 3. Good cause exemptions for not attending orientation. (a) The county
168.21agency shall not impose the sanction under section
168.22participant has good cause for failing to attend orientation. Good cause exists when:
168.23(1) appropriate child care is not available;
168.24(2) the participant is ill or injured;
168.25(3) a family member is ill and needs care by the participant that prevents the
168.26participant from attending orientation. For a caregiver with a child or adult in the
168.27household who meets the disability or medical criteria for home care services under
168.28section
168.29services program under chapter 256B, or meets the criteria for severe emotional
168.30disturbance under section
168.31illness under section
168.32an interruption in the provision of those services occurs which prevents the participant
168.33from attending orientation;
168.34(4) the caregiver is unable to secure necessary transportation;
168.35(5) the caregiver is in an emergency situation that prevents orientation attendance;
169.1(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
169.2(7) the caregiver documents other verifiable impediments to orientation attendance
169.3beyond the caregiver's control.
169.4(b) Counties must work with clients to provide child care and transportation
169.5necessary to ensure a caregiver has every opportunity to attend orientation.
169.6 Sec. 18. Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:
169.7 Subdivision 1. Application. This section applies to residential treatment programs
169.8for children or group homes for children licensed under chapter 245A, residential
169.9services and programs for juveniles licensed under section
169.10pursuant to sections
169.11provider organizations under section
169.12of day training and habilitation services under sections
169.13lodging facilities licensed under chapter 157, intermediate care facilities for persons with
169.14developmental disabilities, and other facilities licensed to provide residential services to
169.15persons with developmental disabilities.
169.16 Sec. 19. Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:
169.17 Subd. 11. Vulnerable adult. "Vulnerable adult" means any person 18 years of
169.18age or older who:
169.19(1) is a resident inpatient of a facility;
169.20(2) receives services at or from a facility required to be licensed to serve adults
169.21under sections
169.22treatment of chemical dependency or mental illness, or one who is committed as a sexual
169.23psychopathic personality or as a sexually dangerous person under chapter 253B, is not
169.24considered a vulnerable adult unless the person meets the requirements of clause (4);
169.25(3) receives services from a home care provider required to be licensed under section
169.27for personal care assistant services under the medical assistance program as authorized
169.28under sections
169.29
169.30(4) regardless of residence or whether any type of service is received, possesses a
169.31physical or mental infirmity or other physical, mental, or emotional dysfunction:
169.32(i) that impairs the individual's ability to provide adequately for the individual's
169.33own care without assistance, including the provision of food, shelter, clothing, health
169.34care, or supervision; and
170.1(ii) because of the dysfunction or infirmity and the need for assistance, the individual
170.2has an impaired ability to protect the individual from maltreatment.
170.3 Sec. 20. Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:
170.4 Subd. 6. Facility. (a) "Facility" means a hospital or other entity required to be
170.5licensed under sections
170.6serve adults under section
170.7be licensed to serve adults under sections
170.8licensed or required to be licensed under section
170.9under sections
170.10provides, or arranges for personal care assistant services under the medical assistance
170.11program as authorized under sections
170.1219a
170.13(b) For home care providers and personal care attendants, the term "facility" refers
170.14to the provider or person or organization that exclusively offers, provides, or arranges for
170.15personal care services, and does not refer to the client's home or other location at which
170.16services are rendered.
170.17 Sec. 21. Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to
170.18read:
170.19 Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of
170.20age or older who:
170.21 (1) is a resident or inpatient of a facility;
170.22 (2) receives services at or from a facility required to be licensed to serve adults
170.23under sections
170.24treatment of chemical dependency or mental illness, or one who is served in the Minnesota
170.25sex offender program on a court-hold order for commitment, or is committed as a sexual
170.26psychopathic personality or as a sexually dangerous person under chapter 253B, is not
170.27considered a vulnerable adult unless the person meets the requirements of clause (4);
170.28 (3) receives services from a home care provider required to be licensed under section
170.30for personal care assistant services under the medical assistance program as authorized
170.31under sections
170.33 (4) regardless of residence or whether any type of service is received, possesses a
170.34physical or mental infirmity or other physical, mental, or emotional dysfunction:
171.1 (i) that impairs the individual's ability to provide adequately for the individual's
171.2own care without assistance, including the provision of food, shelter, clothing, health
171.3care, or supervision; and
171.4 (ii) because of the dysfunction or infirmity and the need for assistance, the individual
171.5has an impaired ability to protect the individual from maltreatment.
171.8 Section 1. Minnesota Statutes 2008, section 245.462, subdivision 18, is amended to
171.9read:
171.10 Subd. 18. Mental health professional. "Mental health professional" means a
171.11person providing clinical services in the treatment of mental illness who is qualified in at
171.12least one of the following ways:
171.13 (1) in psychiatric nursing: a registered nurse who is licensed under sections
171.14to
171.15 (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family
171.16psychiatric and mental health nursing by a national nurse certification organization; or
171.17 (ii) who has a master's degree in nursing or one of the behavioral sciences or related
171.18fields from an accredited college or university or its equivalent, with at least 4,000 hours
171.19of post-master's supervised experience in the delivery of clinical services in the treatment
171.20of mental illness;
171.21 (2) in clinical social work: a person licensed as an independent clinical social worker
171.22under chapter 148D, or a person with a master's degree in social work from an accredited
171.23college or university, with at least 4,000 hours of post-master's supervised experience in
171.24the delivery of clinical services in the treatment of mental illness;
171.25 (3) in psychology: an individual licensed by the Board of Psychology under sections
171.27and treatment of mental illness;
171.28 (4) in psychiatry: a physician licensed under chapter 147 and certified by the
171.29American Board of Psychiatry and Neurology or eligible for board certification in
171.30psychiatry;
171.31 (5) in marriage and family therapy: the mental health professional must be a
171.32marriage and family therapist licensed under sections
171.33two years of post-master's supervised experience in the delivery of clinical services in
171.34the treatment of mental illness;
172.1 (6) in licensed professional clinical counseling, the mental health professional
172.2shall be a licensed professional clinical counselor under section 148B.5301 with at least
172.34,000 hours of postmaster's supervised experience in the delivery of clinical services in
172.4the treatment of mental illness; or
172.5 (7) in allied fields: a person with a master's degree from an accredited college or
172.6university in one of the behavioral sciences or related fields, with at least 4,000 hours of
172.7post-master's supervised experience in the delivery of clinical services in the treatment of
172.8mental illness.
172.9 Sec. 2. Minnesota Statutes 2008, section 245.470, subdivision 1, is amended to read:
172.10 Subdivision 1. Availability of outpatient services. (a) County boards must provide
172.11or contract for enough outpatient services within the county to meet the needs of adults
172.12with mental illness residing in the county. Services may be provided directly by the
172.13county through county-operated mental health centers or mental health clinics approved
172.14by the commissioner under section
172.15operated mental health centers or mental health clinics approved by the commissioner
172.16under section
172.17programs certified by the Joint Commission on Accreditation of Hospital Organizations;
172.18or by contract with a licensed mental health professional as defined in section
172.19subdivision 18
172.20section
172.21 (1) conducting diagnostic assessments;
172.22 (2) conducting psychological testing;
172.23 (3) developing or modifying individual treatment plans;
172.24 (4) making referrals and recommending placements as appropriate;
172.25 (5) treating an adult's mental health needs through therapy;
172.26 (6) prescribing and managing medication and evaluating the effectiveness of
172.27prescribed medication; and
172.28 (7) preventing placement in settings that are more intensive, costly, or restrictive
172.29than necessary and appropriate to meet client needs.
172.30 (b) County boards may request a waiver allowing outpatient services to be provided
172.31in a nearby trade area if it is determined that the client can best be served outside the
172.32county.
172.33 Sec. 3. Minnesota Statutes 2008, section 245.4871, subdivision 27, is amended to read:
173.1 Subd. 27. Mental health professional. "Mental health professional" means a
173.2person providing clinical services in the diagnosis and treatment of children's emotional
173.3disorders. A mental health professional must have training and experience in working with
173.4children consistent with the age group to which the mental health professional is assigned.
173.5A mental health professional must be qualified in at least one of the following ways:
173.6 (1) in psychiatric nursing, the mental health professional must be a registered nurse
173.7who is licensed under sections
173.8specialist in child and adolescent psychiatric or mental health nursing by a national nurse
173.9certification organization or who has a master's degree in nursing or one of the behavioral
173.10sciences or related fields from an accredited college or university or its equivalent, with
173.11at least 4,000 hours of post-master's supervised experience in the delivery of clinical
173.12services in the treatment of mental illness;
173.13 (2) in clinical social work, the mental health professional must be a person licensed
173.14as an independent clinical social worker under chapter 148D, or a person with a master's
173.15degree in social work from an accredited college or university, with at least 4,000 hours of
173.16post-master's supervised experience in the delivery of clinical services in the treatment
173.17of mental disorders;
173.18 (3) in psychology, the mental health professional must be an individual licensed by
173.19the board of psychology under sections
173.20psychology competencies in the diagnosis and treatment of mental disorders;
173.21 (4) in psychiatry, the mental health professional must be a physician licensed under
173.22chapter 147 and certified by the American board of psychiatry and neurology or eligible
173.23for board certification in psychiatry;
173.24 (5) in marriage and family therapy, the mental health professional must be a
173.25marriage and family therapist licensed under sections
173.26two years of post-master's supervised experience in the delivery of clinical services in the
173.27treatment of mental disorders or emotional disturbances;
173.28 (6) in licensed professional clinical counseling, the mental health professional shall
173.29be a licensed professional clinical counselor under section 148B.5301 with at least 4,000
173.30hours of postmaster's supervised experience in the delivery of clinical services in the
173.31treatment of mental disorders or emotional disturbances; or
173.32 (7) in allied fields, the mental health professional must be a person with a master's
173.33degree from an accredited college or university in one of the behavioral sciences or related
173.34fields, with at least 4,000 hours of post-master's supervised experience in the delivery of
173.35clinical services in the treatment of emotional disturbances.
174.1 Sec. 4. Minnesota Statutes 2008, section 245.488, subdivision 1, is amended to read:
174.2 Subdivision 1. Availability of outpatient services. (a) County boards must provide
174.3or contract for enough outpatient services within the county to meet the needs of each
174.4child with emotional disturbance residing in the county and the child's family. Services
174.5may be provided directly by the county through county-operated mental health centers or
174.6mental health clinics approved by the commissioner under section
174.7by contract with privately operated mental health centers or mental health clinics approved
174.8by the commissioner under section
174.9mental health outpatient programs certified by the Joint Commission on Accreditation
174.10of Hospital Organizations; or by contract with a licensed mental health professional as
174.11defined in section
174.12parent may be required to pay a fee based in accordance with section
174.13services include:
174.14 (1) conducting diagnostic assessments;
174.15 (2) conducting psychological testing;
174.16 (3) developing or modifying individual treatment plans;
174.17 (4) making referrals and recommending placements as appropriate;
174.18 (5) treating the child's mental health needs through therapy; and
174.19 (6) prescribing and managing medication and evaluating the effectiveness of
174.20prescribed medication.
174.21 (b) County boards may request a waiver allowing outpatient services to be provided
174.22in a nearby trade area if it is determined that the child requires necessary and appropriate
174.23services that are only available outside the county.
174.24 (c) Outpatient services offered by the county board to prevent placement must be at
174.25the level of treatment appropriate to the child's diagnostic assessment.
174.26 Sec. 5. Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision
174.27to read:
174.28 Subd. 8a. Placing authority. "Placing authority" means a county, prepaid health
174.29plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to
174.309530.6655.
174.31 Sec. 6. Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision
174.32to read:
174.33 Subd. 6. Monitoring. The commissioner shall gather and placing authorities shall
174.34provide information to measure compliance with Minnesota Rules, parts 9530.6600 to
175.19530.6655. The commissioner shall specify the format for data collection to facilitate
175.2tracking, aggregating, and using the information.
175.3 Sec. 7. Minnesota Statutes 2008, section 254B.03, subdivision 1, is amended to read:
175.4 Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
175.5dependency services to persons residing within its jurisdiction who meet criteria
175.6established by the commissioner for placement in a chemical dependency residential or
175.7nonresidential treatment service. Chemical dependency money must be administered
175.8by the local agencies according to law and rules adopted by the commissioner under
175.9sections
175.10 (b) In order to contain costs,
175.11commissioner of human services
175.12services who can provide economical and appropriate treatment. Unless the local agency
175.13is a social services department directly administered by a county or human services board,
175.14the local agency shall not be an eligible vendor under section
175.15may approve proposals from county boards to provide services in an economical manner
175.16or to control utilization, with safeguards to ensure that necessary services are provided.
175.17If a county implements a demonstration or experimental medical services funding plan,
175.18the commissioner shall transfer the money as appropriate.
175.19
175.20
175.21 (c) A culturally specific vendor that provides assessments under a variance under
175.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
175.23persons not covered by the variance.
175.24EFFECTIVE DATE.This section is effective July 1, 2011.
175.25 Sec. 8. Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read:
175.26 Subd. 3. Local agencies to pay state for county share. Local agencies shall pay
175.27the state for the county share of the services authorized by the local agency, except when
175.28the payment is made according to section 254B.09, subdivision 8.
175.29 Sec. 9. Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision
175.30to read:
175.31 Subd. 9. Commissioner to select vendors and set rates. (a) Effective July 1, 2011,
175.32the commissioner shall:
175.33(1) enter into agreements with eligible vendors that:
176.1(i) meet the standards in section 254B.05, subdivision 1;
176.2(ii) have good standing in all applicable licensure; and
176.3(iii) have a current approved provider agreement as a Minnesota health care program
176.4provider; and
176.5(2) set rates for services reimbursed under this chapter.
176.6(b) When setting rates, the commissioner shall consider the complexity and the
176.7acuity of the problems presented by the client.
176.8(c) When rates set under this section and rates set under section 254B.09, subdivision
176.98, apply to the same treatment placement, section 254B.09, subdivision 8, supersedes.
176.10 Sec. 10. Minnesota Statutes 2008, section 254B.05, subdivision 1, is amended to read:
176.11 Subdivision 1. Licensure required. Programs licensed by the commissioner are
176.12eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
176.13notwithstanding the provisions of section
176.14federally recognized tribal lands that provide chemical dependency primary treatment,
176.15extended care, transitional residence, or outpatient treatment services, and are licensed by
176.16tribal government are eligible vendors. Detoxification programs are not eligible vendors.
176.17Programs that are not licensed as a chemical dependency residential or nonresidential
176.18treatment program by the commissioner or by tribal government are not eligible vendors.
176.19To be eligible for payment under the Consolidated Chemical Dependency Treatment Fund,
176.20a vendor of a chemical dependency service must participate in the Drug and Alcohol
176.21Abuse Normative Evaluation System and the treatment accountability plan.
176.22Effective January 1, 2000, vendors of room and board are eligible for chemical
176.23dependency fund payment if the vendor:
176.24(1)
176.25residents bringing chemicals into the facility or using chemicals while residing in the
176.26facility and provide consequences for infractions of those rules;
176.27(2) has a current contract with a county or tribal governing body;
176.28(3) is determined to meet applicable health and safety requirements;
176.29(4) is not a jail or prison; and
176.30(5) is not concurrently receiving funds under chapter 256I for the recipient.
176.31EFFECTIVE DATE.This section is effective July 1, 2011.
176.32 Sec. 11. Minnesota Statutes 2008, section 254B.09, subdivision 2, is amended to read:
176.33 Subd. 2. American Indian agreements. The commissioner may enter into
176.34agreements with federally recognized tribal units to pay for chemical dependency
177.1treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The
177.2agreements must clarify how the governing body of the tribal unit fulfills local agency
177.3responsibilities regarding:
177.4
177.5
177.6
177.7
177.8
177.9will be included in invoices sent to the commissioner for payment, to the extent that
177.10money allocated under subdivisions 4 and 5 is used.
177.11EFFECTIVE DATE.This section is effective July 1, 2011.
177.12 Sec. 12. [254B.11] MAXIMUM RATES.
177.13The commissioner shall publish maximum rates for vendors of the consolidated
177.14chemical dependency treatment fund by July 1 of each year for implementation the
177.15following January 1. Rates for calendar year 2010 must not exceed 185 percent of the
177.16average rate on January 1, 2009, for each group of vendors with similar attributes. Unless
177.17a new rate methodology is developed under section 254B.12, rates for services provided on
177.18and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009,
177.19for each group of vendors with similar attributes. Payment for services provided by Indian
177.20Health Services or by agencies operated by Indian tribes for medical assistance-eligible
177.21individuals must be governed by the applicable federal rate methodology.
177.22 Sec. 13. [254B.12] RATE METHODOLOGY.
177.23The commissioner shall, with broad-based stakeholder input, develop a
177.24recommendation and present a report to the 2011 legislature, including proposed
177.25legislation for a new rate methodology for the consolidated chemical dependency
177.26treatment fund. The new methodology must replace county-negotiated rates with a
177.27uniform statewide methodology that must include a graduated reimbursement scale based
177.28on the patients' level of acuity and complexity.
177.29 Sec. 14. Minnesota Statutes 2008, section 256B.0622, subdivision 2, is amended to
177.30read:
177.31 Subd. 2. Definitions. For purposes of this section, the following terms have the
177.32meanings given them.
178.1 (a) "Intensive nonresidential rehabilitative mental health services" means adult
178.2rehabilitative mental health services as defined in section
178.3paragraph (a), except that these services are provided by a multidisciplinary staff using
178.4a total team approach consistent with assertive community treatment, the Fairweather
178.5Lodge treatment model, as defined by the standards established by the National Coalition
178.6for Community Living, and other evidence-based practices, and directed to recipients with
178.7a serious mental illness who require intensive services.
178.8 (b) "Intensive residential rehabilitative mental health services" means short-term,
178.9time-limited services provided in a residential setting to recipients who are in need of
178.10more restrictive settings and are at risk of significant functional deterioration if they do
178.11not receive these services. Services are designed to develop and enhance psychiatric
178.12stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more
178.13independent setting. Services must be directed toward a targeted discharge date with
178.14specified client outcomes and must be consistent with the Fairweather Lodge treatment
178.15model as defined in paragraph (a), and other evidence-based practices.
178.16 (c) "Evidence-based practices" are nationally recognized mental health services that
178.17are proven by substantial research to be effective in helping individuals with serious
178.18mental illness obtain specific treatment goals.
178.19 (d) "Overnight staff" means a member of the intensive residential rehabilitative
178.20mental health treatment team who is responsible during hours when recipients are
178.21typically asleep.
178.22 (e) "Treatment team" means all staff who provide services under this section to
178.23recipients. At a minimum, this includes the clinical supervisor, mental health professionals
178.24as defined in section
178.25practitioners as defined in section
178.26workers under section
178.27under section
178.28 Sec. 15. Minnesota Statutes 2008, section 256B.0623, subdivision 5, is amended to
178.29read:
178.30 Subd. 5. Qualifications of provider staff. Adult rehabilitative mental health
178.31services must be provided by qualified individual provider staff of a certified provider
178.32entity. Individual provider staff must be qualified under one of the following criteria:
178.33 (1) a mental health professional as defined in section
178.34clauses (1) to
178.35mental health professional as defined in section
179.1(6), recommending receipt of adult mental health rehabilitative services, the definition of
179.2mental health professional for purposes of this section includes a person who is qualified
179.3under section
179.4national certification as a certified rehabilitation counselor or certified psychosocial
179.5rehabilitation practitioner;
179.6 (2) a mental health practitioner as defined in section
179.7mental health practitioner must work under the clinical supervision of a mental health
179.8professional;
179.9 (3) a certified peer specialist under section
179.10must work under the clinical supervision of a mental health professional; or
179.11 (4) a mental health rehabilitation worker. A mental health rehabilitation worker
179.12means a staff person working under the direction of a mental health practitioner or mental
179.13health professional and under the clinical supervision of a mental health professional in
179.14the implementation of rehabilitative mental health services as identified in the recipient's
179.15individual treatment plan who:
179.16 (i) is at least 21 years of age;
179.17 (ii) has a high school diploma or equivalent;
179.18 (iii) has successfully completed 30 hours of training during the past two years in all
179.19of the following areas: recipient rights, recipient-centered individual treatment planning,
179.20behavioral terminology, mental illness, co-occurring mental illness and substance abuse,
179.21psychotropic medications and side effects, functional assessment, local community
179.22resources, adult vulnerability, recipient confidentiality; and
179.23 (iv) meets the qualifications in subitem (A) or (B):
179.24 (A) has an associate of arts degree in one of the behavioral sciences or human
179.25services, or is a registered nurse without a bachelor's degree, or who within the previous
179.26ten years has:
179.27 (1) three years of personal life experience with serious and persistent mental illness;
179.28 (2) three years of life experience as a primary caregiver to an adult with a serious
179.29mental illness or traumatic brain injury; or
179.30 (3) 4,000 hours of supervised paid work experience in the delivery of mental health
179.31services to adults with a serious mental illness or traumatic brain injury; or
179.32 (B)(1) is fluent in the non-English language or competent in the culture of the
179.33ethnic group to which at least 20 percent of the mental health rehabilitation worker's
179.34clients belong;
179.35 (2) receives during the first 2,000 hours of work, monthly documented individual
179.36clinical supervision by a mental health professional;
180.1 (3) has 18 hours of documented field supervision by a mental health professional
180.2or practitioner during the first 160 hours of contact work with recipients, and at least six
180.3hours of field supervision quarterly during the following year;
180.4 (4) has review and cosignature of charting of recipient contacts during field
180.5supervision by a mental health professional or practitioner; and
180.6 (5) has 40 hours of additional continuing education on mental health topics during
180.7the first year of employment.
180.8 Sec. 16. Minnesota Statutes 2008, section 256B.0624, subdivision 5, is amended to
180.9read:
180.10 Subd. 5. Mobile crisis intervention staff qualifications. For provision of adult
180.11mental health mobile crisis intervention services, a mobile crisis intervention team is
180.12comprised of at least two mental health professionals as defined in section
180.13subdivision 18
180.14professional and one mental health practitioner as defined in section
180.1517
180.16a mental health professional on the team. The team must have at least two people with
180.17at least one member providing on-site crisis intervention services when needed. Team
180.18members must be experienced in mental health assessment, crisis intervention techniques,
180.19and clinical decision-making under emergency conditions and have knowledge of local
180.20services and resources. The team must recommend and coordinate the team's services
180.21with appropriate local resources such as the county social services agency, mental health
180.22services, and local law enforcement when necessary.
180.23 Sec. 17. Minnesota Statutes 2008, section 256B.0624, subdivision 8, is amended to
180.24read:
180.25 Subd. 8. Adult crisis stabilization staff qualifications. (a) Adult mental health
180.26crisis stabilization services must be provided by qualified individual staff of a qualified
180.27provider entity. Individual provider staff must have the following qualifications:
180.28 (1) be a mental health professional as defined in section
180.29clauses (1) to
180.30 (2) be a mental health practitioner as defined in section
180.31The mental health practitioner must work under the clinical supervision of a mental health
180.32professional; or
180.33 (3) be a mental health rehabilitation worker who meets the criteria in section
181.1practitioner as defined in section
181.2mental health professional; and works under the clinical supervision of a mental health
181.3professional.
181.4 (b) Mental health practitioners and mental health rehabilitation workers must have
181.5completed at least 30 hours of training in crisis intervention and stabilization during
181.6the past two years.
181.7 Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 42, is amended to
181.8read:
181.9 Subd. 42. Mental health professional. Notwithstanding Minnesota Rules, part
181.109505.0175, subpart 28, the definition of a mental health professional shall include a person
181.11who is qualified as specified in section
181.12or
181.13Minnesota Rules, parts 9505.0170 to 9505.0475.
181.14 Sec. 19. Minnesota Statutes 2008, section 256B.0943, subdivision 1, is amended to
181.15read:
181.16 Subdivision 1. Definitions. For purposes of this section, the following terms have
181.17the meanings given them.
181.18 (a) "Children's therapeutic services and supports" means the flexible package of
181.19mental health services for children who require varying therapeutic and rehabilitative
181.20levels of intervention. The services are time-limited interventions that are delivered using
181.21various treatment modalities and combinations of services designed to reach treatment
181.22outcomes identified in the individual treatment plan.
181.23 (b) "Clinical supervision" means the overall responsibility of the mental health
181.24professional for the control and direction of individualized treatment planning, service
181.25delivery, and treatment review for each client. A mental health professional who is an
181.26enrolled Minnesota health care program provider accepts full professional responsibility
181.27for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
181.28and oversees or directs the supervisee's work.
181.29 (c) "County board" means the county board of commissioners or board established
181.30under sections
181.31 (d) "Crisis assistance" has the meaning given in section
181.32 (e) "Culturally competent provider" means a provider who understands and can
181.33utilize to a client's benefit the client's culture when providing services to the client. A
181.34provider may be culturally competent because the provider is of the same cultural or
182.1ethnic group as the client or the provider has developed the knowledge and skills through
182.2training and experience to provide services to culturally diverse clients.
182.3 (f) "Day treatment program" for children means a site-based structured program
182.4consisting of group psychotherapy for more than three individuals and other intensive
182.5therapeutic services provided by a multidisciplinary team, under the clinical supervision
182.6of a mental health professional.
182.7 (g) "Diagnostic assessment" has the meaning given in section
182.811
182.9 (h) "Direct service time" means the time that a mental health professional, mental
182.10health practitioner, or mental health behavioral aide spends face-to-face with a client
182.11and the client's family. Direct service time includes time in which the provider obtains
182.12a client's history or provides service components of children's therapeutic services and
182.13supports. Direct service time does not include time doing work before and after providing
182.14direct services, including scheduling, maintaining clinical records, consulting with others
182.15about the client's mental health status, preparing reports, receiving clinical supervision
182.16directly related to the client's psychotherapy session, and revising the client's individual
182.17treatment plan.
182.18 (i) "Direction of mental health behavioral aide" means the activities of a mental
182.19health professional or mental health practitioner in guiding the mental health behavioral
182.20aide in providing services to a client. The direction of a mental health behavioral aide
182.21must be based on the client's individualized treatment plan and meet the requirements in
182.22subdivision 6, paragraph (b), clause (5).
182.23 (j) "Emotional disturbance" has the meaning given in section
182.2415
182.25section
182.26 (k) "Individual behavioral plan" means a plan of intervention, treatment, and
182.27services for a child written by a mental health professional or mental health practitioner,
182.28under the clinical supervision of a mental health professional, to guide the work of the
182.29mental health behavioral aide.
182.30 (l) "Individual treatment plan" has the meaning given in section
182.31subdivision 21
182.32 (m) "Mental health professional" means an individual as defined in section
182.33subdivision 27
182.34subdivision 7
182.35 (n) "Preschool program" means a day program licensed under Minnesota Rules,
182.36parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
183.1supports provider to provide a structured treatment program to a child who is at least 33
183.2months old but who has not yet attended the first day of kindergarten.
183.3 (o) "Skills training" means individual, family, or group training designed to improve
183.4the basic functioning of the child with emotional disturbance and the child's family in the
183.5activities of daily living and community living, and to improve the social functioning of the
183.6child and the child's family in areas important to the child's maintaining or reestablishing
183.7residency in the community. Individual, family, and group skills training must:
183.8 (1) consist of activities designed to promote skill development of the child and the
183.9child's family in the use of age-appropriate daily living skills, interpersonal and family
183.10relationships, and leisure and recreational services;
183.11 (2) consist of activities that will assist the family's understanding of normal child
183.12development and to use parenting skills that will help the child with emotional disturbance
183.13achieve the goals outlined in the child's individual treatment plan; and
183.14 (3) promote family preservation and unification, promote the family's integration
183.15with the community, and reduce the use of unnecessary out-of-home placement or
183.16institutionalization of children with emotional disturbance.
183.17 Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to
183.18read:
183.19 Subd. 47. Treatment foster care services. Effective July 1,
183.20to federal approval, medical assistance covers treatment foster care services according to
183.21section
183.22 Sec. 21. Minnesota Statutes 2008, section 256B.0943, subdivision 12, is amended to
183.23read:
183.24 Subd. 12. Excluded services. The following services are not eligible for medical
183.25assistance payment as children's therapeutic services and supports:
183.26 (1) service components of children's therapeutic services and supports
183.27simultaneously provided by more than one provider entity unless prior authorization is
183.28obtained;
183.29 (2) treatment by multiple providers within the same agency at the same clock time;
183.30(3) children's therapeutic services and supports provided in violation of medical
183.31assistance policy in Minnesota Rules, part 9505.0220;
183.32
183.33who is not qualified as a mental health behavioral aide and employed by a certified
183.34children's therapeutic services and supports provider entity;
184.1
184.2program license holder, including foster care providers under the terms of a service
184.3agreement or administrative rules governing licensure;
184.4
184.5otherwise covered by medical assistance, including:
184.6 (i) a service that is primarily recreation oriented or that is provided in a setting that
184.7is not medically supervised. This includes sports activities, exercise groups, activities
184.8such as craft hours, leisure time, social hours, meal or snack time, trips to community
184.9activities, and tours;
184.10 (ii) a social or educational service that does not have or cannot reasonably be
184.11expected to have a therapeutic outcome related to the client's emotional disturbance;
184.12 (iii) consultation with other providers or service agency staff about the care or
184.13progress of a client;
184.14 (iv) prevention or education programs provided to the community; and
184.15 (v) treatment for clients with primary diagnoses of alcohol or other drug abuse; and
184.16
184.17 Sec. 22. Minnesota Statutes 2008, section 256B.0944, is amended by adding a
184.18subdivision to read:
184.19 Subd. 4a. Alternative provider standards. If a provider entity demonstrates that,
184.20due to geographic or other barriers, it is not feasible to provide mobile crisis intervention
184.21services 24 hours a day, seven days a week, according to the standards in subdivision 4,
184.22paragraph (b), clause (1), the commissioner may approve a crisis response provider based
184.23on an alternative plan proposed by a provider entity. The alternative plan must:
184.24(1) result in increased access and a reduction in disparities in the availability of
184.25crisis services; and
184.26(2) provide mobile services outside of the usual nine-to-five office hours and on
184.27weekends and holidays.
184.28 Sec. 23. Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to
184.29read:
184.30 Subdivision 1. Scope.
184.31subject to federal approval, medical assistance covers medically necessary, intensive
184.32nonresidential rehabilitative mental health services as defined in subdivision 2, for
184.33recipients as defined in subdivision 3, when the services are provided by an entity meeting
184.34the standards in this section.
185.1 Sec. 24. Minnesota Statutes 2008, section 256J.08, subdivision 73a, is amended to read:
185.2 Subd. 73a. Qualified professional. (a) For physical illness, injury, or incapacity,
185.3a "qualified professional" means a licensed physician, a physician's assistant, a nurse
185.4practitioner, or a licensed chiropractor.
185.5 (b) For developmental disability and intelligence testing, a "qualified professional"
185.6means an individual qualified by training and experience to administer the tests necessary
185.7to make determinations, such as tests of intellectual functioning, assessments of adaptive
185.8behavior, adaptive skills, and developmental functioning. These professionals include
185.9licensed psychologists, certified school psychologists, or certified psychometrists working
185.10under the supervision of a licensed psychologist.
185.11 (c) For learning disabilities, a "qualified professional" means a licensed psychologist
185.12or school psychologist with experience determining learning disabilities.
185.13 (d) For mental health, a "qualified professional" means a licensed physician or a
185.14qualified mental health professional. A "qualified mental health professional" means:
185.15 (1) for children, in psychiatric nursing, a registered nurse who is licensed under
185.16sections
185.17and adolescent psychiatric or mental health nursing by a national nurse certification
185.18organization or who has a master's degree in nursing or one of the behavioral sciences
185.19or related fields from an accredited college or university or its equivalent, with at least
185.204,000 hours of post-master's supervised experience in the delivery of clinical services in
185.21the treatment of mental illness;
185.22 (2) for adults, in psychiatric nursing, a registered nurse who is licensed under
185.23sections
185.24and mental health nursing by a national nurse certification organization or who has a
185.25master's degree in nursing or one of the behavioral sciences or related fields from an
185.26accredited college or university or its equivalent, with at least 4,000 hours of post-master's
185.27supervised experience in the delivery of clinical services in the treatment of mental illness;
185.28 (3) in clinical social work, a person licensed as an independent clinical social worker
185.29under chapter 148D, or a person with a master's degree in social work from an accredited
185.30college or university, with at least 4,000 hours of post-master's supervised experience in
185.31the delivery of clinical services in the treatment of mental illness;
185.32 (4) in psychology, an individual licensed by the Board of Psychology under sections
185.34diagnosis and treatment of mental illness;
186.1 (5) in psychiatry, a physician licensed under chapter 147 and certified by the
186.2American Board of Psychiatry and Neurology or eligible for board certification in
186.3psychiatry;
186.4 (6) in marriage and family therapy, the mental health professional must be a
186.5marriage and family therapist licensed under sections
186.6two years of post-master's supervised experience in the delivery of clinical services in the
186.7treatment of mental illness; and
186.8 (7) in licensed professional clinical counseling, the mental health professional
186.9shall be a licensed professional clinical counselor under section 148B.5301 with at least
186.104,000 hours of postmaster's supervised experience in the delivery of clinical services in
186.11the treatment of mental illness.
186.12 Sec. 25. AUTISM SPECTRUM DISORDER TASK FORCE.
186.13(a) The Autism Spectrum Disorder Task Force is composed of 15 members,
186.14appointed as follows:
186.15(1) two members of the senate appointed by the Subcommittee on Committees of the
186.16Committee on Rules and Administration, one of whom must be a member of the minority;
186.17(2) two members of the house of representatives, one from the majority party,
186.18appointed by the speaker of the house, and one from the minority party, appointed by
186.19the minority leader;
186.20 (3) two members appointed by the legislature, with regard to geographic diversity in
186.21the state, who are parents of children with autism spectrum disorder (ASD); one member
186.22shall be appointed by the senate Subcommittee on Committees of the Committee on
186.23Rules and Administration making appointments for the senate; and one member shall be
186.24appointed by the speaker of the house making the appointments for the house;
186.25(4) one member appointed by the Minnesota chapter of the American Academy of
186.26Pediatrics who is a general primary care pediatrician;
186.27(5) one member appointed by the Minnesota Academy of Family Physicians who is
186.28a family practice physician;
186.29(6) one member appointed by the Minnesota Psychological Association who is a
186.30neuropsychologist;
186.31(7) one member appointed by the directors of public school student support services;
186.32(8) one member appointed by the Somali American Autism Foundation;
186.33(9) one member appointed by the ARC of Minnesota;
186.34(10) one member appointed by the Autism Society of Minnesota;
187.1(11) one member appointed by the Parent Advocacy Coalition for Educational
187.2Rights; and
187.3(12) one member appointed by the Minnesota Council of Health Plans.
187.4Appointments must be made by September 1, 2009. The Legislative Coordinating
187.5Commission shall provide meeting space for the task force. The senate member appointed
187.6by the minority leader of the senate shall convene the first meeting of the task force no
187.7later than October 1, 2009. The task force shall elect a chair at the first meeting.
187.8(b) If federal or state funding is available, the commissioners of education,
187.9employment and economic development, health, and human services shall provide
187.10assistance to the task force.
187.11(c) The task force shall develop recommendations and report on the following topics:
187.12(1) ways to improve services provided by all state and political subdivisions;
187.13(2) sources of public and private funding available for treatment and ways to
187.14improve efficiency in the use of these funds;
187.15(3) methods to improve coordination in the delivery of service between public
187.16and private agencies, health providers, and schools, and to address any geographic
187.17discrepancies in the delivery of services;
187.18(4) increasing the availability of and the training for medical providers and educators
187.19who identify and provide services to individuals with ASD; and
187.20(5) treatment options supported by peer-reviewed, established scientific research
187.21for individuals with ASD.
187.22(d) The task force shall coordinate with existing efforts at the Departments of
187.23Education, Health, Human Services, and Employment and Economic Development
187.24related to ASD.
187.25(e) By January 15 of each year, the task force shall provide a report regarding its
187.26findings and consideration of the topics listed under paragraph (c), and the action taken
187.27under paragraph (d), including draft legislation if necessary, to the chairs and ranking
187.28minority members of the legislative committees with jurisdiction over health and human
187.29services.
187.30(f) This section expires June 30, 2011.
187.31 Sec. 26. STATE-COUNTY CHEMICAL HEALTH CARE HOME PILOT
187.32PROJECT.
187.33 Subdivision 1. Establishment; purpose. There is established a state-county
187.34chemical health care home pilot project. The purpose of the pilot project is for the
187.35Department of Human Services and counties to authentically and creatively work in
188.1partnership to redesign the current chemical health service delivery system in a way
188.2that promotes greater accountability, productivity, and results in the delivery of state
188.3chemical dependency services. The pilot project or projects must look to provide
188.4appropriate flexibility in a way that ensures timely access to needed services as well
188.5as better aligning systems and services to offer the most appropriate level of chemical
188.6health care services to the client. This may include, but is not limited to, looking into new
188.7governance agreements, performance agreements, or service level agreements. Pilot
188.8projects must maintain eligibility requirements for the consolidated chemical dependency
188.9treatment fund, continue to meet the requirements of Minnesota Rules, parts 9530.6600 to
188.109530.6655 (also known as Rule 25) and Minnesota Rules, parts 9530.6405 to 9530.6505
188.11(also known as Rule 31), and must not put at risk current and future federal funding toward
188.12chemical health-related services in the state of Minnesota.
188.13 Subd. 2. Workgroup; report. A workgroup must be convened on or before July
188.1415, 2009, consisting of representatives from the Department of Human Services and
188.15potential participating counties to develop draft proposals for pilot projects meeting the
188.16requirements of this section. The workgroup shall report back to the legislative committees
188.17with jurisdiction over chemical health by January 15, 2010, for potential approval of one
188.18metro and one nonmetro county pilot project to be implemented beginning July 10, 2010.
188.19 Subd. 3. Report. The Department of Human Services shall evaluate the efficacy and
188.20feasibility of the pilot projects and report the results of that evaluation to the legislative
188.21committees having jurisdiction over chemical health by June 30, 2011. Expansion of pilot
188.22projects may occur only if the department's report finds the pilot projects effective.
188.23 Subd. 4. Expiration. This section expires June 30, 2012.
188.24EFFECTIVE DATE.This section is effective the day following final enactment.
188.27 Section 1. Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to
188.28read:
188.29 Subd. 2. Definitions. For purposes of this section, the following terms have the
188.30meanings given.
188.31(a) "Assessment reference date" means the last day of the minimum data set
188.32observation period. The date sets the designated endpoint of the common observation
188.33period, and all minimum data set items refer back in time from that point.
189.1(b) "Case mix index" means the weighting factors assigned to the RUG-III
189.2classifications.
189.3(c) "Index maximization" means classifying a resident who could be assigned to
189.4more than one category, to the category with the highest case mix index.
189.5(d) "Minimum data set" means the assessment instrument specified by the Centers for
189.6Medicare and Medicaid Services and designated by the Minnesota Department of Health.
189.7(e) "Representative" means a person who is the resident's guardian or conservator,
189.8the person authorized to pay the nursing home expenses of the resident, a representative
189.9of the nursing home ombudsman's office whose assistance has been requested, or any
189.10other individual designated by the resident.
189.11(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
189.12facility's residents according to their clinical and functional status identified in data
189.13supplied by the facility's minimum data set.
189.14(g) "Activities of daily living" means grooming, dressing, bathing, transferring,
189.15mobility, positioning, eating, and toileting.
189.16(h) "Nursing facility level of care determination" means the assessment process
189.17that results in a determination of a resident's or prospective resident's need for nursing
189.18facility level of care as established in subdivision 11 for purposes of medical assistance
189.19payment of long-term care services for:
189.20(1) nursing facility services under section 256B.434 or 256B.441;
189.21(2) elderly waiver services under section 256B.0915;
189.22(3) CADI and TBI waiver services under section 256B.49; and
189.23(4) state payment of alternative care services under section 256B.0913.
189.24EFFECTIVE DATE.The section is effective January 1, 2011.
189.25 Sec. 2. Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:
189.26 Subd. 4. Resident assessment schedule. (a) A facility must conduct and
189.27electronically submit to the commissioner of health case mix assessments that conform
189.28with the assessment schedule defined by Code of Federal Regulations, title 42, section
189.30Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
189.31Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made
189.32in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0,
189.33August 1996. The commissioner of health may substitute successor manuals or question
189.34and answer documents published by the United States Department of Health and Human
190.1Services, Centers for Medicare and Medicaid Services, to replace or supplement the
190.2current version of the manual or document.
190.3(b) The assessments used to determine a case mix classification for reimbursement
190.4include the following:
190.5(1) a new admission assessment must be completed by day 14 following admission;
190.6(2) an annual assessment must be completed within 366 days of the last
190.7comprehensive assessment;
190.8(3) a significant change assessment must be completed within 14 days of the
190.9identification of a significant change; and
190.10(4) the second quarterly assessment following either a new admission assessment,
190.11an annual assessment, or a significant change assessment, and all quarterly assessments
190.12beginning October 1, 2006. Each quarterly assessment must be completed within 92
190.13days of the previous assessment.
190.14(c) In addition to the assessments listed in paragraph (b), the assessments used to
190.15determine nursing facility level of care include the following:
190.16(1) preadmission screening completed under section 256B.0911, subdivision 4a,
190.17by a county, tribe, or managed care organization under contract with the Department
190.18of Human Services; and
190.19(2) a face-to-face long-term care consultation assessment completed under section
190.20256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization
190.21under contract with the Department of Human Services.
190.22EFFECTIVE DATE.The section is effective January 1, 2011.
190.23 Sec. 3. Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:
190.24 Subd. 8. Request for reconsideration of resident classifications. (a) The resident,
190.25or resident's representative, or the nursing facility or boarding care home may request that
190.26the commissioner of health reconsider the assigned reimbursement classification. The
190.27request for reconsideration must be submitted in writing to the commissioner within
190.2830 days of the day the resident or the resident's representative receives the resident
190.29classification notice. The request for reconsideration must include the name of the
190.30resident, the name and address of the facility in which the resident resides, the reasons for
190.31the reconsideration, the requested classification changes, and documentation supporting
190.32the requested classification. The documentation accompanying the reconsideration request
190.33is limited to documentation which establishes that the needs of the resident at the time of
190.34the assessment justify a classification which is different than the classification established
190.35by the commissioner of health.
191.1(b) Upon request, the nursing facility must give the resident or the resident's
191.2representative a copy of the assessment form and the other documentation that was given
191.3to the commissioner of health to support the assessment findings. The nursing facility
191.4shall also provide access to and a copy of other information from the resident's record that
191.5has been requested by or on behalf of the resident to support a resident's reconsideration
191.6request. A copy of any requested material must be provided within three working days of
191.7receipt of a written request for the information. If a facility fails to provide the material
191.8within this time, it is subject to the issuance of a correction order and penalty assessment
191.9under sections
191.10issued under this subdivision must require that the nursing facility immediately comply
191.11with the request for information and that as of the date of the issuance of the correction
191.12order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and
191.13an increase in the $100 fine by $50 increments for each day the noncompliance continues.
191.14(c) In addition to the information required under paragraphs (a) and (b), a
191.15reconsideration request from a nursing facility must contain the following information: (i)
191.16the date the reimbursement classification notices were received by the facility; (ii) the date
191.17the classification notices were distributed to the resident or the resident's representative;
191.18and (iii) a copy of a notice sent to the resident or to the resident's representative. This
191.19notice must inform the resident or the resident's representative that a reconsideration of the
191.20resident's classification is being requested, the reason for the request, that the resident's
191.21rate will change if the request is approved by the commissioner, the extent of the change,
191.22that copies of the facility's request and supporting documentation are available for review,
191.23and that the resident also has the right to request a reconsideration. If the facility fails to
191.24provide the required information with the reconsideration request, the request must be
191.25denied, and the facility may not make further reconsideration requests on that specific
191.26reimbursement classification.
191.27(d) Reconsideration by the commissioner must be made by individuals not involved
191.28in reviewing the assessment, audit, or reconsideration that established the disputed
191.29classification. The reconsideration must be based upon the initial assessment and upon the
191.30information provided to the commissioner under paragraphs (a) and (b). If necessary for
191.31evaluating the reconsideration request, the commissioner may conduct on-site reviews.
191.32Within 15 working days of receiving the request for reconsideration, the commissioner
191.33shall affirm or modify the original resident classification. The original classification
191.34must be modified if the commissioner determines that the assessment resulting in the
191.35classification did not accurately reflect the needs or assessment characteristics of the
191.36resident at the time of the assessment. The resident and the nursing facility or boarding
192.1care home shall be notified within five working days after the decision is made. A decision
192.2by the commissioner under this subdivision is the final administrative decision of the
192.3agency for the party requesting reconsideration.
192.4(e) The resident classification established by the commissioner shall be the
192.5classification that applies to the resident while the request for reconsideration is pending.
192.6If a request for reconsideration applies to an assessment used to determine nursing facility
192.7level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible
192.8for nursing facility level of care while the request for reconsideration is pending.
192.9(f) The commissioner may request additional documentation regarding a
192.10reconsideration necessary to make an accurate reconsideration determination.
192.11EFFECTIVE DATE.The section is effective January 1, 2011.
192.12 Sec. 4. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
192.13to read:
192.14 Subd. 11. Nursing facility level of care. (a) For purposes of medical assistance
192.15payment of long-term care services, a recipient must be determined, using assessments
192.16defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
192.17(1) the person needs the assistance of another person or constant supervision to begin
192.18and complete at least four of the following activities of living: bathing, bed mobility,
192.19dressing, eating, grooming, toileting, transferring, and walking;
192.20(2) the person needs the assistance of another person or constant supervision to begin
192.21and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
192.22(3) the person has significant difficulty with memory, using information, daily
192.23decision making, or behavioral needs that require intervention;
192.24(4) the person has had a qualifying nursing facility stay of at least 90 days; or
192.25(5) the person is determined to be at risk for nursing facility admission or
192.26readmission through a face-to-face long-term care consultation assessment as specified
192.27in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care
192.28organization under contract with the Department of Human Services. The person is
192.29considered at risk under this clause if the person currently lives alone or will live alone
192.30upon discharge and also meets one of the following criteria:
192.31(i) the person has experienced a fall resulting in a fracture;
192.32(ii) the person has been determined to be at risk of maltreatment or neglect,
192.33including self-neglect; or
192.34(iii) the person has a sensory impairment that substantially impacts functional ability
192.35and maintenance of a community residence.
193.1(b) The assessment used to establish medical assistance payment for nursing facility
193.2services must be the most recent assessment performed under subdivision 4, paragraph
193.3(b), that occurred no more than 90 calendar days before the effective date of medical
193.4assistance eligibility for payment of long-term care services. In no case shall medical
193.5assistance payment for long-term care services occur prior to the date of the determination
193.6of nursing facility level of care.
193.7(c) The assessment used to establish medical assistance payment for long-term care
193.8services provided under sections 256B.0915 and 256B.49 and alternative care payment
193.9for services provided under section 256B.0913 must be the most recent face-to-face
193.10assessment performed under section 256B.0911, subdivision 3a, that occurred no more
193.11than 60 calendar days before the effective date of medical assistance eligibility for
193.12payment of long-term care services.
193.13EFFECTIVE DATE.The section is effective January 1, 2011.
193.14 Sec. 5. Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
193.15to read:
193.16 Subd. 12. Appeal of nursing facility level of care determination. A resident or
193.17prospective resident whose level of care determination results in a denial of long-term care
193.18services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
193.19paragraph (h), clause (7).
193.20EFFECTIVE DATE.The section is effective January 1, 2011.
193.21 Sec. 6. Minnesota Statutes 2008, section 144A.073, is amended by adding a
193.22subdivision to read:
193.23 Subd. 12. Extension of approval of moratorium exception projects.
193.24Notwithstanding subdivision 3, the commissioner of health shall extend project approval
193.25by an additional 18 months for an approved proposal for an exception to the nursing home
193.26licensure and certification moratorium if the proposal was approved under this section
193.27between July 1, 2007, and June 30, 2009.
193.28 Sec. 7. Minnesota Statutes 2008, section 144A.44, subdivision 2, is amended to read:
193.29 Subd. 2. Interpretation and enforcement of rights. These rights are established
193.30for the benefit of persons who receive home care services. "Home care services" means
193.31home care services as defined in section
193.32care assistance services, including services covered by medical assistance under section
193.33256B.0625, subdivision 19a. A home care provider may not require a person to surrender
194.1these rights as a condition of receiving services. A guardian or conservator or, when there
194.2is no guardian or conservator, a designated person, may seek to enforce these rights. This
194.3statement of rights does not replace or diminish other rights and liberties that may exist
194.4relative to persons receiving home care services, persons providing home care services, or
194.5providers licensed under Laws 1987, chapter 378. A copy of these rights must be provided
194.6to an individual at the time home care services, including personal care assistance
194.7services, are initiated. The copy shall also contain the address and phone number of the
194.8Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care
194.9and a brief statement describing how to file a complaint with these offices. Information
194.10about how to contact the Office of Ombudsman for Long-Term Care shall be included in
194.11notices of change in client fees and in notices where home care providers initiate transfer
194.12or discontinuation of services.
194.13 Sec. 8. Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision
194.14to read:
194.15 Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
194.16initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
194.172960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
194.189555.6265, under this chapter for a physical location that will not be the primary residence
194.19of the license holder for the entire period of licensure. If a license is issued during this
194.20moratorium, and the license holder changes the license holder's primary residence away
194.21from the physical location of the foster care license, the commissioner shall revoke the
194.22license according to section 245A.07. Exceptions to the moratorium include:
194.23(1) foster care settings that are required to be registered under chapter 144D;
194.24(2) foster care licenses replacing foster care licenses in existence on the effective
194.25date of this section and determined to be needed by the commissioner under paragraph (b);
194.26(3) new foster care licenses determined to be needed by the commissioner under
194.27paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
194.28(4) new foster care licenses determined to be needed by the commissioner under
194.29paragraph (b) for persons requiring hospital level care; or
194.30(5) new foster care licenses determined to be needed by the commissioner for the
194.31transition of people from personal care assistance to the home and community-based
194.32services.
194.33(b) The commissioner shall determine the need for newly licensed foster care homes
194.34as defined under this subdivision. As part of the determination, the commissioner shall
194.35consider the availability of foster care capacity in the area which the licensee seeks to
195.1operate, and the recommendation of the local county board. The determination by the
195.2commissioner must be final. A determination of need is not required for a change in
195.3ownership at the same address.
195.4 (c) Residential settings that would otherwise be subject to the moratorium established
195.5in paragraph (a), that are in the process of receiving an adult or child foster care license as
195.6of July 1, 2009, shall be allowed to continue to complete the process of receiving an adult
195.7or child foster care license. For this paragraph, all of the following conditions must be met
195.8to be considered in process of receiving an adult or child foster care license:
195.9 (1) participants have made decisions to move into the residential setting, including
195.10documentation in each participant's care plan;
195.11 (2) the provider has purchased housing or has made a financial investment in the
195.12property;
195.13 (3) the lead agency has approved the plans, including costs for the residential setting
195.14for each individual;
195.15 (4) the completion of the licensing process, including all necessary inspections, is
195.16the only remaining component prior to being able to provide services; and
195.17 (5) the needs of the individuals cannot be met within the existing capacity in that
195.18county.
195.19To qualify for the process under this paragraph, the lead agency must submit
195.20documentation to the commissioner by August 1, 2009, that all of the above criteria are
195.21met.
195.22(d) The commissioner shall study the effects of the license moratorium under this
195.23subdivision and shall report back to the legislature by January 15, 2011.
195.24EFFECTIVE DATE.This section is effective the day following final enactment.
195.25 Sec. 9. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
195.26to read:
195.27 Subd. 8. Community residential setting license. (a) The commissioner shall
195.28establish provider standards for residential support services that integrate service standards
195.29and the residential setting under one license. The commissioner shall propose statutory
195.30language and an implementation plan for licensing requirements for residential support
195.31services to the legislature by January 15, 2011.
195.32(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
195.33for services in settings licensed as adult foster care under Minnesota Rules, parts
195.349555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to
196.12960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph
196.2(b), must be required to obtain a community residential setting license.
196.3 Sec. 10. Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision
196.4to read:
196.5 Subd. 1a. Day training and habilitation rates. The commissioner shall establish
196.6a statewide rate-setting methodology for all day training and habilitation services. The
196.7rate-setting methodology must abide by the principles of transparency and equitability
196.8across the state. The methodology must involve a uniform process of structuring rates for
196.9each service and must promote quality and participant choice.
196.10 Sec. 11. Minnesota Statutes 2008, section 252.50, subdivision 1, is amended to read:
196.11 Subdivision 1. Community-based programs established. The commissioner
196.12shall establish a system of state-operated, community-based programs for persons with
196.13developmental disabilities. For purposes of this section, "state-operated, community-based
196.14program" means a program administered by the state to provide treatment and habilitation
196.15in noninstitutional community settings to persons with developmental disabilities.
196.16Employees of the programs, except clients who work within and benefit from these
196.17treatment and habilitation programs, must be state employees under chapters 43A and
196.18179A. Although any clients who work within and benefit from these treatment and
196.19habilitation programs are not employees under chapters 43A and 179A, the Department
196.20of Human Services may consider clients who work within and benefit from these
196.21programs employees for federal tax purposes. The establishment of state-operated,
196.22community-based programs must be within the context of a comprehensive definition of
196.23the role of state-operated services in the state. The role of state-operated services must
196.24be defined within the context of a comprehensive system of services for persons with
196.25developmental disabilities. State-operated, community-based programs may include, but
196.26are not limited to, community group homes, foster care, supportive living services, day
196.27training and habilitation programs, and respite care arrangements. The commissioner
196.28may operate the pilot projects established under Laws 1985, First Special Session
196.29chapter 9, article 1, section 2, subdivision 6, and shall, within the limits of available
196.30appropriations, establish additional state-operated, community-based programs for
196.31persons with developmental disabilities. State-operated, community-based programs may
196.32accept admissions from regional treatment centers, from the person's own home, or from
196.33community programs. State-operated, community-based programs offering day program
196.34services may be provided for persons with developmental disabilities who are living in
197.1state-operated, community-based residential programs until July 1, 2000. No later than
197.21994, the commissioner, together with family members, counties, advocates, employee
197.3representatives, and other interested parties, shall begin planning so that by July 1, 2000,
197.4state-operated, community-based residential facilities will be in compliance with section
197.6 Sec. 12. Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
197.7to read:
197.8 Subd. 29. State medical review team. (a) To ensure the timely processing of
197.9determinations of disability by the commissioner's state medical review team under
197.10sections 256B.055, subdivision 7, paragraph (b), 256B.057, subdivision 9, paragraph
197.11(j), and 256B.055, subdivision 12, the commissioner shall review all medical evidence
197.12submitted by county agencies with a referral and seek additional information from
197.13providers, applicants, and enrollees to support the determination of disability where
197.14necessary. Disability shall be determined according to the rules of title XVI and title
197.15XIX of the Social Security Act and pertinent rules and policies of the Social Security
197.16Administration.
197.17 (b) Prior to a denial or withdrawal of a requested determination of disability due
197.18to insufficient evidence, the commissioner shall (1) ensure that the missing evidence is
197.19necessary and appropriate to a determination of disability, and (2) assist applicants and
197.20enrollees to obtain the evidence, including, but not limited to, medical examinations
197.21and electronic medical records.
197.22(c) The commissioner shall provide the chairs of the legislative committees with
197.23jurisdiction over health and human services finance and budget the following information
197.24on the activities of the state medical review team by February 1, 2010, and annually
197.25thereafter:
197.26(1) the number of applications to the state medical review team that were denied,
197.27approved, or withdrawn;
197.28(2) the average length of time from receipt of the application to a decision;
197.29(3) the number of appeals and appeal results;
197.30(4) for applicants, their age, health coverage at the time of application, hospitalization
197.31history within three months of application, and whether an application for Social Security
197.32or Supplemental Security Income benefits is pending; and
197.33(5) specific information on the medical certification, licensure, or other credentials
197.34of the person or persons performing the medical review determinations and length of
197.35time in that position.
198.1 Sec. 13. [256.0281] INTERAGENCY DATA EXCHANGE.
198.2The Department of Human Services, the Department of Health, and the Office of the
198.3Ombudsman for Mental Health and Developmental Disabilities may establish interagency
198.4agreements governing the electronic exchange of data on providers and individuals
198.5collected, maintained, or used by each agency when such exchange is outlined by each
198.6agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
198.7(1) to improve provider enrollment processes for home and community-based
198.8services and state plan home care services;
198.9(2) to improve quality management of providers between state agencies;
198.10(3) to establish and maintain provider eligibility to participate as providers under
198.11Minnesota health care programs; or
198.12(4) to meet the quality assurance reporting requirements under federal law under
198.13section 1915(c) of the Social Security Act related to home and community-based waiver
198.14programs.
198.15Each interagency agreement must include provisions to ensure anonymity of individuals,
198.16including mandated reporters, and must outline the specific uses of and access to shared
198.17data within each agency. Electronic interfaces between source data systems developed
198.18under these interagency agreements must incorporate these provisions as well as other
198.19HIPPA provisions related to individual data.
198.20 Sec. 14. Minnesota Statutes 2008, section 256.476, subdivision 5, is amended to read:
198.21 Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of
198.22transferring persons to the consumer support grant program from the family support
198.23program and personal care assistant services, home health aide services, or private duty
198.24nursing services, the amount of funds transferred by the commissioner between the
198.25family support program account, the medical assistance account, or the consumer support
198.26grant account shall be based on each county's participation in transferring persons to the
198.27consumer support grant program from those programs and services.
198.28 (b) At the beginning of each fiscal year, county allocations for consumer support
198.29grants shall be based on:
198.30 (1) the number of persons to whom the county board expects to provide consumer
198.31supports grants;
198.32 (2) their eligibility for current program and services;
198.33 (3) the
198.3411; and
199.1 (4) projected dates when persons will start receiving grants. County allocations shall
199.2be adjusted periodically by the commissioner based on the actual transfer of persons or
199.3service openings, and the
199.4persons or service openings, to the consumer support grant program.
199.5 (c) The amount of funds transferred by the commissioner from the medical
199.6assistance account for an individual may be changed if it is determined by the county or its
199.7agent that the individual's need for support has changed.
199.8 (d) The authority to utilize funds transferred to the consumer support grant account
199.9for the purposes of implementing and administering the consumer support grant program
199.10will not be limited or constrained by the spending authority provided to the program
199.11of origination.
199.12 (e) The commissioner may use up to five percent of each county's allocation, as
199.13adjusted, for payments for administrative expenses, to be paid as a proportionate addition
199.14to reported direct service expenditures.
199.15 (f) The county allocation for each person or the person's legal representative or other
199.16authorized representative cannot exceed the amount allowed under subdivision 11.
199.17 (g) The commissioner may recover, suspend, or withhold payments if the county
199.18board, local agency, or grantee does not comply with the requirements of this section.
199.19 (h) Grant funds unexpended by consumers shall return to the state once a year. The
199.20annual return of unexpended grant funds shall occur in the quarter following the end of
199.21the state fiscal year.
199.22 Sec. 15. Minnesota Statutes 2008, section 256.476, subdivision 11, is amended to read:
199.23 Subd. 11. Consumer support grant program after July 1, 2001.
199.24July 1, 2001, the commissioner shall allocate consumer support grant resources to
199.25serve additional individuals based on a review of Medicaid authorization and payment
199.26information of persons eligible for a consumer support grant from the most recent fiscal
199.27year. The commissioner shall use the following methodology to calculate maximum
199.28allowable monthly consumer support grant levels:
199.29 (1) For individuals whose program of origination is medical assistance home care
199.30under sections
199.31grant levels are calculated by:
199.32 (i) determining
199.33for each home care rating;
199.34 (ii) calculating the overall ratio of actual payments to service authorizations by
199.35program;
200.1 (iii) applying the overall ratio to the average service authorization level of each
200.2home care rating;
200.3 (iv) adjusting the result for any authorized rate increases provided by the legislature;
200.4and
200.5 (v) adjusting the result for the average monthly utilization per recipient.
200.6 (2) The commissioner may review and evaluate the methodology to reflect changes
200.7in the home care
200.8programs.
200.9
200.10
200.11
200.12
200.13
200.14 Sec. 16. Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:
200.15 Subd. 7. Consumer information and assistance and long-term care options
200.16counseling;
200.17shall operate a statewide
200.18their families in making informed choices about long-term care options and health care
200.19benefits. Language services to persons with limited English language skills may be made
200.20available. The service, known as Senior LinkAge Line, must be available during business
200.21hours through a statewide toll-free number and must also be available through the Internet.
200.22 (b) The service must
200.23older adults, caregivers, and providers in accessing information and options counseling
200.24about choices in long-term care services that are purchased through private providers or
200.25available through public options. The service must:
200.26 (1) develop a comprehensive database that includes detailed listings in both
200.27consumer- and provider-oriented formats;
200.28 (2) make the database accessible on the Internet and through other telecommunication
200.29and media-related tools;
200.30 (3) link callers to interactive long-term care screening tools and make these tools
200.31available through the Internet by integrating the tools with the database;
200.32 (4) develop community education materials with a focus on planning for long-term
200.33care and evaluating independent living, housing, and service options;
200.34 (5) conduct an outreach campaign to assist older adults and their caregivers in
200.35finding information on the Internet and through other means of communication;
201.1 (6) implement a messaging system for overflow callers and respond to these callers
201.2by the next business day;
201.3 (7) link callers with county human services and other providers to receive more
201.4in-depth assistance and consultation related to long-term care options;
201.5 (8) link callers with quality profiles for nursing facilities and other providers
201.6developed by the commissioner of health;
201.7 (9) incorporate information about housing with services and consumer rights
201.8within the MinnesotaHelp.info network long-term care database to facilitate consumer
201.9comparison of services and costs among housing with services establishments and with
201.10other in-home services and to support financial self-sufficiency as long as possible.
201.11Housing with services establishments and their arranged home care providers shall provide
201.12information to the commissioner of human services that is consistent with information
201.13required by the commissioner of health under section
201.14Information Guide. The commissioner of human services shall provide the data to the
201.15Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
201.16care database
201.17(10) provide long-term care options counseling. Long-term care options counselors
201.18shall:
201.19(i) for individuals not eligible for case management under a public program or public
201.20funding source, provide interactive decision support under which consumers, family
201.21members, or other helpers are supported in their deliberations to determine appropriate
201.22long-term care choices in the context of the consumer's needs, preferences, values, and
201.23individual circumstances, including implementing a community support plan;
201.24(ii) provide Web-based educational information and collateral written materials to
201.25familiarize consumers, family members, or other helpers with the long-term care basics,
201.26issues to be considered, and the range of options available in the community;
201.27(iii) provide long-term care futures planning, which means providing assistance to
201.28individuals who anticipate having long-term care needs to develop a plan for the more
201.29distant future; and
201.30(iv) provide expertise in benefits and financing options for long-term care, including
201.31Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
201.32private pay options, and ways to access low or no-cost services or benefits through
201.33volunteer-based or charitable programs; and
201.34(11) using risk management and support planning protocols, provide long-term care
201.35options counseling to current residents of nursing homes deemed appropriate for discharge
201.36by the commissioner. In order to meet this requirement, the commissioner shall provide
202.1designated Senior LinkAge Line contact centers with a list of nursing home residents
202.2appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall
202.3provide these residents, if they indicate a preference to receive long-term care options
202.4counseling, with initial assessment, review of risk factors, independent living support
202.5consultation, or referral to:
202.6(i) services under section 256B.0911, subdivision 3;
202.7(ii) designated care coordinators of contracted entities under section 256B.035 for
202.8persons who are enrolled in a managed care plan; or
202.9(iii) the long-term care consultation team for those who are appropriate for relocation
202.10service coordination due to high-risk factors or psychological or physical disability.
202.11
202.12
202.13
202.14
202.15
202.16 Sec. 17. Minnesota Statutes 2008, section 256B.055, subdivision 7, is amended to read:
202.17 Subd. 7. Aged, blind, or disabled persons. (a) Medical assistance may be paid for
202.18a person who meets the categorical eligibility requirements of the supplemental security
202.19income program or, who would meet those requirements except for excess income or
202.20assets, and who meets the other eligibility requirements of this section.
202.21(b) Following a determination that the applicant is not aged or blind and does not
202.22meet any other category of eligibility for medical assistance and has not been determined
202.23disabled by the Social Security Administration, applicants under this subdivision shall be
202.24referred to the commissioner's state medical review team for a determination of disability.
202.25 Sec. 18. Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to
202.26read:
202.27 Subd. 6a. Home health services. Home health services are those services specified
202.28in Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical
202.29assistance covers home health services at a recipient's home residence. Medical assistance
202.30does not cover home health services for residents of a hospital, nursing facility, or
202.31intermediate care facility, unless the commissioner of human services has
202.32skilled nurse visits for less than 90 days for a resident at an intermediate care facility for
202.33persons with developmental disabilities, to prevent an admission to a hospital or nursing
202.34facility or unless a resident who is otherwise eligible is on leave from the facility and the
203.1facility either pays for the home health services or forgoes the facility per diem for the
203.2leave days that home health services are used. Home health services must be provided by
203.3a Medicare certified home health agency. All nursing and home health aide services must
203.4be provided according to sections
203.5 Sec. 19. Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to
203.6read:
203.7 Subd. 7. Private duty nursing. Medical assistance covers private duty nursing
203.8services in a recipient's home. Recipients who are authorized to receive private duty
203.9nursing services in their home may use approved hours outside of the home during hours
203.10when normal life activities take them outside of their home. To use private duty nursing
203.11services at school, the recipient or responsible party must provide written authorization in
203.12the care plan identifying the chosen provider and the daily amount of services to be used at
203.13school. Medical assistance does not cover private duty nursing services for residents of a
203.14hospital, nursing facility, intermediate care facility, or a health care facility licensed by the
203.15commissioner of health, except as authorized in section
203.16recipients in hospitals or unless a resident who is otherwise eligible is on leave from the
203.17facility and the facility either pays for the private duty nursing services or forgoes the
203.18facility per diem for the leave days that private duty nursing services are used. Total hours
203.19of service and payment allowed for services outside the home cannot exceed that which is
203.20otherwise allowed in an in-home setting according to sections
203.22the limits established under sections
203.23duty nursing services may not be reimbursed if the nurse is the family foster care provider
203.24of a recipient who is under age 18, unless allowed under section 256B.0654, subdivision 4.
203.25 Sec. 20. Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to
203.26read:
203.27 Subd. 19a. Personal care
203.28personal care
203.292010, to qualify for personal care
203.30assistance and be determined dependent in one activity of daily living as defined in section
203.31256B.0659, subdivision 1, paragraph (b), or in a Level I behavior as defined in section
203.32256B.0659, subdivision 1, paragraph (c). Beginning July 1, 2011, to qualify for personal
203.33care assistance services, a recipient must require assistance and be determined dependent
203.34in at least two activities of daily living as defined in section 256B.0659. Recipients or
204.1responsible parties must be able to identify the recipient's needs, direct and evaluate task
204.2accomplishment, and provide for health and safety. Approved hours may be used outside
204.3the home when normal life activities take them outside the home. To use personal care
204.4
204.5written authorization in the care plan identifying the chosen provider and the daily amount
204.6of services to be used at school. Total hours for services, whether actually performed
204.7inside or outside the recipient's home, cannot exceed that which is otherwise allowed for
204.8personal care
204.10
204.11facility, health care facility licensed by the commissioner of health, or unless a resident
204.12who is otherwise eligible is on leave from the facility and the facility either pays for the
204.13personal care
204.14days that personal care
204.15assistance services must be provided according to sections
204.16to
204.17personal care assistant is the spouse or
204.18a recipient under age 18, or the responsible party or the family foster care provider of a
204.19recipient who cannot direct the recipient's own care unless, in the case of a foster care
204.20provider, a county or state case manager visits the recipient as needed, but not less than
204.21every six months, to monitor the health and safety of the recipient and to ensure the goals
204.22of the care plan are met.
204.23
204.24
204.25Notwithstanding the provisions of section
204.26
204.27not the responsible party and not the personal care provider organization, may be
204.28
204.29to provide personal care
204.30conservator meets all criteria for a personal care assistant according to section
204.31and shall not be considered to have a service provider interest for purposes of participation
204.32on the screening team under section
204.33 Sec. 21. Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to
204.34read:
205.1 Subd. 19c. Personal care. Medical assistance covers personal care
205.2assistance services provided by an individual who is qualified to provide the services
205.3according to subdivision 19a and sections
205.4
205.5a plan, and
205.6
205.7
205.8
205.9
205.10
205.11"Qualified professional" means a mental health professional as defined in section
205.12subdivision 18
205.14qualified developmental disabilities specialist undersection 245B.07, subdivision 4
205.15
205.16
205.17
205.18required in
205.19 Sec. 22. Minnesota Statutes 2008, section 256B.0641, subdivision 3, is amended to
205.20read:
205.21 Subd. 3. Facility in receivership. Subdivision 2 does not apply to the change of
205.22ownership of a facility to a nonrelated organization while the facility to be sold, transferred
205.23or reorganized is in receivership under section 144A.14, 144A.15,
205.24and the commissioner during the receivership has not determined the need to place
205.25residents of the facility into a newly constructed or newly established facility. Nothing
205.26in this subdivision limits the liability of a former owner.
205.27 Sec. 23. Minnesota Statutes 2008, section 256B.0651, is amended to read:
205.28256B.0651 HOME CARE SERVICES.
205.29 Subdivision 1. Definitions. (a)
205.30
205.31sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g)
205.32have the meanings given.
205.33(b) "Activities of daily living" has the meaning given in section 256B.0659,
205.34subdivision 1, paragraph (b).
206.1(c) "Assessment" means a review and evaluation of a recipient's need for home care
206.2services conducted in person.
206.3
206.4
206.5
206.6
206.7
206.8
206.9
206.10
206.11
206.12
206.13
206.14
206.15means medical assistance covered services that are home health agency services, including
206.16skilled nurse visits; home health aide visits; physical therapy, occupational therapy,
206.17respiratory therapy, and language-speech pathology therapy; private duty nursing; and
206.18personal care assistance.
206.19(e) "Home residence," effective January 1, 2010, means a residence owned or rented
206.20by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid
206.21responsible party or legal representative; or a family foster home where the license holder
206.22lives with the recipient and is not paid to provide home care services for the recipient
206.23except as allowed under sections 256B.0651, subdivision 9, and 256B.0654, subdivision 4.
206.24
206.259505.0170 to 9505.0475.
206.26
206.27
206.28
206.29
206.30(g) "Ventilator-dependent" means an individual who receives mechanical ventilation
206.31for life support at least six hours per day and is expected to be or has been dependent on a
206.32ventilator for at least 30 consecutive days.
206.33 Subd. 2. Services covered. Home care services covered under this section and
206.34sections
206.35(1) nursing services under
206.36256B.0653
207.1(2) private duty nursing services under
207.27
207.3(3) home health services under
207.4256B.0653
207.5(4) personal care
207.6subdivision 19a
207.7(5) supervision of personal care
207.8professional under
207.9(6)
207.10
207.11
207.12
207.13
207.14assistance services by the county public health nurse for services under
207.16 Subd. 3. Noncovered home care services. The following home care services are
207.17not eligible for payment under medical assistance:
207.18
207.19
207.20
207.21
207.22
207.23
207.24
207.25
207.26
207.27
207.28
207.29
207.30
207.31
207.32
207.33
207.34
207.35
208.1
208.2
208.3
208.4
208.5
208.6(1) services provided in a nursing facility, hospital, or intermediate care facility with
208.7exceptions in section 256B.0653;
208.8(2) services for the sole purpose of monitoring medication compliance with an
208.9established medication program for a recipient;
208.10(3) home care services for covered services under the Medicare program or any other
208.11insurance held by the recipient;
208.12(4) services to other members of the recipient's household;
208.13(5) any home care service included in the daily rate of the community-based
208.14residential facility where the recipient is residing;
208.15(6) nursing and rehabilitation therapy services that are reasonably accessible to a
208.16recipient outside the recipient's place of residence, excluding the assessment, counseling
208.17and education, and personal assistance care; or
208.18(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients
208.19that do not qualify for Medicare visit billing.
208.20 Subd. 4.
208.21in subdivision 11 must receive the commissioner's
208.22begin, except when:
208.23(1) the home care services were required to treat an emergency medical condition
208.24that if not immediately treated could cause a recipient serious physical or mental disability,
208.25continuation of severe pain, or death. The provider must request retroactive authorization
208.26no later than five working days after giving the initial service. The provider must be able
208.27to substantiate the emergency by documentation such as reports, notes, and admission or
208.28discharge histories;
208.29(2)
208.30
208.31
208.32
208.33a recipient's medical assistance eligibility has lapsed, is then retroactively reinstated,
208.34and an authorization for home care services is completed based on the date of a current
208.35assessment, eligibility, and request for authorization;
209.1(3) a third-party payor for home care services has denied or adjusted a payment.
209.2Authorization requests must be submitted by the provider within 20 working days of the
209.3notice of denial or adjustment. A copy of the notice must be included with the request;
209.4(4) the commissioner has determined that a county or state human services agency
209.5has made an error; or
209.6(5)
209.7
209.8
209.9
209.10disenrollment from a health plan, the commissioner shall accept the current health plan
209.11authorization for personal care assistance services for up to 60 days. The request must
209.12be received within the first 30 days of the disenrollment. If the recipient's reenrollment
209.13in managed care is after the 60 days and before 90 days, the provider shall request an
209.14additional 30-day extension of the current health plan authorization, for a total limit of
209.1590 days from the time of disenrollment.
209.16
209.17
209.18 Subd. 6.
209.19designee, shall review the assessment,
209.20
209.21submitted. The commissioner shall, within 30 days after receiving a complete request,
209.22assessment, and service plan, authorize home care services as
209.23section.
209.24
209.25
209.26by the commissioner or the commissioner's designee.
209.27on medical necessity and cost-effectiveness when compared with other care options.
209.28The commissioner must receive the request for authorization of skilled nurse visits and
209.29home health aide visits within 20 working days of the start of service. When home health
209.30services are used in combination with personal care and private duty nursing, the cost of
209.31all home care services shall be considered for cost-effectiveness.
209.32
209.33
209.34
209.35monthly medical assistance authorization for home care services shall not exceed what the
209.36commissioner would pay for care at the highest cost hospital designated as a long-term
210.1hospital under the Medicare program. For purposes of this paragraph, home care services
210.2means all direct care services provided in the home that would be included in the payment
210.3for care at the long-term hospital.
210.4
210.5
210.6definition of ventilator dependent and the EN home care rating and utilize a combination
210.7of home care services are limited up to a total of 24 hours of home care services per day.
210.8Additional hours may be authorized when a recipient's assessment indicates a need for two
210.9staff to perform activities. Additional time is limited to four hours per day.
210.10 Subd. 7.
210.11commissioner's designee shall determine the time period for which
210.12shall be effective
210.13
210.14the
210.15A personal care provider agency must request a new personal care
210.16 services assessment, or service update if allowed, at least 60 days prior to the end of
210.17the current
210.18made on a form approved by the commissioner.
210.19
210.20
210.21(b) The amount and type of personal care assistance services authorized based
210.22upon the assessment and service plan must remain in effect for the recipient whether
210.23the recipient chooses a different provider or enrolls or disenrolls from a managed care
210.24plan under section 256B.0659, unless the service needs of the recipient change and new
210.25assessment is warranted under section 256B.0655, subdivision 1b.
210.26(c) A recipient who appeals a reduction in previously authorized home care
210.27services may continue previously authorized services, other than temporary services
210.28under subdivision 8, pending an appeal under section
210.29
210.30 a detailed explanation of
210.31care assistance tasks are reduced
210.32
210.33the reduction in the recipient's notice of denial, termination, or reduction.
210.34 Subd. 8.
210.35
210.36a temporary authorization for home care services
211.1approve a temporary level of home care services based on the assessment, and service
211.2or care plan information, and primary payer coverage determination information as
211.3required. Authorization for a temporary level of home care services including nurse
211.4supervision is limited to the time specified by the commissioner, but shall not exceed
211.545 days
211.6
211.7
211.8future
211.9 Subd. 9.
211.10provided in an adult or child foster care setting must receive
211.11
211.12(b) The commissioner may not authorize:
211.13(1) home care services that are the responsibility of the foster care provider under
211.14the terms of the foster care placement agreement, difficulty of care rate as of January 1,
211.152010, and administrative rules;
211.16(2) personal care
211.17also the personal care provider or personal care assistant
211.18
211.19
211.20defined in section 256B.0625, subdivision 19a; or
211.21
211.22
211.23
211.24
211.25
211.26
211.27
211.28
211.29
211.30
211.31
211.32
211.33 Subd. 11. Limits on services without
211.34the following home care services during a calendar year:
212.1(1) up to two face-to-face assessments to determine a recipient's need for personal
212.2care
212.3(2) one service update done to determine a recipient's need for personal care
212.4assistance services; and
212.5(3) up to nine face-to-face skilled nurse visits.
212.6 Subd. 12. Approval of home care services. The commissioner or the
212.7commissioner's designee shall determine the medical necessity of home care services,
212.8the level of caregiver according to subdivision 2, and the institutional comparison
212.9according to subdivisions 4 to 12 and sections
212.10subdivisions 3 and 4
212.11scope, and duration of home care services reimbursable by medical assistance, based
212.12on the assessment, primary payer coverage determination information as required, the
212.13service plan, the recipient's age, the cost of services, the recipient's medical condition, and
212.14diagnosis or disability. The commissioner may publish additional criteria for determining
212.15medical necessity according to section
212.16 Subd. 13. Recovery of excessive payments. The commissioner shall seek
212.17monetary recovery from providers of payments made for services which exceed the limits
212.18established in this section and sections
212.19subdivision does not apply to services provided to a recipient at the previously authorized
212.20level pending an appeal under section
212.21 Subd. 14. Referrals to Medicare providers required. Home care providers that
212.22do not participate in or accept Medicare assignment must refer and document the referral
212.23of dual-eligible recipients to Medicare providers when Medicare is determined to be the
212.24appropriate payer for services and supplies and equipment. Providers must be terminated
212.25from participation in the medical assistance program for failure to make these referrals.
212.26 Subd. 15. Quality assurance for program integrity. The commissioner shall
212.27establish an ongoing quality assurance process for home care services to monitor program
212.28integrity, including provider standards and training, consumer surveys, and random
212.29reviews of documentation.
212.30 Subd. 16. Oversight of enrolled providers. The commissioner has the authority to
212.31request proof of documentation of meeting provider standards, quality standards of care,
212.32correct billing practices, and other information. Failure to comply with or to provide access
212.33and information to demonstrate compliance with laws, rules, or policies may result in
212.34suspension, denial, or termination of the provider agency's enrollment with the department.
213.1 Sec. 24. Minnesota Statutes 2008, section 256B.0652, is amended to read:
213.2256B.0652
213.3SERVICES.
213.4 Subdivision 1. State coordination. The commissioner shall supervise the
213.5coordination of the
213.6reimbursed by medical assistance.
213.7 Subd. 2. Duties. (a) The commissioner may contract with or employ
213.8
213.9provide home care
213.10recipients who are receiving home care services.
213.11(b) Reimbursement for the
213.12medical assistance administrative authority. The state shall pay the nonfederal share.
213.13The functions will be to:
213.14(1) assess the recipient's individual need for services required to be cared for safely
213.15in the community;
213.16(2) ensure that a
213.17by the appropriate agency or individual;
213.18(3) ensure cost-effectiveness and nonduplication of medical assistance home care
213.19services;
213.20(4) recommend the approval or denial of the use of medical assistance funds to pay
213.21for home care services;
213.22(5) reassess the recipient's need for and level of home care services at a frequency
213.23determined by the commissioner;
213.24(6) conduct on-site assessments when determined necessary by the commissioner
213.25and recommend changes to care plans that will provide more efficient and appropriate
213.26home care; and
213.27(7) on the department's Web site:
213.28(i) provide a link to MinnesotaHelp.info for a list of enrolled home care agencies
213.29with the following information: main office address, contact information for the agency,
213.30counties in which services are provided, type of home care services provided, whether
213.31the personal care assistance choice option is offered, types of qualified professionals
213.32employed, number of personal care assistants employed, and data on staff turnover; and
213.33(ii) post data on home care services including information from both fee-for-service
213.34and managed care plans on recipients as available.
213.35(c) In addition, the commissioner or the commissioner's designee may:
214.1(1) review care plans, service plans, and reimbursement data for utilization of
214.2services that exceed community-based standards for home care, inappropriate home care
214.3services, medical necessity, home care services that do not meet quality of care standards,
214.4or unauthorized services and make appropriate referrals within the department or to other
214.5appropriate entities based on the findings;
214.6(2) assist the recipient in obtaining services necessary to allow the recipient to
214.7remain safely in or return to the community;
214.8(3) coordinate home care services with other medical assistance services under
214.9section
214.10(4) assist the recipient with problems related to the provision of home care services;
214.11(5) assure the quality of home care services; and
214.12(6) assure that all liable third-party payers including, but not limited to, Medicare
214.13have been used prior to medical assistance for home care services
214.14
214.15
214.16(d) For the purposes of this section, "home care services" means medical assistance
214.17services defined under section
214.18 Subd. 3. Assessment and
214.19personal care assistance and developmental disabilities services.
214.20
214.21and streamlining administrative requirements, the assessment and
214.22process for persons receiving both home care and home and community-based waivered
214.23services for persons with developmental disabilities shall meet the requirements of
214.24sections
214.25(a) Upon request for home care services and subsequent assessment by the public
214.26health nurse under sections
214.27nurse shall participate in the screening process, as appropriate, and, if home care
214.28services are determined to be necessary, participate in the development of a service plan
214.29coordinating the need for home care and home and community-based waivered services
214.30with the assigned county case manager, the recipient of services, and the recipient's legal
214.31representative, if any.
214.32(b) The public health nurse shall give
214.33to the extent that home care services are:
214.34(1) medically necessary;
214.35(2) chosen by the recipient and their legal representative, if any, from the array of
214.36home care and home and community-based waivered services available;
215.1(3) coordinated with other services to be received by the recipient as described
215.2in the service plan; and
215.3(4) provided within the county's reimbursement limits for home care and home and
215.4community-based waivered services for persons with developmental disabilities.
215.5(c) If the public health agency is or may be the provider of home care services to the
215.6recipient, the public health agency shall provide the commissioner of human services with
215.7a written plan that specifies how the assessment and
215.8held separate and distinct from the provision of services.
215.9 Sec. 25. Minnesota Statutes 2008, section 256B.0653, is amended to read:
215.10256B.0653 HOME HEALTH AGENCY
215.11 Subdivision 1.
215.12
215.13
215.14
215.15
215.16
215.17
215.18
215.19
215.20
215.21home health agency services including, home health aide, skilled nursing visits, physical
215.22therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.
215.23 Subd. 2.
215.24
215.25
215.26
215.27
215.28
215.29
215.30
215.31
215.32
215.33
215.34
215.35
216.1
216.2
216.3
216.4
216.5
216.6
216.7(a) "Assessment" means an evaluation of the recipient's medical need for home
216.8health agency services by a registered nurse or appropriate therapist that is conducted
216.9within 30 days of a request.
216.10(b) "Home care therapies" means occupational, physical, and respiratory therapy
216.11and speech-language pathology services provided in the home by a Medicare certified
216.12home health agency.
216.13(c) "Home health agency services" means services delivered in the recipient's home
216.14residence, except as specified in section 256B.0625, by a home health agency to a recipient
216.15with medical needs due to illness, disability, or physical conditions.
216.16(d) "Home health aide" means an employee of a home health agency who completes
216.17medically oriented tasks written in the plan of care for a recipient.
216.18(e) "Home health agency" means a home care provider agency that is
216.19Medicare-certified.
216.20(f) "Occupational therapy services" mean the services defined in Minnesota Rules,
216.21part 9505.0390.
216.22(g) "Physical therapy services" mean the services defined in Minnesota Rules, part
216.239505.0390.
216.24(h) "Respiratory therapy services" mean the services defined in chapter 147C and
216.25Minnesota Rules, part 4668.0003, subpart 37.
216.26(i) "Speech-language pathology services" mean the services defined in Minnesota
216.27Rules, part 9505.0390.
216.28(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks
216.29required due to a recipient's medical condition that can only be safely provided by a
216.30professional nurse to restore and maintain optimal health.
216.31(k) "Store-and-forward technology" means telehomecare services that do not occur
216.32in real time via synchronous transmissions such as diabetic and vital sign monitoring.
216.33(l) "Telehomecare" means the use of telecommunications technology via
216.34live, two-way interactive audiovisual technology which may be augmented by
216.35store-and-forward technology.
217.1(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to
217.2deliver a skilled nurse visit to a recipient located at a site other than the site where the
217.3nurse is located and is used in combination with face-to-face skilled nurse visits to
217.4adequately meet the recipient's needs.
217.5 Subd. 3.
217.6
217.7
217.8
217.9
217.10
217.11
217.12
217.13
217.14
217.15
217.16
217.17
217.18
217.19
217.20
217.21
217.22
217.23
217.24
217.25
217.26
217.27(a) Home health aide visits must be provided by a certified home health aide
217.28using a written plan of care that is updated in compliance with Medicare regulations.
217.29A home health aide shall provide hands-on personal care, perform simple procedures
217.30as an extension of therapy or nursing services, and assist in instrumental activities of
217.31daily living as defined in section 256B.0659. Home health aide visits must be provided
217.32in the recipient's home.
217.33(b) All home health aide visits must have authorization under section 256B.0652.
217.34The commissioner shall limit home health aide visits to no more than one visit per day
217.35per recipient.
218.1(c) Home health aides must be supervised by a registered nurse or an appropriate
218.2therapist when providing services that are an extension of therapy.
218.3 Subd. 4. Skilled nurse visit services. (a) Skilled nurse visit services must be
218.4provided by a registered nurse or a licensed practical nurse under the supervision of a
218.5registered nurse, according to the written plan of care and accepted standards of medical
218.6and nursing practice according to chapter 148. Skilled nurse visit services must be ordered
218.7by a physician and documented in a plan of care that is reviewed and approved by the
218.8ordering physician at least once every 60 days. All skilled nurse visits must be medically
218.9necessary and provided in the recipient's home residence except as allowed under section
218.10256B.0625, subdivision 6a.
218.11(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of
218.12up to two visits per day per recipient. All visits must be based on assessed needs.
218.13(c) Telehomecare skilled nurse visits are allowed when the recipient's health status
218.14can be accurately measured and assessed without a need for a face-to-face, hands-on
218.15encounter. All telehomecare skilled nurse visits must have authorization and are paid at
218.16the same allowable rates as face-to-face skilled nurse visits.
218.17(d) The provision of telehomecare must be made via live, two-way interactive
218.18audiovisual technology and may be augmented by utilizing store-and-forward
218.19technologies. Individually identifiable patient data obtained through real-time or
218.20store-and-forward technology must be maintained as health records according to sections
218.21144.291 to 144.298. If the video is used for research, training, or other purposes unrelated
218.22to the care of the patient, the identity of the patient must be concealed.
218.23(e) Authorization for skilled nurse visits must be completed under section
218.24256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not
218.25require authorization. All telehomecare skilled nurse visits require authorization.
218.26 Subd. 5. Home care therapies. (a) Home care therapies include the following:
218.27physical therapy, occupational therapy, respiratory therapy, and speech and language
218.28pathology therapy services.
218.29(b) Home care therapies must be:
218.30(1) provided in the recipient's residence after it has been determined the recipient is
218.31unable to access outpatient therapy;
218.32(2) prescribed, ordered, or referred by a physician and documented in a plan of care
218.33and reviewed, according to Minnesota Rules, part 9505.0390;
218.34(3) assessed by an appropriate therapist; and
218.35(4) provided by a Medicare-certified home health agency enrolled as a Medicaid
218.36provider agency.
219.1(c) Restorative and specialized maintenance therapies must be provided according to
219.2Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
219.3used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
219.4(d) For both physical and occupational therapies, the therapist and the therapist's
219.5assistant may not both bill for services provided to a recipient on the same day.
219.6 Subd. 6. Noncovered home health agency services. The following are not eligible
219.7for payment under medical assistance as a home health agency service:
219.8(1) telehomecare skilled nurses services that is communication between the home
219.9care nurse and recipient that consists solely of a telephone conversation, facsimile,
219.10electronic mail, or a consultation between two health care practitioners;
219.11(2) the following skilled nurse visits:
219.12(i) for the purpose of monitoring medication compliance with an established
219.13medication program for a recipient;
219.14(ii) administering or assisting with medication administration, including injections,
219.15prefilling syringes for injections, or oral medication setup of an adult recipient, when,
219.16as determined and documented by the registered nurse, the need can be met by an
219.17available pharmacy or the recipient or a family member is physically and mentally able
219.18to self-administer or prefill a medication;
219.19(iii) services done for the sole purpose of supervision of the home health aide or
219.20personal care assistant;
219.21(iv) services done for the sole purpose to train other home health agency workers;
219.22(v) services done for the sole purpose of blood samples or lab draw when the
219.23recipient is able to access these services outside the home; and
219.24(vi) Medicare evaluation or administrative nursing visits required by Medicare;
219.25(3) home health aide visits when the following activities are the sole purpose for the
219.26visit: companionship, socialization, household tasks, transportation, and education; and
219.27(4) home care therapies provided in other settings such as a clinic, day program, or as
219.28an inpatient or when the recipient can access therapy outside of the recipient's residence.
219.29 Sec. 26. Minnesota Statutes 2008, section 256B.0654, is amended to read:
219.30256B.0654 PRIVATE DUTY NURSING.
219.31 Subdivision 1. Definitions.
219.32
219.33
219.34
220.1
220.2
220.3
220.4
220.5ventilator dependent or for whom a physician has certified that
220.6
220.7(ICU) level of care
220.8
220.9(b) "Private duty nursing" means ongoing professional nursing services by a
220.10registered or licensed practical nurse including assessment, professional nursing tasks, and
220.11education, based on an assessment and physician orders to maintain or restore optimal
220.12health of the recipient.
220.13(c) "Private duty nursing agency" means a medical assistance enrolled provider
220.14licensed under chapter 144A to provide private duty nursing services.
220.15(d) "Regular private duty nursing" means nursing services provided to a recipient
220.16who is considered stable and not at an inpatient hospital intensive care unit level of care,
220.17but may have episodes of instability that are not life threatening.
220.18(e) "Shared private duty nursing" means the provision of nursing services by a
220.19private duty nurse to two recipients at the same time and in the same setting.
220.20 Subd. 2. Authorization; private duty nursing services. (a) All private duty
220.21nursing services shall be
220.22designee.
220.23medical necessity and cost-effectiveness when compared with alternative care options.
220.24The commissioner may authorize medically necessary private duty nursing services in
220.25quarter-hour units when:
220.26(1) the recipient requires more individual and continuous care than can be provided
220.27during a skilled nurse visit; or
220.28(2) the cares are outside of the scope of services that can be provided by a home
220.29health aide or personal care assistant.
220.30(b) The commissioner may authorize:
220.31(1) up to two times the average amount of direct care hours provided in nursing
220.32facilities statewide for case mix classification "K" as established by the annual cost report
220.33submitted to the department by nursing facilities in May 1992;
220.34(2) private duty nursing in combination with other home care services up to the total
220.35cost allowed under section
221.1(3) up to 16 hours per day if the recipient requires more nursing than the maximum
221.2number of direct care hours as established in clause (1) and the recipient meets the hospital
221.3admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.
221.4(c) The commissioner may authorize up to 16 hours per day of medically necessary
221.5private duty nursing services or up to 24 hours per day of medically necessary private duty
221.6nursing services until such time as the commissioner is able to make a determination of
221.7eligibility for recipients who are cooperatively applying for home care services under
221.8the community alternative care program developed under section
221.9determined by the appropriate regulatory agency that a health benefit plan is or is not
221.10required to pay for appropriate medically necessary health care services. Recipients
221.11or their representatives must cooperatively assist the commissioner in obtaining this
221.12determination. Recipients who are eligible for the community alternative care program
221.13may not receive more hours of nursing under this section and sections
221.15authorized under section
221.16 Subd. 2a. Private duty nursing services. (a) Private duty nursing services must
221.17be used:
221.18(1) in the recipient's home or outside the home when normal life activities require;
221.19(2) when the recipient requires more individual and continuous care than can be
221.20provided during a skilled nurse visit; and
221.21(3) when the care required is outside of the scope of services that can be provided by
221.22a home health aide or personal care assistant.
221.23(b) Private duty nursing services must be:
221.24(1) assessed by a registered nurse on a form approved by the commissioner;
221.25(2) ordered by a physician and documented in a plan of care that is reviewed by the
221.26physician at least once every 60 days; and
221.27(3) authorized by the commissioner under section 256B.0652.
221.28 Subd. 2b. Noncovered private duty nursing services. Private duty nursing
221.29services do not cover the following:
221.30(1) nursing services by a nurse who is the family foster care provider of a person
221.31who has not reached 18 years of age unless allowed under subdivision 4;
221.32(2) nursing services to more than two persons receiving shared private duty nursing
221.33services from a private duty nurse in a single setting; and
221.34(3) nursing services provided by a registered nurse or licensed practical nurse who is
221.35the recipient's legal guardian or related to the recipient as spouse, parent, or family foster
222.1parent whether by blood, marriage, or adoption except as specified in section 256B.0652,
222.2subdivision 4.
222.3 Subd. 3. Shared private duty nursing
222.4payments for shared private duty nursing services by a private duty nurse shall be limited
222.5according to this subdivision.
222.6
222.7
222.8provided in this subdivision, all other statutory and regulatory provisions relating to
222.9private duty nursing services apply to shared private duty nursing services. Nothing in
222.10this subdivision shall be construed to reduce the total number of private duty nursing
222.11hours authorized for an individual recipient.
222.12
222.13
222.14
222.15
222.16
222.17
222.18
222.19
222.20
222.21private duty nurse to two medical assistance eligible recipients at the same time and in
222.22the same setting. This subdivision does not apply when a private duty nurse is caring for
222.23multiple recipients in more than one setting.
222.24(c) For the purposes of this subdivision, "setting" means:
222.25(1) the home residence or foster care home of one of the individual recipients as
222.26defined in section 256B.0651;
222.27(2) a child care program licensed under chapter 245A or operated by a local school
222.28district or private school;
222.29(3) an adult day care service licensed under chapter 245A; or
222.30(4) outside the home residence or foster care home of one of the recipients when
222.31normal life activities take the recipients outside the home.
222.32
222.33
222.34(d) The private duty nursing agency must offer the recipient the option of shared or
222.35one-on-one private duty nursing services. The recipient may withdraw from participating
222.36in a shared service arrangement at any time.
223.1
223.2physician, in conjunction with the
223.3determine:
223.4(1) whether shared private duty nursing care is an appropriate option based on the
223.5individual needs and preferences of the recipient; and
223.6(2) the amount of shared private duty nursing services authorized as part of the
223.7overall authorization of nursing services.
223.8
223.9private duty nursing agency, shall approve the setting, grouping, and arrangement of
223.10shared private duty nursing care based on the individual needs and preferences of the
223.11recipients. Decisions on the selection of recipients to share services must be based on the
223.12ages of the recipients, compatibility, and coordination of their care needs.
223.13
223.14legal representative and the private duty nursing agency, and documented in the recipient's
223.15health service record:
223.16(1) the additional training needed by the private duty nurse to provide care to
223.17two recipients in the same setting and to ensure that the needs of the recipients are met
223.18appropriately and safely;
223.19(2) the setting in which the shared private duty nursing care will be provided;
223.20(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness
223.21of the service and process used to make changes in service or setting;
223.22(4) a contingency plan which accounts for absence of the recipient in a shared private
223.23duty nursing setting due to illness or other circumstances;
223.24(5) staffing backup contingencies in the event of employee illness or absence; and
223.25(6) arrangements for additional assistance to respond to urgent or emergency care
223.26needs of the recipients.
223.27
223.28
223.29
223.30(h)
223.31
223.32The documentation for shared private duty nursing must be on a form approved by
223.33the commissioner for each individual recipient sharing private duty nursing. The
223.34documentation must be part of the recipient's health service record and include:
223.35(1) permission by the recipient or the recipient's legal representative for the
223.36maximum number of shared nursing
224.1permission for shared private duty nursing services provided in and outside the recipient's
224.2home residence;
224.3(2)
224.4
224.5
224.6
224.7
224.8private duty nursing
224.9
224.10permission, or services provided to others in and outside the recipient's residence; and
224.11
224.12each identified private duty nurse, including:
224.13(i) the names of each recipient receiving shared private duty nursing services
224.14
224.15(ii) the setting for the shared services, including the starting and ending times that
224.16the recipient received shared private duty nursing care; and
224.17(iii) notes by the private duty nurse regarding changes in the recipient's condition,
224.18problems that may arise from the sharing of private duty nursing services, and scheduling
224.19and care issues.
224.20
224.21
224.22
224.23
224.24
224.25(i) The commissioner shall provide a rate methodology for shared private duty
224.26nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed
224.271.5 times the regular private duty nursing rates paid for serving a single individual by a
224.28registered nurse or licensed practical nurse. These rates apply only to situations in which
224.29both recipients are present and receive shared private duty nursing care on the date for
224.30which the service is billed.
224.31 Subd. 4. Hardship criteria; private duty nursing. (a) Payment is allowed for
224.32extraordinary services that require specialized nursing skills and are provided by parents
224.33of minor children, family foster parents, spouses, and legal guardians who are providing
224.34private duty nursing care under the following conditions:
224.35(1) the provision of these services is not legally required of the parents, spouses,
224.36or legal guardians;
225.1(2) the services are necessary to prevent hospitalization of the recipient; and
225.2(3) the recipient is eligible for state plan home care or a home and community-based
225.3waiver and one of the following hardship criteria are met:
225.4(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to
225.5provide nursing care for the recipient;
225.6(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with
225.7less compensation to provide nursing care for the recipient;
225.8(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to
225.9provide nursing care for the recipient; or
225.10(iv) because of labor conditions, special language needs, or intermittent hours of
225.11care needed, the parent, spouse, or legal guardian is needed in order to provide adequate
225.12private duty nursing services to meet the medical needs of the recipient.
225.13(b) Private duty nursing may be provided by a parent, spouse, family foster parent,
225.14or legal guardian who is a nurse licensed in Minnesota. Private duty nursing services
225.15provided by a parent, spouse, family foster parent, or legal guardian cannot be used in
225.16lieu of nursing services covered and available under liable third-party payors, including
225.17Medicare. The private duty nursing provided by a parent, spouse, family foster parent, or
225.18legal guardian must be included in the service
225.19services for a single recipient or recipients with the same residence and provided by the
225.20parent, spouse, family foster parent, or legal guardian may not exceed 50 percent of the
225.21total approved nursing hours, or eight hours per day, whichever is less, up to a maximum
225.22of 40 hours per week. A parent or parents, spouse, family foster parent, or legal guardian
225.23shall not provide more than 40 hours of services in a seven-day period. For parents, family
225.24foster parents, and legal guardians, 40 hours is the total amount allowed regardless of the
225.25number of children or adults who receive services. Nothing in this subdivision precludes
225.26the parent's, spouse's, or legal guardian's obligation of assuming the nonreimbursed family
225.27responsibilities of emergency backup caregiver and primary caregiver.
225.28(c) A parent, family foster parent, or a spouse may not be paid to provide private
225.29duty nursing care if:
225.30(1) the parent or spouse fails to pass a criminal background check according to
225.31chapter 245C
225.32(2) it has been determined by the
225.33case manager, or the physician that the private duty nursing
225.34family foster parent, spouse, or legal guardian is unsafe; or
225.35(3) the parent, family foster parent, spouse, or legal guardian do not follow physician
225.36orders.
226.1(d) For purposes of this section, "assessment" means a review and evaluation of a
226.2recipient's need for home care services conducted in person. Assessments for private duty
226.3nursing must be conducted by a registered nurse.
226.4 Sec. 27. Minnesota Statutes 2008, section 256B.0655, subdivision 1b, is amended to
226.5read:
226.6 Subd. 1b. Assessment. "Assessment" means a review and evaluation of a recipient's
226.7need for home care services conducted in person. Assessments for personal care assistant
226.8services shall be conducted by the county public health nurse or a certified public
226.9health nurse under contract with the county.
226.10must include: documentation of health status, determination of need, evaluation of
226.11service effectiveness, identification of appropriate services, service plan development
226.12or modification, coordination of services, referrals and follow-up to appropriate payers
226.13and community resources, completion of required reports, recommendation of service
226.14authorization, and consumer education. Once the need for personal care assistant
226.15services is determined under this section or sections
226.16and
226.17contract with the county is responsible for communicating this recommendation to the
226.18commissioner and the recipient.
226.19
226.20
226.21when there is a significant change in the recipient's condition or when there is a change
226.22in the need for personal care assistant services. A service update may substitute for
226.23the annual face-to-face assessment when there is not a significant change in recipient
226.24condition or a change in the need for personal care assistant service. A service update
226.25may be completed by telephone, used when there is no need for an increase in personal
226.26care assistant services, and used for two consecutive assessments if followed by a
226.27face-to-face assessment. A service update must be completed on a form approved by the
226.28commissioner. A service update or review for temporary increase includes a review of
226.29initial baseline data, evaluation of service effectiveness, redetermination of service need,
226.30modification of service plan and appropriate referrals, update of initial forms, obtaining
226.31service authorization, and on going consumer education. Assessments must be completed
226.32on forms provided by the commissioner within 30 days of a request for home care services
226.33by a recipient or responsible party or personal care provider agency.
227.1 Sec. 28. Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to
227.2read:
227.3 Subd. 4.
227.4professional.
227.5
227.6
227.7
227.8
227.9
227.10qualified professional,
227.11limits established in section 256B.0651, subdivision 11, must be
227.12the commissioner or the commissioner's designee before services begin except for the
227.13assessments established in
227.14The authorization for personal care assistance and qualified professional services under
227.15section 256B.0659 must be completed within 30 days after receiving a complete request.
227.16(b) The amount of personal care
227.17based on the recipient's home care rating. The home care rating shall be determined by
227.18the commissioner or the commissioner's designee based on information submitted to the
227.19commissioner identifying the following:
227.20(1) total number of dependencies of activities of daily living as defined in section
227.21256B.0659;
227.22(2) number of complex health-related functions as defined in section 256B.0659; and
227.23(3) number of behavior descriptions as defined in section 256B.0659.
227.24(c) The methodology to determine total time for personal care assistance services for
227.25each home care rating is based on the median paid units per day for each home care rating
227.26from fiscal year 2007 data for the personal care assistance program. Each home care rating
227.27has a base level of hours assigned. Additional time is added through the assessment and
227.28identification of the following:
227.29(1) 30 additional minutes per day for a dependency in each critical activity of daily
227.30living as defined in section 256B.0659;
227.31(2) 30 additional minutes per day for each complex health-related function as
227.32defined in section 256B.0659; and
227.33(3) 30 additional minutes per day for each behavior issue as defined in section
227.34256B.0659.
227.35(d) A limit of 96 units of qualified professional supervision may be authorized for
227.36each recipient receiving personal care assistance services. A request to the commissioner
228.1to exceed this total in a calendar year must be requested by the personal care provider
228.2agency on a form approved by the commissioner.
228.3
228.4
228.5
228.6
228.7
228.8
228.9
228.10
228.11
228.12
228.13
228.14
228.15
228.16
228.17
228.18
228.19
228.20
228.21
228.22
228.23
228.24
228.25
228.26
228.27
228.28
228.29
228.30
228.31
228.32
228.33
228.34
228.35
228.36
229.1
229.2
229.3
229.4
229.5
229.6
229.7
229.8
229.9
229.10
229.11
229.12
229.13
229.14
229.15
229.16
229.17
229.18
229.19
229.20
229.21
229.22
229.23
229.24
229.25
229.26
229.27
229.28
229.29
229.30
229.31
229.32
229.33
229.34
229.35
229.36
230.1
230.2
230.3
230.4
230.5
230.6
230.7
230.8EFFECTIVE DATE.The amendments to paragraphs (a) and (b) are effective
230.9January 1, 2010.
230.10 Sec. 29. Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to
230.11read:
230.12 Subd. 8. Self-directed budget requirements. The budget for the provision of the
230.13self-directed service option shall be
230.14 (1)
230.15
230.16assistance units, not to exceed the maximum number of personal care assistance units
230.17available, as determined by section 256B.0655;
230.18 (2)
230.19
230.20
230.21 (i) with a reduction to the unit rate to pay for a program administrator as defined in
230.22subdivision 10; and
230.23 (ii) an additional adjustment to the unit rate as needed to ensure cost neutrality for
230.24the state.
230.25 Sec. 30. Minnesota Statutes 2008, section 256B.0657, is amended by adding a
230.26subdivision to read:
230.27 Subd. 12. Enrollment and evaluation. Enrollment in the self-directed supports
230.28option is available to current personal care assistance recipients upon annual personal care
230.29assistance reassessment, with a maximum enrollment of 1,000 people in the first fiscal
230.30year of implementation and an additional 1,000 people in the second fiscal year. The
230.31commissioner shall evaluate the self-directed supports option during the first two years of
230.32implementation and make any necessary changes prior to the option becoming available
230.33statewide.
231.1 Sec. 31. [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.
231.2 Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in
231.3paragraphs (b) to (p) have the meanings given unless otherwise provided in text.
231.4(b) "Activities of daily living" means grooming, dressing, bathing, transferring,
231.5mobility, positioning, eating, and toileting.
231.6(c) "Behavior," effective January 1, 2010, means a category to determine the home
231.7care rating and is based on the criteria found in this section. "Level I behavior" means
231.8physical aggression towards self, others, or destruction of property that requires the
231.9immediate response of another person.
231.10(d) "Complex health-related needs," effective January 1, 2010, means a category to
231.11determine the home care rating and is based on the criteria found in this section.
231.12(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
231.13mobility, eating, and toileting.
231.14(f) "Dependency in activities of daily living" means a person requires assistance to
231.15begin and complete one or more of the activities of daily living.
231.16(g) "Health-related procedures and tasks" means procedures and tasks that can
231.17be delegated or assigned by a licensed health care professional under state law to be
231.18performed by a personal care assistant.
231.19(h) "Instrumental activities of daily living" means activities to include meal planning
231.20and preparation; basic assistance with paying bills; shopping for food, clothing, and
231.21other essential items; performing household tasks integral to the personal care assistance
231.22services; communication by telephone and other media; and traveling, including to
231.23medical appointments and to participate in the community.
231.24(i) "Managing employee" has the same definition as Code of Federal Regulations,
231.25title 42, section 455.
231.26(j) "Qualified professional" means a professional providing supervision of personal
231.27care assistance services and staff as defined in section 256B.0625, subdivision 19c.
231.28(k) "Personal care assistance provider agency" means a medical assistance enrolled
231.29provider that provides or assists with providing personal care assistance services and
231.30includes personal care assistance provider organizations, personal care assistance choice
231.31agency, class A licensed nursing agency, and Medicare-certified home health agency.
231.32(l) "Personal care assistant" or "PCA" means an individual employed by a personal
231.33care assistance agency who provides personal care assistance services.
231.34(m) "Personal care assistance care plan" means a written description of personal
231.35care assistance services developed by the personal care assistance provider according
231.36to the service plan.
232.1(n) "Responsible party" means an individual who is capable of providing the support
232.2necessary to assist the recipient to live in the community.
232.3(o) "Self-administered medication" means medication taken orally, by injection or
232.4insertion, or applied topically without the need for assistance.
232.5(p) "Service plan" means a written summary of the assessment and description of the
232.6services needed by the recipient.
232.7 Subd. 2. Personal care assistance services; covered services. (a) The personal
232.8care assistance services eligible for payment include services and supports furnished
232.9to an individual, as needed, to assist in:
232.10(1) activities of daily living;
232.11(2) health-related procedures and tasks;
232.12(3) observation and redirection of behaviors; and
232.13(4) instrumental activities of daily living.
232.14(b) Activities of daily living include the following covered services:
232.15(1) dressing, including assistance with choosing, application, and changing of
232.16clothing and application of special appliances, wraps, or clothing;
232.17(2) grooming, including assistance with basic hair care, oral care, shaving, applying
232.18cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included,
232.19except for recipients who are diabetic or have poor circulation;
232.20(3) bathing, including assistance with basic personal hygiene and skin care;
232.21(4) eating, including assistance with hand washing and application of orthotics
232.22required for eating, transfers, and feeding;
232.23(5) transfers, including assistance with transferring the recipient from one seating or
232.24reclining area to another;
232.25(6) mobility, including assistance with ambulation, including use of a wheelchair.
232.26Mobility does not include providing transportation for a recipient;
232.27(7) positioning, including assistance with positioning or turning a recipient for
232.28necessary care and comfort; and
232.29(8) toileting, including assistance with helping recipient with bowel or bladder
232.30elimination and care including transfers, mobility, positioning, feminine hygiene, use of
232.31toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and
232.32adjusting clothing.
232.33(c) Health-related procedures and tasks include the following covered services:
232.34(1) range of motion and passive exercise to maintain a recipient's strength and
232.35muscle functioning;
233.1(2) assistance with self-administered medication as defined by this section, including
233.2reminders to take medication, bringing medication to the recipient, and assistance with
233.3opening medication under the direction of the recipient or responsible party;
233.4(3) interventions for seizure disorders, including monitoring and observation; and
233.5(4) other activities considered within the scope of the personal care service and
233.6meeting the definition of health-related procedures and tasks under this section.
233.7(d) A personal care assistant may provide health-related procedures and tasks
233.8associated with the complex health-related needs of a recipient if the procedures and
233.9tasks meet the definition of health-related procedures and tasks under this section and the
233.10personal care assistant is trained by a qualified professional and demonstrates competency
233.11to safely complete the procedures and tasks. Delegation of health-related procedures and
233.12tasks and all training must be documented in the personal care assistance care plan and the
233.13recipient's and personal care assistant's files.
233.14(e) Effective January 1, 2010, for a personal care assistant to provide the
233.15health-related procedures and tasks of tracheostomy suctioning and services to recipients
233.16on ventilator support there must be:
233.17(1) delegation and training by a registered nurse, certified or licensed respiratory
233.18therapist, or a physician;
233.19(2) utilization of clean rather than sterile procedure;
233.20(3) specialized training about the health-related procedures and tasks and equipment,
233.21including ventilator operation and maintenance;
233.22(4) individualized training regarding the needs of the recipient; and
233.23(5) supervision by a qualified professional who is a registered nurse.
233.24(f) Effective January 1, 2010, a personal care assistant may observe and redirect the
233.25recipient for episodes where there is a need for redirection due to behaviors. Training of
233.26the personal care assistant must occur based on the needs of the recipient, the personal
233.27care assistance care plan, and any other support services provided.
233.28(g) Instrumental activities of daily living under subdivision 1, paragraph (h).
233.29 Subd. 3. Noncovered personal care assistance services. (a) Personal care
233.30assistance services are not eligible for medical assistance payment under this section
233.31when provided:
233.32(1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal
233.33guardian, licensed foster provider, except as allowed under section 256B.0651, subdivision
233.349a, or responsible party;
233.35(2) in lieu of other staffing options in a residential or child care setting;
233.36(3) solely as a child care or babysitting service; or
234.1(4) without authorization by the commissioner or the commissioner's designee.
234.2(b) The following personal care services are not eligible for medical assistance
234.3payment under this section when provided in residential settings:
234.4(1) effective January 1, 2010, when the provider of home care services who is not
234.5related by blood, marriage, or adoption owns or otherwise controls the living arrangement,
234.6including licensed or unlicensed services; or
234.7(2) when personal care assistance services are the responsibility of a residential or
234.8program license holder under the terms of a service agreement and administrative rules.
234.9(c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible
234.10for medical assistance reimbursement for personal care assistance services under this
234.11section include:
234.12(1) sterile procedures;
234.13(2) injections of fluids and medications into veins, muscles, or skin;
234.14(3) home maintenance or chore services;
234.15(4) homemaker services not an integral part of assessed personal care assistance
234.16services needed by a recipient;
234.17(5) application of restraints or implementation of procedures under section 245.825;
234.18(6) instrumental activities of daily living for children under the age of 18; and
234.19(7) assessments for personal care assistance services by personal care assistance
234.20provider agencies or by independently enrolled registered nurses.
234.21 Subd. 4. Assessment for personal care assistance services. (a) An assessment
234.22as defined in section 256B.0655, subdivision 1b, must be completed for personal care
234.23assistance services.
234.24(b) The following limitations apply to the assessment:
234.25(1) a person must be assessed as dependent in an activity of daily living based
234.26on the person's need, on a daily basis, for:
234.27(i) cueing and constant supervision to complete the task; or
234.28(ii) hands-on assistance to complete the task; and
234.29(2) a child may not be found to be dependent in an activity of daily living if because
234.30of the child's age an adult would either perform the activity for the child or assist the child
234.31with the activity. Assistance needed is the assistance appropriate for a typical child of
234.32the same age.
234.33(c) Assessment for complex health-related needs must meet the criteria in this
234.34paragraph. During the assessment process, a recipient qualifies as having complex
234.35health-related needs if the recipient has one or more of the interventions that are ordered by
234.36a physician, specified in a personal care assistance care plan, and found in the following:
235.1(1) tube feedings requiring:
235.2(i) a gastro/jejunostomy tube; or
235.3(ii) continuous tube feeding lasting longer than 12 hours per day;
235.4(2) wounds described as:
235.5 (i) stage III or stage IV;
235.6 (ii) multiple wounds;
235.7 (iii) requiring sterile or clean dressing changes or a wound vac; or
235.8 (iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
235.9specialized care;
235.10 (3) parenteral therapy described as:
235.11 (i) IV therapy more than two times per week lasting longer than four hours for
235.12each treatment; or
235.13 (ii) total parenteral nutrition (TPN) daily;
235.14 (4) respiratory interventions including:
235.15 (i) oxygen required more than eight hours per day;
235.16 (ii) respiratory vest more than one time per day;
235.17 (iii) bronchial drainage treatments more than two times per day;
235.18 (iv) sterile or clean suctioning more than six times per day;
235.19 (v) dependence on another to apply respiratory ventilation augmentation devises
235.20such as BiPAP and CPAP; and
235.21 (vi) ventilator dependence under section 256B.0652;
235.22 (5) insertion and maintenance of catheter including:
235.23(i) sterile catheter changes more than one time per month;
235.24(ii) clean self-catheterization more than six times per day; or
235.25(iii) bladder irrigations;
235.26(6) bowel program more than two times per week requiring more than 30 minutes to
235.27perform each time;
235.28(7) neurological intervention including:
235.29(i) seizures more than two times per week and requiring significant physical
235.30assistance to maintain safety; or
235.31(ii) swallowing disorders diagnosed by a physician and requiring specialized
235.32assistance from another on a daily basis; and
235.33(8) other congenital or acquired diseases creating a need for significantly increased
235.34direct hands-on assistance and interventions in six to eight activities of daily living.
236.1(d) An assessment of behaviors must meet the criteria in this paragraph. A recipient
236.2qualifies as having a need for assistance due to behaviors if the recipient's behavior requires
236.3assistance at least four times per week and shows one or more of the following behaviors:
236.4(1) physical aggression towards self or others, or destruction of property that requires
236.5the immediate response of another person;
236.6(2) increased vulnerability due to cognitive deficits or socially inappropriate
236.7behavior; or
236.8(3) verbally aggressive and resistive to care.
236.9 Subd. 5. Service, support planning, and referral. (a) The assessor, with the
236.10recipient or responsible party, shall review the assessment information and determine
236.11referrals for other payers, services, and community supports as appropriate.
236.12(b) The recipient must be referred for evaluation, services, or supports that are
236.13appropriate to help meet the recipient's needs including, but not limited to, the following
236.14circumstances:
236.15(1) when there is another payer who is responsible to provide the service to meet
236.16the recipient's needs;
236.17(2) when the recipient qualifies for assistance due to mental illness or behaviors
236.18under this section, a referral for a mental health diagnostic and functional assessment
236.19must be completed, or referral must be made for other specific mental health services or
236.20other community services;
236.21(3) when the recipient is eligible for medical assistance and meets medical assistance
236.22eligibility for a home health aide or skilled nurse visit;
236.23(4) when the recipient would benefit from an evaluation for another service; and
236.24(5) when there is a more appropriate service to meet the assessed needs.
236.25 (c) The reimbursement rates for public health nurse visits that relate to the provision
236.26of personal care assistance services under this section and section
236.2719a
236.28 (1) $210.50 for a face-to-face assessment visit;
236.29 (2) $105.25 for each service update; and
236.30 (3) $105.25 for each request for a temporary service increase.
236.31 (d) The rates specified in paragraph (c) must be adjusted to reflect provider rate
236.32increases for personal care assistance services that are approved by the legislature for the
236.33fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied
236.34by the legislature to provider rate increases for personal care assistance services also
236.35apply to adjustments under this paragraph.
237.1 (e) Effective July 1, 2008, the payment rate for an assessment under this section and
237.2section
237.3on time and the service agreement documentation is not submitted in time to continue
237.4services. The commissioner shall reduce the amount of the claim for those assessments
237.5that are not submitted on time.
237.6 Subd. 6. Service plan. The service plan must be completed by the assessor with the
237.7recipient and responsible party on a form determined by the commissioner and include
237.8a summary of the assessment with a description of the need, authorized amount, and
237.9expected outcomes and goals of personal care assistance services. The recipient and
237.10the provider chosen by the recipient or responsible party must be given a copy of the
237.11completed service plan within ten working days of the assessment. The recipient or
237.12responsible party must be given information by the assessor about the options in the
237.13personal care assistance program to allow for review and decision making.
237.14 Subd. 7. Personal care assistance care plan. (a) Each recipient must have a
237.15current personal care assistance care plan based on the service plan in subdivision 6 that is
237.16developed by the qualified professional with the recipient and responsible party. A copy of
237.17the most current personal care assistance care plan is required to be in the recipient's home
237.18and in the recipient's file at the provider agency.
237.19(b) The personal care assistance care plan must have the following components:
237.20(1) start and end date of the care plan;
237.21(2) recipient demographic information, including name and telephone number;
237.22(3) emergency numbers, procedures, and a description of measures to address
237.23identified safety and vulnerability issues, including a backup staffing plan;
237.24(4) name of responsible party and instructions for contact;
237.25(5) description of the recipient's individualized needs for assistance with activities of
237.26daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
237.27(6) dated signatures of recipient or responsible party and qualified professional.
237.28(c) The personal care assistance care plan must have instructions and comments
237.29about the recipient's needs for assistance and any special instructions or procedures
237.30required. The month-to-month plan for the use of personal care assistance services is part
237.31of the personal care assistance care plan. The personal care assistance care plan must
237.32be completed within the first week after start of services with a personal care provider
237.33agency and must be updated as needed when there is a change in need for personal care
237.34assistance services. A new personal care assistance care plan is required annually at the
237.35time of the reassessment.
238.1 Subd. 8. Communication with recipient's physician. The personal care assistance
238.2program requires communication with the recipient's physician about a recipient's assessed
238.3needs for personal care assistance services. The commissioner shall work with the state
238.4medical director to develop options for communication with the recipient's physician.
238.5 Subd. 9. Responsible party; generally. (a) "Responsible party," effective January
238.61, 2010, means an individual who is capable of providing the support necessary to assist
238.7the recipient to live in the community.
238.8(b) A responsible party must be 18 years of age, actively participate in planning and
238.9directing of personal care assistance services, and attend all assessments for the recipient.
238.10(c) A responsible party must not be the:
238.11(1) personal care assistant;
238.12(2) home care provider agency owner or staff; or
238.13(3) county staff acting as part of employment.
238.14(d) A licensed family foster parent who lives with the recipient may be the
238.15responsible party as long as the family foster parent meets the other responsible party
238.16requirements.
238.17(e) A responsible party is required when:
238.18(1) the person is a minor according to section 524.5-102, subdivision 10;
238.19(2) the person is an incapacitated adult according to section 524.5-102, subdivision
238.206, resulting in a court-appointed guardian; or
238.21(3) the assessment according to section 256B.0655, subdivision 1b, determines that
238.22the recipient is in need of a responsible party to direct the recipient's care.
238.23(f) There may be two persons designated as the responsible party for reasons such
238.24as divided households and court-ordered custodies. Each person named as responsible
238.25party must meet the program criteria and responsibilities.
238.26(g) The recipient or the recipient's legal representative shall appoint a responsible
238.27party if necessary to direct and supervise the care provided to the recipient. The
238.28responsible party must be identified at the time of assessment and listed on the recipient's
238.29service agreement and personal care assistance care plan.
238.30 Subd. 10. Responsible party; duties; delegation. (a) A responsible party shall
238.31enter into a written agreement with a personal care assistance provider agency, on a form
238.32determined by the commissioner, to perform the following duties:
238.33(1) be available while care is provided in a method agreed upon by the individual
238.34or the individual's legal representative and documented in the recipient's personal care
238.35assistance care plan;
239.1(2) monitor personal care assistance services to ensure the recipient's personal care
239.2assistance care plan is being followed; and
239.3(3) review and sign personal care assistance time sheets after services are provided
239.4to provide verification of the personal care assistance services.
239.5Failure to provide the support required by the recipient must result in a referral to the
239.6county common entry point.
239.7(b) Responsible parties who are parents of minors or guardians of minors or
239.8incapacitated persons may delegate the responsibility to another adult who is not the
239.9personal care assistant during a temporary absence of at least 24 hours but not more
239.10than six months. The person delegated as a responsible party must be able to meet the
239.11definition of the responsible party, except that the delegated responsible party is required
239.12to reside with the recipient only while serving as the responsible party. The responsible
239.13party must ensure that the delegate performs the functions of the responsible party, is
239.14identified at the time of the assessment, and is listed on the personal care assistance
239.15care plan. The responsible party must communicate to the personal care assistance
239.16provider agency about the need for a delegate responsible party, including the name of the
239.17delegated responsible party, dates the delegated responsible party will be living with the
239.18recipient, and contact numbers.
239.19 Subd. 11. Personal care assistant; requirements. (a) A personal care assistant
239.20must meet the following requirements:
239.21(1) be at least 18 years of age with the exception of persons who are 16 or 17 years
239.22of age with these additional requirements:
239.23(i) supervision by a qualified professional every 60 days; and
239.24(ii) employment by only one personal care assistance provider agency responsible
239.25for compliance with current labor laws;
239.26(2) be employed by a personal care assistance provider agency;
239.27(3) enroll with the department as a personal care assistant after clearing a background
239.28study. Before a personal care assistant provides services, the personal care assistance
239.29provider agency must initiate a background study on the personal care assistant under
239.30chapter 245C, and the personal care assistance provider agency must have received a
239.31notice from the commissioner that the personal care assistant is:
239.32(i) not disqualified under section 245C.14; or
239.33(ii) is disqualified, but the personal care assistant has received a set aside of the
239.34disqualification under section 245C.22;
239.35(4) be able to effectively communicate with the recipient and personal care
239.36assistance provider agency;
240.1(5) be able to provide covered personal care assistance services according to the
240.2recipient's personal care assistance care plan, respond appropriately to recipient needs,
240.3and report changes in the recipient's condition to the supervising qualified professional
240.4or physician;
240.5(6) not be a consumer of personal care assistance services;
240.6(7) maintain daily written records including, but not limited to, time sheets under
240.7subdivision 12;
240.8(8) effective January 1, 2010, complete standardized training as determined by the
240.9commissioner before completing enrollment. Personal care assistant training must include
240.10successful completion of the following training components: basic first aid, vulnerable
240.11adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of
240.12personal care assistants including information about assistance with lifting and transfers
240.13for recipients, emergency preparedness, orientation to positive behavioral practices, fraud
240.14issues, and completion of time sheets. Upon completion of the training components,
240.15the personal care assistant must demonstrate the competency to provide assistance to
240.16recipients;
240.17(9) complete training and orientation on the needs of the recipient within the first
240.18seven days after the services begin; and
240.19(10) be limited to providing and being paid for up to 310 hours per month of personal
240.20care assistance services regardless of the number of recipients being served or the number
240.21of personal care assistance provider agencies enrolled with.
240.22(b) A legal guardian may be a personal care assistant if the guardian is not being paid
240.23for the guardian services and meets the criteria for personal care assistants in paragraph (a).
240.24(c) Effective January 1, 2010, persons who do not qualify as a personal care assistant
240.25include parents and stepparents of minors, spouses, paid legal guardians, family foster
240.26care providers, except as otherwise allowed in section 256B.0625, subdivision 19a, or
240.27staff of a residential setting.
240.28 Subd. 12. Documentation of personal care assistance services provided. (a)
240.29Personal care assistance services for a recipient must be documented daily by each personal
240.30care assistant, on a time sheet form approved by the commissioner. All documentation
240.31may be Web-based, electronic, or paper documentation. The completed form must be
240.32submitted on a monthly basis to the provider and kept in the recipient's health record.
240.33(b) The activity documentation must correspond to the personal care assistance care
240.34plan and be reviewed by the qualified professional.
241.1(c) The personal care assistant time sheet must be on a form approved by the
241.2commissioner documenting time the personal care assistant provides services in the home.
241.3The following criteria must be included in the time sheet:
241.4(1) full name of personal care assistant and individual provider number;
241.5(2) provider name and telephone numbers;
241.6(3) full name of recipient;
241.7(4) consecutive dates, including month, day, and year, and arrival and departure
241.8time with a.m. or p.m. notations;
241.9(5) signatures of recipient or the responsible party;
241.10(6) personal signature of the personal care assistant;
241.11(7) any shared care provided, if applicable;
241.12(8) a statement that it is a federal crime to provide false information on personal
241.13care service billings for medical assistance payments; and
241.14(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
241.15 Subd. 13. Qualified professional; qualifications. (a) The qualified professional
241.16must be employed by a personal care assistance provider agency and meet the definition
241.17under section 256B.0625, subdivision 19c. Before a qualified professional provides
241.18services, the personal care assistance provider agency must initiate a background study on
241.19the qualified professional under chapter 245C, and the personal care assistance provider
241.20agency must have received a notice from the commissioner that the qualified professional:
241.21(1) is not disqualified under section 245C.14; or
241.22(2) is disqualified, but the qualified professional has received a set aside of the
241.23disqualification under section 245C.22.
241.24(b) The qualified professional shall perform the duties of training, supervision, and
241.25evaluation of the personal care assistance staff and evaluation of the effectiveness of
241.26personal care assistance services. The qualified professional shall:
241.27(1) develop and monitor with the recipient a personal care assistance care plan based
241.28on the service plan and individualized needs of the recipient;
241.29(2) develop and monitor with the recipient a monthly plan for the use of personal
241.30care assistance services;
241.31(3) review documentation of personal care assistance services provided;
241.32(4) provide training and ensure competency for the personal care assistant in the
241.33individual needs of the recipient; and
241.34(5) document all training, communication, evaluations, and needed actions to
241.35improve performance of the personal care assistants.
242.1(c) The qualified professional shall complete the provider training with basic
242.2information about the personal care assistance program approved by the commissioner
242.3within six months of the date hired by a personal care assistance provider agency.
242.4Qualified professionals who have completed the required trainings as an employee with a
242.5personal care assistance provider agency do not need to repeat the required trainings if they
242.6are hired by another agency, if they have completed the training within the last three years.
242.7 Subd. 14. Qualified professional; duties. (a) Effective January 1, 2010, all personal
242.8care assistants must be supervised by a qualified professional.
242.9(b) Through direct training, observation, return demonstrations, and consultation
242.10with the staff and the recipient, the qualified professional must ensure and document
242.11that the personal care assistant is:
242.12(1) capable of providing the required personal care assistance services;
242.13(2) knowledgeable about the plan of personal care assistance services before services
242.14are performed; and
242.15(3) able to identify conditions that should be immediately brought to the attention of
242.16the qualified professional.
242.17(c) The qualified professional shall evaluate the personal care assistant within the
242.18first 14 days of starting to provide services for a recipient except for the personal care
242.19assistance choice option under subdivision 19, paragraph (a), clause (4). The qualified
242.20professional shall evaluate the personal care assistance services for a recipient through
242.21direct observation of a personal care assistant's work:
242.22(1) at least every 90 days thereafter for the first year of a recipient's services; and
242.23(2) every 120 days after the first year of a recipient's service or whenever needed for
242.24response to a recipient's request for increased supervision of the personal care assistance
242.25staff.
242.26(d) Communication with the recipient is a part of the evaluation process of the
242.27personal care assistance staff.
242.28(e) At each supervisory visit, the qualified professional shall evaluate personal care
242.29assistance services including the following information:
242.30(1) satisfaction level of the recipient with personal care assistance services;
242.31(2) review of the month-to-month plan for use of personal care assistance services;
242.32(3) review of documentation of personal care assistance services provided;
242.33(4) whether the personal care assistance services are meeting the goals of the service
242.34as stated in the personal care assistance care plan and service plan;
242.35(5) a written record of the results of the evaluation and actions taken to correct any
242.36deficiencies in the work of a personal care assistant; and
243.1(6) revision of the personal care assistance care plan as necessary in consultation
243.2with the recipient or responsible party, to meet the needs of the recipient.
243.3(f) The qualified professional shall complete the required documentation in the
243.4agency recipient and employee files and the recipient's home, including the following
243.5documentation:
243.6(1) the personal care assistance care plan based on the service plan and individualized
243.7needs of the recipient;
243.8(2) a month-to-month plan for use of personal care assistance services;
243.9(3) changes in need of the recipient requiring a change to the level of service and the
243.10personal care assistance care plan;
243.11(4) evaluation results of supervision visits and identified issues with personal care
243.12assistance staff with actions taken;
243.13(5) all communication with the recipient and personal care assistance staff; and
243.14(6) hands-on training or individualized training for the care of the recipient.
243.15(g) The documentation in paragraph (f) must be done on agency forms.
243.16(h) The services that are not eligible for payment as qualified professional services
243.17include:
243.18(1) direct professional nursing tasks that could be assessed and authorized as skilled
243.19nursing tasks;
243.20(2) supervision of personal care assistance completed by telephone;
243.21(3) agency administrative activities;
243.22(4) training other than the individualized training required to provide care for a
243.23recipient; and
243.24(5) any other activity that is not described in this section.
243.25 Subd. 15. Flexible use. (a) "Flexible use" means the scheduled use of authorized
243.26hours of personal care assistance services, which vary within a service authorization
243.27period covering no more than six months, in order to more effectively meet the needs and
243.28schedule of the recipient. Each 12-month service agreement is divided into two six-month
243.29authorization date spans. No more than 75 percent of the total authorized units for a
243.3012-month service agreement may be used in a six-month date span.
243.31(b) Authorization of flexible use occurs during the authorization process under
243.32section 256B.0652. The flexible use of authorized hours does not increase the total
243.33amount of authorized hours available to a recipient. The commissioner shall not authorize
243.34additional personal care assistance services to supplement a service authorization that
243.35is exhausted before the end date under a flexible service use plan, unless the assessor
243.36determines a change in condition and a need for increased services is established.
244.1Authorized hours not used within the six-month period must not be carried over to another
244.2time period.
244.3(c) A recipient who has terminated personal care assistance services before the end
244.4of the 12-month authorization period must not receive additional hours upon reapplying
244.5during the same 12-month authorization period, except if a change in condition is
244.6documented. Services must be prorated for the remainder of the 12-month authorization
244.7period based on the first six-month assessment.
244.8(d) The recipient, responsible party, and qualified professional must develop a
244.9written month-to-month plan of the projected use of personal care assistance services that
244.10is part of the personal care assistance care plan and ensures:
244.11(1) that the health and safety needs of the recipient are met throughout both date
244.12spans of the authorization period; and
244.13(2) that the total authorized amount of personal care assistance services for each date
244.14span must not be used before the end of each date span in the authorization period.
244.15(e) The personal care assistance provider agency shall monitor the use of personal
244.16care assistance services to ensure health and safety needs of the recipient are met
244.17throughout both date spans of the authorization period. The commissioner or the
244.18commissioner's designee shall provide written notice to the provider and the recipient or
244.19responsible party when a recipient is at risk of exceeding the personal care assistance
244.20services prior to the end of the six-month period.
244.21(f) Misuse and abuse of the flexible use of personal care assistance services resulting
244.22in the overuse of units in a manner where the recipient will not have enough units to meet
244.23their needs for assistance and ensure health and safety for the entire six-month date span
244.24may lead to an action by the commissioner. The commissioner may take action including,
244.25but not limited to: (1) restricting recipients to service authorizations of no more than one
244.26month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring
244.27a qualified professional to monitor and report services on a monthly basis.
244.28 Subd. 16. Shared services. (a) Medical assistance payments for shared personal
244.29care assistance services are limited according to this subdivision.
244.30(b) Shared service is the provision of personal care assistance services by a personal
244.31care assistant to two or three recipients, eligible for medical assistance, who voluntarily
244.32enter into an agreement to receive services at the same time and in the same setting.
244.33(c) For the purposes of this subdivision, "setting" means:
244.34(1) the home residence or family foster care home of one or more of the individual
244.35recipients; or
245.1(2) a child care program licensed under chapter 245A or operated by a local school
245.2district or private school.
245.3(d) Shared personal care assistance services follow the same criteria for covered
245.4services as subdivision 2.
245.5(e) Noncovered shared personal care assistance services include the following:
245.6(1) services for more than three recipients by one personal care assistant at one time;
245.7(2) staff requirements for child care programs under chapter 245C;
245.8(3) caring for multiple recipients in more than one setting;
245.9(4) additional units of personal care assistance based on the selection of the option;
245.10and
245.11(5) use of more than one personal care assistance provider agency for the shared
245.12care services.
245.13(f) The option of shared personal care assistance is elected by the recipient or the
245.14responsible party with the assistance of the assessor. The option must be determined
245.15appropriate based on the ages of the recipients, compatibility, and coordination of their
245.16assessed care needs. The recipient or the responsible party, in conjunction with the
245.17qualified professional, shall arrange the setting and grouping of shared services based
245.18on the individual needs and preferences of the recipients. The personal care assistance
245.19provider agency shall offer the recipient or the responsible party the option of shared or
245.20one-on-one personal care assistance services or a combination of both. The recipient or
245.21the responsible party may withdraw from participating in a shared services arrangement at
245.22any time.
245.23(g) Authorization for the shared service option must be determined by the
245.24commissioner based on the criteria that the shared service is appropriate to meet all of the
245.25recipients' needs and their health and safety is maintained. The authorization of shared
245.26services is part of the overall authorization of personal care assistance services. Nothing
245.27in this subdivision must be construed to reduce the total number of hours authorized for
245.28an individual recipient.
245.29(h) A personal care assistant providing shared personal care assistance services must:
245.30(1) receive training specific for each recipient served; and
245.31(2) follow all required documentation requirements for time and services provided.
245.32(i) A qualified professional shall:
245.33(1) evaluate the ability of the personal care assistant to provide services for all of
245.34the recipients in a shared setting;
246.1(2) visit the shared setting as services are being provided at least once every six
246.2months or whenever needed for response to a recipient's request for increased supervision
246.3of the personal care assistance staff;
246.4(3) provide ongoing monitoring and evaluation of the effectiveness and
246.5appropriateness of the shared services;
246.6(4) develop a contingency plan with each of the recipients which accounts for
246.7absence of the recipient in a share services setting due to illness or other circumstances;
246.8(5) obtain permission from each of the recipients who are sharing a personal care
246.9assistant for number of shared hours for services provided inside and outside the home
246.10residence; and
246.11(6) document the training completed by the personal care assistants specific to the
246.12shared setting and recipients sharing services.
246.13 Subd. 17. Shared services; rates. The commissioner shall provide a rate system for
246.14shared personal care assistance services. For two persons sharing services, the rate paid
246.15to a provider must not exceed one and one-half times the rate paid for serving a single
246.16individual, and for three persons sharing services, the rate paid to a provider must not
246.17exceed twice the rate paid for serving a single individual. These rates apply only when all
246.18of the criteria for the shared care personal care assistance service have been met.
246.19 Subd. 18. Personal care assistance choice option; generally. (a) The
246.20commissioner may allow a recipient of personal care assistance services to use a fiscal
246.21intermediary to assist the recipient in paying and accounting for medically necessary
246.22covered personal care assistance services. Unless otherwise provided in this section, all
246.23other statutory and regulatory provisions relating to personal care assistance services apply
246.24to a recipient using the personal care assistance choice option.
246.25(b) Personal care assistance choice is an option of the personal care assistance
246.26program that allows the recipient who receives personal care assistance services to be
246.27responsible for the hiring, training, scheduling, and firing of personal care assistants. This
246.28program offers greater control and choice for the recipient in who provides the personal
246.29care assistance service and when the service is scheduled. The recipient or the recipient's
246.30responsible party must choose a personal care assistance choice provider agency as
246.31a fiscal intermediary. This personal care assistance choice provider agency manages
246.32payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is
246.33responsible for providing the consumer training and support in managing the recipient's
246.34personal care assistance services.
247.1 Subd. 19. Personal care assistance choice option; qualifications; duties. (a)
247.2Under personal care assistance choice, the recipient or responsible party shall:
247.3(1) recruit, hire, schedule, and terminate personal care assistants and a qualified
247.4professional;
247.5(2) develop a personal care assistance care plan based on the assessed needs
247.6and addressing the health and safety of the recipient with the assistance of a qualified
247.7professional as needed;
247.8(3) orient and train the personal care assistant with assistance as needed from the
247.9qualified professional;
247.10(4) effective January 1, 2010, supervise and evaluate the personal care assistant with
247.11the qualified professional, who is required to visit the recipient at least every 180 days;
247.12(5) monitor and verify in writing and report to the personal care assistance choice
247.13agency the number of hours worked by the personal care assistant and the qualified
247.14professional;
247.15(6) engage in an annual face-to-face reassessment to determine continuing eligibility
247.16and service authorization; and
247.17(7) use the same personal care assistance choice provider agency if shared personal
247.18assistance care is being used.
247.19(b) The personal care assistance choice provider agency shall:
247.20(1) meet all personal care assistance provider agency standards;
247.21(2) enter into a written agreement with the recipient, responsible party, and personal
247.22care assistants;
247.23(3) not be related as a parent, child, sibling, or spouse to the recipient, qualified
247.24professional, or the personal care assistant; and
247.25(4) ensure arm's-length transactions without undue influence or coercion with the
247.26recipient and personal care assistant.
247.27(c) The duties of the personal care assistance choice provider agency are to:
247.28(1) be the employer of the personal care assistant and the qualified professional for
247.29employment law and related regulations including, but not limited to, purchasing and
247.30maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
247.31and liability insurance, and submit any or all necessary documentation including, but not
247.32limited to, workers' compensation and unemployment insurance;
247.33(2) bill the medical assistance program for personal care assistance services and
247.34qualified professional services;
247.35(3) request and complete background studies that comply with the requirements for
247.36personal care assistants and qualified professionals;
248.1(4) pay the personal care assistant and qualified professional based on actual hours
248.2of services provided;
248.3(5) withhold and pay all applicable federal and state taxes;
248.4(6) verify and keep records of hours worked by the personal care assistant and
248.5qualified professional;
248.6(7) make the arrangements and pay taxes and other benefits, if any; and comply with
248.7any legal requirements for a Minnesota employer;
248.8(8) enroll in the medical assistance program as a personal care assistance choice
248.9agency; and
248.10(9) enter into a written agreement as specified in subdivision 20 before services
248.11are provided.
248.12 Subd. 20. Personal care assistance choice option; administration. (a) Before
248.13services commence under the personal care assistance choice option, and annually
248.14thereafter, the personal care assistance choice provider agency, recipient, or responsible
248.15party, each personal care assistant, and the qualified professional shall enter into a written
248.16agreement. The agreement must include at a minimum:
248.17(1) duties of the recipient, qualified professional, personal care assistant, and
248.18personal care assistance choice provider agency;
248.19(2) salary and benefits for the personal care assistant and the qualified professional;
248.20(3) administrative fee of the personal care assistance choice provider agency and
248.21services paid for with that fee, including background study fees;
248.22(4) grievance procedures to respond to complaints;
248.23(5) procedures for hiring and terminating the personal care assistant; and
248.24(6) documentation requirements including, but not limited to, time sheets, activity
248.25records, and the personal care assistance care plan.
248.26(b) Effective January 1, 2010, except for the administrative fee of the personal care
248.27assistance choice provider agency as reported on the written agreement, the remainder
248.28of the rates paid to the personal care assistance choice provider agency must be used to
248.29pay for the salary and benefits for the personal care assistant or the qualified professional.
248.30The provider agency must use a minimum of 72.5 percent of the revenue generated by
248.31the medical assistance rate for personal care assistance services for employee personal
248.32care assistant wages and benefits.
248.33(c) The commissioner shall deny, revoke, or suspend the authorization to use the
248.34personal care assistance choice option if:
248.35(1) it has been determined by the qualified professional or public health nurse that
248.36the use of this option jeopardizes the recipient's health and safety;
249.1(2) the parties have failed to comply with the written agreement specified in this
249.2subdivision;
249.3(3) the use of the option has led to abusive or fraudulent billing for personal care
249.4assistance services; or
249.5(4) the department terminates the personal care assistance choice option.
249.6(d) The recipient or responsible party may appeal the commissioner's decision in
249.7paragraph (c) according to section 256.045. The denial, revocation, or suspension to
249.8use the personal care assistance choice option must not affect the recipient's authorized
249.9level of personal care assistance services.
249.10 Subd. 21. Requirements for initial enrollment of personal care assistance
249.11provider agencies. (a) All personal care assistance provider agencies must provide, at the
249.12time of enrollment as a personal care assistance provider agency in a format determined
249.13by the commissioner, information and documentation that includes, but is not limited to,
249.14the following:
249.15(1) the personal care assistance provider agency's current contact information
249.16including address, telephone number, and e-mail address;
249.17(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
249.18provider's payments from Medicaid in the previous year, whichever is less;
249.19(3) proof of fidelity bond coverage in the amount of $20,000;
249.20(4) proof of workers' compensation insurance coverage;
249.21(5) a description of the personal care assistance provider agency's organization
249.22identifying the names of all owners, managing employees, staff, board of directors, and
249.23the affiliations of the directors, owners, or staff to other service providers;
249.24(6) a copy of the personal care assistance provider agency's written policies and
249.25procedures including: hiring of employees; training requirements; service delivery;
249.26and employee and consumer safety including process for notification and resolution
249.27of consumer grievances, identification and prevention of communicable diseases, and
249.28employee misconduct;
249.29(7) copies of all other forms the personal care assistance provider agency uses in
249.30the course of daily business including, but not limited to:
249.31(i) a copy of the personal care assistance provider agency's time sheet if the time
249.32sheet varies from the standard time sheet for personal care assistance services approved
249.33by the commissioner, and a letter requesting approval of the personal care assistance
249.34provider agency's nonstandard time sheet;
249.35(ii) the personal care assistance provider agency's template for the personal care
249.36assistance care plan; and
250.1(iii) the personal care assistance provider agency's template and the written
250.2agreement in subdivision 20 for recipients using the personal care assistance choice
250.3option, if applicable;
250.4(8) a list of all trainings and classes that the personal care assistance provider agency
250.5requires of its staff providing personal care assistance services;
250.6(9) documentation that the personal care assistance provider agency and staff have
250.7successfully completed all the training required by this section;
250.8(10) documentation of the agency's marketing practices;
250.9(11) disclosure of ownership, leasing, or management of all residential properties
250.10that is used or could be used for providing home care services; and
250.11(12) documentation that the agency will use the following percentages of revenue
250.12generated from the medical assistance rate paid for personal care assistance services
250.13for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
250.14personal care assistance choice option and 72.5 percent of revenue from other personal
250.15care assistance providers.
250.16(b) Personal care assistance provider agencies shall provide the information specified
250.17in paragraph (a) to the commissioner at the time the personal care assistance provider
250.18agency enrolls as a vendor or upon request from the commissioner. The commissioner
250.19shall collect the information specified in paragraph (a) from all personal care assistance
250.20providers beginning upon enactment of this section.
250.21(c) All personal care assistance provider agencies shall complete mandatory training
250.22as determined by the commissioner before enrollment as a provider. Personal care
250.23assistance provider agencies are required to send all owners, qualified professionals
250.24employed by the agency, and all other managing employees to the initial and subsequent
250.25trainings. Personal care assistance provider agency billing staff shall complete training
250.26about personal care assistance program financial management. This training is effective
250.27upon enactment of this section. Any personal care assistance provider agency enrolled
250.28before that date shall, if it has not already, complete the provider training within 18 months
250.29of the effective date of this section. Any new owners, new qualified professionals, and new
250.30managing employees are required to complete mandatory training as a requisite of hiring.
250.31 Subd. 22. Annual review for personal care providers. (a) All personal care
250.32assistance provider agencies shall resubmit, on an annual basis, the information specified
250.33in subdivision 21, in a format determined by the commissioner, and provide a copy of the
250.34personal care assistance provider agency's most current version of its grievance policies
250.35and procedures along with a written record of grievances and resolutions of the grievances
251.1that the personal care assistance provider agency has received in the previous year and any
251.2other information requested by the commissioner.
251.3(b) The commissioner shall send annual review notification to personal care
251.4assistance provider agencies 30 days prior to renewal. The notification must:
251.5(1) list the materials and information the personal care assistance provider agency is
251.6required to submit;
251.7(2) provide instructions on submitting information to the commissioner; and
251.8(3) provide a due date by which the commissioner must receive the requested
251.9information.
251.10Personal care assistance provider agencies shall submit required documentation for
251.11annual review within 30 days of notification from the commissioner. If no documentation
251.12is submitted, the personal care assistance provider agency enrollment number must be
251.13terminated or suspended.
251.14(c) Personal care assistance provider agencies also currently licensed under
251.15Minnesota Rules, part 4668.0012, as a class A provider or currently certified for
251.16participation in Medicare as a home health agency are deemed in compliance with
251.17the personal care assistance requirements for enrollment, annual review process, and
251.18documentation.
251.19 Subd. 23. Enrollment requirements following termination. (a) A terminated
251.20personal care assistance provider agency, including all named individuals on the current
251.21enrollment disclosure form and known or discovered affiliates of the personal care
251.22assistance provider agency, is not eligible to enroll as a personal care assistance provider
251.23agency for two years following the termination.
251.24(b) After the two-year period in paragraph (a), if the provider seeks to reenroll
251.25as a personal care assistance provider agency, the personal care assistance provider
251.26agency must be placed on a one-year probation period, beginning after completion of
251.27the following:
251.28(1) the department's provider trainings under this section; and
251.29(2) initial enrollment requirements under subdivision 21.
251.30(c) During the probationary period the commissioner shall complete site visits and
251.31request submission of documentation to review compliance with program policy.
251.32 Subd. 24. Personal care assistance provider agency; general duties. A personal
251.33care assistance provider agency shall:
251.34(1) enroll as a Medicaid provider meeting all provider standards, including
251.35completion of the required provider training;
251.36(2) comply with general medical assistance coverage requirements;
252.1(3) demonstrate compliance with law and policies of the personal care assistance
252.2program to be determined by the commissioner;
252.3(4) comply with background study requirements;
252.4(5) verify and keep records of hours worked by the personal care assistant and
252.5qualified professional;
252.6(6) market agency services only through printed information in brochures and on
252.7Web sites and not engage in any agency-initiated direct contact or marketing in person, by
252.8phone, or other electronic means to potential recipients, guardians, or family members;
252.9(7) pay the personal care assistant and qualified professional based on actual hours
252.10of services provided;
252.11(8) withhold and pay all applicable federal and state taxes;
252.12(9) effective January 1, 2010, document that the agency uses a minimum of 72.5
252.13percent of the revenue generated by the medical assistance rate for personal care assistance
252.14services for employee personal care assistant wages and benefits;
252.15(10) make the arrangements and pay unemployment insurance, taxes, workers'
252.16compensation, liability insurance, and other benefits, if any;
252.17(11) enter into a written agreement under subdivision 20 before services are provided;
252.18(12) report suspected neglect and abuse to the common entry point according to
252.19section 256B.0651;
252.20(13) provide the recipient with a copy of the home care bill of rights at start of
252.21service; and
252.22 (14) request reassessments at least 60 days prior to the end of the current
252.23authorization for personal care assistance services, on forms provided by the commissioner.
252.24 Subd. 25. Personal care assistance provider agency; background studies.
252.25Personal care assistance provider agencies enrolled to provide personal care assistance
252.26services under the medical assistance program shall comply with the following:
252.27(1) owners who have a five percent interest or more and all managing employees
252.28are subject to a background study as provided in chapter 245C. This applies to currently
252.29enrolled personal care assistance provider agencies and those agencies seeking enrollment
252.30as a personal care assistance provider agency. Managing employee has the same meaning
252.31as Code of Federal Regulations, title 42, section 455. An organization is barred from
252.32enrollment if:
252.33(i) the organization has not initiated background studies on owners and managing
252.34employees; or
252.35(ii) the organization has initiated background studies on owners and managing
252.36employees, but the commissioner has sent the organization a notice that an owner or
253.1managing employee of the organization has been disqualified under section 245C.14,
253.2and the owner or managing employee has not received a set aside of the disqualification
253.3under section 245C.22;
253.4(2) a background study must be initiated and completed for all qualified
253.5professionals; and
253.6(3) a background study must be initiated and completed for all personal care
253.7assistants.
253.8 Subd. 26. Personal care assistance provider agency; communicable disease
253.9prevention. A personal care assistance provider agency shall establish and implement
253.10policies and procedures for prevention, control, and investigation of infections and
253.11communicable diseases according to current nationally recognized infection control
253.12practices or guidelines established by the United States Centers for Disease Control and
253.13Prevention, as well as applicable regulations of other federal or state agencies.
253.14 Subd. 27. Personal care assistance provider agency; ventilator training. The
253.15personal care assistance provider agency is required to provide training for the personal
253.16care assistant responsible for working with a recipient who is ventilator dependent. All
253.17training must be administered by a respiratory therapist, nurse, or physician. Qualified
253.18professional supervision by a nurse must be completed and documented on file in the
253.19personal care assistant's employment record and the recipient's health record. If offering
253.20personal care services to a ventilator-dependent recipient, the personal care assistance
253.21provider agency shall demonstrate the ability to:
253.22(1) train the personal care assistant;
253.23(2) supervise the personal care assistant in ventilator operation and maintenance; and
253.24(3) supervise the recipient and responsible party in ventilator operation and
253.25maintenance.
253.26 Subd. 28. Personal care assistance provider agency; required documentation.
253.27Required documentation must be completed and kept in the personal care assistance
253.28provider agency file or the recipient's home residence. The required documentation
253.29consists of:
253.30(1) employee files, including:
253.31(i) applications for employment;
253.32(ii) background study requests and results;
253.33(iii) orientation records about the agency policies;
253.34(iv) trainings completed with demonstration of competence;
253.35(v) supervisory visits;
254.1(vi) evaluations of employment; and
254.2(vii) signature on fraud statement;
254.3(2) recipient files, including:
254.4(i) demographics;
254.5(ii) emergency contact information and emergency backup plan;
254.6(iii) personal care assistance service plan;
254.7(iv) personal care assistance care plan;
254.8(v) month-to-month service use plan;
254.9(vi) all communication records;
254.10(vii) start of service information, including the written agreement with recipient; and
254.11(viii) date the home care bill of rights was given to the recipient;
254.12(3) agency policy manual, including:
254.13(i) policies for employment and termination;
254.14(ii) grievance policies with resolution of consumer grievances;
254.15(iii) staff and consumer safety;
254.16(iv) staff misconduct; and
254.17(v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
254.18resolution of consumer grievances;
254.19(4) time sheets for each personal care assistant along with completed activity sheets
254.20for each recipient served; and
254.21(5) agency marketing and advertising materials and documentation of marketing
254.22activities and costs.
254.23 Subd. 29. Transitional assistance. The commissioner, counties, health plans,
254.24tribes, and personal care assistance providers shall work together to provide transitional
254.25assistance for recipients and families to come into compliance with the new requirements
254.26of this section and ensure the personal care assistance services are not provided by the
254.27housing provider.
254.28 Subd. 30. Notice of service changes to recipients. The commissioner must provide:
254.29(1) by October 31, 2009, information to recipients likely to be affected that (i)
254.30describes the changes to the personal care assistance program that may result in the
254.31loss of access to personal care assistance services, and (ii) includes resources to obtain
254.32further information; and
254.33(2) notice of changes in medical assistance home care services to each affected
254.34recipient at least 30 days before the effective date of the change.
254.35The notice shall include how to get further information on the changes, how to get help to
254.36obtain other services, a list of community resources, and appeal rights. Notwithstanding
255.1section 256.045, a recipient may request continued services pending appeal within the
255.2time period allowed to request an appeal.
255.3EFFECTIVE DATE.Subdivisions 4, 22, and 27 are effective January 1, 2010.
255.4 Sec. 32. Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to
255.5read:
255.6 Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
255.7services is to assist persons with long-term or chronic care needs in making long-term
255.8care decisions and selecting options that meet their needs and reflect their preferences.
255.9The availability of, and access to, information and other types of assistance, including
255.10assessment and support planning, is also intended to prevent or delay certified nursing
255.11facility placements and to provide transition assistance after admission. Further, the goal
255.12of these services is to contain costs associated with unnecessary certified nursing facility
255.13admissions. Long-term consultation services must be available to any person regardless
255.14of public program eligibility. The
255.15
255.16broadest program possible within the funding available.
255.17(b) These services must be coordinated with
255.18counseling provided under section
255.19
255.20telephone assistance and follow up and to offer a variety of cost-effective alternatives to
255.21persons with disabilities and elderly persons. The county or tribal agency or managed
255.22care plan providing long-term care consultation services shall encourage the use of
255.23volunteers from families, religious organizations, social clubs, and similar civic and
255.24service organizations to provide community-based services.
255.25 Sec. 33. Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to
255.26read:
255.27 Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
255.28(a) "Long-term care consultation services" means:
255.29(1)
255.30
255.31
255.32
255.33
255.34
256.1
256.2available to the individual;
256.3
256.4
256.5programs;
256.6(5) face-to-face long-term care consultation assessments, which may be completed
256.7in a hospital, nursing facility, intermediate care facility for persons with developmental
256.8disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
256.9residence;
256.10
256.11a
256.12paragraph (a);
256.13
256.14community-based waiver service eligibility including level of care determination for
256.15individuals who need
256.16section 144.0724, subdivision 11, or 256B.092, service eligibility including state plan
256.17home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs
256.18(a) and (c), based on assessment and support plan development with appropriate referrals
256.19
256.20
256.21no cost-effective community services available; and
256.22
256.23admission.
256.24(b) "Long-term options counseling" means the services provided by the linkage
256.25lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
256.26telephone assistance and follow up once a long-term care consultation assessment has
256.27been completed.
256.28
256.29under chapter 256B and the alternative care program under section
256.30(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
256.31plans administering long-term care consultation assessment and support planning services.
256.32EFFECTIVE DATE.This section is effective January 1, 2011.
256.33 Sec. 34. Minnesota Statutes 2008, section 256B.0911, is amended by adding a
256.34subdivision to read:
257.1 Subd. 2b. Certified assessors. (a) Beginning January 1, 2011, each lead agency
257.2shall use certified assessors who have completed training and certification process
257.3determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate
257.4best practices in assessment and support planning including person-centered planning
257.5principals and have a common set of skills that must ensure consistency and equitable
257.6access to services statewide. Assessors must be part of a multidisciplinary team of
257.7professionals that includes public health nurses, social workers, and other professionals
257.8as defined in paragraph (b). For persons with complex health care needs, a public health
257.9nurse or registered nurse from a multidisciplinary team must be consulted.
257.10(b) Certified assessors are persons with a minimum of a bachelor's degree in social
257.11work, nursing with a public health nursing certificate, or other closely related field with at
257.12least one year of home and community-based experience or a two-year registered nursing
257.13degree with at least three years of home and community-based experience that have
257.14received training and certification specific to assessment and consultation for long-term
257.15care services in the state.
257.16 Sec. 35. Minnesota Statutes 2008, section 256B.0911, is amended by adding a
257.17subdivision to read:
257.18 Subd. 2c. Assessor training and certification. The commissioner shall develop a
257.19curriculum and an assessor certification process to begin no later than January 1, 2010.
257.20All existing lead agency staff designated to provide the services defined in subdivision
257.211a must be certified by December 30, 2010. Each lead agency is required to ensure that
257.22they have sufficient numbers of certified assessors to provide long-term consultation
257.23assessment and support planning within the timelines and parameters of the service by
257.24January 1, 2011. Certified assessors are required to be recertified every three years.
257.25 Sec. 36. Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to
257.26read:
257.27 Subd. 3. Long-term care consultation team. (a) Until January 1, 2011, a long-term
257.28care consultation team shall be established by the county board of commissioners. Each
257.29local consultation team shall consist of at least one social worker and at least one public
257.30health nurse from their respective county agencies. The board may designate public
257.31health or social services as the lead agency for long-term care consultation services. If a
257.32county does not have a public health nurse available, it may request approval from the
257.33commissioner to assign a county registered nurse with at least one year experience in
258.1home care to participate on the team. Two or more counties may collaborate to establish
258.2a joint local consultation team or teams.
258.3(b) The team is responsible for providing long-term care consultation services to
258.4all persons located in the county who request the services, regardless of eligibility for
258.5Minnesota health care programs.
258.6(c) The commissioner shall allow arrangements and make recommendations that
258.7encourage counties to collaborate to establish joint local long-term care consultation teams
258.8to ensure that long-term care consultations are done within the timelines and parameters
258.9of the service. This includes integrated service models as required in subdivision 1,
258.10paragraph (b).
258.11 Sec. 37. Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to
258.12read:
258.13 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
258.14services planning, or other assistance intended to support community-based living,
258.15including persons who need assessment in order to determine waiver or alternative
258.16care program eligibility, must be visited by a long-term care consultation team within
258.17
258.18recommended. After January 1, 2011, these requirements also apply to personal care
258.19assistance services, private duty nursing, and home health agency services, on timelines
258.20established in subdivision 5. Face-to-face assessments must be conducted according
258.21to paragraphs (b) to (i).
258.22 (b) The county may utilize a team of either the social worker or public health nurse,
258.23or both
258.24assessment in a face-to-face interview. The consultation team members must confer
258.25regarding the most appropriate care for each individual screened or assessed.
258.26 (c) The
258.27
258.28of the health, psychological, functional, environmental, and social needs of referred
258.29individuals and provide information necessary to develop a support plan that meets the
258.30consumers needs, using an assessment form provided by the commissioner.
258.31 (d) The
258.32interview with the person being assessed and the person's legal representative,
258.33as required by legally executed documents, and other individuals as requested by the
258.34person, who can provide information on the needs, strengths, and preferences of the
259.1person necessary to develop a support plan that ensures the person's health and safety, but
259.2who is not a provider of service or has any financial interest in the provision of services.
259.3 (e) The
259.4be provided with written recommendations for
259.5
259.6cost-effective alternatives available were offered to the individual. For purposes of
259.7this requirement, "cost-effective alternatives" means community services and living
259.8arrangements that cost the same as or less than
259.9 (f) If the person chooses to use community-based services, the
259.10
259.11support plan, regardless of whether the individual is eligible for Minnesota health care
259.12programs.
259.13 identifying community supports without participating in a complete assessment. Upon
259.14a request for assistance identifying community support, the person must be transferred
259.15or referred to the services available under sections 256.975, subdivision 7, and 256.01,
259.16subdivision 24, for telephone assistance and follow up.
259.17 (g) The person has the right to make the final decision between
259.18
259.19
259.204a, paragraph (c).
259.21 (h) The team must give the person receiving assessment or support planning, or
259.22the person's legal representative, materials, and forms supplied by the commissioner
259.23containing the following information:
259.24 (1) the need for and purpose of preadmission screening if the person selects nursing
259.25facility placement;
259.26 (2) the role of the long-term care consultation assessment and support planning in
259.27waiver and alternative care program eligibility determination;
259.28 (3) information about Minnesota health care programs;
259.29 (4) the person's freedom to accept or reject the recommendations of the team;
259.30 (5) the person's right to confidentiality under the Minnesota Government Data
259.31Practices Act, chapter 13;
259.32 (6) the long-term care consultant's decision regarding the person's need for
259.33
259.34144.0724, subdivision 11, or 256B.092; and
260.1 (7) the person's right to appeal the decision regarding the need for nursing facility
260.2level of care or the county's final decisions regarding public programs eligibility according
260.3to section
260.4 (i) Face-to-face assessment completed as part of eligibility determination for
260.5the alternative care, elderly waiver, community alternatives for disabled individuals,
260.6community alternative care, and traumatic brain injury waiver programs under sections
260.8than 60 calendar days after the date of assessment. The effective eligibility start date
260.9for these programs can never be prior to the date of assessment. If an assessment was
260.10completed more than 60 days before the effective waiver or alternative care program
260.11eligibility start date, assessment and support plan information must be updated in a
260.12face-to-face visit and documented in the department's Medicaid Management Information
260.13System (MMIS). The effective date of program eligibility in this case cannot be prior to
260.14the date the updated assessment is completed.
260.15 Sec. 38. Minnesota Statutes 2008, section 256B.0911, subdivision 3b, is amended to
260.16read:
260.17 Subd. 3b. Transition assistance. (a) A long-term care consultation team shall
260.18provide assistance to persons residing in a nursing facility, hospital, regional treatment
260.19center, or intermediate care facility for persons with developmental disabilities who
260.20request or are referred for assistance. Transition assistance must include assessment,
260.21community support plan development, referrals to long-term care options counseling
260.22under section 256B.975, subdivision 10, for community support plan implementation and
260.23to Minnesota health care programs, and referrals to programs that provide assistance
260.24with housing. Transition assistance must also include information about the Centers for
260.25Independent Living and the Senior LinkAge Line, and about other organizations that
260.26can provide assistance with relocation efforts, and information about contacting these
260.27organizations to obtain their assistance and support.
260.28 (b) The county shall develop transition processes with institutional social workers
260.29and discharge planners to ensure that:
260.30 (1) persons admitted to facilities receive information about transition assistance
260.31that is available;
260.32 (2) the assessment is completed for persons within ten working days of the date of
260.33request or recommendation for assessment; and
260.34 (3) there is a plan for transition and follow-up for the individual's return to the
260.35community. The plan must require notification of other local agencies when a person
261.1who may require assistance is screened by one county for admission to a facility located
261.2in another county.
261.3 (c) If a person who is eligible for a Minnesota health care program is admitted to a
261.4nursing facility, the nursing facility must include a consultation team member or the case
261.5manager in the discharge planning process.
261.6 Sec. 39. Minnesota Statutes 2008, section 256B.0911, subdivision 3c, is amended to
261.7read:
261.8 Subd. 3c. Transition to housing with services. (a) Housing with services
261.9establishments offering or providing assisted living under chapter 144G shall inform
261.10all prospective residents of the availability of and contact information for transitional
261.11consultation services under this subdivision prior to executing a lease or contract with the
261.12prospective resident. The purpose of transitional long-term care consultation is to support
261.13persons with current or anticipated long-term care needs in making informed choices
261.14among options that include the most cost-effective and least restrictive settings, and to
261.15delay spenddown to eligibility for publicly funded programs by connecting people to
261.16alternative services in their homes before transition to housing with services. Regardless
261.17of the consultation, prospective residents maintain the right to choose housing with
261.18services or assisted living if that option is their preference.
261.19 (b) Transitional consultation services are provided as determined by the
261.20commissioner of human services in partnership with county long-term care consultation
261.21units, and the Area Agencies on Aging, and are a combination of telephone-based
261.22and in-person assistance provided under models developed by the commissioner. The
261.23consultation shall be performed in a manner that provides objective and complete
261.24information. Transitional consultation must be provided within five working days of the
261.25request of the prospective resident as follows:
261.26 (1) the consultation must be provided by a qualified professional as determined by
261.27the commissioner;
261.28 (2) the consultation must include a review of the prospective resident's reasons for
261.29considering assisted living, the prospective resident's personal goals, a discussion of the
261.30prospective resident's immediate and projected long-term care needs, and alternative
261.31community services or assisted living settings that may meet the prospective resident's
261.32needs; and
261.33 (3) the prospective resident shall be informed of the availability of long-term care
261.34consultation services described in subdivision 3a that are available at no charge to the
261.35prospective resident to assist the prospective resident in assessment and planning to meet
262.1the prospective resident's long-term care needs. The Senior LinkAge Line and long-term
262.2care consultation team shall give the highest priority to referrals who are at highest risk of
262.3nursing facility placement or as needed for determining eligibility.
262.4 Sec. 40. Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to
262.5read:
262.6 Subd. 4a. Preadmission screening activities related to nursing facility
262.7admissions. (a) All applicants to Medicaid certified nursing facilities, including certified
262.8boarding care facilities, must be screened prior to admission regardless of income, assets,
262.9or funding sources for nursing facility care, except as described in subdivision 4b. The
262.10purpose of the screening is to determine the need for nursing facility level of care as
262.11described in paragraph (d) and to complete activities required under federal law related to
262.12mental illness and developmental disability as outlined in paragraph (b).
262.13(b) A person who has a diagnosis or possible diagnosis of mental illness or
262.14developmental disability must receive a preadmission screening before admission
262.15regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need
262.16for further evaluation and specialized services, unless the admission prior to screening is
262.17authorized by the local mental health authority or the local developmental disabilities case
262.18manager, or unless authorized by the county agency according to Public Law 101-508.
262.19The following criteria apply to the preadmission screening:
262.20(1) the county must use forms and criteria developed by the commissioner to identify
262.21persons who require referral for further evaluation and determination of the need for
262.22specialized services; and
262.23(2) the evaluation and determination of the need for specialized services must be
262.24done by:
262.25(i) a qualified independent mental health professional, for persons with a primary or
262.26secondary diagnosis of a serious mental illness; or
262.27(ii) a qualified developmental disability professional, for persons with a primary or
262.28secondary diagnosis of developmental disability. For purposes of this requirement, a
262.29qualified developmental disability professional must meet the standards for a qualified
262.30developmental disability professional under Code of Federal Regulations, title 42, section
262.32(c) The local county mental health authority or the state developmental disability
262.33authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
262.34nursing facility if the individual does not meet the nursing facility level of care criteria or
262.35needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
263.1purposes of this section, "specialized services" for a person with developmental disability
263.2means active treatment as that term is defined under Code of Federal Regulations, title
263.342, section
263.4(d) The determination of the need for nursing facility level of care must be made
263.5according to criteria established in section 144.0724, subdivision 11, and 256B.092,
263.6using forms developed by the commissioner. In assessing a person's needs, consultation
263.7team members shall have a physician available for consultation and shall consider the
263.8assessment of the individual's attending physician, if any. The individual's physician must
263.9be included if the physician chooses to participate. Other personnel may be included on
263.10the team as deemed appropriate by the county.
263.11EFFECTIVE DATE.The section is effective January 1, 2011.
263.12 Sec. 41. Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to
263.13read:
263.14 Subd. 5. Administrative activity. The commissioner shall
263.15
263.16
263.17
263.18processes, including timelines for when assessments need to be completed, required to
263.19provide the services in this section and shall implement integrated solutions to automate
263.20the business processes to the extent necessary for community support plan approval,
263.21reimbursement, program planning, evaluation, and policy development.
263.22 Sec. 42. Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to
263.23read:
263.24 Subd. 6. Payment for long-term care consultation services. (a) The total payment
263.25for each county must be paid monthly by certified nursing facilities in the county. The
263.26monthly amount to be paid by each nursing facility for each fiscal year must be determined
263.27by dividing the county's annual allocation for long-term care consultation services by 12
263.28to determine the monthly payment and allocating the monthly payment to each nursing
263.29facility based on the number of licensed beds in the nursing facility. Payments to counties
263.30in which there is no certified nursing facility must be made by increasing the payment
263.31rate of the two facilities located nearest to the county seat.
263.32 (b) The commissioner shall include the total annual payment determined under
263.33paragraph (a) for each nursing facility reimbursed under section
263.34according to section
264.1 (c) In the event of the layaway, delicensure and decertification, or removal from
264.2layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
264.3the per diem payment amount in paragraph (b) and may adjust the monthly payment
264.4amount in paragraph (a). The effective date of an adjustment made under this paragraph
264.5shall be on or after the first day of the month following the effective date of the layaway,
264.6delicensure and decertification, or removal from layaway.
264.7 (d) Payments for long-term care consultation services are available to the county
264.8or counties to cover staff salaries and expenses to provide the services described in
264.9subdivision 1a. The county shall employ, or contract with other agencies to employ, within
264.10the limits of available funding, sufficient personnel to provide long-term care consultation
264.11services while meeting the state's long-term care outcomes and objectives as defined in
264.12section
264.13objectives as approved by the commissioner in the biennial home and community-based
264.14services quality assurance plan on a form provided by the commissioner.
264.15 (e) Notwithstanding section
264.16screening costs under the medical assistance program may not be recovered from a facility.
264.17 (f) The commissioner of human services shall amend the Minnesota medical
264.18assistance plan to include reimbursement for the local consultation teams.
264.19 (g) The county may bill, as case management services, assessments, support
264.20planning, and follow-along provided to persons determined to be eligible for case
264.21management under Minnesota health care programs. No individual or family member
264.22shall be charged for an initial assessment or initial support plan development provided
264.23under subdivision 3a or 3b.
264.24(h) The commissioner shall develop an alternative payment methodology for
264.25long-term care consultation services that includes the funding available under this
264.26subdivision, and sections 256B.092 and 256B.0659. In developing the new payment
264.27methodology, the commissioner shall consider the maximization of federal funding for
264.28this activity.
264.29 Sec. 43. Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to
264.30read:
264.31 Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
264.32reimbursement for nursing facilities shall be authorized for a medical assistance recipient
264.33only if a preadmission screening has been conducted prior to admission or the county has
264.34authorized an exemption. Medical assistance reimbursement for nursing facilities shall
264.35not be provided for any recipient who the local screener has determined does not meet the
265.1level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
265.2if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
265.3Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
265.4mental illness is approved by the local mental health authority or an admission for a
265.5recipient with developmental disability is approved by the state developmental disability
265.6authority.
265.7 (b) The nursing facility must not bill a person who is not a medical assistance
265.8recipient for resident days that preceded the date of completion of screening activities as
265.9required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
265.10resident days in the nursing facility resident day totals reported to the commissioner.
265.11EFFECTIVE DATE.The section is effective January 1, 2011.
265.12 Sec. 44. Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to
265.13read:
265.14 Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
265.15 (a) Funding for services under the alternative care program is available to persons who
265.16meet the following criteria:
265.17 (1) the person has been determined by a community assessment under section
265.19facility, but for the provision of services under the alternative care program. Effective
265.20January 1, 2011, this determination must be made according to the criteria established in
265.21section 144.0724, subdivision 11;
265.22 (2) the person is age 65 or older;
265.23 (3) the person would be eligible for medical assistance within 135 days of admission
265.24to a nursing facility;
265.25 (4) the person is not ineligible for the payment of long-term care services by the
265.26medical assistance program due to an asset transfer penalty under section
265.27equity interest in the home exceeding $500,000 as stated in section
265.28 (5) the person needs long-term care services that are not funded through other state
265.29or federal funding;
265.30 (6) except for individuals described in clause (7), the monthly cost of the alternative
265.31care services funded by the program for this person does not exceed 75 percent of the
265.32monthly limit described under section
265.33does not prohibit the alternative care client from payment for additional services, but in no
265.34case may the cost of additional services purchased under this section exceed the difference
265.35between the client's monthly service limit defined under section
266.13
266.2care-related supplies and equipment or environmental modifications and adaptations are or
266.3will be purchased for an alternative care services recipient, the costs may be prorated on a
266.4monthly basis for up to 12 consecutive months beginning with the month of purchase.
266.5If the monthly cost of a recipient's other alternative care services exceeds the monthly
266.6limit established in this paragraph, the annual cost of the alternative care services shall be
266.7determined. In this event, the annual cost of alternative care services shall not exceed 12
266.8times the monthly limit described in this paragraph;
266.9 (7) for individuals assigned a case mix classification A as described under section
266.10256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily
266.11living, (ii) only one dependency in bathing, dressing, grooming, or walking, or (iii) a
266.12dependency score of less than three if eating is the only dependency as determined by an
266.13assessment performed under section 256B.0911, the monthly cost of alternative care
266.14services funded by the program cannot exceed $600 per month for all new participants
266.15enrolled in the program on or after July 1, 2009. This monthly limit shall be applied to
266.16all other participants who meet this criteria at reassessment. This monthly limit shall be
266.17increased annually as described in section 256B.0915, subdivision 3a, paragraph (a). This
266.18monthly limit does not prohibit the alternative care client from payment for additional
266.19services, but in no case may the cost of additional services purchased exceed the difference
266.20between the client's monthly service limit defined in this clause and the limit described in
266.21clause (6) for case mix classification A; and
266.22(8) the person is making timely payments of the assessed monthly fee.
266.23A person is ineligible if payment of the fee is over 60 days past due, unless the person
266.24agrees to:
266.25 (i) the appointment of a representative payee;
266.26 (ii) automatic payment from a financial account;
266.27 (iii) the establishment of greater family involvement in the financial management of
266.28payments; or
266.29 (iv) another method acceptable to the lead agency to ensure prompt fee payments.
266.30 The lead agency may extend the client's eligibility as necessary while making
266.31arrangements to facilitate payment of past-due amounts and future premium payments.
266.32Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
266.33reinstated for a period of 30 days.
266.34 (b) Alternative care funding under this subdivision is not available for a person
266.35who is a medical assistance recipient or who would be eligible for medical assistance
266.36without a spenddown or waiver obligation. A person whose initial application for medical
267.1assistance and the elderly waiver program is being processed may be served under the
267.2alternative care program for a period up to 60 days. If the individual is found to be eligible
267.3for medical assistance, medical assistance must be billed for services payable under the
267.4federally approved elderly waiver plan and delivered from the date the individual was
267.5found eligible for the federally approved elderly waiver plan. Notwithstanding this
267.6provision, alternative care funds may not be used to pay for any service the cost of which:
267.7(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
267.8or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
267.9to participate in the federally approved elderly waiver program under the special income
267.10standard provision.
267.11 (c) Alternative care funding is not available for a person who resides in a licensed
267.12nursing home, certified boarding care home, hospital, or intermediate care facility, except
267.13for case management services which are provided in support of the discharge planning
267.14process for a nursing home resident or certified boarding care home resident to assist with
267.15a relocation process to a community-based setting.
267.16 (d) Alternative care funding is not available for a person whose income is greater
267.17than the maintenance needs allowance under section
267.18to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
267.19year for which alternative care eligibility is determined, who would be eligible for the
267.20elderly waiver with a waiver obligation.
267.21 Sec. 45. Minnesota Statutes 2008, section 256B.0915, subdivision 3a, is amended to
267.22read:
267.23 Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
267.24waivered services to an individual elderly waiver client except for individuals described
267.25in paragraph (b) shall be the weighted average monthly nursing facility rate of the case
267.26mix resident class to which the elderly waiver client would be assigned under Minnesota
267.27Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance
267.28as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in
267.29which the resident assessment system as described in section
267.30rate determination is implemented. Effective on the first day of the state fiscal year in
267.31which the resident assessment system as described in section
267.32rate determination is implemented and the first day of each subsequent state fiscal year, the
267.33monthly limit for the cost of waivered services to an individual elderly waiver client shall
267.34be the rate of the case mix resident class to which the waiver client would be assigned
267.35under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the
268.1previous state fiscal year, adjusted by the greater of any legislatively adopted home and
268.2community-based services percentage rate increase or the average statewide percentage
268.3increase in nursing facility payment rates.
268.4 (b) The monthly limit for the cost of waivered services to an individual elderly
268.5waiver client assigned to a case mix classification A under paragraph (a) with (1) no
268.6dependencies in activities of daily living, (2) only one dependency in bathing, dressing,
268.7grooming, or walking, or (3) a dependency score of less than three if eating is the only
268.8dependency, shall be the lower of the case mix classification amount for case mix A as
268.9determined under paragraph (a) or the case mix classification amount for case mix A
268.10effective on October 1, 2008, per month for all new participants enrolled in the program
268.11on or after July 1, 2009. This monthly limit shall be applied to all other participants who
268.12meet this criteria at reassessment.
268.13(c) If extended medical supplies and equipment or environmental modifications are
268.14or will be purchased for an elderly waiver client, the costs may be prorated for up to
268.1512 consecutive months beginning with the month of purchase. If the monthly cost of a
268.16recipient's waivered services exceeds the monthly limit established in paragraph (a) or (b),
268.17the annual cost of all waivered services shall be determined. In this event, the annual cost
268.18of all waivered services shall not exceed 12 times the monthly limit of waivered services
268.19as described in paragraph (a) or (b).
268.20 Sec. 46. Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to
268.21read:
268.22 Subd. 3e. Customized living service rate. (a) Payment for customized living
268.23services shall be a monthly rate
268.24parameters established by the commissioner. The payment agreement must delineate the
268.25
268.26component service included in the recipient's customized living service
268.27plan. The lead agency shall ensure that there is a documented need
268.28parameters established by the commissioner for all component customized living services
268.29authorized.
268.30(b) The
268.31to be provided utilizing component rates established by the commissioner. Counties and
268.32tribes shall use tools issued by the commissioner to develop and document customized
268.33living service plans and rates.
269.1
269.2comparable elderly waiver or medical assistance services and must reflect economies of
269.3scale. Customized living services must not include rent or raw food costs.
269.4
269.5customized living
269.6
269.7of the greater of either the statewide or any of the geographic groups' weighted average
269.8monthly nursing facility rate of the case mix resident class to which the elderly waiver
269.9eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
269.10less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until
269.11the July 1 of the state fiscal year in which the resident assessment system as described
269.12in section
269.13July 1 of the state fiscal year in which the resident assessment system as described in
269.14section
269.15subsequent state fiscal year, the individualized monthly
269.16for the services described in this clause shall not exceed the limit
269.17which was in effect on June 30 of the previous state fiscal year
269.18
269.19
269.20
269.21all service rate maximums for home and community-based service providers.
269.22
269.23Department of Health as a class A or class F home care provider and provided in a
269.24building that is registered as a housing with services establishment under chapter 144D.
269.25 Sec. 47. Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to
269.26read:
269.27 Subd. 3h. Service rate limits; 24-hour customized living services. (a) The
269.28payment
269.29
269.30of human services. The payment agreement must delineate the
269.31
269.32in each recipient's customized living service
269.33shall ensure that there is a documented need within the parameters established by the
269.34commissioner for all component customized living services authorized. The lead agency
270.1shall not authorize 24-hour customized living services unless there is a documented need
270.2for 24-hour supervision.
270.3(b) For purposes of this section, "24-hour supervision" means that the recipient
270.4requires assistance due to needs related to one or more of the following:
270.5 (1) intermittent assistance with toileting, positioning, or transferring;
270.6 (2) cognitive or behavioral issues;
270.7 (3) a medical condition that requires clinical monitoring; or
270.8 (4)
270.9all new participants enrolled in the program on or after January 1, 2011, and all other
270.10participants at their first reassessment after January 1, 2011, dependency in at least two
270.11of the following activities of daily living as determined by assessment under section
270.12256B.0911: bathing; dressing; grooming; walking; or eating; and needs medication
270.13management and at least 50 hours of service per month. The lead agency shall ensure that
270.14the frequency and mode of supervision of the recipient and the qualifications of staff
270.15providing supervision are described and meet the needs of the recipient.
270.16
270.17(c) The
270.18based on the amount of component services to be provided utilizing component rates
270.19established by the commissioner. Counties and tribes will use tools issued by the
270.20commissioner to develop and document customized living plans and authorize rates.
270.21
270.22comparable elderly waiver or medical assistance services and must reflect economies
270.23of scale.
270.24(e) The individually
270.25in combination with the payment for other elderly waiver services, including case
270.26management, must not exceed the recipient's community budget cap specified in
270.27subdivision 3a. Customized living services must not include rent or raw food costs.
270.28(f) The individually authorized 24-hour customized living payment rates shall not
270.29exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
270.30living services in effect and in the Medicaid management information systems on March
270.3131, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
270.32to 9549.0059, to which elderly waiver service clients are assigned. When there are
270.33fewer than 50 authorizations in effect in the case mix resident class, the commissioner
270.34shall multiply the calculated service payment rate maximum for the A classification by
270.35the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
270.369549.0059, to determine the applicable payment rate maximum. Service payment rate
271.1maximums shall be updated annually based on legislatively adopted changes to all service
271.2rates for home and community-based service providers.
271.3 (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
271.4may establish alternative payment rate systems for 24-hour customized living services in
271.5housing with services establishments which are freestanding buildings with a capacity of
271.616 or fewer, by applying a single hourly rate for covered component services provided
271.7in either:
271.8 (1) licensed corporate adult foster homes; or
271.9 (2) specialized dementia care units which meet the requirements of section 144D.065
271.10and in which:
271.11 (i) each resident is offered the option of having their own apartment; or
271.12 (ii) the units are licensed as board and lodge establishments with maximum capacity
271.13of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
271.14subparts 1, 2, 3, and 4, item A.
271.15 Sec. 48. Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to
271.16read:
271.17 Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
271.18shall receive an initial assessment of strengths, informal supports, and need for services
271.19in accordance with section
271.20client served under the elderly waiver must be conducted at least every 12 months and at
271.21other times when the case manager determines that there has been significant change in
271.22the client's functioning. This may include instances where the client is discharged from
271.23the hospital. There must be a determination that the client requires nursing facility level of
271.24care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments
271.25to initiate and maintain participation in the waiver program.
271.26(b) Regardless of other assessments identified in section 144.0724, subdivision
271.274, as appropriate to determine nursing facility level of care for purposes of medical
271.28assistance payment for nursing facility services, only face-to-face assessments conducted
271.29according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
271.30level of care determination will be accepted for purposes of initial and ongoing access to
271.31waiver service payment.
271.32EFFECTIVE DATE.This section is effective January 1, 2011.
271.33 Sec. 49. Minnesota Statutes 2008, section 256B.0915, is amended by adding a
271.34subdivision to read:
272.1 Subd. 10. Waiver payment rates; managed care organizations. The
272.2commissioner shall adjust the elderly waiver capitation payment rates for managed care
272.3organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
272.4service rate limits for customized living services and 24-hour customized living services
272.5under subdivisions 3e and 3h for the contract period beginning October 1, 2009. Medical
272.6assistance rates paid to customized living providers by managed care organizations
272.7under this section shall not exceed the maximum service rate limits determined by the
272.8commissioner under subdivisions 3e and 3h.
272.9 Sec. 50. Minnesota Statutes 2008, section 256B.0916, subdivision 2, is amended to
272.10read:
272.11 Subd. 2. Distribution of funds; partnerships. (a) Beginning with fiscal year 2000,
272.12the commissioner shall distribute all funding available for home and community-based
272.13waiver services for persons with developmental disabilities to individual counties or to
272.14groups of counties that form partnerships to jointly plan, administer, and authorize funding
272.15for eligible individuals. The commissioner shall encourage counties to form partnerships
272.16that have a sufficient number of recipients and funding to adequately manage the risk
272.17and maximize use of available resources.
272.18 (b) Counties must submit a request for funds and a plan for administering the
272.19program as required by the commissioner. The plan must identify the number of clients to
272.20be served, their ages, and their priority listing based on:
272.21 (1) requirements in Minnesota Rules, part 9525.1880; and
272.22 (2)
272.23statewide priorities identified in section 256B.092, subdivision 12.
272.24
272.25
272.26
272.27
272.28The plan must also identify changes made to improve services to eligible persons and to
272.29improve program management.
272.30 (c) In allocating resources to counties, priority must be given to groups of counties
272.31that form partnerships to jointly plan, administer, and authorize funding for eligible
272.32individuals and to counties determined by the commissioner to have sufficient waiver
272.33capacity to maximize resource use.
273.1 (d) Within 30 days after receiving the county request for funds and plans, the
273.2commissioner shall provide a written response to the plan that includes the level of
273.3resources available to serve additional persons.
273.4 (e) Counties are eligible to receive medical assistance administrative reimbursement
273.5for administrative costs under criteria established by the commissioner.
273.6 Sec. 51. Minnesota Statutes 2008, section 256B.0917, is amended by adding a
273.7subdivision to read:
273.8 Subd. 14. Essential community supports grants. (a) The purpose of the essential
273.9community supports grant program is to provide targeted services to persons 65 years and
273.10older who need essential community support, but whose needs do not meet the level of
273.11care required for nursing facility placement under section 144.0724, subdivision 11.
273.12(b) Within the limits of the appropriation and not to exceed $400 per person per
273.13month, funding must be available to a person who:
273.14(1) is age 65 or older;
273.15(2) is not eligible for medical assistance;
273.16(3) would otherwise be financially eligible for the alternative care program under
273.17section 256B.0913, subdivision 4;
273.18(4) has received a community assessment under section 256B.0911, subdivision 3a
273.19or 3b, and does not require the level of care provided in a nursing facility;
273.20(5) has a community support plan; and
273.21(6) has been determined by a community assessment under section 256B.0911,
273.22subdivision 3a or 3b, to be a person who would require provision of at least one of the
273.23following services, as defined in the approved elderly waiver plan, in order to maintain
273.24their community residence:
273.25(i) caregiver support;
273.26(ii) homemaker;
273.27(iii) chore; or
273.28(iv) a personal emergency response device or system.
273.29(c) The person receiving any of the essential community supports in this subdivision
273.30must also receive service coordination as part of their community support plan.
273.31(d) A person who has been determined to be eligible for an essential community
273.32support grant must be reassessed at least annually and continue to meet the criteria in
273.33paragraph (b) to remain eligible for an essential community support grant.
274.1(e) The commissioner shall allocate grants to counties and tribes under contract with
274.2the department based upon the historic use of the medical assistance elderly waiver and
274.3alternative care grant programs and other criteria as determined by the commissioner.
274.4EFFECTIVE DATE.This section is effective January 1, 2011.
274.5 Sec. 52. Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to
274.6read:
274.7 Subd. 8a. County concurrence. (a) If the county of financial responsibility wishes
274.8to place a person in another county for services, the county of financial responsibility shall
274.9seek concurrence from the proposed county of service and the placement shall be made
274.10cooperatively between the two counties. Arrangements shall be made between the two
274.11counties for ongoing social service, including annual reviews of the person's individual
274.12service plan. The county where services are provided may not make changes in the
274.13person's service plan without approval by the county of financial responsibility.
274.14(b) When a person has been screened and authorized for services in an intermediate
274.15care facility for persons with developmental disabilities or for home and community-based
274.16services for persons with developmental disabilities, the case manager shall assist that
274.17person in identifying a service provider who is able to meet the needs of the person
274.18according to the person's individual service plan. If the identified service is to be provided
274.19in a county other than the county of financial responsibility, the county of financial
274.20responsibility shall request concurrence of the county where the person is requesting to
274.21receive the identified services. The county of service may refuse to concur if:
274.22(1) it can demonstrate that the provider is unable to provide the services identified in
274.23the person's individual service plan as services that are needed and are to be provided; or
274.24(2) in the case of an intermediate care facility for persons with developmental
274.25disabilities, there has been no authorization for admission by the admission review team
274.26as required in section
274.27
274.28
274.29
274.30
274.31
274.32(c) The county of service shall notify the county of financial responsibility of
274.33concurrence or refusal to concur no later than 20 working days following receipt of the
274.34written request. Unless other mutually acceptable arrangements are made by the involved
274.35county agencies, the county of financial responsibility is responsible for costs of social
275.1services and the costs associated with the development and maintenance of the placement.
275.2The county of service may request that the county of financial responsibility purchase
275.3case management services from the county of service or from a contracted provider
275.4of case management when the county of financial responsibility is not providing case
275.5management as defined in this section and rules adopted under this section, unless other
275.6mutually acceptable arrangements are made by the involved county agencies. Standards
275.7for payment limits under this section may be established by the commissioner. Financial
275.8disputes between counties shall be resolved as provided in section
275.9 Sec. 53. Minnesota Statutes 2008, section 256B.092, is amended by adding a
275.10subdivision to read:
275.11 Subd. 11. Residential support services. (a) Upon federal approval, there is
275.12established a new service called residential support that is available on the CAC, CADI,
275.13DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent
275.14necessary to ensure there is no duplication between other services. Residential support
275.15services must be provided by vendors licensed as a community residential setting as
275.16defined in section 245A.11, subdivision 8.
275.17(b) Residential support services must meet the following criteria:
275.18(1) providers of residential support services must own or control the residential site;
275.19(2) the residential site must not be the primary residence of the license holder;
275.20(3) the residential site must have a designated program supervisor responsible for
275.21program oversight, development, and implementation of policies and procedures;
275.22(4) the provider of residential support services must provide supervision, training,
275.23and assistance as described in the person's community support plan; and
275.24(5) the provider of residential support services must meet the requirements of
275.25licensure and additional requirements of the person's community support plan.
275.26(c) Providers of residential support services that meet the definition in paragraph (a)
275.27must be registered using a process determined by the commissioner beginning July 1, 2009.
275.28 Sec. 54. Minnesota Statutes 2008, section 256B.092, is amended by adding a
275.29subdivision to read:
275.30 Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
275.31establish statewide priorities for individuals on the waiting list for developmental
275.32disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
275.33include, but are not limited to, individuals who continue to have a need for waiver services
275.34after they have maximized the use of state plan services and other funding resources,
276.1including natural supports, prior to accessing waiver services, and who meet at least one
276.2of the following criteria:
276.3(1) have unstable living situations due to the age, incapacity, or sudden loss of
276.4the primary caregivers;
276.5(2) are moving from an institution due to bed closures;
276.6(3) experience a sudden closure of their current living arrangement;
276.7(4) require protection from confirmed abuse, neglect, or exploitation;
276.8(5) experience a sudden change in need that can no longer be met through state plan
276.9services or other funding resources alone; or
276.10(6) meet other priorities established by the department.
276.11(b) When allocating resources to lead agencies, the commissioner must take into
276.12consideration the number of individuals waiting who meet statewide priorities and the
276.13lead agencies' current use of waiver funds and existing service options.
276.14(c) The commissioner shall evaluate the impact of the use of statewide priorities and
276.15provide recommendations to the legislature on whether to continue the use of statewide
276.16priorities in the November 1, 2011, annual report required by the commissioner in sections
276.17256B.0916, subdivision 7, and 256B.49, subdivision 21.
276.18 Sec. 55. [256B.0948] FOSTER CARE RATE LIMITS.
276.19The commissioner shall decrease by five percent rates for adult foster care and
276.20supportive living services that are reimbursed under section 256B.092 or 256B.49, and
276.21are above the 95th percentile of the statewide rates for the service. The reduction in rates
276.22shall take into account the acuity of individuals served based on the methodology used to
276.23allocate dollars to local lead agency budgets, and assure that affected service rates are not
276.24reduced below the rate level represented by the above percentile due to this rate change.
276.25Lead agency contracts for services specified in this section shall be amended to implement
276.26these rate changes for services rendered on or after July 1, 2009. The commissioner shall
276.27make corresponding reductions to waiver allocations and capitated rates.
276.28 Sec. 56. Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:
276.29 Subdivision 1. Subrogation. Upon furnishing medical assistance or alternative
276.30care services under section 256B.0913 to any person who has private accident or health
276.31care coverage, or receives or has a right to receive health or medical care from any
276.32type of organization or entity, or has a cause of action arising out of an occurrence that
276.33necessitated the payment of medical assistance, the state agency or the state agency's agent
276.34shall be subrogated, to the extent of the cost of medical care furnished, to any rights the
277.1person may have under the terms of the coverage, or against the organization or entity
277.2providing or liable to provide health or medical care, or under the cause of action.
277.3 The right of subrogation created in this section includes all portions of the cause
277.4of action, notwithstanding any settlement allocation or apportionment that purports to
277.5dispose of portions of the cause of action not subject to subrogation.
277.6 Sec. 57. Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:
277.7 Subd. 5. Private benefits to be used first. Private accident and health care coverage
277.8including Medicare for medical services is primary coverage and must be exhausted before
277.9medical assistance
277.10home health care, personal care assistant services, hospice, supplies and equipment, or
277.11services covered under a Centers for Medicare and Medicaid Services waiver. When a
277.12person who is otherwise eligible for medical assistance has private accident or health care
277.13coverage, including Medicare or a prepaid health plan, the private health care benefits
277.14available to the person must be used first and to the fullest extent.
277.15 Sec. 58. Minnesota Statutes 2008, section 256B.434, subdivision 4, is amended to read:
277.16 Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
277.17have their payment rates determined under this section rather than section
277.18commissioner shall establish a rate under this subdivision. The nursing facility must enter
277.19into a written contract with the commissioner.
277.20 (b) A nursing facility's case mix payment rate for the first rate year of a facility's
277.21contract under this section is the payment rate the facility would have received under
277.22section
277.23 (c) A nursing facility's case mix payment rates for the second and subsequent years
277.24of a facility's contract under this section are the previous rate year's contract payment
277.25rates plus an inflation adjustment and, for facilities reimbursed under this section or
277.26section
277.27licensing fees for the facility taking effect on or after July 1, 2001. The index for the
277.28inflation adjustment must be based on the change in the Consumer Price Index-All Items
277.29(United States City average) (CPI-U) forecasted by the commissioner of finance's national
277.30economic consultant, as forecasted in the fourth quarter of the calendar year preceding
277.31the rate year. The inflation adjustment must be based on the 12-month period from the
277.32midpoint of the previous rate year to the midpoint of the rate year for which the rate is
277.33being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001,
277.34July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1,
278.12008, October 1, 2009,
278.2paragraph shall apply only to the property-related payment rate, except that adjustments
278.3to include the cost of any increase in Health Department licensing fees taking effect on
278.4or after July 1, 2001, shall be provided. Beginning in 2005, adjustment to the property
278.5payment rate under this section and section
278.6In determining the amount of the property-related payment rate adjustment under this
278.7paragraph, the commissioner shall determine the proportion of the facility's rates that are
278.8property-related based on the facility's most recent cost report.
278.9 (d) The commissioner shall develop additional incentive-based payments of up to
278.10five percent above a facility's operating payment rate for achieving outcomes specified
278.11in a contract. The commissioner may solicit contract amendments and implement those
278.12which, on a competitive basis, best meet the state's policy objectives. The commissioner
278.13shall limit the amount of any incentive payment and the number of contract amendments
278.14under this paragraph to operate the incentive payments within funds appropriated for this
278.15purpose. The contract amendments may specify various levels of payment for various
278.16levels of performance. Incentive payments to facilities under this paragraph may be in the
278.17form of time-limited rate adjustments or onetime supplemental payments. In establishing
278.18the specified outcomes and related criteria, the commissioner shall consider the following
278.19state policy objectives:
278.20 (1) successful diversion or discharge of residents to the residents' prior home or other
278.21community-based alternatives;
278.22 (2) adoption of new technology to improve quality or efficiency;
278.23 (3) improved quality as measured in the Nursing Home Report Card;
278.24 (4) reduced acute care costs; and
278.25 (5) any additional outcomes proposed by a nursing facility that the commissioner
278.26finds desirable.
278.27 (e) Notwithstanding the threshold in section
278.28take action to come into compliance with existing or pending requirements of the life
278.29safety code provisions or federal regulations governing sprinkler systems must receive
278.30reimbursement for the costs associated with compliance if all of the following conditions
278.31are met:
278.32 (1) the expenses associated with compliance occurred on or after January 1, 2005,
278.33and before December 31, 2008;
278.34 (2) the costs were not otherwise reimbursed under subdivision 4f or section
279.1 (3) the total allowable costs reported under this paragraph are less than the minimum
279.2threshold established under section
279.3subdivision 16.
279.4The commissioner shall use money appropriated for this purpose to provide to qualifying
279.5nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
279.62008. Nursing facilities that have spent money or anticipate the need to spend money
279.7to satisfy the most recent life safety code requirements by (1) installing a sprinkler
279.8system or (2) replacing all or portions of an existing sprinkler system may submit to the
279.9commissioner by June 30, 2007, on a form provided by the commissioner the actual
279.10costs of a completed project or the estimated costs, based on a project bid, of a planned
279.11project. The commissioner shall calculate a rate adjustment equal to the allowable
279.12costs of the project divided by the resident days reported for the report year ending
279.13September 30, 2006. If the costs from all projects exceed the appropriation for this
279.14purpose, the commissioner shall allocate the money appropriated on a pro rata basis
279.15to the qualifying facilities by reducing the rate adjustment determined for each facility
279.16by an equal percentage. Facilities that used estimated costs when requesting the rate
279.17adjustment shall report to the commissioner by January 31, 2009, on the use of this
279.18money on a form provided by the commissioner. If the nursing facility fails to provide
279.19the report, the commissioner shall recoup the money paid to the facility for this purpose.
279.20If the facility reports expenditures allowable under this subdivision that are less than
279.21the amount received in the facility's annualized rate adjustment, the commissioner shall
279.22recoup the difference.
279.23 Sec. 59. Minnesota Statutes 2008, section 256B.434, is amended by adding a
279.24subdivision to read:
279.25 Subd. 21. Payment of post-PERA pension benefit costs. Nursing facilities that
279.26convert or converted after September 30, 2006, from public to private ownership shall
279.27have a portion of their post-PERA pension costs treated as a component of the historic
279.28operating rate. Effective for the rate years beginning on or after October 1, 2009, and prior
279.29to October 1, 2016, the commissioner shall determine the pension costs to be included
279.30in the facility's base for determining rates under this section by using the following
279.31formula: post-privatization pension benefit costs as a percent of salary shall be determined
279.32from either the cost report for the first full reporting year after privatization or the most
279.33recent report year available, whichever is later. This percentage shall be applied to the
279.34salary costs of the alternative payment system base rate year to determine the allowable
279.35amount of pension costs. The adjustments provided for in sections 256B.431, 256B.434,
280.1256B.441, and any other law enacted after the base rate year and prior to the year for
280.2which rates are being determined shall be applied to the allowable amount. The adjusted
280.3allowable amount shall be added to the operating rate effective the first rate year PERA
280.4ceases to remain as a pass-through component of the rate.
280.5 Sec. 60. Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:
280.6 Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
280.7services shall calculate the amount of the planned closure rate adjustment available under
280.8subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
280.9(1) the amount available is the net reduction of nursing facility beds multiplied
280.10by $2,080;
280.11(2) the total number of beds in the nursing facility or facilities receiving the planned
280.12closure rate adjustment must be identified;
280.13(3) capacity days are determined by multiplying the number determined under
280.14clause (2) by 365; and
280.15(4) the planned closure rate adjustment is the amount available in clause (1), divided
280.16by capacity days determined under clause (3).
280.17(b) A planned closure rate adjustment under this section is effective on the first day
280.18of the month following completion of closure of the facility designated for closure in the
280.19application and becomes part of the nursing facility's total operating payment rate.
280.20(c) Applicants may use the planned closure rate adjustment to allow for a property
280.21payment for a new nursing facility or an addition to an existing nursing facility or as an
280.22operating payment rate adjustment. Applications approved under this subdivision are
280.23exempt from other requirements for moratorium exceptions under section
280.24subdivisions 2 and 3
280.25(d) Upon the request of a closing facility, the commissioner must allow the facility a
280.26closure rate adjustment as provided under section
280.27(e) A facility that has received a planned closure rate adjustment may reassign it
280.28to another facility that is under the same ownership at any time within three years of its
280.29effective date. The amount of the adjustment shall be computed according to paragraph (a).
280.30(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
280.31the commissioner shall recalculate planned closure rate adjustments for facilities that
280.32delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
280.33bed dollar amount. The recalculated planned closure rate adjustment shall be effective
280.34from the date the per bed dollar amount is increased.
281.1(g) For planned closures approved after June 30, 2009, the commissioner of human
281.2services shall calculate the amount of the planned closure rate adjustment available under
281.3subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
281.4 Sec. 61. Minnesota Statutes 2008, section 256B.441, subdivision 55, is amended to
281.5read:
281.6 Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years
281.7beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
281.8under this section shall be phased in by blending the operating rate with the operating
281.9payment rate determined under section
281.10rate to be used that is determined under section
281.11the operating payment rate related to performance-based incentive payments under section
281.13operating payment rate for each facility shall be 13 percent of the operating payment rate
281.14from this section, and 87 percent of the operating payment rate from section
281.15For the rate
281.16operating payment rate for each facility shall be 14 percent of the operating payment rate
281.17from this section, and 86 percent of the operating payment rate from section
281.18
281.19
281.20
281.21
281.22
281.23
281.24
281.25
281.26October 1, 2013, the operating payment rate for each facility shall be 65 percent of the
281.27operating payment rate from this section, and 35 percent of the operating payment rate
281.28from section
281.29payment rate for each facility shall be 82 percent of the operating payment rate from this
281.30section, and 18 percent of the operating payment rate from section
281.31year beginning October 1, 2015, the operating payment rate for each facility shall be the
281.32operating payment rate determined under this section. The blending of operating payment
281.33rates under this section shall be performed separately for each RUG's class.
282.1 (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
282.2to the operating payment rate increases under paragraph (a) by creating a minimum
282.3percentage increase and a maximum percentage increase.
282.4 (1) Each nursing facility that receives a blended October 1, 2008, operating payment
282.5rate increase under paragraph (a) of less than one percent, when compared to its operating
282.6payment rate on September 30, 2008, computed using rates with RUG's weight of
282.7shall receive a rate adjustment of one percent.
282.8 (2) The commissioner shall determine a maximum percentage increase that will
282.9result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
282.10facilities with a blended October 1, 2008, operating payment rate increase under paragraph
282.11(a) greater than the maximum percentage increase determined by the commissioner, when
282.12compared to its operating payment rate on September 30, 2008, computed using rates with
282.13a RUG's weight of
282.14 (3) Nursing facilities with a blended October 1, 2008, operating payment rate
282.15increase under paragraph (a) greater than one percent and less than the maximum
282.16percentage increase determined by the commissioner, when compared to its operating
282.17payment rate on September 30, 2008, computed using rates with a RUG's weight of
282.18shall receive the blended October 1, 2008, operating payment rate increase determined
282.19under paragraph (a).
282.20 (4) The October 1, 2009, through October 1, 2015, operating payment rate for
282.21facilities receiving the maximum percentage increase determined in clause (2) shall be
282.22the amount determined under paragraph (a) less the difference between the amount
282.23determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
282.24(2). This rate restriction does not apply to rate increases provided in any other section.
282.25 (c) A portion of the funds received under this subdivision that are in excess of
282.26operating payment rates that a facility would have received under section
282.27determined in accordance with clauses (1) to (3), shall be subject to the requirements in
282.28section
282.29 (1) Determine the amount of additional funding available to a facility, which shall be
282.30equal to total medical assistance resident days from the most recent reporting year times
282.31the difference between the blended rate determined in paragraph (a) for the rate year being
282.32computed and the blended rate for the prior year.
282.33 (2) Determine the portion of all operating costs, for the most recent reporting year,
282.34that are compensation related. If this value exceeds 75 percent, use 75 percent.
282.35 (3) Subtract the amount determined in clause (2) from 75 percent.
283.1 (4) The portion of the fund received under this subdivision that shall be subject to
283.2the requirements in section
283.3the amount determined in clause (1) times the amount determined in clause (3).
283.4 Sec. 62. Minnesota Statutes 2008, section 256B.441, subdivision 58, is amended to
283.5read:
283.6 Subd. 58. Implementation delay. Within six months prior to the effective date of
283.7(1) rebasing of property payment rates under subdivision 1; (2) quality-based rate limits
283.8under subdivision 50; and (3) the removal of planned closure rate adjustments and single
283.9bed room incentives from external fixed costs under subdivision 53, the commissioner
283.10shall compare the average operating cost for all facilities combined from the most recent
283.11cost reports to the average medical assistance operating payment rates for all facilities
283.12combined from the same time period. Each provision shall not go into effect until the
283.13average medical assistance operating payment rate is at least 92 percent of the average
283.14operating cost. The rebasing of property payment rates under subdivision 1, and the
283.15removal of planned closure rate adjustments and single-bed room incentives from external
283.16fixed costs under subdivision 53 shall not go into effect until 82 percent of the operating
283.17payment rate from this section is phased in as described in subdivision 55.
283.18 Sec. 63. Minnesota Statutes 2008, section 256B.441, is amended by adding a
283.19subdivision to read:
283.20 Subd. 59. Single-bed payments for medical assistance recipients. Effective
283.21October 1, 2009, the amount paid for a private room under Minnesota Rules, part
283.229549.0070, subpart 3, is reduced from 115 percent to 111.5 percent.
283.23 Sec. 64. Minnesota Statutes 2008, section 256B.49, is amended by adding a
283.24subdivision to read:
283.25 Subd. 11a. Waivered services waiting list. (a) The commissioner shall establish
283.26statewide priorities for individuals on the waiting list for CAC, CADI, and TBI waiver
283.27services, as of January 1, 2010. The statewide priorities must include, but are not limited
283.28to, individuals who continue to have a need for waiver services after they have maximized
283.29the use of state plan services and other funding resources, including natural supports, prior
283.30to accessing waiver services, and who meet at least one of the following criteria:
283.31(1) have unstable living situations due to the age, incapacity, or sudden loss of
283.32the primary caregivers;
283.33(2) are moving from an institution due to bed closures;
284.1(3) experience a sudden closure of their current living arrangement;
284.2(4) require protection from confirmed abuse, neglect, or exploitation;
284.3(5) experience a sudden change in need that can no longer be met through state plan
284.4services or other funding resources alone; or
284.5(6) meet other priorities established by the department.
284.6(b) When allocating resources to lead agencies, the commissioner must take into
284.7consideration the number of individuals waiting who meet statewide priorities and the
284.8lead agencies' current use of waiver funds and existing service options.
284.9(c) The commissioner shall evaluate the impact of the use of statewide priorities and
284.10provide recommendations to the legislature on whether to continue the use of statewide
284.11priorities in the November 1, 2011, annual report required by the commissioner in sections
284.12256B.0916, subdivision 7, and 256B.49, subdivision 21.
284.13 Sec. 65. Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:
284.14 Subd. 12. Informed choice. Persons who are determined likely to require the level
284.15of care provided in a nursing facility as determined under sections 144.0724, subdivision
284.1611, and 256B.0911, or hospital shall be informed of the home and community-based
284.17support alternatives to the provision of inpatient hospital services or nursing facility
284.18services. Each person must be given the choice of either institutional or home and
284.19community-based services using the provisions described in section
284.202
284.21EFFECTIVE DATE.This section is effective January 1, 2011.
284.22 Sec. 66. Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:
284.23 Subd. 13. Case management. (a) Each recipient of a home and community-based
284.24waiver shall be provided case management services by qualified vendors as described
284.25in the federally approved waiver application. The case management service activities
284.26provided will include:
284.27 (1) assessing the needs of the individual within 20 working days of a recipient's
284.28request;
284.29 (2) developing the written individual service plan within ten working days after the
284.30assessment is completed;
284.31 (3) informing the recipient or the recipient's legal guardian or conservator of service
284.32options;
284.33 (4) assisting the recipient in the identification of potential service providers;
284.34 (5) assisting the recipient to access services;
285.1 (6) coordinating, evaluating, and monitoring of the services identified in the service
285.2plan;
285.3 (7) completing the annual reviews of the service plan; and
285.4 (8) informing the recipient or legal representative of the right to have assessments
285.5completed and service plans developed within specified time periods, and to appeal county
285.6action or inaction under section
285.7nursing facility level of care.
285.8 (b) The case manager may delegate certain aspects of the case management service
285.9activities to another individual provided there is oversight by the case manager. The case
285.10manager may not delegate those aspects which require professional judgment including
285.11assessments, reassessments, and care plan development.
285.12EFFECTIVE DATE.This section is effective January 1, 2011.
285.13 Sec. 67. Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:
285.14 Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
285.15strengths, informal support systems, and need for services shall be completed within
285.1620 working days of the recipient's request. Reassessment of each recipient's strengths,
285.17support systems, and need for services shall be conducted at least every 12 months and at
285.18other times when there has been a significant change in the recipient's functioning.
285.19(b) There must be a determination that the client requires a hospital level of care or a
285.20nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and
285.21subsequent assessments to initiate and maintain participation in the waiver program.
285.22(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
285.23appropriate to determine nursing facility level of care for purposes of medical assistance
285.24payment for nursing facility services, only face-to-face assessments conducted according
285.25to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
285.26determination or a nursing facility level of care determination must be accepted for
285.27purposes of initial and ongoing access to waiver services payment.
285.28(d) Persons with developmental disabilities who apply for services under the nursing
285.29facility level waiver programs shall be screened for the appropriate level of care according
285.30to section
285.31
285.32under this section before their 65th birthday may remain eligible for these services after
285.33their 65th birthday if they continue to meet all other eligibility factors.
285.34EFFECTIVE DATE.The section is effective January 1, 2011.
286.1 Sec. 68. Minnesota Statutes 2008, section 256B.49, is amended by adding a
286.2subdivision to read:
286.3 Subd. 22. Residential support services. For the purposes of this section, the
286.4provisions of section 256B.092, subdivision 11, are controlling.
286.5 Sec. 69. [256B.4912] HOME AND COMMUNITY-BASED WAIVERS;
286.6PROVIDERS AND PAYMENT.
286.7 Subdivision 1. Provider qualifications. For the home and community-based
286.8waivers providing services to seniors and individuals with disabilities, the commissioner
286.9shall establish:
286.10(1) agreements with enrolled waiver service providers to ensure providers meet
286.11qualifications defined in the waiver plans;
286.12(2) regular reviews of provider qualifications; and
286.13(3) processes to gather the necessary information to determine provider
286.14qualifications.
286.15By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision
286.1611, that are employees of waiver service providers must meet the requirements of chapter
286.17245C prior to providing waiver services and as part of ongoing enrollment. Upon federal
286.18approval, this requirement must also apply to consumer-directed community supports.
286.19 Subd. 2. Rate-setting methodologies. The commissioner shall establish
286.20statewide rate-setting methodologies that meet federal waiver requirements for home
286.21and community-based waiver services for individuals with disabilities. The rate-setting
286.22methodologies must abide by the principles of transparency and equitability across the
286.23state. The methodologies must involve a uniform process of structuring rates for each
286.24service and must promote quality and participant choice.
286.25 Sec. 70. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to
286.26read:
286.27 Subd. 2. Contract provisions. (a) The service contract with each intermediate
286.28care facility must include provisions for:
286.29(1) modifying payments when significant changes occur in the needs of the
286.30consumers;
286.31(2)
286.32
286.33
286.34
287.1
287.2
287.3
287.4standards set forth in the service contract.
287.5(b) The commissioner of human services and the commissioner of health, in
287.6consultation with representatives from counties, advocacy organizations, and the provider
287.7community, shall review the consolidated standards under chapter 245B and the supervised
287.8living facility rule under Minnesota Rules, chapter 4665, to determine what provisions
287.9in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for
287.10intermediate care facilities in order to enable facilities to implement the performance
287.11measures in their contract and provide quality services to residents without a duplication
287.12of or increase in regulatory requirements.
287.13 Sec. 71. Minnesota Statutes 2008, section 256B.5012, is amended by adding a
287.14subdivision to read:
287.15 Subd. 8. ICF/MR rate decreases effective July 1, 2009. Effective July 1, 2009,
287.16the commissioner shall decrease each facility reimbursed under this section operating
287.17payment adjustments equal to 2.58 percent of the operating payment rates in effect on
287.18June 30, 2009. For each facility, the commissioner shall implement the rate reduction,
287.19based on occupied beds, using the percentage specified in this subdivision multiplied by
287.20the total payment rate, including the variable rate but excluding the property-related
287.21payment rate, in effect on the preceding date. The total rate reduction shall include the
287.22adjustment provided in section 256B.502, subdivision 7.
287.23 Sec. 72. Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:
287.24 Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
287.25and sections
287.26basis beginning January 1, 1996. Managed care contracts which were in effect on June
287.2730, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
287.28through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
287.29commissioner may issue separate contracts with requirements specific to services to
287.30medical assistance recipients age 65 and older.
287.31 (b) A prepaid health plan providing covered health services for eligible persons
287.32pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
287.33of its contract with the commissioner. Requirements applicable to managed care programs
288.1under chapters 256B, 256D, and 256L, established after the effective date of a contract
288.2with the commissioner take effect when the contract is next issued or renewed.
288.3 (c) Effective for services rendered on or after January 1, 2003, the commissioner
288.4shall withhold five percent of managed care plan payments under this section for the
288.5prepaid medical assistance and general assistance medical care programs pending
288.6completion of performance targets. Each performance target must be quantifiable,
288.7objective, measurable, and reasonably attainable, except in the case of a performance
288.8target based on a federal or state law or rule. Criteria for assessment of each performance
288.9target must be outlined in writing prior to the contract effective date. The managed
288.10care plan must demonstrate, to the commissioner's satisfaction, that the data submitted
288.11regarding attainment of the performance target is accurate. The commissioner shall
288.12periodically change the administrative measures used as performance targets in order
288.13to improve plan performance across a broader range of administrative services. The
288.14performance targets must include measurement of plan efforts to contain spending
288.15on health care services and administrative activities. The commissioner may adopt
288.16plan-specific performance targets that take into account factors affecting only one plan,
288.17including characteristics of the plan's enrollee population. The withheld funds must be
288.18returned no sooner than July of the following year if performance targets in the contract
288.19are achieved. The commissioner may exclude special demonstration projects under
288.20subdivision 23. A managed care plan or a county-based purchasing plan under section
288.22under this paragraph that is reasonably expected to be returned.
288.23 (d)(1) Effective for services rendered on or after January 1, 2009, the commissioner
288.24shall withhold three percent of managed care plan payments under this section for the
288.25prepaid medical assistance and general assistance medical care programs. The withheld
288.26funds must be returned no sooner than July 1 and no later than July 31 of the following
288.27year. The commissioner may exclude special demonstration projects under subdivision 23.
288.28 (2) A managed care plan or a county-based purchasing plan under section
288.30this paragraph. The return of the withhold under this paragraph is not subject to the
288.31requirements of paragraph (c).
288.32(e) Effective for services provided on or after January 1, 2010, the commissioner
288.33shall require that managed care plans use the assessment and authorization processes,
288.34forms, timelines, standards, documentation, and data reporting requirements, protocols,
288.35billing processes, and policies consistent with medical assistance fee-for-service or the
288.36Department of Human Services contract requirements consistent with medical assistance
289.1fee-for-service or the Department of Human Services contract requirements for all
289.2personal care assistance services under section 256B.0659.
289.3 Sec. 73. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read:
289.4 Subd. 5. Special needs. In addition to the state standards of assistance established in
289.5subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
289.6Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
289.7center, or a group residential housing facility.
289.8 (a) The county agency shall pay a monthly allowance for medically prescribed
289.9diets if the cost of those additional dietary needs cannot be met through some other
289.10maintenance benefit. The need for special diets or dietary items must be prescribed by
289.11a licensed physician. Costs for special diets shall be determined as percentages of the
289.12allotment for a one-person household under the thrifty food plan as defined by the United
289.13States Department of Agriculture. The types of diets and the percentages of the thrifty
289.14food plan that are covered are as follows:
289.15 (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
289.16 (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
289.17of thrifty food plan;
289.18 (3) controlled protein diet, less than 40 grams and requires special products, 125
289.19percent of thrifty food plan;
289.20 (4) low cholesterol diet, 25 percent of thrifty food plan;
289.21 (5) high residue diet, 20 percent of thrifty food plan;
289.22 (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
289.23 (7) gluten-free diet, 25 percent of thrifty food plan;
289.24 (8) lactose-free diet, 25 percent of thrifty food plan;
289.25 (9) antidumping diet, 15 percent of thrifty food plan;
289.26 (10) hypoglycemic diet, 15 percent of thrifty food plan; or
289.27 (11) ketogenic diet, 25 percent of thrifty food plan.
289.28 (b) Payment for nonrecurring special needs must be allowed for necessary home
289.29repairs or necessary repairs or replacement of household furniture and appliances using
289.30the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
289.31as long as other funding sources are not available.
289.32 (c) A fee for guardian or conservator service is allowed at a reasonable rate
289.33negotiated by the county or approved by the court. This rate shall not exceed five percent
289.34of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
289.35guardian or conservator is a member of the county agency staff, no fee is allowed.
290.1 (d) The county agency shall continue to pay a monthly allowance of $68 for
290.2restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
290.31990, and who eats two or more meals in a restaurant daily. The allowance must continue
290.4until the person has not received Minnesota supplemental aid for one full calendar month
290.5or until the person's living arrangement changes and the person no longer meets the criteria
290.6for the restaurant meal allowance, whichever occurs first.
290.7 (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
290.8is allowed for representative payee services provided by an agency that meets the
290.9requirements under SSI regulations to charge a fee for representative payee services. This
290.10special need is available to all recipients of Minnesota supplemental aid regardless of
290.11their living arrangement.
290.12 (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
290.13maximum allotment authorized by the federal Food Stamp Program for a single individual
290.14which is in effect on the first day of July of each year will be added to the standards of
290.15assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
290.16as shelter needy and are: (i) relocating from an institution, or an adult mental health
290.17residential treatment program under section
290.18supports option as defined under section
290.19community-based waiver recipients living in their own home or rented or leased apartment
290.20which is not owned, operated, or controlled by a provider of service not related by blood
290.21or marriage.
290.22 (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
290.23shelter needy benefit under this paragraph is considered a household of one. An eligible
290.24individual who receives this benefit prior to age 65 may continue to receive the benefit
290.25after the age of 65.
290.26 (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
290.27exceed 40 percent of the assistance unit's gross income before the application of this
290.28special needs standard. "Gross income" for the purposes of this section is the applicant's or
290.29recipient's income as defined in section
290.30in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
290.31state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
290.32considered shelter needy for purposes of this paragraph.
290.33(g) Notwithstanding this subdivision, recipients of home and community-based
290.34services may relocate to services without 24-hour supervision and receive the equivalent
290.35of the recipient's group residential housing allocation in Minnesota supplemental
290.36assistance shelter needy funding if the cost of the services and housing is equal to or less
291.1than provided to the recipient in home and community-based services and the relocation is
291.2the recipient's choice and is approved by the recipient or guardian.
291.3(h) To access housing and services as provided in paragraph (g), the recipient may
291.4choose housing that may or may not be owned, operated, or controlled by the recipient's
291.5service provider.
291.6(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The
291.7commissioner shall assess the development of publicly owned housing, other housing
291.8alternatives, and whether a public equity housing fund may be established that would
291.9maintain the state's interest, to the extent paid from group residential housing and
291.10Minnesota supplemental aid shelter needy funds in provider-owned housing so that when
291.11sold, the state would recover its share for a public equity fund to be used for future public
291.12needs under this chapter. The commissioner shall report findings and recommendations to
291.13the legislative committees and budget divisions with jurisdiction over health and human
291.14services policy and financing by January 15, 2012.
291.15(j) In selecting prospective services needed by recipients for whom home and
291.16community-based services have been authorized, the recipient and the recipient's guardian
291.17shall first consider alternatives to home and community-based services. Minnesota
291.18supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental
291.19aid shelter needy funding as provided in this section shall remain permanent unless the
291.20recipient with the recipient's guardian later chooses to access home and community-based
291.21services.
291.22 Sec. 74. Minnesota Statutes 2008, section 626.556, subdivision 3c, is amended to read:
291.23 Subd. 3c. Local welfare agency, Department of Human Services or Department
291.24of Health responsible for assessing or investigating reports of maltreatment. (a)
291.25The county local welfare agency is the agency responsible for assessing or investigating
291.26allegations of maltreatment in child foster care, family child care,
291.27child care
291.28in the local welfare agency's county, and unlicensed personal care assistance provider
291.29organizations providing services and receiving reimbursements under chapter 256B.
291.30(b) The Department of Human Services is the agency responsible for assessing or
291.31investigating allegations of maltreatment in facilities licensed under chapters 245A and
291.32245B, except for child foster care and family child care.
291.33(c) The Department of Health is the agency responsible for assessing or investigating
291.34allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58
291.35
292.1(d) The commissioners of human services, public safety, and education must
292.2jointly submit a written report by January 15, 2007, to the education policy and finance
292.3committees of the legislature recommending the most efficient and effective allocation
292.4of agency responsibility for assessing or investigating reports of maltreatment and must
292.5specifically address allegations of maltreatment that currently are not the responsibility
292.6of a designated agency.
292.7 Sec. 75. Minnesota Statutes 2008, section 626.5572, subdivision 13, is amended to
292.8read:
292.9 Subd. 13. Lead agency. "Lead agency" is the primary administrative agency
292.10responsible for investigating reports made under section
292.11(a) The Department of Health is the lead agency for the facilities which are licensed
292.12or are required to be licensed as hospitals, home care providers, nursing homes, residential
292.13care homes, or boarding care homes.
292.14(b) The Department of Human Services is the lead agency for the programs licensed
292.15or required to be licensed as adult day care, adult foster care, programs for people with
292.16developmental disabilities, mental health programs, or chemical health programs
292.17
292.18(c) The county social service agency or its designee is the lead agency for all
292.19other reports, including reports involving vulnerable adults receiving services from an
292.20unlicensed personal care provider organization under section 256B.0659.
292.21 Sec. 76. DEVELOPMENT OF ALTERNATIVE SERVICES.
292.22The commissioner of human services, in consultation with advocates, consumers,
292.23and legislators, shall develop alternative services to personal care assistance services for
292.24persons with mental health and other behavioral challenges who can benefit from other
292.25services that more appropriately meet their needs and assist them in living independently
292.26in the community. In the development of these services, the commissioner shall:
292.27(1) take into consideration ways in which these alternative services will qualify for
292.28federal financial participation; and
292.29(2) analyze a variety of alternatives, including but not limited to a 1915(i) state
292.30plan option.
292.31The commissioner shall report to the legislature by January 15, 2011, with plans for
292.32implementation of these services by July 1, 2011.
292.33 Sec. 77. 30-DAY NOTICE REQUIRED.
293.1Notwithstanding any contrary provision in law, persons impacted by amendments
293.2in this article to Minnesota Statutes, sections 256B.0625, subdivision 19c; 256B.0655,
293.3subdivision 4; 256B.0659; and 256B.0911, subdivision 1, must be given a 30-day notice
293.4of action by the commissioner. This section expires July 1, 2011.
293.5 Sec. 78. COLA COMPENSATION REQUIREMENTS.
293.6Effective July 1, 2009, providers who received rate increases under Laws 2007,
293.7chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15,
293.8section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years
293.92008 and 2009 are no longer required to continue or retain employee compensation or
293.10wage-related increases required by those sections. This paragraph shall not apply to
293.11employees covered by a collective bargaining agreement.
293.12 Sec. 79. PROVIDER RATE AND GRANT REDUCTIONS.
293.13(a) The commissioner of human services shall decrease grants, allocations,
293.14reimbursement rates, or rate limits, as applicable, by 2.58 percent effective July 1, 2009,
293.15for services rendered on or after that date. County or tribal contracts for services specified
293.16in this section must be amended to pass through these rate reductions within 60 days of
293.17the effective date of the decrease and must be retroactive from the effective date of the
293.18rate decrease.
293.19(b) The annual rate decreases described in this section must be provided to:
293.20(1) home and community-based waivered services for persons with developmental
293.21disabilities or related conditions, including consumer-directed community supports, under
293.22Minnesota Statutes, section 256B.501;
293.23(2) home and community-based waivered services for the elderly, including
293.24consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
293.25(3) waivered services under community alternatives for disabled individuals,
293.26including consumer-directed community supports, under Minnesota Statutes, section
293.27256B.49;
293.28(4) community alternative care waivered services, including consumer-directed
293.29community supports, under Minnesota Statutes, section 256B.49;
293.30(5) traumatic brain injury waivered services, including consumer-directed
293.31community supports, under Minnesota Statutes, section 256B.49;
293.32(6) nursing services and home health services under Minnesota Statutes, section
293.33256B.0625, subdivision 6a;
293.34(7) personal care services and qualified professional supervision of personal care
293.35services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
294.1(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
294.2subdivision 7;
294.3(9) day training and habilitation services for adults with developmental disabilities
294.4or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
294.5additional cost of rate adjustments on day training and habilitation services, provided as a
294.6social service under Minnesota Statutes, section 256M.60;
294.7(10) alternative care services under Minnesota Statutes, section 256B.0913;
294.8(11) the group residential housing supplementary service rate under Minnesota
294.9Statutes, section 256I.05, subdivision 1a;
294.10(12) semi-independent living services (SILS) under Minnesota Statutes, section
294.11252.275, including SILS funding under county social services grants formerly funded
294.12under Minnesota Statutes, chapter 256I;
294.13(13) community support services for deaf and hard-of-hearing adults with mental
294.14illness who use or wish to use sign language as their primary means of communication
294.15under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
294.16grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9;
294.17and Laws 1997, First Special Session chapter 5, section 20;
294.18(14) physical therapy services under Minnesota Statutes, sections 256B.0625,
294.19subdivision 8, and 256D.03, subdivision 4;
294.20(15) occupational therapy services under Minnesota Statutes, sections 256B.0625,
294.21subdivision 8a, and 256D.03, subdivision 4;
294.22(16) speech-language therapy services under Minnesota Statutes, section 256D.03,
294.23subdivision 4, and Minnesota Rules, part 9505.0390;
294.24(17) respiratory therapy services under Minnesota Statutes, section 256D.03,
294.25subdivision 4, and Minnesota Rules, part 9505.0295;
294.26(18) consumer support grants under Minnesota Statutes, section 256.476;
294.27(19) family support grants under Minnesota Statutes, section 252.32;
294.28(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
294.29and 256B.0928;
294.30(21) disability linkage line grants under Minnesota Statutes, section 256.01,
294.31subdivision 24; and
294.32(22) housing access grants under Minnesota Statutes, section 256B.0658.
294.33(c) A managed care plan receiving state payments for the services in this section
294.34must include these decreases in their payments to providers effective on October 1
294.35following the effective date of the rate decrease.
295.1 Sec. 80. RECOMMENDATIONS FOR PERSONAL CARE ASSISTANCE
295.2SERVICES CHANGES, CONSULTATION WITH STAKEHOLDERS, AND DATA
295.3REPORTING.
295.4The commissioner shall:
295.5(1) consult with existing stakeholder groups convened under the commissioner's
295.6authority, including the home and community-based expert services panel beginning in
295.7August 2009 on implementation of the changes in the personal care assistance program,
295.8assistance for recipients whose services and housing must change, alternative services
295.9for those whose personal care assistance services are terminated or reduced, costs for
295.10those whose services will change, data on the effects of the changes in the personal care
295.11assistance program for recipients, and ongoing data on personal care assistance services
295.12for public reporting; and
295.13(2) report data on the training developed and delivered for all types of participants in
295.14the personal care assistance program, audit and financial integrity measures and results,
295.15information developed for consumers and responsible parties, available demographic,
295.16health care service use, and housing information about individuals who no longer qualify
295.17for personal care assistance, and quality assurance measures and results to the legislative
295.18committees with jurisdiction over health and human services policy and finance by
295.19January 15, 2010, and January 15, 2011.
295.20 Sec. 81. ESTABLISHING A SINGLE SET OF STANDARDS.
295.21(a) The commissioner of human services shall consult with disability service
295.22providers, advocates, counties, and consumer families to develop a single set of standards
295.23governing services for people with disabilities receiving services under the home and
295.24community-based waiver services program to replace all or portions of existing laws and
295.25rules including, but not limited to, data practices, licensure of facilities and providers,
295.26background studies, reporting of maltreatment of minors, reporting of maltreatment of
295.27vulnerable adults, and the psychotropic medication checklist. The standards must:
295.28(1) enable optimum consumer choice;
295.29(2) be consumer driven;
295.30(3) link services to individual needs and life goals;
295.31(4) be based on quality assurance and individual outcomes;
295.32(5) utilize the people closest to the recipient, who may include family, friends, and
295.33health and service providers, in conjunction with the recipient's risk management plan to
295.34assist the recipient or the recipient's guardian in making decisions that meet the recipient's
295.35needs in a cost-effective manner and assure the recipient's health and safety;
296.1(6) utilize person-centered planning; and
296.2(7) maximize federal financial participation.
296.3(b) The commissioner may consult with existing stakeholder groups convened under
296.4the commissioner's authority, including the home and community-based expert services
296.5panel established by the commissioner in 2008, to meet all or some of the requirements
296.6of this section.
296.7(c) The commissioner shall provide the reports and plans required by this section to
296.8the legislative committees and budget divisions with jurisdiction over health and human
296.9services policy and finance by January 15, 2012.
296.10 Sec. 82. COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED
296.11WAIVER PROGRAMS.
296.12The commissioner of human services shall confer with representatives of recipients,
296.13advocacy groups, counties, providers, and health plans to develop and update a common
296.14service menu for home and community-based waiver programs. The commissioner may
296.15consult with existing stakeholder groups convened under the commissioner's authority to
296.16meet all or some of the requirements of this section.
296.17 Sec. 83. INTERMEDIATE CARE FACILITIES FOR PERSONS WITH
296.18DEVELOPMENTAL DISABILITIES REPORT.
296.19The commissioner of human services shall consult with providers and advocates of
296.20intermediate care facilities for persons with developmental disabilities to monitor progress
296.21made in response to the commissioner's December 15, 2008, report to the legislature
296.22regarding intermediate care facilities for persons with developmental disabilities.
296.23 Sec. 84. HOUSING OPTIONS.
296.24The commissioner of human services, in consultation with the commissioner of
296.25administration and the Minnesota Housing Finance Agency, and representatives of
296.26counties, residents' advocacy groups, consumers of housing services, and provider
296.27agencies shall explore ways to maximize the availability and affordability of housing
296.28choices available to persons with disabilities or who need care assistance due to other
296.29health challenges. A goal shall also be to minimize state physical plant costs in order to
296.30serve more persons with appropriate program and care support. Consideration shall be
296.31given to:
296.32(1) improved access to rent subsidies;
296.33(2) use of cooperatives, land trusts, and other limited equity ownership models;
297.1(3) whether a public equity housing fund should be established that would maintain
297.2the state's interest, to the extent paid from state funds, including group residential housing
297.3and Minnesota supplemental aid shelter-needy funds in provider-owned housing, so that
297.4when sold, the state would recover its share for a public equity fund to be used for future
297.5public needs under this chapter;
297.6(4) the desirability of the state acquiring an ownership interest or promoting the
297.7use of publicly owned housing;
297.8(5) promoting more choices in the market for accessible housing that meets the
297.9needs of persons with physical challenges; and
297.10(6) what consumer ownership models, if any, are appropriate.
297.11The commissioner shall provide a written report on the findings of the evaluation of
297.12housing options to the chairs and ranking minority members of the house of representatives
297.13and senate standing committees with jurisdiction over health and human services policy
297.14and funding by December 15, 2010. This report shall replace the November 1, 2010,
297.15annual report by the commissioner required in Minnesota Statutes, sections 256B.0916,
297.16subdivision 7, and 256B.49, subdivision 21.
297.17 Sec. 85. REVISOR'S INSTRUCTION.
297.18 Subdivision 1. Renumbering of Minnesota Statutes, section 256B.0652,
297.19authorization and review of home care services. (a) The revisor of statutes shall
297.20renumber each section of Minnesota Statutes listed in column A with the number in
297.21column B.
298.3(b) The revisor of statutes shall make necessary cross-reference changes in statutes
298.4and rules consistent with the renumbering in paragraph (a). The Department of Human
298.5Services shall assist the revisor with any cross-reference changes. The revisor may make
298.6changes necessary to correct the punctuation, grammar, or structure of the remaining text
298.7to conform with the intent of the renumbering in paragraph (a).
298.8 Subd. 2. Renumbering personal care assistance services. The revisor of statutes
298.9shall replace any reference to Minnesota Statutes, section 256B.0655 with section
298.10256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross
298.11reference changes that are necessary as a result of this section. The Department of Human
298.12Services shall assist the revisor in making these changes, and if necessary, shall draft a
298.13corrections bill with changes for introduction in the 2010 legislative session. The revisor
298.14may make changes to punctuation, grammar, or sentence structure to preserve the integrity
298.15of statutes and effectuate the intention of this section.
298.16 Sec. 86. REPEALER.
298.17(a) Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e,
298.181h, 1i, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1, 2, 3, and 4, are
298.19repealed.
298.20(b) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431,
298.21subdivision 23, are repealed effective May 1, 2009.
298.22(c) Minnesota Statutes 2008, section 256B.0655, subdivisions 1f, 1g, and 2, are
298.23repealed effective January 1, 2010.
298.27 Section 1. [402A.01] CITATION.
298.28Sections 402A.01 to 402A.50 may be cited as the "State-County Results,
298.29Accountability, and Service Delivery Reform Act."
298.30 Sec. 2. [402A.10] DEFINITIONS.
298.31 Subdivision 1. Terms defined. For the purposes of this chapter, the terms defined
298.32in this section have the meanings given.
299.1 Subd. 2. Commissioner. "Commissioner" means the commissioner of human
299.2services.
299.3 Subd. 3. Council. "Council" means the State-County Results, Accountability, and
299.4Service Delivery Redesign Council established in section 402A.20.
299.5 Subd. 4. Essential human services or essential services. "Essential human
299.6services" or "essential services" means assistance and services to recipients or potential
299.7recipients of public welfare and other services delivered by counties that are mandated in
299.8federal and state law that are to be available in all counties of the state.
299.9 Subd. 5. Service delivery authority. "Service delivery authority" means a single
299.10county, or group of counties operating by execution of a joint powers agreement under
299.11section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of
299.12the county board of commissioners to participate in the redesign under this chapter.
299.13 Subd. 6. Steering committee. "Steering committee" means the Steering Committee
299.14on Performance and Outcome Reforms.
299.15EFFECTIVE DATE.This section is effective the day following final enactment.
299.16 Sec. 3. [402A.15] STEERING COMMITTEE ON PERFORMANCE AND
299.17OUTCOME REFORMS.
299.18 Subdivision 1. Duties. (a) The Steering Committee on Performance and Outcome
299.19Reforms shall develop a uniform process to establish and review performance and
299.20outcome standards for all essential human services based on the current level of resources
299.21available, and to develop appropriate reporting measures and a uniform accountability
299.22process for responding to a county's or human service authority's failure to make adequate
299.23progress on achieving performance measures. The accountability process shall focus on
299.24the performance measures rather than inflexible implementation requirements.
299.25(b) The steering committee shall:
299.26(1) by November 1, 2009, establish an agreed upon list of essential services;
299.27(2) by February 15, 2010, develop and recommend to the legislature a uniform,
299.28graduated process, in addition to the remedies identified in section 402A.18, for responding
299.29to a county's failure to make adequate progress on achieving performance measures; and
299.30(3) by December 15, 2012, for each essential service make recommendations to the
299.31legislature regarding (1) performance measures and goals based on those measures for
299.32each essential service, (2) a system for reporting on the performance measures and goals,
299.33and (3) appropriate resources, including funding, needed to achieve those performance
299.34measures and goals. The resource recommendations shall take into consideration program
300.1demand and the unique differences of local areas in geography and the populations
300.2served. Priority shall be given to services with the greatest variation in availability and
300.3greatest administrative demands. By January 15 of each year starting January 15, 2011,
300.4the steering committee shall report its recommendations to the governor and legislative
300.5committees with jurisdiction over health and human services. As part of its report, the
300.6steering committee shall, as appropriate, recommend statutory provisions, rules and
300.7requirements, and reports that should be repealed or eliminated.
300.8(c) As far as possible, the performance measures, reporting system, and funding
300.9shall be consistent across program areas. The development of performance measures shall
300.10consider the manner in which data will be collected and performance will be reported.
300.11The steering committee shall consider state and local administrative costs related to
300.12collecting data and reporting outcomes when developing performance measures. The
300.13steering committee shall correlate the performance measures and goals to available
300.14levels of resources, including state and local funding. The steering committee shall
300.15take into consideration that the goal of implementing changes to program monitoring
300.16and reporting the progress toward achieving outcomes is to significantly minimize the
300.17cost of administrative requirements and to allow funds freed by reduced administrative
300.18expenditures to be used to provide additional services, allow flexibility in service design
300.19and management, and focus energies on achieving program and client outcomes.
300.20(d) In making its recommendations, the steering committee shall consider input from
300.21the council established in section 402A.20. The steering committee shall review the
300.22measurable goals established in a memorandum of understanding entered into under
300.23section 402A.30, subdivision 2, paragraph (b), and consider whether they may be applied
300.24as statewide performance outcomes.
300.25(e) The steering committee shall form work groups that include persons who provide
300.26or receive essential services and representatives of organizations who advocate on behalf
300.27of those persons.
300.28(f) By December 15, 2009, the steering committee shall establish a three-year
300.29schedule for completion of its work. The schedule shall be published on the Department of
300.30Human Services Web site and reported to the legislative committees with jurisdiction over
300.31health and human services. In addition, the commissioner shall post quarterly updates on
300.32the progress of the steering committee on the Department of Human Services Web site.
300.33 Subd. 2. Composition. (a) The steering committee shall include:
300.34(1) the commissioner of human services, or designee, and two additional
300.35representatives of the department;
301.1(2) two county commissioners, representative of rural and urban counties, selected
301.2by the Association of Minnesota Counties;
301.3(3) two county directors of human services, representative of rural and urban
301.4counties, selected by the Minnesota Association of County Social Service Administrators;
301.5and
301.6(4) three clients or client advocates representing different populations receiving
301.7services from the Department of Human Services, who are appointed by the commissioner.
301.8(b) The commissioner, or designee, and a county commissioner shall serve as
301.9cochairs of the committee. The committee shall be convened within 60 days of final
301.10enactment of this legislation.
301.11(c) State agency staff shall serve as informational resources and staff to the steering
301.12committee. Statewide county associations may assemble county program data as required.
301.13(d) To promote information sharing and coordination between the steering committee
301.14and council, one of the county representatives from paragraph (a), clause (2), and one of the
301.15county representatives from paragraph (a), clause (3), must also serve as a representative
301.16on the council under section 402A.20, subdivision 1, paragraph (b), clause (5) or (6).
301.17EFFECTIVE DATE.This section is effective the day following final enactment.
301.18 Sec. 4. [402A.18] COMMISSIONER POWER TO REMEDY FAILURE TO
301.19MEET PERFORMANCE OUTCOMES.
301.20 Subdivision 1. Underperforming county; specific service. If the commissioner
301.21determines that a county or service delivery authority is deficient in achieving minimum
301.22performance outcomes for a specific essential service, the commissioner may impose
301.23the following remedies:
301.24(1) voluntary incorporation of the administration and operation of the specific
301.25essential service with an existing service delivery authority or another county. A
301.26service delivery authority or county incorporating an underperforming county shall
301.27not be financially liable for the costs associated with remedying performance outcome
301.28deficiencies;
301.29(2) mandatory incorporation of the administration and operation of the specific
301.30essential service with an existing service delivery authority or another county. A
301.31service delivery authority or county incorporating an underperforming county shall
301.32not be financially liable for the costs associated with remedying performance outcome
301.33deficiencies; or
301.34(3) transfer of authority for program administration and operation of the specific
301.35essential service to the commissioner.
302.1 Subd. 2. Underperforming county; more than one-half of service. If the
302.2commissioner determines that a county or service delivery authority is deficient in
302.3achieving minimum performance outcomes for more than one-half of the defined essential
302.4service, the commissioner may impose the following remedies:
302.5(1) voluntary incorporation of the administration and operation of the specific
302.6essential service with an existing service delivery authority or another county. A
302.7service delivery authority or county incorporating an underperforming county shall
302.8not be financially liable for the costs associated with remedying performance outcome
302.9deficiencies;
302.10(2) mandatory incorporation of the administration and operation of the specific
302.11essential service with an existing service delivery authority or another county. A
302.12service delivery authority or county incorporating an underperforming county shall
302.13not be financially liable for the costs associated with remedying performance outcome
302.14deficiencies; or
302.15(3) transfer of authority for program administration and operation of the specific
302.16essential service to the commissioner.
302.17 Subd. 3. Conditions prior to imposing remedies. Before the commissioner may
302.18impose the remedies authorized under this section, the following conditions must be met:
302.19(1) the county or service delivery authority determined by the commissioner
302.20to be deficient in achieving minimum performance outcomes has the opportunity, in
302.21coordination with the council, to develop a program outcome improvement plan. The
302.22program outcome improvement plan must be developed no later than six months from the
302.23date of the deficiency determination; and
302.24(2) the council has conducted an assessment of the program outcome improvement
302.25plan to determine if the county or service delivery authority has made satisfactory progress
302.26toward performance outcomes and has made a recommendation about remedies to the
302.27commissioner. The review and recommendation must be made to the commissioner within
302.2812 months from the date of the deficiency determination.
302.29 Sec. 5. [402A.20] COUNCIL.
302.30 Subdivision 1. Council. (a) The State-County Results, Accountability, and Service
302.31Delivery Redesign Council is established. Appointed council members must be appointed
302.32by their respective agencies, associations, or governmental units by November 1, 2009.
302.33The council shall be cochaired by the commissioner of human services, or designee, and a
302.34county representative from paragraph (b), clause (4) or (5), appointed by the Association
302.35of Minnesota Counties. Recommendations of the council must be approved by a majority
303.1of the council members. The provisions of section 15.059 do not apply to this council,
303.2and this council does not expire.
303.3(b) The council must consist of the following members:
303.4(1) two legislators appointed by the speaker of the house, one from the minority
303.5and one from the majority;
303.6(2) two legislators appointed by the Senate Rules Committee, one from the majority
303.7and one from the minority;
303.8(3) the commissioner of human services, or designee, and three employees from
303.9the department;
303.10(4) two county commissioners appointed by the Association of Minnesota Counties;
303.11(5) two county representatives appointed by the Minnesota Association of County
303.12Social Service Administrators;
303.13(6) one representative appointed by AFSCME as a nonvoting member; and
303.14(7) one representative appointed by the Teamsters as a nonvoting member.
303.15(c) Administrative support to the council may be provided by the Association of
303.16Minnesota Counties and affiliates.
303.17(d) Member agencies and associations are responsible for initial and subsequent
303.18appointments to the council.
303.19 Subd. 2. Council duties. The council shall:
303.20(1) provide review of the redesign process;
303.21(2) certify, in accordance with section 402A.30, subdivision 4, the formation of
303.22a service delivery authority, including the memorandum of understanding in section
303.23402A.30, subdivision 2, paragraph (b);
303.24(3) ensure the consistency of the memoranda of understanding entered into
303.25under section 402A.30, subdivision 2, paragraph (b), with the performance standards
303.26recommended by the steering committee and enacted by the legislature;
303.27(4) ensure the consistency of the memoranda of understanding, to the extent
303.28appropriate, or other memoranda of understanding entered into by other service delivery
303.29authorities;
303.30(5) establish a process to take public input on the service delivery framework
303.31specified in the memorandum of understanding in section 402A.30, subdivision 2,
303.32paragraph (b);
303.33(6) form work groups as necessary to carry out the duties of the council under the
303.34redesign;
304.1(7) serve as a forum for resolving conflicts among participating counties or between
304.2participating counties and the commissioner of human services, provided nothing in this
304.3section is intended to create a formal binding legal process;
304.4(8) engage in the program improvement process established in section 402A.18,
304.5subdivision 3; and
304.6(9) identify and recommend incentives for counties to participate in human services
304.7authorities.
304.8EFFECTIVE DATE.This section is effective the day following final enactment.
304.9 Sec. 6. [402A.30] DESIGNATION OF SERVICE DELIVERY AUTHORITY.
304.10 Subdivision 1. Establishment. After certification by the council and approval by
304.11the commissioner, in accordance with subdivision 4, a county or consortium of counties
304.12may establish a service delivery authority to redesign the delivery of some or all essential
304.13services. Once a county or consortium of counties establishes a service delivery authority,
304.14no county that is a participant in the service delivery authority may participate in or be
304.15a member of any other service delivery authority. The service delivery authority may
304.16allow an additional county or counties to join the service delivery authority subject to the
304.17approval of the council and the commissioner.
304.18 Subd. 2. New state-county governance framework. (a) To establish a service
304.19delivery authority, each participating county and the state must enter into a binding
304.20memorandum of understanding to establish a joint state-county service delivery
304.21framework:
304.22(b) The memorandum of understanding must:
304.23(1) comply with current state and federal law except where waivers are approved
304.24under clause (7);
304.25(2) define the scope of essential services over which the service delivery authority
304.26has jurisdiction;
304.27(3) designate a single administrative structure to oversee the delivery of services over
304.28which the service delivery authority has jurisdiction and identify a single administrative
304.29agent for purposes of contact and communication with the department;
304.30(4) define measurable performance and outcome goals in key operational areas
304.31that the service delivery authority is expected to achieve, provided that the performance
304.32goals must, at a minimum, satisfy performance outcomes recommended by the steering
304.33committee and enacted into law;
305.1(5) identify the state and local resources, including funding and administrative and
305.2information technology support, and other requirements necessary for the service delivery
305.3authority to achieve the performance and outcome goals;
305.4(6) state the relief available to the service delivery authority if the resource
305.5commitments identified in clause (5) are not met;
305.6(7) identify in the agreement the waivers from statutory requirements that are needed
305.7to ensure greater local control and flexibility to determine the most cost-effective means
305.8of achieving specified measurable goals and the date by which the commissioner shall
305.9grant the identified waivers;
305.10(8) set forth a graduated accountability process and penalties for responding to a
305.11county's failure to make adequate progress on achieving performance and outcome goals;
305.12(9) set forth a reasonable level of targeted reductions in overhead and administrative
305.13costs for each county participating in the service delivery authority; and
305.14(10) set forth the terms under which a county may withdraw from participation.
305.15The memorandum of understanding may be later amended to add additional services over
305.16which the service delivery authority has jurisdiction.
305.17(c) Nothing in this chapter precludes local governments from utilizing sections
305.18465.81 and 465.82 to establish procedures for local governments to merge, with the
305.19consent of the voters. Any agreement under paragraph (b) must be governed by this
305.20chapter. Nothing in this chapter limits the authority of a county board to enter into
305.21contractual agreements for services not covered by the provisions of a memorandum of
305.22understanding establishing a service delivery authority with other agencies or with other
305.23units of government.
305.24 Subd. 3. Duties. The service delivery authority shall:
305.25(1) within the scope of essential services set forth in the memorandum of
305.26understanding establishing the authority, carry out the responsibilities required of local
305.27agencies under chapter 393 and human services boards under chapter 402;
305.28(2) manage the public resources devoted to human services and other public services
305.29delivered or purchased by the counties that are subsidized or regulated by the Department
305.30of Human Services under chapters 245 and 267;
305.31(3) employ staff to assist in carrying out its duties;
305.32(4) develop and maintain a continuity of operations plan to ensure the continued
305.33operation or resumption of essential human services functions in the event of any business
305.34interruption according to local, state, and federal emergency planning requirements;
305.35(5) receive and expend funds received for the redesign process under the
305.36memorandum of understanding;
306.1(6) plan and deliver services directly or through contract with other governmental
306.2or nongovernmental providers;
306.3(7) rent, purchase, sell, and otherwise dispose of real and personal property as
306.4necessary to carry out the redesign; and
306.5(8) carry out any other service designated as a responsibility of a county.
306.6 Subd. 4. Process for establishing a service delivery authority. (a) The county or
306.7consortium of counties proposing to form a service delivery authority shall, in conjunction
306.8with the commissioner, prevent a proposed memorandum of understanding to the council
306.9accompanied by a resolution from the board of commissioners of each participating
306.10county stating the county's intent to participate in a service delivery authority.
306.11(b) The council shall certify a county or consortium of counties as a service delivery
306.12authority if:
306.13(1) the conditions in subdivision 2, paragraphs (a) and (b), are met; and
306.14(2) the county or consortium of counties are:
306.15(i) a single county with a population of 55,000 or more;
306.16(ii) a consortium of counties with a total combined population of 55,000 or more and
306.17the counties comprising the consortium are in reasonable geographic proximity; or
306.18(iii) four or more counties in reasonable geographic proximity without regard
306.19to population.
306.20The council may recommend that the commissioner of human services exempt a
306.21single county or multicounty service delivery authority from the minimum population
306.22standard if that service delivery authority can demonstrate that it can otherwise meet
306.23the requirements of this chapter.
306.24(c) After the council has certified a county or consortium of counties as a service
306.25delivery authority, the commissioner may enter into the memoranda of understanding with
306.26the participating counties to form the service delivery authority.
306.27 Subd. 5. Single county service delivery authority. For counties with populations
306.28over 55,000, the board of county commissioners may be the service delivery authority and
306.29retain existing authority under law.
306.30 Sec. 7. [402A.45] ESSENTIAL SERVICES OUTSIDE THE JURISDICTION OF
306.31A SERVICE DELIVERY AUTHORITY.
306.32(a) With the approval of the council, a county that is a participant in a service
306.33delivery authority may enter into cooperative arrangements with other service delivery
306.34authorities or other counties to provide essential services that are not within the jurisdiction
306.35and duties of the service delivery authority.
307.1(b) With the approval of the council, a service delivery authority may enter into a
307.2cooperative arrangement with a nonparticipating county to provide an essential service
307.3within the jurisdiction and duties of the service delivery authority.
307.4 Sec. 8. [402A.50] PRIVATE SECTOR FUNDING.
307.5The council may support stakeholder agencies, if not otherwise prohibited by law, to
307.6separately or jointly seek and receive funds to provide expert technical assistance to the
307.7council, the council's work group, and any subwork groups for executing the provisions
307.8of the redesign.
307.9 Sec. 9. APPROPRIATION.
307.10$350,000 is appropriated for the biennium beginning July 1, 2009, from the general
307.11fund to the State-County Results, Accountability, and Service Delivery Redesign Council,
307.12for the purposes of the State-County Results, Accountability, and Service Delivery Reform
307.13Act under Minnesota Statutes, sections 402A.01 to 402A.50. The council shall establish a
307.14methodology for distributing funds to certified service delivery authorities for the purposes
307.15of carrying out the requirements of the redesign.
307.18 Section 1. Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to
307.19read:
307.20 Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
307.21 (1) for a water supply well that is not in use under a maintenance permit, $175
307.22annually;
307.23 (2) for construction of a monitoring well, $215, which includes the state core
307.24function fee;
307.25 (3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;
307.26 (4) for a monitoring well owned by a federal agency, state agency, or local unit of
307.27government that is unsealed under a maintenance permit, $50 annually. "Local unit of
307.28government" means a statutory or home rule charter city, town, county, or soil and water
307.29conservation district, watershed district, an organization formed for the joint exercise of
307.30powers under section 471.59, a board of health or community health board, or other
307.31special purpose district or authority with local jurisdiction in water and related land
307.32resources management;
307.33(5) for monitoring wells used as a leak detection device at a single motor fuel retail
307.34outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
308.1chemical facility site, the construction permit fee is $215, which includes the state core
308.2function fee, per site regardless of the number of wells constructed on the site, and
308.3the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site
308.4regardless of the number of monitoring wells located on site;
308.5
308.6for water supply wells, $215, which includes the state core function fee;
308.7
308.8capacity, $215;
308.9(8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;
308.10(9) for a vertical heat exchanger with greater than 50 tons of heating/cooling
308.11capacity, $650;
308.12
308.13annually for each dewatering well, except a dewatering project comprising more than five
308.14dewatering wells shall be issued a single permit for $875 annually for dewatering wells
308.15recorded on the permit; and
308.16
308.17 Sec. 2. Minnesota Statutes 2008, section 144.121, subdivision 1a, is amended to read:
308.18 Subd. 1a. Fees for ionizing radiation-producing equipment. (a) A facility with
308.19ionizing radiation-producing equipment must pay an annual initial or annual renewal
308.20registration fee consisting of a base facility fee of
308.21each radiation source, as follows:
308.31(b) A facility with radiation therapy and accelerator equipment must pay an annual
308.32registration fee of $500. A facility with an industrial accelerator must pay an annual
308.33registration fee of $150.
309.1(c) Electron microscopy equipment is exempt from the registration fee requirements
309.2of this section.
309.3 Sec. 3. Minnesota Statutes 2008, section 144.121, subdivision 1b, is amended to read:
309.4 Subd. 1b. Penalty fee for late registration. Applications for initial or renewal
309.5registrations submitted to the commissioner after the time specified by the commissioner
309.6shall be accompanied by
309.7due in addition to the fees prescribed in subdivision 1a.
309.8 Sec. 4. Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:
309.9 Subd. 1a. Fees. All plans and specifications for public pool and spa construction,
309.10installation, or alteration or requests for a variance that are submitted to the commissioner
309.11according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate
309.12fees. All public pool construction plans submitted for review after January 1, 2009,
309.13must be certified by a professional engineer registered in the state of Minnesota. If the
309.14commissioner determines, upon review of the plans, that inadequate fees were paid, the
309.15necessary additional fees shall be paid before plan approval. For purposes of determining
309.16fees, a project is defined as a proposal to construct or install a public pool, spa, special
309.17purpose pool, or wading pool and all associated water treatment equipment and drains,
309.18gutters, decks, water recreation features, spray pads, and those design and safety features
309.19that are within five feet of any pool or spa. The commissioner shall charge the following
309.20fees for plan review and inspection of public pools and spas and for requests for variance
309.21from the public pool and spa rules:
309.22 (1) each pool,
309.23 (2) each spa pool,
309.24 (3) each slide,
309.25 (4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses
309.26(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum
309.27fee of
309.28 (5) alterations to an existing pool without changing the size or configuration of
309.29the pool,
309.30 (6) removal or replacement of pool disinfection equipment only,
309.31 (7) request for variance from the public pool and spa rules, $500.
309.32 Sec. 5. Minnesota Statutes 2008, section 144.125, subdivision 1, is amended to read:
310.1 Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
310.2officer or other person in charge of each institution caring for infants 28 days or less
310.3of age, (2) the person required in pursuance of the provisions of section
310.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
310.5birth, to arrange to have administered to every infant or child in its care tests for heritable
310.6and congenital disorders according to subdivision 2 and rules prescribed by the state
310.7commissioner of health. Testing and the recording and reporting of test results shall be
310.8performed at the times and in the manner prescribed by the commissioner of health. The
310.9commissioner shall charge a fee so that the total of fees collected will approximate the
310.10costs of conducting the tests and implementing and maintaining a system to follow-up
310.11infants with heritable or congenital disorders, including hearing loss detected through the
310.12early hearing detection and intervention program under section
310.13per specimen. Effective July 1, 2010, the fee shall be increased to $106 per specimen. The
310.14increased fee amount shall be deposited in the general fund. Costs associated with capital
310.15expenditures and the development of new procedures may be prorated over a three-year
310.16period when calculating the amount of the fees.
310.17EFFECTIVE DATE.This section is effective July 1, 2010.
310.18 Sec. 6. Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read:
310.19 Subdivision 1.
310.20authorized to issue
310.21
310.22 Sec. 7. Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read:
310.23 Subd. 3. Issuance of
310.24the application that the health and safety of the persons using the camp will be properly
310.25safeguarded, the commissioner may, prior to actual inspection of the camp, issue the
310.26
310.27be posted in a conspicuous place on the premises occupied by the camp.
310.28 Sec. 8. Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision
310.29to read:
310.30 Subd. 8a. Disclosure pamphlet. "Disclosure pamphlet" means the EPA pamphlet
310.31titled "Renovate Right: Important Lead Hazard Information for Families, Child Care
310.32Providers and Schools" developed under section 406(a) of the Toxic Substance Control
310.33Act.
311.1 Sec. 9. Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to
311.2read:
311.3 Subd. 22b. Lead sampling technician. "Lead sampling technician" means an
311.4individual who performs clearance inspections for
311.5
311.6
311.7under section
311.8 Sec. 10. Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to
311.9read:
311.10 Subd. 26a. Regulated lead work. (a) "Regulated lead work" means:
311.11(1) abatement;
311.12(2) interim controls;
311.13(3) a clearance inspection;
311.14(4) a lead hazard screen;
311.15(5) a lead inspection;
311.16(6) a lead risk assessment;
311.17(7) lead project designer services;
311.18(8) lead sampling technician services;
311.19(9) swab team services
311.20(10) renovation activities; or
311.21(11) activities performed to comply with lead orders issued by a board of health.
311.22(b) Regulated lead work does not include abatement, interim controls, swab team
311.23services, or renovation activities that disturb painted surfaces that total no more than:
311.24
311.25
311.26
311.27
311.28
311.29
311.30
311.31
311.32
311.33
312.1 Sec. 11. Minnesota Statutes 2008, section 144.9501, is amended by adding a
312.2subdivision to read:
312.3 Subd. 26b. Renovation. "Renovation" means the modification of any affected
312.4property that results in the disturbance of painted surfaces, unless that activity is performed
312.5as an abatement. A renovation performed for the purpose of converting a building or part
312.6of a building into an affected property is a renovation under this subdivision.
312.7 Sec. 12. Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to
312.8read:
312.9 Subd. 1g. Certified lead firm.
312.10
312.11
312.12employs individuals to perform regulated lead work outside of the person's property must
312.13obtain certification as a lead firm. The certificate must be in writing, contain an expiration
312.14date, be signed by the commissioner, and give the name and address of the person to
312.15whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted
312.16with each application. The certificate or a copy of the certificate must be readily available
312.17at the worksite for review by the contracting entity, the commissioner, and other public
312.18health officials charged with the health, safety, and welfare of the state's citizens.
312.19 Sec. 13. Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read:
312.20 Subd. 4. Notice of regulated lead work. (a) At least five working days before
312.21starting work at each regulated lead worksite, the person performing the regulated lead
312.22work shall give written notice to the commissioner and the appropriate board of health.
312.23(b) This provision does not apply to lead hazard screen, lead inspection, lead risk
312.24assessment, lead sampling technician, renovation, or lead project design activities.
312.25 Sec. 14. Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:
312.26 Subd. 2. Regulated lead work standards and methods. (a) The commissioner
312.27shall adopt rules establishing regulated lead work standards and methods in accordance
312.28with the provisions of this section, for lead in paint, dust, drinking water, and soil in
312.29a manner that protects public health and the environment for all residences, including
312.30residences also used for a commercial purpose, child care facilities, playgrounds, and
312.31schools.
312.32(b) In the rules required by this section, the commissioner shall require lead hazard
312.33reduction of intact paint only if the commissioner finds that the intact paint is on a
313.1chewable or lead-dust producing surface that is a known source of actual lead exposure to
313.2a specific individual. The commissioner shall prohibit methods that disperse lead dust into
313.3the air that could accumulate to a level that would exceed the lead dust standard specified
313.4under this section. The commissioner shall work cooperatively with the commissioner
313.5of administration to determine which lead hazard reduction methods adopted under this
313.6section may be used for lead-safe practices including prohibited practices, preparation,
313.7disposal, and cleanup. The commissioner shall work cooperatively with the commissioner
313.8of the Pollution Control Agency to develop disposal procedures. In adopting rules under
313.9this section, the commissioner shall require the best available technology for regulated
313.10lead work methods, paint stabilization, and repainting.
313.11(c) The commissioner of health shall adopt regulated lead work standards and
313.12methods for lead in bare soil in a manner to protect public health and the environment.
313.13The commissioner shall adopt a maximum standard of 100 parts of lead per million in
313.14bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts
313.15of lead per million. Soil lead hazard reduction methods shall focus on erosion control
313.16and covering of bare soil.
313.17(d) The commissioner shall adopt regulated lead work standards and methods for
313.18lead in dust in a manner to protect the public health and environment. Dust standards
313.19shall use a weight of lead per area measure and include dust on the floor, on the window
313.20sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust
313.21removal and other practices which minimize the formation of lead dust from paint, soil, or
313.22other sources.
313.23(e) The commissioner shall adopt lead hazard reduction standards and methods for
313.24lead in drinking water both at the tap and public water supply system or private well
313.25in a manner to protect the public health and the environment. The commissioner may
313.26adopt the rules for controlling lead in drinking water as contained in Code of Federal
313.27Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include
313.28an educational approach of minimizing lead exposure from lead in drinking water.
313.29(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
313.30removal of exterior lead-based coatings from residences and steel structures by abrasive
313.31blasting methods is conducted in a manner that protects health and the environment.
313.32(g) All regulated lead work standards shall provide reasonable margins of safety that
313.33are consistent with more than a summary review of scientific evidence and an emphasis on
313.34overprotection rather than underprotection when the scientific evidence is ambiguous.
313.35(h) No unit of local government shall have an ordinance or regulation governing
313.36regulated lead work standards or methods for lead in paint, dust, drinking water, or soil
314.1that require a different regulated lead work standard or method than the standards or
314.2methods established under this section.
314.3(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit
314.4of local government of an innovative lead hazard reduction method which is consistent
314.5in approach with methods established under this section.
314.6(j) The commissioner shall adopt rules for issuing lead orders required under section
314.8and other rules necessary to implement sections
314.9(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the
314.10Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property
314.11where a child or pregnant female resides is conducted in a manner that protects health
314.12and the environment.
314.13(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of
314.14the Toxic Substances Control Act.
314.15 Sec. 15. Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:
314.16 Subd. 3. Licensure and certification. The commissioner shall adopt rules to
314.17license lead supervisors, lead workers, lead project designers, lead inspectors,
314.18risk assessors, and lead sampling technicians. The commissioner shall also adopt rules
314.19requiring certification of firms that perform regulated lead work
314.20
314.21of licenses
314.22 Sec. 16. Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:
314.23 Subd. 4. Lead training course. The commissioner shall establish by rule
314.24requirements for training course providers and the renewal period for each lead-related
314.25training course required for certification or licensure. The commissioner shall establish
314.26criteria in rules for the content and presentation of training courses intended to qualify
314.27trainees for licensure under subdivision 3. The commissioner shall establish criteria
314.28in rules for the content and presentation of training courses for lead
314.29
314.30nonrefundable and must be submitted with each application in the amount of $500 for an
314.31initial training course, $250 for renewal of a permit for an initial training course, $250 for
314.32a refresher training course, and $125 for renewal of a permit of a refresher training course.
314.33 Sec. 17. Minnesota Statutes 2008, section 144.9512, subdivision 2, is amended to read:
315.1 Subd. 2. Grants; administration. Within the limits of the available appropriation,
315.2the commissioner shall make grants to
315.3
315.4screening, education, outreach, and swab team services for residential property. Projects
315.5that provide Americorps funding or positions, or leverage matching funds, as part of the
315.6delivery of the services must be given priority for the grant funds.
315.7 Sec. 18. Minnesota Statutes 2008, section 144.966, is amended by adding a subdivision
315.8to read:
315.9 Subd. 3a. Support services to families. The commissioner shall contract with
315.10a nonprofit organization to provide support and assistance to families with children
315.11who are deaf or have a hearing loss. The family support provided must include direct
315.12parent-to-parent assistance and information on communication, educational, and medical
315.13options. The commissioner shall give preference to a nonprofit organization that has the
315.14ability to provide these services throughout the state.
315.15 Sec. 19. Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read:
315.16 Subd. 2.
315.17
315.18
315.19policies, procedures, equipment, and practices to produce reliable data in the analysis of
315.20environmental samples.
315.21EFFECTIVE DATE.This section is effective July 1, 2009.
315.22 Sec. 20. Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read:
315.23 Subd. 4.
315.24means a laboratory that performs tests on samples on a contract or fee-for-service basis.
315.25EFFECTIVE DATE.This section is effective July 1, 2009.
315.26 Sec. 21. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision
315.27to read:
315.28 Subd. 5a. Field of testing. "Field of testing" means the combination of analyte,
315.29method, matrix, and test category for which a laboratory may hold accreditation.
315.30EFFECTIVE DATE.This section is effective July 1, 2009.
316.1 Sec. 22. Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read:
316.2 Subd. 6. Laboratory. "Laboratory" means the state, a person, corporation, or other
316.3entity, including governmental, that examines, analyzes, or tests samples in a specified
316.4physical location.
316.5EFFECTIVE DATE.This section is effective July 1, 2009.
316.6 Sec. 23. Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision
316.7to read:
316.8 Subd. 8. Test category. "Test category" means the combination of program and
316.9category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10),
316.10and 3a, paragraph (a), clauses (1) to (5).
316.11EFFECTIVE DATE.This section is effective July 1, 2009.
316.12 Sec. 24. Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read:
316.13 Subdivision 1. Authorization. The commissioner of health
316.14accredit environmental laboratories
316.15standards developed using a consensus process as established by Circular A-119,
316.16published by the United States Office of Management and Budget.
316.17EFFECTIVE DATE.This section is effective July 1, 2009.
316.18 Sec. 25. Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:
316.19 Subd. 2. Rules and standards. The commissioner may adopt rules to
316.20
316.21standards specified in subdivisions 1 and 2a.
316.22
316.23
316.24
316.25
316.26
316.27
316.28
316.29
316.30
316.31EFFECTIVE DATE.This section is effective July 1, 2009.
317.1 Sec. 26. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
317.2to read:
317.3 Subd. 2a. Standards. The commissioner shall accredit laboratories according to
317.4the most current environmental laboratory accreditation standards under subdivision 1
317.5and as accepted by the accreditation bodies recognized by the National Environmental
317.6Laboratory Accreditation Program (NELAP) of the NELAC Institute.
317.7EFFECTIVE DATE.This section is effective July 1, 2009.
317.8 Sec. 27. Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read:
317.9 Subd. 3. Annual fees. (a) An application for
317.10subdivision
317.11subdivision. The
317.12(1) base
317.13(2) sample preparation techniques
317.14(3) an administrative fee for laboratories located outside this state, $3,750; and
317.15(4) test category
318.5(b)
318.6
318.7may accredit laboratories for fields of testing under the categories listed in clauses (1) to
318.8(10) upon completion of the application requirements provided by subdivision 6 and
318.9receipt of the fees for each category under each program that accreditation is requested.
318.10The categories offered and related fees include:
318.11(1) microbiology, $450;
318.12(2) inorganics, $450;
318.13(3) metals, $1,000;
318.14(4) volatile organics, $1,300;
318.15(5) other organics, $1,300;
318.16(6) radiochemistry, $1,500;
318.17(7) emerging contaminants, $1,500;
318.18(8) agricultural contaminants, $1,250;
318.19(9) toxicity (bioassay), $1,000; and
318.20(10) physical characterization, $250.
318.21(c) The total
318.22preparation techniques fees, the test category fees per program, and, when applicable,
318.23
318.24
318.25
318.26
318.27
318.28
318.29
318.30
318.31
318.32
318.33
318.34
319.1 Sec. 28. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
319.2to read:
319.3 Subd. 3a. Available programs, categories, and analytes. (a) The commissioner
319.4shall accredit laboratories that test samples under the following programs:
319.5(1) the clean water program, such as compliance monitoring under the federal Clean
319.6Water Act, and ambient monitoring of surface and groundwater, or analysis of biological
319.7tissue;
319.8(2) the safe drinking water program, including compliance monitoring under the
319.9federal Safe Drinking Water Act, and the state requirements for monitoring private wells;
319.10(3) the resource conservation and recovery program, including federal and state
319.11requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and
319.12groundwater monitoring wells not intended as drinking water sources;
319.13(4) the underground storage tank program; and
319.14(5) the clean air program, including air and emissions testing under the federal Clean
319.15Air Act, and state and federal requirements for vapor intrusion monitoring.
319.16(b) The commissioner shall maintain and publish a list of analytes available for
319.17accreditation. The list must be reviewed at least once every six months and the changes
319.18published in the State Register and posted on the program's Web site. The commissioner
319.19shall publish the notification of changes and review comments on the changes no less than
319.2030 days from the date the list is published.
319.21 Sec. 29. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
319.22to read:
319.23 Subd. 3b. Additional fees. (a) Laboratories located outside of this state that require
319.24an on-site assessment more frequent than once every two years must pay an additional
319.25assessed fee of $3,000 per assessment for each additional on-site assessment conducted.
319.26The laboratory must pay the fee within 15 business days of receiving the commissioner's
319.27notification that an on-site assessment is required. The commissioner may conduct
319.28additional on-site assessments to determine a laboratory's continued compliance with
319.29the standards provided in subdivision 2a.
319.30(b) A late fee of $200 shall be added to the annual fee for accredited laboratories
319.31submitting renewal applications to the commissioner after November 1.
319.32(c) A change fee shall be assessed if a laboratory requests additional fields of testing
319.33at any time other than when initially applying for or renewing its accreditation. A change
319.34fee does not apply for applications to add fields of testing for new analytes in response
319.35to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid
320.1accreditation for the changed test category and applies for additional analytes within the
320.2same test category. The change fee is equal to the applicable test category fee for the
320.3field of testing requested. An application that requests accreditation of multiple fields of
320.4testing within a test category requires a single payment of the applicable test category fee
320.5per application submitted.
320.6(d) A variance fee shall be assessed if a laboratory requests a variance from a
320.7standard provided in subdivision 2a. The variance fee is $500 per variance.
320.8(e) The commissioner shall assess a fee for changes to laboratory information
320.9regarding ownership, name, address, or personnel. Laboratories must submit changes
320.10through the application process under subdivision 6. The information update fee is $250
320.11per application.
320.12(f) Fees must be set so that the total fees support the laboratory accreditation
320.13program. Direct costs of the accreditation service include program administration,
320.14assessments, the agency's general support costs, and attorney general costs attributable
320.15to the fee function.
320.16 Sec. 30. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
320.17to read:
320.18 Subd. 3c. Refunds and nonpayment. Refunds or credits shall not be made for
320.19applications received but not approved. Accreditation of a laboratory shall not be awarded
320.20until all fees are paid.
320.21 Sec. 31. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
320.22to read:
320.23 Subd. 6. Application. (a) Laboratories seeking accreditation must apply on a form
320.24provided by the commissioner, include the laboratory's procedures and quality manual,
320.25and pay the applicable fees.
320.26(b) Laboratories may be fixed-base or mobile. The commissioner shall accredit
320.27mobile laboratories individually and require a vehicle identification number, license
320.28plate number, or other uniquely identifying information in addition to the application
320.29requirements of paragraph (a).
320.30(c) Laboratories maintained on separate properties, even though operated under the
320.31same management or ownership, must apply separately. Laboratories with more than one
320.32building on the same or adjoining properties do not need to submit a separate application.
320.33(d) The commissioner may accredit laboratories located out-of-state. Accreditation
320.34for out-of-state laboratories may be obtained directly from the commissioner following
321.1the requirements in paragraph (a), or out-of-state laboratories may be accredited through
321.2a reciprocal agreement if the laboratory:
321.3(1) is accredited by a NELAP-recognized accreditation body for those fields of
321.4testing in which the laboratory requests accreditation from the commissioner;
321.5(2) submits an application and documentation according to this subdivision; and
321.6(3) submits a current copy of the laboratory's unexpired accreditation from a
321.7NELAP-recognized accreditation body showing the fields of accreditation for which the
321.8laboratory is currently accredited.
321.9(e) Under the conflict of interest determinations provided in section 43A.38,
321.10subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories
321.11operated by agencies of the executive branch of the state. If accreditation is required,
321.12laboratories operated by agencies of the executive branch of the state must apply for
321.13accreditation through any other NELAP-recognized accreditation body.
321.14EFFECTIVE DATE.This section is effective July 1, 2009.
321.15 Sec. 32. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
321.16to read:
321.17 Subd. 6a. Implementation and effective date. All laboratories must comply with
321.18standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to
321.19applications received and accreditations issued after June 30, 2009. Accreditations issued
321.20on or before June 30, 2009, shall expire upon their current expiration date.
321.21 Sec. 33. Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
321.22to read:
321.23 Subd. 7. Initial accreditation and annual accreditation renewal. (a) The
321.24commissioner shall issue or renew accreditation after receipt of the completed application
321.25and documentation required in this section, provided the laboratory maintains compliance
321.26with the standards specified in subdivision 2a, and attests to the compliance on the
321.27application form.
321.28(b) The commissioner shall prorate the fees in subdivision 3 for laboratories
321.29applying for accreditation after December 31. The fees are prorated on a quarterly basis
321.30beginning with the quarter in which the commissioner receives the completed application
321.31from the laboratory.
321.32(c) Applications for renewal of accreditation must be received by November 1 and
321.33no earlier than October 1 of each year. The commissioner shall send annual renewal
322.1notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
322.2not exempt laboratories from meeting the annual November 1 renewal date.
322.3(d) The commissioner shall issue all accreditations for the calendar year for which
322.4the application is made, and the accreditation shall expire on December 31 of that year.
322.5(e) The accreditation of any laboratory that fails to submit a renewal application
322.6and fees to the commissioner expires automatically on December 31 without notice or
322.7further proceeding. Any person who operates a laboratory as accredited after expiration of
322.8accreditation or without having submitted an application and paid the fees is in violation
322.9of the provisions of this section and is subject to enforcement action under sections
322.10144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
322.11accreditation may reapply under subdivision 6.
322.12EFFECTIVE DATE.This section is effective July 1, 2009.
322.13 Sec. 34. Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:
322.14 Subdivision 1. Remedies available. The provisions of chapters 103I and 157 and
322.15sections
322.16(13), (14), and (15)
322.18to 144.98;
322.19all rules, orders, stipulation agreements, settlements, compliance agreements, licenses,
322.20registrations, certificates, and permits adopted or issued by the department or under any
322.21other law now in force or later enacted for the preservation of public health may, in
322.22addition to provisions in other statutes, be enforced under this section.
322.23EFFECTIVE DATE.This section is effective July 1, 2009.
322.24 Sec. 35. Minnesota Statutes 2008, section 153A.17, is amended to read:
322.25153A.17 EXPENSES; FEES.
322.26
322.27
322.28
322.29
322.30
322.31
322.32
322.33
322.34
323.1
323.2
323.3
323.4complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15,
323.5and the Consumer Information Center under section 153A.18, must be paid from initial
323.6application and examination fees, renewal fees, penalties, and fines.
323.7 (b) The fees are as follows:
323.8(1) the initial and annual renewal certification application fee is $600;
323.9(2) the initial examination fee for the written portion is $500, and for each time it
323.10is taken, thereafter;
323.11(3) the initial examination fee for the practical portion is $1,200, and $600 for each
323.12time it is taken, thereafter; for individuals meeting the requirements of section 148.515,
323.13subdivision 2, the fee for the practical portion of the hearing instrument dispensing
323.14examination is $250 each time it is taken;
323.15(4) the trainee application fee is $200;
323.16(5) the penalty fee for late submission of a renewal application is $200; and
323.17(6) the fee for verification of certification to other jurisdictions or entities is $25.
323.18(c) The commissioner may prorate the certification fee for new applicants based on
323.19the number of quarters remaining in the annual certification period.
323.20(d) All fees are nonrefundable. All fees, penalties, and fines received must be
323.21deposited in the state government special revenue fund.
323.22(e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid
323.23at the time of initial certification application or renewal to recover the commissioner's
323.24accumulated direct expenditures for administering the requirements of this chapter.
323.25 Sec. 36. Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision
323.26to read:
323.27 Subd. 20. Youth camp. "Youth camp" has the meaning given in section 144.71,
323.28subdivision 2.
323.29 Sec. 37. Minnesota Statutes 2008, section 157.16, is amended to read:
323.30157.16 LICENSES REQUIRED; FEES.
323.31 Subdivision 1. License required annually. A license is required annually for every
323.32person, firm, or corporation engaged in the business of conducting a food and beverage
323.33service establishment, youth camp, hotel, motel, lodging establishment, public pool, or
323.34resort. Any person wishing to operate a place of business licensed in this section shall
324.1first make application, pay the required fee specified in this section, and receive approval
324.2for operation, including plan review approval.
324.3Special event food stands are not required to submit plans. Nonprofit organizations
324.4operating a special event food stand with multiple locations at an annual one-day event
324.5shall be issued only one license. Application shall be made on forms provided by the
324.6commissioner and shall require the applicant to state the full name and address of the
324.7owner of the building, structure, or enclosure, the lessee and manager of the food and
324.8beverage service establishment, hotel, motel, lodging establishment, public pool, or resort;
324.9the name under which the business is to be conducted; and any other information as may
324.10be required by the commissioner to complete the application for license.
324.11 Subd. 2. License renewal. Initial and renewal licenses for all food and beverage
324.12service establishments, youth camps, hotels, motels, lodging establishments, public pools,
324.13and resorts shall be issued
324.14
324.15of business after the expiration date of a license or without having submitted an application
324.16and paid the fee shall be deemed to have violated the provisions of this chapter and shall
324.17be subject to enforcement action, as provided in the Health Enforcement Consolidation
324.18Act, sections
324.19total of the license fee for any food and beverage service establishment operating without
324.20a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or
324.21a special event food stand, and a penalty of
324.22license fee for all restaurants, food carts, hotels, motels, lodging establishments, youth
324.23camps, public pools, and resorts operating without a license for a period of up to 30 days.
324.24A late fee of
324.25than 30 days without a license.
324.26 Subd. 2a. Food manager certification. An applicant for certification or certification
324.27renewal as a food manager must submit to the commissioner a
324.28certification fee payable to the Department of Health. The commissioner shall issue a
324.29duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant
324.30submits a completed application on a form provided by the commissioner for a duplicate
324.31certificate and pays $20 to the department for the cost of duplication.
324.32 Subd. 3. Establishment fees; definitions. (a) The following fees are required
324.33for food and beverage service establishments, youth camps, hotels, motels, lodging
324.34establishments, public pools, and resorts licensed under this chapter. Food and beverage
324.35service establishments must pay the highest applicable fee under paragraph (d), clause
325.1(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable
325.2fee under paragraph (d), clause (6) or (7). The license fee for new operators previously
325.3licensed under this chapter for the same calendar year is one-half of the appropriate annual
325.4license fee, plus any penalty that may be required. The license fee for operators opening
325.5on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
325.6that may be required.
325.7 (b) All food and beverage service establishments, except special event food stands,
325.8and all hotels, motels, lodging establishments, public pools, and resorts shall pay an
325.9annual base fee of $150.
325.10 (c) A special event food stand shall pay a flat fee of
325.11food stand" means a fee category where food is prepared or served in conjunction with
325.12celebrations, county fairs, or special events from a special event food stand as defined
325.13in section
325.14 (d) In addition to the base fee in paragraph (b), each food and beverage service
325.15establishment, other than a special event food stand, and each hotel, motel, lodging
325.16establishment, public pool, and resort shall pay an additional annual fee for each fee
325.17category, additional food service, or required additional inspection specified in this
325.18paragraph:
325.19 (1) Limited food menu selection,
325.20fee category that provides one or more of the following:
325.21 (i) prepackaged food that receives heat treatment and is served in the package;
325.22 (ii) frozen pizza that is heated and served;
325.23 (iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
325.24 (iv) soft drinks, coffee, or nonalcoholic beverages; or
325.25 (v) cleaning for eating, drinking, or cooking utensils, when the only food served
325.26is prepared off site.
325.27 (2) Small establishment, including boarding establishments,
325.28establishment" means a fee category that has no salad bar and meets one or more of
325.29the following:
325.30 (i) possesses food service equipment that consists of no more than a deep fat fryer, a
325.31grill, two hot holding containers, and one or more microwave ovens;
325.32 (ii) serves dipped ice cream or soft serve frozen desserts;
325.33 (iii) serves breakfast in an owner-occupied bed and breakfast establishment;
325.34 (iv) is a boarding establishment; or
325.35 (v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum
325.36patron seating capacity of not more than 50.
326.1 (3) Medium establishment,
326.2category that meets one or more of the following:
326.3 (i) possesses food service equipment that includes a range, oven, steam table, salad
326.4bar, or salad preparation area;
326.5 (ii) possesses food service equipment that includes more than one deep fat fryer,
326.6one grill, or two hot holding containers; or
326.7 (iii) is an establishment where food is prepared at one location and served at one or
326.8more separate locations.
326.9 Establishments meeting criteria in clause (2), item (v), are not included in this fee
326.10category.
326.11 (4) Large establishment,
326.12 (i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a
326.13medium establishment, (B) seats more than 175 people, and (C) offers the full menu
326.14selection an average of five or more days a week during the weeks of operation; or
326.15 (ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium
326.16establishment, and (B) prepares and serves 500 or more meals per day.
326.17 (5) Other food and beverage service, including food carts, mobile food units,
326.18seasonal temporary food stands, and seasonal permanent food stands,
326.19 (6) Beer or wine table service,
326.20category where the only alcoholic beverage service is beer or wine, served to customers
326.21seated at tables.
326.22 (7) Alcoholic beverage service, other than beer or wine table service,
326.23 "Alcohol beverage service, other than beer or wine table service" means a fee
326.24category where alcoholic mixed drinks are served or where beer or wine are served from
326.25a bar.
326.26 (8) Lodging per sleeping accommodation unit,
326.27lodging establishments, and resorts, up to a maximum of
326.28sleeping accommodation unit" means a fee category including the number of guest rooms,
326.29cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the
326.30number of beds in a dormitory.
326.31 (9) First public pool,
326.32pool" means a fee category that has the meaning given in section
326.33 (10) First spa,
326.34category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
326.35 (11) Private sewer or water,
326.36category with a water supply other than a community public water supply as defined in
327.1Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an
327.2individual sewage treatment system which uses subsurface treatment and disposal.
327.3 (12) Additional food service,
327.4at a food service establishment, other than the primary food preparation and service area,
327.5used to prepare or serve food to the public.
327.6 (13) Additional inspection fee,
327.7fee to conduct the second inspection each year for elementary and secondary education
327.8facility school lunch programs when required by the Richard B. Russell National School
327.9Lunch Act.
327.10 (e) A fee
327.11license application for restaurants, hotels, motels, lodging establishments,
327.12
327.13this construction plan review is as follows:
328.1 (f) When existing food and beverage service establishments, hotels, motels, lodging
328.2establishments,
328.3remodeled, a fee
328.4
328.5
328.6
328.7The fee for this construction plan review is as follows:
328.26 (g)
328.27submit construction or remodeling plans for review.
328.28(h) Youth camps shall pay an annual single fee for food and lodging as follows:
328.29(1) camps with up to 99 campers, $325;
328.30(2) camps with 100 to 199 campers, $550; and
328.31(3) camps with 200 or more campers; $750.
329.1 Subd. 3a. Statewide hospitality fee. Every person, firm, or corporation that
329.2operates a licensed boarding establishment, food and beverage service establishment,
329.3seasonal temporary or permanent food stand, special event food stand, mobile food unit,
329.4food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the
329.5commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee
329.6for establishments licensed by the Department of Health is required at the same time the
329.7licensure fee is due. For establishments licensed by local governments, the fee is due by
329.8July 1 of each year.
329.9 Subd. 4. Posting requirements. Every food and beverage service establishment,
329.10for-profit youth camp, hotel, motel, lodging establishment, public pool, or resort must have
329.11the license posted in a conspicuous place at the establishment. Mobile food units, food
329.12carts, and seasonal temporary food stands shall be issued decals with the initial license and
329.13each calendar year with license renewals. The current license year decal must be placed on
329.14the unit or stand in a location determined by the commissioner. Decals are not transferable.
329.15 Sec. 38. Minnesota Statutes 2008, section 157.22, is amended to read:
329.16157.22 EXEMPTIONS.
329.17This chapter
329.18(1) interstate carriers under the supervision of the United States Department of
329.19Health and Human Services;
329.20(2) any building constructed and primarily used for religious worship;
329.21(3) any building owned, operated, and used by a college or university in accordance
329.22with health regulations promulgated by the college or university under chapter 14;
329.23(4) any person, firm, or corporation whose principal mode of business is licensed
329.24under sections
329.25or beverage establishment; provided that the holding of any license pursuant to sections
329.27provisions of this chapter or the rules of the state commissioner of health relating to
329.28food and beverage service establishments;
329.29(5) family day care homes and group family day care homes governed by sections
329.31(6) nonprofit senior citizen centers for the sale of home-baked goods;
329.32(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3),
329.33501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of
329.341986, or organizations related to or affiliated with such fraternal or patriotic organizations.
330.1Such organizations may organize events at which home-prepared food is donated by
330.2organization members for sale at the events, provided:
330.3(i) the event is not a circus, carnival, or fair;
330.4(ii) the organization controls the admission of persons to the event, the event agenda,
330.5or both; and
330.6(iii) the organization's licensed kitchen is not used in any manner for the event;
330.7(8) food not prepared at an establishment and brought in by individuals attending a
330.8potluck event for consumption at the potluck event. An organization sponsoring a potluck
330.9event under this clause may advertise the potluck event to the public through any means.
330.10Individuals who are not members of an organization sponsoring a potluck event under this
330.11clause may attend the potluck event and consume the food at the event. Licensed food
330.12establishments other than schools cannot be sponsors of potluck events. A school may
330.13sponsor and hold potluck events in areas of the school other than the school's kitchen,
330.14provided that the school's kitchen is not used in any manner for the potluck event. For
330.15purposes of this clause, "school" means a public school as defined in section
330.16subdivisions 9, 11, 13, and 17
330.17at which a child is provided with instruction in compliance with sections
330.19kitchen;
330.20(9) a home school in which a child is provided instruction at home; and
330.21(10) concession stands operated in conjunction with school-sponsored events on
330.22school property are exempt from the 21-day restriction.
330.23 Sec. 39. Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision
330.24to read:
330.25 Subd. 9. Special event recreational camping area. "Special event recreational
330.26camping area" means a recreational camping area which operates no more than two times
330.27annually and for no more than 14 consecutive days.
330.28 Sec. 40. Minnesota Statutes 2008, section 327.15, is amended to read:
330.29327.15 LICENSE REQUIRED; RENEWAL;
330.30 Subdivision 1. License required; plan review. No person, firm or corporation shall
330.31establish, maintain, conduct or operate a manufactured home park or recreational camping
330.32area within this state without first obtaining
330.33Department of Health. Any person wishing to obtain a license shall submit an application,
330.34pay the required fee specified in this section, and receive approval for operation, including
331.1plan review approval. Application shall be made on forms provided by the commissioner
331.2and shall require the applicant to state the full name and address of the owner of the
331.3manufactured home park or recreational camping area, the name under which the business
331.4is to be conducted, and any other information as may be required by the commissioner
331.5to complete the application for license. Any person, firm, or corporation desiring to
331.6operate either a manufactured home park or a recreational camping area on the same site
331.7in connection with the other, need only obtain one license.
331.8
331.9state the number of manufactured home sites and recreational camping sites allowed
331.10according to state commissioner of health approval.
331.11
331.12The number of licensed sites shall not be increased unless the plans for expansion
331.13
331.14the Department of Health.
331.15
331.16
331.17of the manufactured home park or camping area. The license is not transferable
331.18another person or place.
331.19 Subd. 2. License renewal. Initial and renewal licenses for all manufactured home
331.20parks and recreational camping areas shall be issued annually and shall have an expiration
331.21date included on the license. Any person who operates a manufactured home park or
331.22recreational camping area after the expiration date of a license or without having submitted
331.23an application and paid the fee shall be deemed to have violated the provisions of this
331.24chapter and shall be subject to enforcement action, as provided in the Health Enforcement
331.25Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall
331.26be added to the total of the license fee for any manufactured home park or recreational
331.27camping area operating without a license for a period of up to 30 days. A late fee of $360
331.28shall be added to the license fee for any manufactured home park or recreational camping
331.29area operating more than 30 days without a license.
331.30 Subd. 3. Fees, manufactured home parks and recreational camping areas. (a)
331.31The following fees are required for manufactured home parks and recreational camping
331.32areas licensed under this chapter. Recreational camping areas and manufactured home
331.33parks shall pay the highest applicable fee under paragraph (c). The license fee for new
331.34operators of a manufactured home park or recreational camping area previously licensed
331.35under this chapter for the same calendar year is one-half of the appropriate annual license
331.36fee, plus any penalty that may be required. The license fee for operators opening on
332.1or after October 1 is one-half of the appropriate annual license fee, plus any penalty
332.2that may be required.
332.3(b) All manufactured home parks and recreational camping areas shall pay the
332.4following annual base fee:
332.5(1) a manufactured home park, $150; and
332.6(2) a recreational camping area with:
332.7(i) 24 or less sites, $50;
332.8(ii) 25-99 sites, $212; and
332.9(iii) 100 or more sites, $300.
332.10In addition to the base fee, manufactured home parks and recreational camping areas shall
332.11pay $4 for each licensed site. This paragraph does not apply to special event recreational
332.12camping areas or to operators of a manufactured home park or a recreational camping area
332.13licensed under section 157.16 for the same location.
332.14(c) In addition to the fee in paragraph (b), each manufactured home park or
332.15recreational camping area shall pay an additional annual fee for each fee category
332.16specified in this paragraph:
332.17(1) Manufactured home parks and recreational camping areas with public swimming
332.18pools and spas shall pay the appropriate fees specified in section 157.16.
332.19(2) Individual private sewer or water, $60. "Individual private water" means a fee
332.20category with a water supply other than a community public water supply as defined in
332.21Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an
332.22individual sewage treatment system which uses subsurface treatment and disposal.
332.23(d) The following fees must accompany a plan review application for initial
332.24construction of a manufactured home park or recreational camping area:
332.25(1) for initial construction of less than 25 sites, $375;
332.26(2) for initial construction of 25 to less than 100 sites, $400; and
332.27(3) for initial construction of 100 or more sites, $500.
332.28(e) The following fees must accompany a plan review application when an existing
332.29manufactured home park or recreational camping area is expanded:
332.30(1) for expansion of less than 25 sites, $250;
332.31(2) for expansion of 25 and less than 100 sites, $300; and
332.32(3) for expansion of 100 or more sites, $450.
332.33 Subd. 4. Fees, special event recreational camping areas. (a) The following fees
332.34are required for special event recreational camping areas licensed under this chapter.
332.35(b) All special event recreational camping areas shall pay an annual fee of $150 plus
332.36$1 for each licensed site.
333.1(c) A special event recreational camping area shall pay a late fee of $360 for failing
333.2to obtain a license prior to operating.
333.3(d) The following fees must accompany a plan review application for initial
333.4construction of a special event recreational camping area:
333.5(1) for initial construction of less than 25 special event recreational camping sites,
333.6$375;
333.7(2) for initial construction of 25 to less than 100 sites, $400; and
333.8(3) for initial construction of 100 or more sites, $500.
333.9(e) The following fees must accompany a plan review application for expansion of a
333.10special event recreational camping area:
333.11(1) for expansion of less than 25 sites, $250;
333.12(2) for expansion of 25 and less than 100 sites, $300; and
333.13(3) for expansion of 100 or more sites, $450.
333.14 Sec. 41. Minnesota Statutes 2008, section 327.16, is amended to read:
333.15327.16
333.16 Subdivision 1. Made to state Department of Health. The plan review application
333.17for
333.18area shall be made to the state Department of Health, at such office and in such manner
333.19as may be prescribed by that department.
333.20 Subd. 2. Contents. The
333.21
333.22state Department of Health setting forth:
333.23(1) The full name and address of the applicant or applicants, or names and addresses
333.24of the partners if the applicant is a partnership, or the names and addresses of the officers
333.25if the applicant is a corporation.
333.26(2) A legal description of the site, lot, field, or tract of land upon which the applicant
333.27proposes to operate and maintain a manufactured home park or recreational camping area.
333.28(3) The proposed and existing facilities on and about the site, lot, field, or tract of
333.29land for the proposed construction or alteration and maintaining of a sanitary community
333.30building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry
333.31facilities, source of water supply, sewage, garbage and waste disposal; except that no
333.32toilet facilities shall be required in any manufactured home park which permits only
333.33manufactured homes equipped with toilet facilities discharging to water carried sewage
333.34disposal systems; and method of fire and storm protection.
334.1(4) The proposed method of lighting the structures and site, lot, field, or tract of land
334.2upon which the manufactured home park or recreational camping area is to be located.
334.3(5) The calendar months of the year which the applicant will operate the
334.4manufactured home park or recreational camping area.
334.5(6) Plans and drawings for new construction or alteration, including buildings, wells,
334.6plumbing and sewage disposal systems.
334.7 Subd. 3.
334.8be submitted with all plans and specifications enumerated in subdivision 2,
334.9
334.10
334.11county wherein the park is to be located, or a statement from the municipality or county
334.12that it does not require an approved zoning permit.
334.13
334.14
334.15
334.16state even though the proposed project is not approved and a license is denied.
334.17When construction has been completed in accordance with approved plans and
334.18specifications the state commissioner of health shall promptly cause the manufactured
334.19home park or recreational camping area and appurtenances thereto to be inspected. When
334.20the inspection and report has been made and the state commissioner of health finds that
334.21all requirements of sections
334.22health and safety as the state commissioner of health may require, have been met by
334.23the applicant, the state commissioner of health shall forthwith issue the
334.24in the name of the state.
334.25 Subd. 4.
334.26
334.27
334.28
334.29
334.30
334.31
334.32
334.33and operated according to all applicable state electrical, fire, plumbing, and building codes.
334.34 Subd. 5. Permit. When the plans and specifications have been approved, the state
334.35Department of Health shall issue an approval report permitting the applicant to construct
335.1or make alterations upon a manufactured home park or recreational camping area and the
335.2appurtenances thereto according to the plans and specifications presented.
335.3Such approval does not relieve the applicant from securing building permits in
335.4municipalities that require permits or from complying with any other municipal ordinance
335.5or ordinances, applicable thereto, not in conflict with this statute.
335.6 Subd. 6. Denial of construction. If the application to construct or make alterations
335.7upon a manufactured home park or recreational camping area and the appurtenances
335.8thereto or a
335.9commissioner of health, the commissioner shall so state in writing giving the reason
335.10or reasons for denying the application. If the objections can be corrected the applicant
335.11may amend the application and resubmit it for approval, and if denied the applicant may
335.12appeal from the decision of the state commissioner of health as provided in section
335.14 Sec. 42. Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:
335.15 Subdivision 1. Rules. No domestic animals or house pets of occupants of
335.16manufactured home parks or recreational camping areas shall be allowed to run at large,
335.17or commit any nuisances within the limits of a manufactured home park or recreational
335.18camping area. Each manufactured home park or recreational camping area licensed under
335.19the provisions of sections
335.20provide for the following
335.21 (1) A responsible attendant or caretaker shall be in charge of every manufactured
335.22home park or recreational camping area at all times, who shall maintain the park or
335.23area, and its facilities and equipment in a clean, orderly and sanitary condition. In any
335.24manufactured home park containing more than 50 lots, the attendant, caretaker, or other
335.25responsible park employee, shall be readily available at all times in case of emergency.
335.26 (2) All manufactured home parks shall be well drained and be located so that the
335.27drainage of the park area will not endanger any water supply. No wastewater from
335.28manufactured homes or recreational camping vehicles shall be deposited on the surface of
335.29the ground. All sewage and other water carried wastes shall be discharged into a municipal
335.30sewage system whenever available. When a municipal sewage system is not available, a
335.31sewage disposal system acceptable to the state commissioner of health shall be provided.
335.32 (3) No manufactured home shall be located closer than three feet to the side lot lines
335.33of a manufactured home park, if the abutting property is improved property, or closer than
335.34ten feet to a public street or alley. Each individual site shall abut or face on a driveway
335.35or clear unoccupied space of not less than 16 feet in width, which space shall have
336.1unobstructed access to a public highway or alley. There shall be an open space of at least
336.2ten feet between the sides of adjacent manufactured homes including their attachments
336.3and at least three feet between manufactured homes when parked end to end. The space
336.4between manufactured homes may be used for the parking of motor vehicles and other
336.5property, if the vehicle or other property is parked at least ten feet from the nearest
336.6adjacent manufactured home position. The requirements of this paragraph shall not apply
336.7to recreational camping areas and variances may be granted by the state commissioner
336.8of health in manufactured home parks when the variance is applied for in writing and in
336.9the opinion of the commissioner the variance will not endanger the health, safety, and
336.10welfare of manufactured home park occupants.
336.11 (4) An adequate supply of water of safe, sanitary quality shall be furnished at each
336.12manufactured home park or recreational camping area. The source of the water supply
336.13shall first be approved by the state Department of Health.
336.14 (5) All plumbing shall be installed in accordance with the rules of the state
336.15commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.
336.16 (6) In the case of a manufactured home park with less than ten manufactured homes,
336.17a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of
336.18the park in times of severe weather conditions, such as tornadoes, high winds, and floods.
336.19The shelter or evacuation plan shall be developed with the assistance and approval of
336.20the municipality where the park is located and shall be posted at conspicuous locations
336.21throughout the park. The park owner shall provide each resident with a copy of the
336.22approved shelter or evacuation plan, as provided by section
336.23Nothing in this paragraph requires the Department of Health to review or approve any
336.24shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan
336.25submitted by a park shall not be grounds for action against the park by the Department of
336.26Health if the park has made a good faith effort to develop the plan and obtain municipal
336.27approval.
336.28 (7) A manufactured home park with ten or more manufactured homes, licensed prior
336.29to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the
336.30evacuation of park residents to a safe place of shelter within a reasonable distance of the
336.31park for use by park residents in times of severe weather, including tornadoes and high
336.32winds. The shelter or evacuation plan must be approved by the municipality by March 1,
336.331989. The municipality may require the park owner to construct a shelter if it determines
336.34that a safe place of shelter is not available within a reasonable distance from the park. A
336.35copy of the municipal approval and the plan shall be submitted by the park owner to the
337.1Department of Health. The park owner shall provide each resident with a copy of the
337.2approved shelter or evacuation plan, as provided by section
337.3 (8) A manufactured home park with ten or more manufactured homes, receiving
337.4
337.5by section
337.6emergency housing in a disaster area declared by the President of the United States or
337.7the governor, an approved evacuation plan may be provided in lieu of a shelter for a
337.8period not exceeding 18 months.
337.9 (9) For the purposes of this subdivision, "park owner" and "resident" have the
337.10
337.11 Sec. 43. Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision
337.12to read:
337.13 Subd. 4. Special event recreational camping areas. Each special event camping
337.14area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.
337.15(1) Recreational camping vehicles and tents, including attachments, must be
337.16separated from each other and other structures by at least seven feet.
337.17(2) A minimum area of 300 square feet per site must be provided and the total
337.18number of sites must not exceed one site for every 300 square feet of usable land area.
337.19(3) Each site must abut or face a driveway or clear unoccupied space of at least 16
337.20feet in width, which space must have unobstructed access to a public roadway.
337.21(4) If no approved on-site water supply system is available, hauled water may be
337.22used, provided that persons using hauled water comply with Minnesota Rules, parts
337.234720.4000 to 4720.4600.
337.24(5) Nonburied sewer lines may be permitted provided they are of approved materials,
337.25watertight, and properly maintained.
337.26(6) If a sanitary dumping station is not provided on-site, arrangements must be
337.27made with a licensed sewage pumper to service recreational camping vehicle holding
337.28tanks as needed.
337.29(7) Toilet facilities must be provided consisting of toilets connected to an approved
337.30sewage disposal system, portable toilets, or approved, properly constructed privies.
337.31(8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.
337.32(9) Toilets must be not more than 400 feet from any site.
337.33(10) If a central building or buildings are provided with running water, then toilets
337.34and handwashing lavatories must be provided in the building or buildings that meet the
337.35requirements of this subdivision.
338.1(11) Showers, if provided, must be provided in the ratio of one shower for each sex
338.2for each 250 sites. Showerheads must be provided, where running water is available, for
338.3each camping event exceeding two nights.
338.4(12) Central toilet and shower buildings, if provided, must be constructed with
338.5adequate heating, ventilation, and lighting, and floors of impervious material sloped
338.6to drain. Walls must be of a washable material. Permanent facilities must meet the
338.7requirements of the Americans with Disabilities Act.
338.8(13) An adequate number of durable, covered, watertight containers must be
338.9provided for all garbage and refuse. Garbage and refuse must be collected as often as
338.10necessary to prevent nuisance conditions.
338.11(14) Campgrounds must be located in areas free of poison ivy or other noxious
338.12weeds considered detrimental to health. Sites must not be located in areas of tall grass or
338.13weeds and sites must be adequately drained.
338.14(15) Campsites for recreational vehicles may not be located on inclines of greater
338.15than eight percent grade or one inch drop per lineal foot.
338.16(16) A responsible attendant or caretaker must be available on-site at all times during
338.17the operation of any special event recreational camping area that has 50 or more sites.
338.18 Sec. 44. MINNESOTA COLORECTAL CANCER PREVENTION
338.19DEMONSTRATION PROJECT.
338.20 Subdivision 1. Establishment. The commissioner of health shall award grants
338.21to Hennepin County Medical Center and MeritCare Bemidji for a colorectal screening
338.22demonstration project to provide screening to uninsured and underinsured women and
338.23men. The project shall expire December 31, 2010.
338.24 Subd. 2. Eligibility. To be eligible for colorectal screening under this demonstration
338.25project, an applicant must:
338.26(1) be at least 50 years of age, or under the age of 50 and at high risk for colon cancer;
338.27(2) be uninsured, or if insured, have coverage that does not cover the full cost of
338.28colorectal cancer screenings;
338.29(3) not be eligible for medical assistance, general assistance medical care, or
338.30MinnesotaCare programs; and
338.31(4) have a gross family income at or below 250 percent of the federal poverty level.
338.32 Subd. 3. Services. Services provided under this project shall include:
338.33(1) colorectal cancer screening, according to standard practices of medicine, or
338.34guidelines provided by the Institute for Clinical Systems Improvement or the American
338.35Cancer Society;
339.1(2) follow-up services for abnormal tests; and
339.2(3) diagnostic services to determine the extent and proper course of treatment.
339.3 Subd. 4. Project evaluation. The commissioner of health shall evaluate the
339.4demonstration project and make recommendations for increasing the number of persons in
339.5Minnesota who receive recommended colon cancer screening. The commissioner of health
339.6shall submit the evaluation and recommendations to the legislature by January 15, 2011.
339.7 Sec. 45. RESEARCH OF EXPOSURE PATHWAYS FOR
339.8PERFLUOROCHEMICALS.
339.9The commissioner of health shall study and report to the legislature by January
339.1015, 2011, on the exposure pathways for perfluorochemicals, focusing on food sources
339.11that might be affected by contact with contaminated water or air. This research will be
339.12performed to the extent that nonstate funds and environmental health tracking funds are
339.13available and include garden vegetables produced or consumed by a representative sample
339.14of the population from the east metropolitan area including indigenous people and people
339.15of color. In developing and performing the research, the commissioner must convene and
339.16consult with a citizen advisory group consisting of residents from the east metropolitan
339.17area, including indigenous people and people of color.
339.18 Sec. 46. FEASIBILITY PILOT PROJECT FOR CANCER SURVEILLANCE.
339.19The commissioner of health must provide a grant to the Hennepin County Medical
339.20Center for a one-year feasibility pilot project to collect occupational, residential, and
339.21military service history data from newly diagnosed cancer patients at the Hennepin
339.22County Medical Center's Cancer Center. Funding for this grant shall come from the
339.23Department of Health's current resources for the Chronic Disease and Environmental
339.24Epidemiology Section.
339.25Under this pilot project, Hennepin County Medical Center will design an expansion
339.26of its existing cancer registry to include the collection of additional data, including the
339.27cancer patient's occupational, residential, and military service history. Patient consent is
339.28required for collection of these additional data. The consent must be in writing and must
339.29contain notice informing the patient about private and confidential data concerning the
339.30patient pursuant to Minnesota Statutes, section 13.04, subdivision 2. The patient is entitled
339.31to opt out of the project at any time. The data collection expansion may also include the
339.32cancer patient's possible toxic environmental exposure history, if known. The purpose of
339.33this pilot project is to determine the following:
339.34(1) the feasibility of collecting these data on a statewide scale;
340.1(2) the potential design of a self-administered patient questionnaire template; and
340.2(3) necessary qualifications for staff who will collect these data.
340.3Hennepin County Medical Center must report the results of this pilot project to the
340.4legislature by October 1, 2010.
340.5 Sec. 47. SMOKING CESSATION.
340.6The commissioner of health must prioritize smoking prevention and smoking
340.7cessation activities in low-income, indigenous, and minority communities in their
340.8collaborations with the organization specifically described in Minnesota Statutes, section
340.9144.396, subdivision 8.
340.10 Sec. 48. MEDICAL RESPONSE UNIT REIMBURSEMENT PILOT PROGRAM.
340.11(a) The Department of Public Safety or its contract designee shall collaborate
340.12with the Minnesota Ambulance Association to create the parameters of the medical
340.13response unit reimbursement pilot program, including determining criteria for baseline
340.14data reporting.
340.15(b) In conducting the pilot program, the Department of Public Safety must consult
340.16with the Minnesota Ambulance Association, Minnesota Fire Chiefs Association,
340.17Emergency Services Regulatory Board, and the Minnesota Council of Health Plans to:
340.18(1) identify no more than five medical response units registered as medical response
340.19units with the Minnesota Emergency Medical Services Regulatory Board according to
340.20Minnesota Statutes, chapter 144E, to participate in the program;
340.21(2) outline and develop criteria for reimbursement;
340.22(3) determine the amount of reimbursement for each unit response; and
340.23(4) collect program data to be analyzed for a final report.
340.24(c) Further criteria for the medical response unit reimbursement pilot program
340.25shall include:
340.26(1) the pilot program will expire on December 31, 2010, or when the appropriation
340.27is extended, whichever occurs first;
340.28(2) a report shall be made to the legislature by March 1, 2011, by the Department
340.29of Public Safety or its contractor as to the effectiveness and value of this reimbursement
340.30pilot program to the emergency medical services delivery system, any actual or potential
340.31savings to the health care system, and impact on patient outcomes;
340.32(3) participating medical response units must adhere to the requirements of this
340.33pilot program outlined in an agreement between the Department of Public Safety and
340.34the medical response unit, including but not limited to, requirements relating to data
340.35collection, response criteria, and patient outcomes and disposition;
341.1(4) individual entities licensed to provide ambulance care under Minnesota Statutes,
341.2chapter 144E, are not eligible for participation in this pilot program;
341.3(5) if a participating medical response unit withdraws from the pilot program, the
341.4Department of Public Safety in consultation with the Minnesota Ambulance Association
341.5may choose another pilot site if funding is available;
341.6(6) medical response units must coordinate their operations under this pilot project
341.7with the ambulance service or services licensed to provide care in their first response
341.8geographic areas;
341.9(7) licensed ambulance services that participate with the medical response unit in
341.10the pilot program assume no financial or legal liability for the actions of the participating
341.11medical response unit; and
341.12(8) the Department of Public Safety and its pilot program partners have no ongoing
341.13responsibility to reimburse medical response units beyond the parameters of the pilot
341.14program.
341.15 Sec. 49. REVIEW OF PROPOSED REGULATIONS FOR BODY ART
341.16TECHNICIANS AND BODY ART ESTABLISHMENTS.
341.17The commissioner of health shall review proposed regulatory legislation for
341.18body art technicians and body art establishments and develop recommendations on the
341.19proper level of regulation needed for body art technicians and establishments in order
341.20to protect public health. The recommendations must include a review of how other
341.21states comply with the American Association of Blood Banks standards, how regulatory
341.22requirements affect currently operating body art establishments, and the appropriate level
341.23of coordination between the state and local jurisdictions that currently regulate body art
341.24establishments. The commissioner shall submit the results of the review and possible
341.25regulatory recommendations for body art technicians and establishments to the chairs and
341.26ranking minority members of the legislative committees with jurisdiction over health
341.27care by January 15, 2010.
341.28 Sec. 50. HEARING AIDS; ENFORCEMENT.
341.29Costs incurred by the Minnesota Department of Health for conducting investigations
341.30of unlicensed hearing aid dispensers shall be apportioned between all licensed or
341.31credentialed professions that dispense hearing aids.
341.32EFFECTIVE DATE.This section is effect July 1, 2011.
341.33 Sec. 51. REPEALER.
342.1(a) Minnesota Statutes 2008, sections 103I.112; 144.9501, subdivision 17b; and
342.2327.14, subdivisions 5 and 6, are repealed.
342.3(b) Minnesota Rules, part 4626.2015, subpart 9, is repealed.
342.6 Section 1. Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to
342.7read:
342.8 Subdivision 1. Application fees. Application fees for licensure are as follows:
342.9(1) for a licensed social worker, $45;
342.10(2) for a licensed graduate social worker, $45;
342.11(3) for a licensed independent social worker,
342.12(4) for a licensed independent clinical social worker,
342.13(5) for a temporary license, $50; and
342.14(6) for a licensure by endorsement,
342.15The fee for criminal background checks is the fee charged by the Bureau of Criminal
342.16Apprehension. The criminal background check fee must be included with the application
342.17fee as required pursuant to section
342.18 Sec. 2. Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:
342.19 Subd. 2. License fees. License fees are as follows:
342.20(1) for a licensed social worker,
342.21(2) for a licensed graduate social worker,
342.22(3) for a licensed independent social worker,
342.23(4) for a licensed independent clinical social worker,
342.24(5) for an emeritus license, $43.20; and
342.25(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
342.26If the licensee's initial license term is less or more than 24 months, the required
342.27license fees must be prorated proportionately.
342.28 Sec. 3. Minnesota Statutes 2008, section 148D.180, subdivision 3, is amended to read:
342.29 Subd. 3. Renewal fees. Renewal fees for licensure are as follows:
342.30(1) for a licensed social worker,
342.31(2) for a licensed graduate social worker,
342.32(3) for a licensed independent social worker,
342.33(4) for a licensed independent clinical social worker,
343.1 Sec. 4. Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:
343.2 Subd. 5. Late fees. Late fees are as follows:
343.3(1) renewal late fee,
343.43; and
343.5(2) supervision plan late fee, $40.
343.6 Sec. 5. Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:
343.7 Subdivision 1. Application fees. Application fees for licensure are as follows:
343.8 (1) for a licensed social worker, $45;
343.9 (2) for a licensed graduate social worker, $45;
343.10 (3) for a licensed independent social worker,
343.11 (4) for a licensed independent clinical social worker,
343.12 (5) for a temporary license, $50; and
343.13 (6) for a licensure by endorsement,
343.14 The fee for criminal background checks is the fee charged by the Bureau of Criminal
343.15Apprehension. The criminal background check fee must be included with the application
343.16fee as required according to section
343.17 Sec. 6. Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read:
343.18 Subd. 2. License fees. License fees are as follows:
343.19 (1) for a licensed social worker,
343.20 (2) for a licensed graduate social worker,
343.21 (3) for a licensed independent social worker,
343.22 (4) for a licensed independent clinical social worker,
343.23 (5) for an emeritus license, $43.20; and
343.24 (6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.
343.25 If the licensee's initial license term is less or more than 24 months, the required
343.26license fees must be prorated proportionately.
343.27 Sec. 7. Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read:
343.28 Subd. 3. Renewal fees. Renewal fees for licensure are as follows:
343.29 (1) for a licensed social worker,
343.30 (2) for a licensed graduate social worker,
343.31 (3) for a licensed independent social worker,
343.32 (4) for a licensed independent clinical social worker,
344.1 Sec. 8. Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:
344.2 Subd. 5. Late fees. Late fees are as follows:
344.3 (1) renewal late fee,
344.43; and
344.5 (2) supervision plan late fee, $40.
344.6 Sec. 9. Minnesota Statutes 2008, section 152.126, subdivision 1, is amended to read:
344.7 Subdivision 1. Definitions. For purposes of this section, the terms defined in this
344.8subdivision have the meanings given.
344.9 (a) "Board" means the Minnesota State Board of Pharmacy established under
344.10chapter 151.
344.11 (b) "Controlled substances" means those substances listed in section
344.12subdivisions 3
344.14 (c) "Dispense" or "dispensing" has the meaning given in section
344.16patient by a licensed health care professional.
344.17 (d) "Dispenser" means a person authorized by law to dispense a controlled substance,
344.18pursuant to a valid prescription. For the purposes of this section, a dispenser does not
344.19include a licensed hospital pharmacy that distributes controlled substances for inpatient
344.20hospital care or a veterinarian who is dispensing prescriptions under section
344.21 (e) "Prescriber" means a licensed health care professional who is authorized to
344.22prescribe a controlled substance under section
344.23 (f) "Prescription" has the meaning given in section
344.24 Sec. 10. Minnesota Statutes 2008, section 152.126, subdivision 2, is amended to read:
344.25 Subd. 2. Prescription electronic reporting system. (a) The board shall establish
344.26by January 1, 2010, an electronic system for reporting the information required under
344.27subdivision 4 for all controlled substances dispensed within the state.
344.28 (b) The board may contract with a vendor for the purpose of obtaining technical
344.29assistance in the design, implementation, operation, and maintenance of the electronic
344.30reporting system.
344.31
344.32
344.33
345.1 Sec. 11. Minnesota Statutes 2008, section 152.126, subdivision 6, is amended to read:
345.2 Subd. 6. Access to reporting system data. (a) Except as indicated in this
345.3subdivision, the data submitted to the board under subdivision 4 is private data on
345.4individuals as defined in section
345.5 (b) Except as specified in subdivision 5, the following persons shall be considered
345.6permissible users and may access the data submitted under subdivision 4 in the same or
345.7similar manner, and for the same or similar purposes, as those persons who are authorized
345.8to access similar private data on individuals under federal and state law:
345.9 (1) a prescriber, to the extent the information relates specifically to a current patient,
345.10to whom the prescriber is prescribing or considering prescribing any controlled substance;
345.11 (2) a dispenser, to the extent the information relates specifically to a current patient
345.12to whom that dispenser is dispensing or considering dispensing any controlled substance;
345.13 (3) an individual who is the recipient of a controlled substance prescription for
345.14which data was submitted under subdivision 4, or a guardian of the individual, parent or
345.15guardian of a minor, or health care agent of the individual acting under a health care
345.16directive under chapter 145C;
345.17 (4) personnel of the board specifically assigned to conduct a bona fide investigation
345.18of a specific licensee;
345.19 (5) personnel of the board engaged in the collection of controlled substance
345.20prescription information as part of the assigned duties and responsibilities under this
345.21section;
345.22 (6) authorized personnel of a vendor under contract with the board who are engaged
345.23in the design, implementation, operation, and maintenance of the electronic reporting
345.24system as part of the assigned duties and responsibilities of their employment, provided
345.25that access to data is limited to the minimum amount necessary to
345.26
345.27 (7) federal, state, and local law enforcement authorities acting pursuant to a valid
345.28search warrant; and
345.29 (8) personnel of the medical assistance program assigned to use the data collected
345.30under this section to identify recipients whose usage of controlled substances may warrant
345.31restriction to a single primary care physician, a single outpatient pharmacy, or a single
345.32hospital.
345.33 For purposes of clause (3), access by an individual includes persons in the definition
345.34of an individual under section
345.35 (c) Any permissible user identified in paragraph (b), who directly accesses
345.36the data electronically, shall implement and maintain a comprehensive information
346.1security program that contains administrative, technical, and physical safeguards that
346.2are appropriate to the user's size and complexity, and the sensitivity of the personal
346.3information obtained. The permissible user shall identify reasonably foreseeable internal
346.4and external risks to the security, confidentiality, and integrity of personal information
346.5that could result in the unauthorized disclosure, misuse, or other compromise of the
346.6information and assess the sufficiency of any safeguards in place to control the risks.
346.7 (d) The board shall not release data submitted under this section unless it is provided
346.8with evidence, satisfactory to the board, that the person requesting the information is
346.9entitled to receive the data.
346.10 (e) The board shall not release the name of a prescriber without the written consent
346.11of the prescriber or a valid search warrant or court order. The board shall provide a
346.12mechanism for a prescriber to submit to the board a signed consent authorizing the release
346.13of the prescriber's name when data containing the prescriber's name is requested.
346.14 (f) The board shall maintain a log of all persons who access the data and shall ensure
346.15that any permissible user complies with paragraph (c) prior to attaining direct access to
346.16the data.
346.17(g) Section 13.05, subdivision 6, shall apply to any contract the board enters into
346.18pursuant to subdivision 2. A vendor shall not use data collected under this section for
346.19any purpose not specified in this section.
346.20 Sec. 12. REPEALER.
346.21Minnesota Statutes 2008, section 148D.180, subdivision 8, is repealed.
| 346.24 346.25 |
Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT. |
||||||
346.27from the appropriations in Laws 2008, chapter 363, from the general fund, or any other
346.28fund named, to the Department of Human Services for the purposes specified in this
346.29article, to be available for the fiscal year indicated for each purpose. The figure "2009"
346.30used in this article means that the appropriation or appropriations listed are available
346.31for the fiscal year ending June 30, 2009.
| 346.32 346.33 |
Sec. 2. COMMISSIONER OF HUMAN SERVICES |
||||||
| 347.1 |
Subdivision 1.Total Appropriation |
$ |
(478,994,000) |
||||
| 347.2 |
Appropriations by Fund |
||
| 347.3 |
2009 |
||
| 347.4 |
General |
(445,130,000) |
|
| 347.5 |
Health Care Access |
(19,460,000) |
|
| 347.6 |
Federal TANF |
(14,404,000) |
|
| 347.7 |
Subd. 2.Revenue and Pass-Through |
||||||
| 347.8 |
Federal TANF |
1,107,000 |
| 347.9 347.10 |
Subd. 3.Children and Economic Assistance Grants |
||||||
| 347.11 |
General |
27,002,000 |
|
| 347.12 |
Federal TANF |
(16,211,000) |
347.14appropriation for each purpose are as follows:
| 347.15 |
(a) MFIP/DWP Grants |
||||||
| 347.16 |
General |
17,530,000 |
|
| 347.17 |
Federal TANF |
(16,211,000) |
| 347.18 |
(b) MFIP Child Care Assistance Grants |
4,933,000 |
|||||
| 347.19 |
(c) General Assistance Grants |
1,458,000 |
|||||
| 347.20 |
(d) Minnesota Supplemental Aid Grants |
513,000 |
|||||
| 347.21 |
(e) Group Residential Housing Grants |
2,568,000 |
|||||
| 347.22 |
Subd. 4.Basic Health Care Grants |
||||||
| 347.23 |
General |
(224,341,000) |
|
| 347.24 |
Health Care Access |
(19,460,000) |
348.2appropriation for each purpose are as follows:
| 348.3 |
(a) MinnesotaCare |
||||||
| 348.4 |
Health Care Access |
(19,460,000) |
| 348.5 348.6 |
(b) MA Basic Health Care - Families and Children |
(100,055,000) |
|||||
| 348.7 348.8 |
(c) MA Basic Health Care - Elderly and Disabled |
(136,795,000) |
|||||
| 348.9 |
(d) General Assistance Medical Care |
12,539,000 |
|||||
| 348.10 |
Subd. 5.Continuing Care Grants |
(247,791,000) |
|||||
348.12appropriation for each purpose are as follows:
| 348.13 |
(a) MA Long-Term Care Facilities |
(59,204,000) |
|||||
| 348.14 |
(b) MA Long-Term Care Waivers |
(168,927,000) |
|||||
| 348.15 |
(c) Chemical Dependency Entitlement Grants |
(19,660,000) |
|||||
348.16 Sec. 3. EFFECTIVE DATE.
348.17Sections 1 and 2 are effective the day following final enactment.
| 348.20 |
Section 1. SUMMARY OF APPROPRIATIONS. |
||||||
348.22in this article.
| 349.6 |
Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATION. |
||||||
349.8agencies and for the purposes specified in this article. The appropriations are from the
349.9general fund, or another named fund, and are available for the fiscal years indicated
349.10for each purpose. The figures "2010" and "2011" used in this article mean that the
349.11appropriations listed under them are available for the fiscal year ending June 30, 2010, or
349.12June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal
349.13year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal
349.14year ending June 30, 2009, are effective the day following final enactment.
| 349.15 |
APPROPRIATIONS |
||||||
| 349.16 |
Available for the Year |
||||||
| 349.17 |
Ending June 30 |
||||||
| 349.18 |
2010 |
2011 |
|||||
| 349.19 |
Sec. 3. HUMAN SERVICES |
||||||
| 349.20 |
Subdivision 1.Total Appropriation |
$ |
5,230,100,000 |
$ |
5,997,715,000 |
||
350.2Appropriations and federal receipts for
350.3information systems projects for MAXIS,
350.4PRISM, MMIS, and SSIS must be deposited
350.5in the state system account authorized in
350.6Minnesota Statutes, section 256.014. Money
350.7appropriated for computer projects approved
350.8by the Minnesota Office of Enterprise
350.9Technology, funded by the legislature, and
350.10approved by the commissioner of finance,
350.11may be transferred from one project to
350.12another and from development to operations
350.13as the commissioner of human services
350.14considers necessary, except that any transfers
350.15to one project that exceed $1,000,000 or
350.16multiple transfers to one project that exceed
350.17$1,000,000 in total require the express
350.18approval of the legislature. The preceding
350.19requirement for legislative approval does not
350.20apply to transfers made to establish a project's
350.21initial operating budget each year; instead,
350.22the requirements of section 11, subdivision 2,
350.23of this article apply to those transfers. Any
350.24unexpended balance in the appropriation
350.25for these projects does not cancel but is
350.26available for ongoing development and
350.27operations. Any computer project with a
350.28total cost exceeding $1,000,000, including,
350.29but not limited to, a replacement for the
350.30proposed HealthMatch system, shall not be
350.31commenced without the express approval of
350.32the legislature.
350.33HealthMatch Systems Project. In fiscal
350.34year 2010, $3,054,000 shall be transferred
350.35from the HealthMatch account in the state
351.1systems account in the special revenue fund
351.2to the general fund.
351.3Nonfederal Share Transfers. The
351.4nonfederal share of activities for which
351.5federal administrative reimbursement is
351.6appropriated to the commissioner may be
351.7transferred to the special revenue fund.
351.8TANF Maintenance of Effort.
351.9(a) In order to meet the basic maintenance
351.10of effort (MOE) requirements of the TANF
351.11block grant specified under Code of Federal
351.12Regulations, title 45, section 263.1, the
351.13commissioner may only report nonfederal
351.14money expended for allowable activities
351.15listed in the following clauses as TANF/MOE
351.16expenditures:
351.17(1) MFIP cash, diversionary work program,
351.18and food assistance benefits under Minnesota
351.19Statutes, chapter 256J;
351.20(2) the child care assistance programs
351.21under Minnesota Statutes, sections 119B.03
351.22and 119B.05, and county child care
351.23administrative costs under Minnesota
351.24Statutes, section 119B.15;
351.25(3) state and county MFIP administrative
351.26costs under Minnesota Statutes, chapters
351.27256J and 256K;
351.28(4) state, county, and tribal MFIP
351.29employment services under Minnesota
351.30Statutes, chapters 256J and 256K;
351.31(5) expenditures made on behalf of
351.32noncitizen MFIP recipients who qualify
351.33for the medical assistance without federal
351.34financial participation program under
352.1Minnesota Statutes, section 256B.06,
352.2subdivision 4, paragraphs (d), (e), and (j);
352.3and
352.4(6) qualifying working family credit
352.5expenditures under Minnesota Statutes,
352.6section 290.0671.
352.7(b) The commissioner shall ensure that
352.8sufficient qualified nonfederal expenditures
352.9are made each year to meet the state's
352.10TANF/MOE requirements. For the activities
352.11listed in paragraph (a), clauses (2) to
352.12(6), the commissioner may only report
352.13expenditures that are excluded from the
352.14definition of assistance under Code of
352.15Federal Regulations, title 45, section 260.31.
352.16(c) For fiscal years beginning with state
352.17fiscal year 2003, the commissioner shall
352.18ensure that the maintenance of effort used
352.19by the commissioner of finance for the
352.20February and November forecasts required
352.21under Minnesota Statutes, section 16A.103,
352.22contains expenditures under paragraph (a),
352.23clause (1), equal to at least 16 percent of
352.24the total required under Code of Federal
352.25Regulations, title 45, section 263.1.
352.26(d) For the federal fiscal years beginning on
352.27or after October 1, 2007, the commissioner
352.28may not claim an amount of TANF/MOE in
352.29excess of the 75 percent standard in Code
352.30of Federal Regulations, title 45, section
352.31263.1(a)(2), except:
352.32(1) to the extent necessary to meet the 80
352.33percent standard under Code of Federal
352.34Regulations, title 45, section 263.1(a)(1),
352.35if it is determined by the commissioner
353.1that the state will not meet the TANF work
353.2participation target rate for the current year;
353.3(2) to provide any additional amounts
353.4under Code of Federal Regulations, title 45,
353.5section 264.5, that relate to replacement of
353.6TANF funds due to the operation of TANF
353.7penalties; and
353.8(3) to provide any additional amounts that
353.9may contribute to avoiding or reducing
353.10TANF work participation penalties through
353.11the operation of the excess MOE provisions
353.12of Code of Federal Regulations, title 45,
353.13section 261.43(a)(2).
353.14For the purposes of clauses (1) to (3),
353.15the commissioner may supplement the
353.16MOE claim with working family credit
353.17expenditures to the extent such expenditures
353.18or other qualified expenditures are otherwise
353.19available after considering the expenditures
353.20allowed in this section.
353.21(e) Minnesota Statutes, section 256.011,
353.22subdivision 3, which requires that federal
353.23grants or aids secured or obtained under that
353.24subdivision be used to reduce any direct
353.25appropriations provided by law, do not apply
353.26if the grants or aids are federal TANF funds.
353.27(f) Notwithstanding any contrary provision
353.28in this article, this provision expires June 30,
353.292013.
353.30Working Family Credit Expenditures as
353.31TANF/MOE. The commissioner may claim
353.32as TANF/MOE up to $6,707,000 per year of
353.33working family credit expenditures for fiscal
353.34year 2010 through fiscal year 2011.
354.1Working Family Credit Expenditures
354.2to be Claimed for TANF/MOE. The
354.3commissioner may count the following
354.4amounts of working family credit expenditure
354.5as TANF/MOE:
354.6(1) fiscal year 2010, $30,217,000;
354.7(2) fiscal year 2011, $55,596,000;
354.8(3) fiscal year 2012, $28,519,000; and
354.9(4) fiscal year 2013, $22,138,000.
354.10Notwithstanding any contrary provision in
354.11this article, this rider expires June 30, 2013.
354.12TANF Transfer to Federal Child Care
354.13and Development Fund. The following
354.14TANF fund amounts are appropriated to the
354.15commissioner for the purposes of MFIP and
354.16transition year child care under Minnesota
354.17Statutes, section 119B.05:
354.18(1) fiscal year 2010, $5,909,000;
354.19(2) fiscal year 2011, $9,808,000;
354.20(3) fiscal year 2012, $10,826,000; and
354.21(4) fiscal year 2013, $4,026,000.
354.22The commissioner shall authorize the
354.23transfer of sufficient TANF funds to the
354.24federal child care and development fund to
354.25meet this appropriation and shall ensure that
354.26all transferred funds are expended according
354.27to federal child care and development fund
354.28regulations.
354.29Food Stamps Employment and Training.
354.30(a) The commissioner shall apply for and
354.31claim the maximum allowable federal
354.32matching funds under United States Code,
355.1title 7, section 2025, paragraph (h), for
355.2state expenditures made on behalf of family
355.3stabilization services participants voluntarily
355.4engaged in food stamp employment and
355.5training activities, where appropriate.
355.6(b) Notwithstanding Minnesota Statutes,
355.7sections 256D.051, subdivisions 1a, 6b,
355.8and 6c, and 256J.626, federal food stamps
355.9employment and training funds received
355.10as reimbursement of MFIP consolidated
355.11fund grant expenditures for diversionary
355.12work program participants and child
355.13care assistance program expenditures for
355.14two-parent families must be deposited in the
355.15general fund. The amount of funds must be
355.16limited to $3,350,000 in fiscal year 2010
355.17and $4,440,000 in fiscal years 2011 through
355.182013, contingent on approval by the federal
355.19Food and Nutrition Service.
355.20(c) Consistent with the receipt of these federal
355.21funds, the commissioner may adjust the
355.22level of working family credit expenditures
355.23claimed as TANF maintenance of effort.
355.24Notwithstanding any contrary provision in
355.25this article, this rider expires June 30, 2013.
355.26ARRA Food Support Administration.
355.27The funds available for food support
355.28administration under the American Recovery
355.29and Reinvestment Act (ARRA) of 2009
355.30are appropriated to the commissioner
355.31to pay actual costs of implementing the
355.32food support benefit increases, increased
355.33eligibility determinations, and outreach. Of
355.34these funds, 20 percent shall be allocated
355.35to the commissioner and 80 percent shall
356.1be allocated to counties. The commissioner
356.2shall allocate the county portion based on
356.3caseload. Reimbursement shall be based on
356.4actual costs reported by counties through
356.5existing processes. Tribal reimbursement
356.6must be made from the state portion based
356.7on a caseload factor equivalent to that of a
356.8county.
356.9ARRA Food Support Benefit Increases.
356.10The funds provided for food support benefit
356.11increases under the Supplemental Nutrition
356.12Assistance Program provisions of the
356.13American Recovery and Reinvestment Act
356.14(ARRA) of 2009 must be used for benefit
356.15increases beginning July 1, 2009.
356.16Emergency Fund for the TANF Program.
356.17TANF Emergency Contingency funds
356.18available under the American Recovery
356.19and Reinvestment Act of 2009 (Public Law
356.20111-5) are appropriated to the commissioner.
356.21The commissioner must request TANF
356.22Emergency Contingency funds from the
356.23Secretary of the Department of Health
356.24and Human Services to the extent the
356.25commissioner meets or expects to meet the
356.26requirements of section 403(c) of the Social
356.27Security Act. The commissioner must seek
356.28to maximize such grants. The funds received
356.29must be used as appropriated. Each county
356.30must maintain the county's current level of
356.31emergency assistance funding under the
356.32MFIP consolidated fund and use the funds
356.33under this paragraph to supplement existing
356.34emergency assistance funding levels.
| 356.35 |
Subd. 2.Agency Management |
||||||
357.2appropriation for each purpose are as follows:
| 357.3 |
(a) Financial Operations |
||||||
| 357.4 |
Appropriations by Fund |
||
| 357.5 |
General |
3,380,000 |
3,908,000 |
| 357.6 |
Health Care Access |
1,281,000 |
1,016,000 |
| 357.7 |
Federal TANF |
122,000 |
122,000 |
| 357.8 |
(b) Legal and Regulatory Operations |
||||||
| 357.15 |
(c) Management Operations |
||||||
| 357.16 |
Appropriations by Fund |
||
| 357.17 |
General |
4,334,000 |
4,562,000 |
| 357.18 |
Health Care Access |
242,000 |
242,000 |
357.20to the commissioner shall be reduced by
357.21$381,000 in fiscal year 2010, and $153,000
357.22in fiscal year 2011, to reflect a reduction in
357.23lease costs related to the Minnehaha Avenue
357.24building.
357.25Base Adjustment. The general fund base is
357.26increased by $153,000 in each of fiscal years
357.272012 and 2013.
| 357.28 |
(d) Information Technology Operations |
||||||
| 358.1 |
Appropriations by Fund |
||
| 358.2 |
General |
28,077,000 |
28,077,000 |
| 358.3 |
Health Care Access |
4,856,000 |
4,868,000 |
| 358.4 358.5 |
Subd. 3.Revenue and Pass-Through Revenue Expenditures |
65,746,000 |
67,068,000 |
||||
358.7fund.
| 358.8 358.9 |
Subd. 4.Children and Economic Assistance Grants |
||||||
358.11appropriation for each purpose are as follows:
| 358.12 |
(a) MFIP/DWP Grants |
||||||
| 358.13 |
Appropriations by Fund |
||
| 358.14 |
General |
63,205,000 |
89,033,000 |
| 358.15 |
Federal TANF |
100,404,000 |
85,789,000 |
| 358.16 |
(b) Support Services Grants |
||||||
| 358.17 |
Appropriations by Fund |
||
| 358.18 |
General |
8,715,000 |
12,498,000 |
| 358.19 |
Federal TANF |
121,257,000 |
102,757,000 |
358.21consolidated fund TANF appropriation is
358.22reduced by $1,854,000 in fiscal year 2011
358.23and fiscal year 2012.
358.24Notwithstanding Minnesota Statutes, section
358.25256J.626, subdivision 8, paragraph (b), the
358.26commissioner shall reduce proportionately
358.27the reimbursement to counties for
358.28administrative expenses.
359.1Subsidized Employment Funding Through
359.2ARRA. The commissioner is authorized to
359.3apply for TANF emergency fund grants for
359.4subsidized employment activities. Growth
359.5in expenditures for subsidized employment
359.6within the supported work program and the
359.7MFIP consolidated fund over the amount
359.8expended in the calendar quarters in the
359.9TANF emergency fund base year shall be
359.10used to leverage the TANF emergency fund
359.11grants for subsidized employment and to
359.12fund supported work. The commissioner
359.13shall develop procedures to maximize
359.14reimbursement of these expenditures over the
359.15TANF emergency fund base year quarters,
359.16and may contract directly with employers
359.17and providers to maximize these TANF
359.18emergency fund grants.
359.19Supported Work. Of the TANF
359.20appropriation, $6,400,000 in fiscal year
359.212011 is to the commissioner for supported
359.22work for MFIP recipients and is available
359.23until expended. Supported work includes
359.24paid transitional work experience and
359.25a continuum of employment assistance,
359.26including outreach and recruitment,
359.27program orientation and intake, testing and
359.28assessment, job development and marketing,
359.29preworksite training, supported worksite
359.30experience, job coaching, and postplacement
359.31follow-up, in addition to extensive case
359.32management and referral services.
359.33Base Adjustment. The general fund base
359.34is reduced by $3,783,000 in each of fiscal
359.35years 2012 and 2013. The TANF fund base
360.1is increased by $9,704,000 in each of fiscal
360.2years 2012 and 2013.
360.3Integrated Services Program Funding.
360.4The TANF appropriation for integrated
360.5services program funding is $1,250,000 in
360.6fiscal year 2010 and $2,500,000 in fiscal year
360.72011.
360.8TANF Emergency Fund; Nonrecurrent
360.9Short-Term Benefits. TANF emergency
360.10contingency fund grants received due to
360.11increases in expenditures for nonrecurrent
360.12short-term benefits must be used to offset the
360.13increase in these expenditures for counties
360.14under the MFIP consolidated fund, under
360.15Minnesota Statutes, section 256J.626,
360.16and the diversionary work program. The
360.17commissioner shall develop procedures
360.18to maximize reimbursement of these
360.19expenditures over the TANF emergency fund
360.20base year quarters. Growth in expenditures
360.21for the diversionary work program over the
360.22amount expended in the calendar quarters in
360.23the TANF emergency fund base year shall be
360.24used to leverage these funds.
| 360.25 |
(c) MFIP Child Care Assistance Grants |
||||||
| 360.26 |
Appropriations by Fund |
||
| 360.27 |
General |
61,171,000 |
65,214,000 |
| 360.28 |
Federal TANF |
1,022,000 |
406,000 |
360.30Grant Funds. The funds available from the
360.31child care development block grant under
360.32ARRA must be used for MFIP child care to
360.33the extent that those funds are not earmarked
361.1for quality expansion or to improve the
361.2quality of infant and toddler care.
361.3Acceleration of ARRA Child Care and
361.4Development Fund Expenditure. The
361.5commissioner must liquidate all child care
361.6and development money available under
361.7the American Recovery and Reinvestment
361.8Act (ARRA) of 2009, Public Law 111-5,
361.9by September 30, 2010. In order to expend
361.10those funds by September 30, 2010, the
361.11commissioner may redesignate and expend
361.12the ARRA child care and development funds
361.13appropriated in fiscal year 2011 for purposes
361.14under this section for related purposes that
361.15will allow liquidation by September 30,
361.162010. Child care and development funds
361.17otherwise available to the commissioner
361.18for those related purposes shall be used to
361.19fund the purposes from which the ARRA
361.20child care and development funds had been
361.21redesignated.
| 361.22 361.23 |
(d) Basic Sliding Fee Child Care Assistance Grants |
40,104,000 |
45,096,000 |
||||
361.25decreased by $260,000 in each of fiscal years
361.262012 and 2013.
361.27School Readiness Service Agreements.
361.28$261,000 in fiscal year 2010 and $261,000
361.29in fiscal year 2011 are from the federal
361.30child care development funds received from
361.31the American Recovery and Reinvestment
361.32Act of 2009, Public Law 111-5, to the
361.33commissioner of human services consistent
361.34with federal regulations for the purpose of
362.1school readiness service agreements under
362.2Minnesota Statutes, section 119B.231. This
362.3is a onetime appropriation. Any unexpended
362.4balance the first year is available in the
362.5second year.
362.6Child Care Development Fund
362.7Unexpended Balance. In addition to
362.8the amount provided in this section, the
362.9commissioner shall expend $5,244,000 in
362.10fiscal year 2010 from the federal child care
362.11development fund unexpended balance
362.12for basic sliding fee child care under
362.13Minnesota Statutes, section 119B.03. The
362.14commissioner shall ensure that all child
362.15care and development funds are expended
362.16according to the federal child care and
362.17development fund regulations.
362.18Basic Sliding Fee. $7,045,000 in fiscal year
362.192010 and $6,974,000 in fiscal year 2011 are
362.20from the federal child care development
362.21funds received from the American Recovery
362.22and Reinvestment Act of 2009, Public
362.23Law 111-5, to the commissioner of human
362.24services consistent with federal regulations
362.25for the purpose of basic sliding fee child care
362.26assistance under Minnesota Statutes, section
362.27119B.03. This is a onetime appropriation.
362.28Any unexpended balance the first year is
362.29available in the second year.
362.30Basic Sliding Fee Allocation for Calendar
362.31Year 2010. Notwithstanding Minnesota
362.32Statutes, section 119B.03, subdivision 6,
362.33in calendar year 2010, basic sliding fee
362.34funds shall be distributed according to
362.35this provision. Funds shall be allocated
363.1first in amounts equal to each county's
363.2guaranteed floor, according to Minnesota
363.3Statutes, section 119B.03, subdivision 8,
363.4with any remaining available funds allocated
363.5according to the following formula:
363.6(a) Up to one-fourth of the funds shall be
363.7allocated in proportion to the number of
363.8families participating in the transition year
363.9child care program as reported during and
363.10averaged over the most recent six months
363.11completed at the time of the notice of
363.12allocation. Funds in excess of the amount
363.13necessary to serve all families in this category
363.14shall be allocated according to paragraph (d).
363.15(b) Up to three-fourths of the funds shall
363.16be allocated in proportion to the average
363.17of each county's most recent six months of
363.18reported waiting list as defined in Minnesota
363.19Statutes, section 119B.03, subdivision 2, and
363.20the reinstatement list of those families whose
363.21assistance was terminated with the approval
363.22of the commissioner under Minnesota Rules,
363.23part 3400.0183, subpart 1. Funds in excess
363.24of the amount necessary to serve all families
363.25in this category shall be allocated according
363.26to paragraph (d).
363.27(c) The amount necessary to serve all families
363.28in paragraphs (a) and (b) shall be calculated
363.29based on the basic sliding fee average cost of
363.30care per family in the county with the highest
363.31cost in the most recently completed calendar
363.32year.
363.33(d) Funds in excess of the amount necessary
363.34to serve all families in paragraphs (a) and
363.35(b) shall be allocated in proportion to each
364.1county's total expenditures for the basic
364.2sliding fee child care program reported
364.3during the most recent fiscal year completed
364.4at the time of the notice of allocation. To
364.5the extent that funds are available, and
364.6notwithstanding Minnesota Statutes, section
364.7119B.03, subdivision 8, for the period
364.8January 1, 2011, to December 31, 2011, each
364.9county's guaranteed floor must be equal to its
364.10original calendar year 2010 allocation.
| 364.11 |
(e) Child Care Development Grants |
1,487,000 |
1,487,000 |
||||
364.13$375,000 in fiscal year 2010 and $375,000
364.14in fiscal year 2011 are from the child
364.15care development fund required targeted
364.16quality funds for quality expansion and
364.17infant/toddler from the American Recovery
364.18and Reinvestment Act of 2009, Public
364.19Law 111-5, to the commissioner of human
364.20services for family, friends, and neighbor
364.21grants under Minnesota Statutes, section
364.22119B.232. This appropriation may be used
364.23on programs receiving family, friends, and
364.24neighbor grant funds as of June 30, 2009,
364.25or on new programs or projects. This is a
364.26onetime appropriation. Any unexpended
364.27balance the first year is available in the
364.28second year.
364.29Voluntary quality rating system training,
364.30coaching, consultation, and supports.
364.31$633,000 in fiscal year 2010 and $633,000
364.32in fiscal year 2011 are from the federal child
364.33care development fund required targeted
364.34quality funds for quality expansion and
364.35infant/toddler from the American Recovery
365.1and Reinvestment Act of 2009, Public
365.2Law 111-5, to the commissioner of human
365.3services consistent with federal regulations
365.4for the purpose of providing grants to provide
365.5statewide child-care provider training,
365.6coaching, consultation, and supports to
365.7prepare for the voluntary Minnesota quality
365.8rating system rating tool. This is a onetime
365.9appropriation. Any unexpended balance the
365.10first year is available in the second year.
365.11Voluntary quality rating system. $184,000
365.12in fiscal year 2010 and $1,200,000 in fiscal
365.13year 2011 are from the federal child care
365.14development fund required targeted funds for
365.15quality expansion and infant/toddler from the
365.16American Recovery and Reinvestment Act of
365.172009, Public Law 111-5, to the commissioner
365.18of human services consistent with federal
365.19regulations for the purpose of implementing
365.20the voluntary Parent Aware quality star
365.21rating system pilot in coordination with the
365.22Minnesota Early Learning Foundation. The
365.23appropriation for the first year is to complete
365.24and promote the voluntary Parent Aware
365.25quality rating system pilot program through
365.26June 30, 2010, and the appropriation for the
365.27second year is to continue the voluntary
365.28Minnesota quality rating system pilot
365.29through June 30, 2011. This is a onetime
365.30appropriation. Any unexpended balance the
365.31first year is available in the second year.
| 365.32 |
(f) Child Support Enforcement Grants |
3,705,000 |
3,705,000 |
||||
| 365.33 |
(g) Children's Services Grants |
||||||
| 366.1 |
Appropriations by Fund |
||
| 366.2 |
General |
48,333,000 |
50,498,000 |
| 366.3 |
Federal TANF |
340,000 |
240,000 |
366.5decreased by $5,371,000 in fiscal year 2012
366.6and increased $8,737,000 in fiscal year 2013.
366.7Privatized Adoption Grants. Federal
366.8reimbursement for privatized adoption grant
366.9and foster care recruitment grant expenditures
366.10is appropriated to the commissioner for
366.11adoption grants and foster care and adoption
366.12administrative purposes.
366.13Adoption Assistance Incentive Grants.
366.14Federal funds available during fiscal year
366.152010 and fiscal year 2011 for the adoption
366.16incentive grants are appropriated to the
366.17commissioner for these purposes.
366.18Adoption Assistance and Relative Custody
366.19Assistance. The commissioner may transfer
366.20unencumbered appropriation balances for
366.21adoption assistance and relative custody
366.22assistance between fiscal years and between
366.23programs.
| 366.24 |
(h) Children and Community Services Grants |
67,663,000 |
67,542,000 |
||||
366.26Funding Adjustment. The commissioner
366.27shall recover from each county and tribe
366.28receiving a targeted case management
366.29temporary funding payment in fiscal year
366.302008 an amount equal to that payment. The
366.31commissioner shall recover one-half of the
366.32funds by February 1, 2010, and the remainder
366.33by February 1, 2011. At the commissioner's
367.1discretion and at the request of a county
367.2or tribe, the commissioner may revise
367.3the payment schedule, but full payment
367.4must not be delayed beyond May 1, 2011.
367.5The commissioner may use the recovery
367.6procedure under Minnesota Statutes, section
367.7256.017, to recover the funds. Recovered
367.8funds must be deposited into the general
367.9fund.
| 367.10 |
(i) General Assistance Grants |
48,215,000 |
48,608,000 |
||||
367.12commissioner shall set the monthly standard
367.13of assistance for general assistance units
367.14consisting of an adult recipient who is
367.15childless and unmarried or living apart
367.16from parents or a legal guardian at $203.
367.17The commissioner may reduce this amount
367.18according to Laws 1997, chapter 85, article
367.193, section 54.
367.20Emergency General Assistance. The
367.21amount appropriated for emergency general
367.22assistance funds is limited to no more
367.23than $7,889,812 in fiscal year 2010 and
367.24$7,889,812 in fiscal year 2011. Funds
367.25to counties must be allocated by the
367.26commissioner using the allocation method
367.27specified in Minnesota Statutes, section
367.28256D.06.
| 367.29 |
(j) Minnesota Supplemental Aid Grants |
33,930,000 |
35,191,000 |
||||
367.31Aid Funds. The amount appropriated for
367.32emergency Minnesota supplemental aid
367.33funds is limited to no more than $1,100,000
367.34in fiscal year 2010 and $1,100,000 in fiscal
368.1year 2011. Funds to counties must be
368.2allocated by the commissioner using the
368.3allocation method specified in Minnesota
368.4Statutes, section 256D.46.
| 368.5 |
(k) Group Residential Housing Grants |
111,778,000 |
114,034,000 |
||||
368.7Refinanced. (a) Effective July 1, 2011, the
368.8commissioner shall increase the home and
368.9community-based service rates and county
368.10allocations provided to programs for persons
368.11with disabilities established under section
368.121915(c) of the Social Security Act to the
368.13extent that these programs will be paying
368.14for the costs above the rate established
368.15in Minnesota Statutes, section 256I.05,
368.16subdivision 1.
368.17(b) For persons receiving services under
368.18Minnesota Statutes, section 245A.02, who
368.19reside in licensed adult foster care beds
368.20for which a difficulty of care payment
368.21was being made under Minnesota Statutes,
368.22section 256I.05, subdivision 1c, paragraph
368.23(b), counties may request an exception to
368.24the individual's service authorization not to
368.25exceed the difference between the client's
368.26monthly service expenditures plus the
368.27amount of the difficulty of care payment.
| 368.28 |
(l) Children's Mental Health Grants |
16,885,000 |
16,882,000 |
||||
368.30year's appropriation for children's mental
368.31health grants may be used to fund allocations
368.32in that portion of the fiscal year ending
368.33December 31.
| 369.1 369.2 |
(m) Other Children and Economic Assistance Grants |
16,047,000 |
15,339,000 |
||||
369.4appropriation, $379,000 in fiscal year 2010
369.5and $379,000 in fiscal year 2011 is to the
369.6commissioner for fraud prevention grants to
369.7counties.
369.8Homeless and Runaway Youth. $218,000
369.9in fiscal year 2010 is for the Runaway
369.10and Homeless Youth Act under Minnesota
369.11Statutes, section 256K.45. Funds shall be
369.12spent in each area of the continuum of care
369.13to ensure that programs are meeting the
369.14greatest need. Any unexpended balance in
369.15the first year is available in the second year.
369.16Beginning July 1, 2011, the base is increased
369.17by $119,000 each year.
369.18ARRA Homeless Youth Funds. To the
369.19extent permitted under federal law, the
369.20commissioner shall designate $2,500,000
369.21of the Homeless Prevention and Rapid
369.22Re-Housing Program funds provided under
369.23the American Recovery and Reinvestment
369.24Act of 2009, Public Law 111-5, for agencies
369.25providing homelessness prevention and rapid
369.26rehousing services to youth.
369.27Supportive Housing Services. $1,500,000
369.28each year is for supportive services under
369.29Minnesota Statutes, section 256K.26. This is
369.30a onetime appropriation. Beginning in fiscal
369.31year 2012, the base is increased by $68,000
369.32per year.
369.33Community Action Grants. Community
369.34action grants are reduced one time by
370.1$1,764,000 each year. This reduction is due
370.2to the availability of federal funds under the
370.3American Recovery and Reinvestment Act.
370.4Base Adjustment. The general fund base
370.5is increased by $773,000 in fiscal year 2012
370.6and $773,000 in fiscal year 2013.
370.7Federal ARRA Funds for Existing
370.8Programs. (a) Federal funds received by the
370.9commissioner for the emergency food and
370.10shelter program from the American Recovery
370.11and Reinvestment Act of 2009, Public
370.12Law 111-5, but not previously approved
370.13by the legislature are appropriated to the
370.14commissioner for the purposes of the grant
370.15program.
370.16(b) Federal funds received by the
370.17commissioner for the emergency shelter
370.18grant program including the Homelessness
370.19Prevention and Rapid Re-Housing
370.20Program from the American Recovery and
370.21Reinvestment Act of 2009, Public Law
370.22111-5, are appropriated to the commissioner
370.23for the purposes of the grant programs.
370.24(c) Federal funds received by the
370.25commissioner for the emergency food
370.26assistance program from the American
370.27Recovery and Reinvestment Act of 2009,
370.28Public Law 111-5, are appropriated to the
370.29commissioner for the purposes of the grant
370.30program.
370.31(d) Federal funds received by the
370.32commissioner for senior congregate meals
370.33and senior home-delivered meals from the
370.34American Recovery and Reinvestment Act
370.35of 2009, Public Law 111-5, are appropriated
371.1to the commissioner for the Minnesota Board
371.2on Aging, for purposes of the grant programs.
371.3(e) Federal funds received by the
371.4commissioner for the community services
371.5block grant program from the American
371.6Recovery and Reinvestment Act of 2009,
371.7Public Law 111-5, are appropriated to the
371.8commissioner for the purposes of the grant
371.9program.
371.10Long-Term Homeless Supportive
371.11Service Fund Appropriation. To the
371.12extent permitted under federal law, the
371.13commissioner shall designate $3,000,000
371.14of the Homelessness Prevention and Rapid
371.15Re-Housing Program funds provided under
371.16the American Recovery and Reinvestment
371.17Act of 2009, Public Law, 111-5, to the
371.18long-term homeless service fund under
371.19Minnesota Statutes, section 256K.26. This
371.20appropriation shall become available by July
371.211, 2009. This paragraph is effective the day
371.22following final enactment.
| 371.23 371.24 |
Subd. 5.Children and Economic Assistance Management |
||||||
371.26appropriation for each purpose are as follows:
| 371.27 371.28 |
(a) Children and Economic Assistance Administration |
||||||
| 371.29 |
Appropriations by Fund |
||
| 371.30 |
General |
10,318,000 |
10,308,000 |
| 371.31 |
Federal TANF |
496,000 |
496,000 |
372.2is increased by $700,000 in each of fiscal
372.3years 2012 and 2013.
372.4School Readiness Service Agreements.
372.5$406,000 in fiscal year 2010 and $406,000
372.6in fiscal year 2011 are from the federal
372.7child care development funds received from
372.8the American Recovery and Reinvestment
372.9Act of 2009, Public Law 111-5, to the
372.10commissioner of human services consistent
372.11with federal regulations for the purpose of
372.12school readiness service agreements under
372.13Minnesota Statutes, section 119B.231. This
372.14is a onetime appropriation. Any unexpended
372.15balance the first year is available in the
372.16second year.
| 372.17 372.18 |
(b) Children and Economic Assistance Operations |
||||||
| 372.19 |
Appropriations by Fund |
||
| 372.20 |
General |
33,590,000 |
33,423,000 |
| 372.21 |
Health Care Access |
361,000 |
361,000 |
372.23Payment of Fees. The commissioner is
372.24authorized to allocate up to $310,000 each
372.25year in fiscal years 2010 and 2011 from the
372.26PRISM special revenue account to make
372.27payments to financial institutions in exchange
372.28for performing data matches between account
372.29information held by financial institutions
372.30and the public authority's database of child
372.31support obligors as authorized by Minnesota
372.32Statutes, section 13B.06, subdivision 7.
373.1School Readiness Service Agreements.
373.2$106,000 in fiscal year 2010 and $241,000
373.3in fiscal year 2011 are from the federal
373.4child care development funds received from
373.5the American Recovery and Reinvestment
373.6Act of 2009, Public Law 111-5, to the
373.7commissioner of human services consistent
373.8with federal regulations for the purpose of
373.9school readiness service agreements under
373.10Minnesota Statutes, section 119B.231. This
373.11is a onetime appropriation.
373.12Use of Federal Stabilization Funds.
373.13$33,000,000 in fiscal year 2010 is
373.14appropriated from the fiscal stabilization
373.15account in the federal fund to the
373.16commissioner. This appropriation must not
373.17be used for any activity or service for which
373.18federal reimbursement is claimed. This is a
373.19onetime appropriation.
| 373.20 |
Subd. 6.Basic Health Care Grants |
||||||
373.22appropriation for each purpose are as follows:
| 373.23 |
(a) MinnesotaCare Grants |
391,915,000 |
485,448,000 |
||||
373.25access fund.
| 373.26 373.27 |
(b) MA Basic Health Care Grants - Families and Children |
751,988,000 |
973,088,000 |
||||
373.29(MERC). Of these funds, the commissioner
373.30of human services shall transfer $38,000,000
373.31in fiscal year 2010 to the medical education
373.32research fund. These funds must restore the
373.33fiscal year 2009 unallotment of the transfers
374.1under Minnesota Statutes, section 256B.69,
374.2subdivision 5c, paragraph (a), for the July 1,
374.32008, through June 30, 2009, period.
374.4Newborn Screening Fee. Of the general
374.5fund appropriation, $34,000 in fiscal
374.6year 2011 is to the commissioner for the
374.7hospital reimbursement increase described
374.8under Minnesota Statutes, section 256.969,
374.9subdivision 28.
374.10Local Share Payment Modification
374.11Required for ARRA Compliance.
374.12Effective from July 1, 2009, to December
374.1331, 2010, Hennepin County's monthly
374.14contribution to the nonfederal share of
374.15medical assistance costs must be reduced
374.16to the percentage required on September
374.171, 2008, to meet federal requirements for
374.18enhanced federal match under the American
374.19Reinvestment and Recovery Act (ARRA)
374.20of 2009. Notwithstanding the requirements
374.21of Minnesota Statutes, section 256B.19,
374.22subdivision 1c, paragraph (d), for the period
374.23beginning July 1, 2009, to December 31,
374.242010, Hennepin County's monthly payment
374.25under that provision is reduced to $434,688.
374.26Capitation Payments. Effective from
374.27July 1, 2009, to December 31, 2010,
374.28notwithstanding the provisions of Minnesota
374.29Statutes 2008, section 256B.19, subdivision
374.301c, paragraph (c), the commissioner shall
374.31increase capitation payments made to the
374.32Metropolitan Health Plan under Minnesota
374.33Statutes 2008, section 256B.69, by
374.34$6,800,000 to recognize higher than average
375.1medical education costs. The increased
375.2amount includes federal matching funds.
375.3Use of Savings. Any savings derived
375.4from implementation of the prohibition in
375.5Minnesota Statutes, section 256B.032, on the
375.6enrollment of low-quality, high-cost health
375.7care providers as vendors of state health care
375.8program services shall be used to offset on a
375.9pro rata basis the reimbursement reductions
375.10for basic care services in Minnesota Statutes,
375.11section 256B.766.
| 375.12 375.13 |
(c) MA Basic Health Care Grants - Elderly and Disabled |
970,183,000 |
1,142,310,000 |
||||
375.15Notwithstanding Minnesota Statutes, section
375.16256B.69, subdivision 5a, paragraph (b), for
375.17the period beginning July 1, 2009, to June
375.1830, 2011, the monthly enrollment of persons
375.19receiving home and community-based
375.20waivered services under Minnesota
375.21Disability Health Options shall not exceed
375.221,000. If the budget neutrality provision
375.23in Minnesota Statutes, section 256B.69,
375.24subdivision 23, paragraph (f), is reached
375.25prior to June 30, 2013, the commissioner may
375.26waive this monthly enrollment requirement.
375.27Hospital Fee-for-Service Payment Delay.
375.28Payments from the Medicaid Management
375.29Information System that would otherwise
375.30have been made for inpatient hospital
375.31services for Minnesota health care program
375.32enrollees must be delayed as follows: for
375.33fiscal year 2011, payments in the month of
375.34June equal to $15,937,000 must be included
376.1in the first payment of fiscal year 2012 and
376.2for fiscal year 2013, payments in the month
376.3of June equal to $6,666,000 must be included
376.4in the first payment of fiscal year 2014. The
376.5provisions of Minnesota Statutes, section
376.616A.124, do not apply to these delayed
376.7payments. Notwithstanding any contrary
376.8provision in this article, this paragraph
376.9expires December 31, 2014.
376.10Nonhospital Fee-for-Service Payment
376.11Delay. Payments from the Medicaid
376.12Management Information System that would
376.13otherwise have been made for nonhospital
376.14acute care services for Minnesota health
376.15care program enrollees must be delayed as
376.16follows: payments in the month of June equal
376.17to $23,438,000 for fiscal year 2011 must be
376.18included in the first payment for fiscal year
376.192012, and payments in the month of June
376.20equal to $27,156,000 for fiscal year 2013
376.21must be included in the first payment for
376.22fiscal year 2014. This payment delay must
376.23not include nursing facilities, intermediate
376.24care facilities for persons with developmental
376.25disabilities, home and community-based
376.26services, prepaid health plans, personal care
376.27provider organizations, and home health
376.28agencies. The provisions of Minnesota
376.29Statutes, section 16A.124, do not apply to
376.30these delayed payments. Notwithstanding
376.31any contrary provision in this article, this
376.32paragraph expires December 31, 2014.
| 376.33 |
(d) General Assistance Medical Care Grants |
345,223,000 |
381,081,000 |
||||
| 376.34 |
(e) Other Health Care Grants |
||||||
| 377.1 |
Appropriations by Fund |
||
| 377.2 |
General |
295,000 |
295,000 |
| 377.3 |
Health Care Access |
23,533,000 |
7,080,000 |
377.5fund base is reduced to $190,000 in each of
377.6fiscal years 2012 and 2013.
| 377.7 |
Subd. 7.Health Care Management |
||||||
377.9appropriation for each purpose are as follows:
| 377.10 |
(a) Health Care Administration |
||||||
| 377.11 |
Appropriations by Fund |
||
| 377.12 |
General |
7,831,000 |
7,742,000 |
| 377.13 |
Health Care Access |
1,812,000 |
906,000 |
| 377.14 |
(b) Health Care Operations |
||||||
| 377.15 |
Appropriations by Fund |
||
| 377.16 |
General |
19,914,000 |
18,949,000 |
| 377.17 |
Health Care Access |
25,099,000 |
25,875,000 |
377.19fund base is increased by $1,006,000 in
377.20fiscal year 2012 and $1,781,000 in fiscal year
377.212013. The general fund base is decreased by
377.22$237,000 in fiscal year 2012 and $237,000 in
377.23fiscal year 2013.
| 377.24 |
Subd. 8.Continuing Care Grants |
||||||
377.26appropriation for each purpose are as follows:
| 377.27 |
(a) Aging and Adult Services Grants |
||||||
| 378.1 |
Appropriations by Fund |
||
| 378.2 |
General |
13,488,000 |
15,779,000 |
| 378.3 |
Federal |
500,000 |
0 |
378.5increased by $5,751,000 in fiscal year 2012
378.6and $6,705,000 in fiscal year 2013.
378.7Information and Assistance
378.8Reimbursement. Federal administrative
378.9reimbursement obtained from information
378.10and assistance services provided by the
378.11Senior LinkAge or Disability Linkage lines
378.12to people who are identified as eligible for
378.13medical assistance shall be appropriated to
378.14the commissioner for this activity.
378.15Community Service Development Grant
378.16Reduction. Funding for community service
378.17development grants must be reduced by
378.18$251,000 for fiscal year 2010; $266,000 in
378.19fiscal year 2011; $25,000 in fiscal year 2012;
378.20and $25,000 in fiscal year 2013. Base level
378.21funding shall be restored in fiscal year 2014.
378.22Senior Nutrition Use of Federal Funds.
378.23For fiscal year 2010, general fund grants
378.24for home-delivered meals and congregate
378.25dining shall be reduced by $500,000. The
378.26commissioner must replace these general
378.27fund reductions with equal amounts from
378.28federal funding for senior nutrition from the
378.29American Recovery and Reinvestment Act
378.30of 2009.
| 378.31 |
(b) Alternative Care Grants |
50,234,000 |
48,576,000 |
||||
379.2decreased by $3,598,000 in fiscal year 2012
379.3and $3,470,000 in fiscal year 2013.
379.4Alternative Care Transfer. Any money
379.5allocated to the alternative care program that
379.6is not spent for the purposes indicated does
379.7not cancel but must be transferred to the
379.8medical assistance account.
| 379.9 379.10 |
(c) Medical Assistance Grants; Long-Term Care Facilities. |
367,444,000 |
419,749,000 |
||||
| 379.11 379.12 |
(d) Medical Assistance Long-Term Care Waivers and Home Care Grants |
854,373,000 |
1,043,411,000 |
||||
379.14Waivers. During the fiscal years beginning
379.15on July 1, 2009, and July 1, 2010, the
379.16commissioner shall allocate money for home
379.17and community-based waiver programs
379.18under Minnesota Statutes, section 256B.49,
379.19to ensure a reduction in state spending that is
379.20equivalent to limiting the caseload growth of
379.21the TBI waiver to 12.5 allocations per month
379.22each year of the biennium and the CADI
379.23waiver to 95 allocations per month each year
379.24of the biennium. Limits do not apply: (1)
379.25when there is an approved plan for nursing
379.26facility bed closures for individuals under
379.27age 65 who require relocation due to the
379.28bed closure; (2) to fiscal year 2009 waiver
379.29allocations delayed due to unallotment; or (3)
379.30to transfers authorized by the commissioner
379.31from the personal care assistance program
379.32of individuals having a home care rating
379.33of "CS," "MT," or "HL." Priorities for the
379.34allocation of funds must be for individuals
380.1anticipated to be discharged from institutional
380.2settings or who are at imminent risk of a
380.3placement in an institutional setting.
380.4Manage Growth in DD Waiver. The
380.5commissioner shall manage the growth in
380.6the DD waiver by limiting the allocations
380.7included in the February 2009 forecast to 15
380.8additional diversion allocations each month
380.9for the calendar years that begin on January
380.101, 2010, and January 1, 2011. Additional
380.11allocations must be made available for
380.12transfers authorized by the commissioner
380.13from the personal care program of individuals
380.14having a home care rating of "CS," "MT,"
380.15or "HL."
380.16Adjustment to Lead Agency Waiver
380.17Allocations. Prior to the availability of the
380.18alternative license defined in Minnesota
380.19Statutes, section 245A.11, subdivision 8,
380.20the commissioner shall reduce lead agency
380.21waiver allocations for the purposes of
380.22implementing a moratorium on corporate
380.23foster care.
380.24Alternatives to Personal Care Assistance
380.25Services. Base level funding of $3,237,000
380.26in fiscal year 2012 and $4,856,000 in
380.27fiscal year 2013 is to implement alternative
380.28services to personal care assistance services
380.29for persons with mental health and other
380.30behavioral challenges who can benefit
380.31from other services that more appropriately
380.32meet their needs and assist them in living
380.33independently in the community. These
380.34services may include, but not be limited to, a
380.351915(i) state plan option.
| 381.1 |
(e) Mental Health Grants |
||||||
| 381.2 |
Appropriations by Fund |
||
| 381.3 |
General |
77,739,000 |
77,739,000 |
| 381.4 |
Health Care Access |
750,000 |
750,000 |
| 381.5 |
Lottery Prize |
1,508,000 |
1,508,000 |
381.7year's appropriation for adult mental health
381.8grants may be used to fund allocations in that
381.9portion of the fiscal year ending December
381.1031.
| 381.11 |
(f) Deaf and Hard-of-Hearing Grants |
1,930,000 |
1,917,000 |
||||
| 381.12 |
(g) Chemical Dependency Entitlement Grants |
111,303,000 |
122,822,000 |
||||
381.14For services provided during fiscal years
381.152010 and 2011, county-negotiated rates and
381.16provider claims to the consolidated chemical
381.17dependency fund must not exceed rates
381.18charged for these services on January 1, 2009.
381.19For services provided in fiscal years 2012
381.20and 2013, statewide average rates under the
381.21new rate methodology to be developed under
381.22Minnesota Statutes, section 254B.12, must
381.23not exceed the average rates charged for these
381.24services on January 1, 2009, plus $3,787,000
381.25for fiscal year 2012 and $5,023,000 for fiscal
381.26year 2013. Notwithstanding any provision
381.27to the contrary in this article, this provision
381.28expires on June 30, 2013.
381.29Chemical Dependency Special Revenue
381.30Account. For fiscal year 2010, $750,000
381.31must be transferred from the consolidated
382.1chemical dependency treatment fund
382.2administrative account and deposited into the
382.3general fund.
382.4County CD Share of MA Costs for
382.5ARRA Compliance. Notwithstanding the
382.6provisions of Minnesota Statutes, chapter
382.7254B, for chemical dependency services
382.8provided during the period July 1, 2009,
382.9to December 31, 2010, and reimbursed by
382.10medical assistance at the enhanced federal
382.11matching rate provided under the American
382.12Recovery and Reinvestment Act of 2009, the
382.13county share is 30 percent of the nonfederal
382.14share.
| 382.15 382.16 |
(h) Chemical Dependency Nonentitlement Grants |
1,729,000 |
1,729,000 |
||||
382.18decreased by $3,000 in each of fiscal years
382.192012 and 2013.
| 382.20 |
(i) Other Continuing Care Grants |
18,272,000 |
13,139,000 |
||||
382.22increased by $7,028,000 in fiscal year 2012
382.23and increased by $8,243,000 in fiscal year
382.242013.
382.25Technology Grants. $650,000 in fiscal
382.26year 2010 and $1,000,000 in fiscal year
382.272011 are for technology grants, case
382.28consultation, evaluation, and consumer
382.29information grants related to developing and
382.30supporting alternatives to shift-staff foster
382.31care residential service models.
382.32Other Continuing Care Grants; HIV
382.33Grants. Money appropriated for the HIV
383.1drug and insurance grant program in fiscal
383.2year 2010 may be used in either year of the
383.3biennium.
| 383.4 |
Subd. 9.Continuing Care Management |
||||||
| 383.5 |
Appropriations by Fund |
||
| 383.6 |
General |
24,927,000 |
25,314,000 |
| 383.7 383.8 |
State Government Special Revenue |
875,000 |
125,000 |
| 383.9 |
Lottery Prize |
157,000 |
157,000 |
383.11July 1, 2009, state funding for the quality
383.12assurance commission under Minnesota
383.13Statutes, section 256B.0951, is canceled.
383.14County Maintenance of Effort. $350,000 in
383.15fiscal year 2010 is from the general fund for
383.16the State-County Results Accountability and
383.17Service Delivery Reform under Minnesota
383.18Statutes, chapter 402A.
383.19Base Adjustment. The general fund base is
383.20decreased $2,697,000 in fiscal year 2012 and
383.21$2,791,000 in fiscal year 2013.
| 383.22 |
Subd. 10.State-Operated Services |
258,794,000 |
266,191,000 |
||||
383.24appropriation for each purpose are as follows:
383.25Transfer Authority Related to
383.26State-Operated Services. Money
383.27appropriated to finance state-operated
383.28services may be transferred between the
383.29fiscal years of the biennium with the approval
383.30of the commissioner of finance.
383.31County Past Due Receivables. The
383.32commissioner is authorized to withhold
384.1county federal administrative reimbursement
384.2when the county of financial responsibility
384.3for cost-of-care payments due the state
384.4under Minnesota Statutes, section 246.54
384.5or 253B.045, is 90 days past due. The
384.6commissioner shall deposit the withheld
384.7federal administrative earnings for the county
384.8into the general fund to settle the claims with
384.9the county of financial responsibility. The
384.10process for withholding funds is governed by
384.11Minnesota Statutes, section 256.017.
384.12Forecast and Census Data. The
384.13commissioner shall include census data and
384.14fiscal projections for state-operated services
384.15and Minnesota sex offender services with the
384.16November and February budget forecasts.
384.17Notwithstanding any contrary provision in
384.18this article, this paragraph shall not expire.
| 384.19 |
(a) Adult Mental Health Services |
107,702,000 |
107,201,000 |
||||
384.21the appropriation in this article to the
384.22commissioner for mental health treatment
384.23services provided by state-operated services
384.24shall be used for the Minnesota sex offender
384.25program.
384.26Community Behavioral Health Hospitals.
384.27Under Minnesota Statutes, section 246.51,
384.28subdivision 1, a determination order for the
384.29clients served in a community behavioral
384.30health hospital operated by the commissioner
384.31of human services is only required when
384.32a client's third-party coverage has been
384.33exhausted.
385.1Base Adjustment. The general fund base is
385.2decreased by $500,000 for fiscal year 2012
385.3and by $500,000 for fiscal year 2013.
| 385.4 |
(b) Minnesota Sex Offender Services |
||||||
| 385.5 |
Appropriations by Fund |
||
| 385.6 |
General |
38,348,000 |
67,503,000 |
| 385.7 |
Federal Fund |
26,495,000 |
0 |
385.9this appropriation, $26,495,000 in fiscal year
385.102010 is from the fiscal stabilization account
385.11in the federal fund to the commissioner.
385.12This appropriation must not be used for
385.13any activity or service for which federal
385.14reimbursement is claimed. This is a onetime
385.15appropriation.
| 385.16 385.17 |
(c) Minnesota Security Hospital and METO Services |
||||||
| 385.18 |
Appropriations by Fund |
||
| 385.19 |
General |
230,000,000 |
83,735,000 |
| 385.20 |
Federal Fund |
83,504,000 |
0 |
385.22purposes of enhancing the safety of
385.23the public, improving supervision, and
385.24enhancing community-based mental health
385.25treatment, state-operated services may
385.26establish additional community capacity
385.27for providing treatment and supervision
385.28of clients who have been ordered into a
385.29less restrictive alternative of care from the
385.30state-operated services transitional services
386.1program consistent with Minnesota Statutes,
386.2section 246.014.
386.3Use of Federal Stabilization Funds.
386.4$83,505,000 in fiscal year 2010 is
386.5appropriated from the fiscal stabilization
386.6account in the federal fund to the
386.7commissioner. This appropriation must not
386.8be used for any activity or service for which
386.9federal reimbursement is claimed. This is a
386.10onetime appropriation.
| 386.11 |
Sec. 4. COMMISSIONER OF HEALTH |
||||||
| 386.12 |
Subdivision 1.Total Appropriation |
$ |
165,717,000 |
$ |
161,841,000 |
||
| 386.20 386.21 |
Subd. 2.Community and Family Health Promotion |
||||||
386.29fund appropriation, $300,000 in fiscal year
386.302011 is to the commissioner for the purpose
387.1of providing support services to families as
387.2required under Minnesota Statutes, section
387.3144.966, subdivision 3a. $74,000 of this
387.4appropriation in fiscal year 2011 and $51,000
387.5of this appropriation in subsequent fiscal
387.6years may be used by the commissioner
387.7for administrative costs associated with
387.8increasing the fee, contract administration,
387.9program oversight, and provide follow-up to
387.10families who need assistance beyond those
387.11available through the contractor.
387.12Support Services for Families With
387.13Children Who are Deaf or Have Hearing
387.14Loss. Of the general fund amount, $16,000
387.15in fiscal year 2010 and $284,000 in fiscal
387.16year 2011 is for support services to families
387.17with children who are deaf or have hearing
387.18loss. Of this amount, in fiscal year 2011,
387.19$223,000 is for grants and the balance is for
387.20administrative costs. Base funding in fiscal
387.21years 2012 and 2013 is $300,000 each year.
387.22Of this amount, $241,000 each year is for
387.23grants and the balance is for administrative
387.24costs.
387.25Funding Usage. Up to 75 percent of the
387.26fiscal year 2012 appropriation for local public
387.27health grants may be used to fund calendar
387.28year 2011 allocations for this program. The
387.29general fund reduction of $5,193,000 in
387.30fiscal year 2011 for local public health grants
387.31is onetime and the base funding for local
387.32public health grants for fiscal year 2012 is
387.33increased by $5,193,000.
387.34Colorectal Screening. $88,000 in fiscal year
387.352010 and $62,000 in fiscal year 2011 are
388.1for grants to the Hennepin County Medical
388.2Center and MeritCare Bemidji for colorectal
388.3screening demonstration projects.
388.4Feasibility Pilot Project for Cancer
388.5Surveillance. Of the general fund
388.6appropriation for fiscal year 2010, $100,000
388.7is to the commissioner to provide grant
388.8funding to cover the cost of one full-time
388.9equivalent position at the Hennepin County
388.10Medical Center to carry out the feasibility
388.11pilot project.
388.12American Recovery and Reinvestment
388.13Act Funds. Federal funds received by the
388.14commissioner for WIC program management
388.15information systems from the American
388.16Recovery and Reinvestment Act of 2009,
388.17Public Law 111-5, are appropriated to the
388.18commissioner for the purpose of the grant.
388.19TANF Appropriations. (1) $1,156,000 of
388.20the TANF funds are appropriated each year to
388.21the commissioner for family planning grants
388.22under Minnesota Statutes, section 145.925.
388.23(2) $3,579,000 of the TANF funds are
388.24appropriated each year to the commissioner
388.25for home visiting and nutritional services
388.26listed under Minnesota Statutes, section
388.27145.882, subdivision 7, clauses (6) and (7).
388.28Funds must be distributed to community
388.29health boards according to Minnesota
388.30Statutes, section 145A.131, subdivision 1.
388.31(3) $2,000,000 of the TANF funds are
388.32appropriated each year to the commissioner
388.33for decreasing racial and ethnic disparities
388.34in infant mortality rates under Minnesota
388.35Statutes, section 145.928, subdivision 7.
389.1(4) $4,998,000 of the TANF funds are
389.2appropriated each year to the commissioner
389.3for the family home visiting grant program
389.4according to Minnesota Statutes, section
389.5145A.17. $4,000,000 of the funding must
389.6be distributed to community health boards
389.7according to Minnesota Statutes, section
389.8145A.131, subdivision 1. $998,000 of
389.9the funding must be distributed to tribal
389.10governments based on Minnesota Statutes,
389.11section 145A.14, subdivision 2a. The
389.12commissioner may use five percent of
389.13the funds appropriated each fiscal year to
389.14conduct the ongoing evaluations required
389.15under Minnesota Statutes, section 145A.17,
389.16subdivision 7, and may use ten percent of
389.17the funds appropriated each fiscal year to
389.18provide training and technical assistance as
389.19required under Minnesota Statutes, section
389.20145A.17, subdivisions 4 and 5.
389.21Base Adjustment. The general fund base
389.22is increased by $10,302,000 for fiscal year
389.232012 and increased by $5,109,000 for fiscal
389.24year 2013. The health care access fund base
389.25is reduced to $1,719,000 for both fiscal years
389.262012 and 2013.
389.27TANF Carryforward. Any unexpended
389.28balance of the TANF appropriation in the
389.29first year of the biennium does not cancel but
389.30is available for the second year.
| 389.31 |
Subd. 3.Policy Quality and Compliance |
||||||
| 389.32 |
Appropriations by Fund |
||
| 389.33 |
General |
7,491,000 |
7,242,000 |
| 390.1 390.2 |
State Government Special Revenue |
14,173,000 |
14,173,000 |
| 390.3 |
Health Care Access |
17,561,000 |
12,090,000 |
390.5Demonstration Project. Notwithstanding
390.6the provisions of Laws 2007, chapter 147,
390.7article 19, section 3, subdivision 6, paragraph
390.8(e), base level funding to the commissioner
390.9for the demonstration project grant described
390.10in Minnesota Statutes, section 62Q.80,
390.11subdivision 1a, shall be zero for fiscal years
390.122011 and 2012.
390.13Medical Education and Research Cost
390.14Federal Compliance. Notwithstanding
390.15Laws 2008, chapter 363, article 18, section
390.164, subdivision 3, the base level funding
390.17for the commissioner to distribute to the
390.18Mayo Clinic for transitional funding while
390.19federal compliance changes are made to the
390.20medical education and research cost funding
390.21distribution formula shall be $0 for fiscal
390.22years 2010 and 2011.
390.23Autism Clinical Research. The
390.24commissioner, in partnership with a
390.25Minnesota research institution, shall apply
390.26for funds available for research grants under
390.27the American Recovery and Reinvestment
390.28Act (ARRA) of 2009 in order to expand
390.29research and treatment of autism spectrum
390.30disorders.
390.31Health Information Technology. (a) Of
390.32the health care access fund appropriation,
390.33$4,000,000 is to fund the revolving loan
390.34account under Minnesota Statutes, section
391.162J.496. This appropriation must not be
391.2expended unless it is matched with federal
391.3funding under the federal Health Information
391.4Technology for Economic and Clinical
391.5Health (HITECH) Act. This appropriation
391.6must not be included in the agency's base
391.7budget for the fiscal year beginning July 1,
391.82012.
391.9(b) On or before June 30, 2013, $1,200,000
391.10shall be transferred from the revolving loan
391.11account under Minnesota Statutes, section
391.1262J.496, to the health care access fund.
391.13This is a onetime transfer and must not be
391.14included in the agency's base budget for the
391.15fiscal year beginning July 1, 2014.
391.16Base Adjustment. The general fund
391.17base is $8,243,000 in fiscal year 2012 and
391.18$8,243,000 in fiscal year 2013. The health
391.19care access fund base is $10,950,000 in fiscal
391.20year 2012 and $6,816,000 in fiscal year 2013.
| 391.21 |
Subd. 4.Health Protection |
||||||
| 391.22 |
Appropriations by Fund |
||
| 391.23 |
General |
9,871,000 |
9,780,000 |
| 391.24 391.25 |
State Government Special Revenue |
30,209,000 |
30,209,000 |
391.27reduced by $50,000 in each of fiscal years
391.282012 and 2013.
391.29Health Protection Appropriations. (a)
391.30$163,000 each year is for the lead abatement
391.31grant program.
391.32(b) $100,000 each year is for emergency
391.33preparedness and response activities.
392.1(c) $50,000 each year is for tuberculosis
392.2prevention and control. This is a onetime
392.3appropriation.
392.4American Recovery and Reinvestment
392.5Act Funds. Federal funds received
392.6by the commissioner for immunization
392.7operations from the American Recovery
392.8and Reinvestment Act of 2009, Public Law
392.9111-5, are appropriated to the commissioner
392.10for the purposes of the grant.
| 392.11 |
Subd. 5.Administrative Support Services |
7,190,000 |
7,190,000 |
||||
| 392.12 |
Sec. 5. HEALTH-RELATED BOARDS |
||||||
| 392.13 |
Subdivision 1.Total Appropriation |
$ |
15,017,000 |
$ |
14,831,000 |
||
392.15government special revenue fund.
392.16Transfer. In fiscal year 2010, $6,000,000
392.17shall be transferred from the state government
392.18special revenue fund to the general fund.
392.19The amounts that may be spent for each
392.20purpose are specified in the following
392.21subdivisions.
| 392.22 |
Subd. 2.Board of Chiropractic Examiners |
447,000 |
447,000 |
||||
| 392.23 |
Subd. 3.Board of Dentistry |
1,009,000 |
1,009,000 |
||||
| 392.24 392.25 |
Subd. 4.Board of Dietetic and Nutrition Practice |
105,000 |
105,000 |
||||
| 392.26 392.27 |
Subd. 5.Board of Marriage and Family Therapy |
137,000 |
137,000 |
||||
| 392.28 |
Subd. 6.Board of Medical Practice |
3,674,000 |
3,674,000 |
||||
| 392.29 |
Subd. 7.Board of Nursing |
4,217,000 |
4,219,000 |
||||
| 393.1 393.2 |
Subd. 8.Board of Nursing Home Administrators |
1,146,000 |
958,000 |
||||
393.4Costs. Of this appropriation, $524,000
393.5in fiscal year 2010 and $526,000 in
393.6fiscal year 2011 are for operating costs
393.7of the administrative services unit. The
393.8administrative services unit may receive
393.9and expend reimbursements for services
393.10performed by other agencies.
393.11Administrative Services Unit - Retirement
393.12Costs. Of this appropriation in fiscal year
393.132010, $201,000 is for onetime retirement
393.14costs in the health-related boards. This
393.15funding may be transferred to the health
393.16boards incurring those costs for their
393.17payment. These funds are available either
393.18year of the biennium.
393.19Administrative Services Unit - Volunteer
393.20Health Care Provider Program. Of this
393.21appropriation, $79,000 in fiscal year 2010
393.22and $89,000 in fiscal year 2011 are to pay
393.23for medical professional liability coverage
393.24required under Minnesota Statutes, section
393.25214.40.
393.26Administrative Services Unit - Contested
393.27Cases and Other Legal Proceedings. Of
393.28this appropriation, $200,000 in fiscal year
393.292010 and $200,000 in fiscal year 2011
393.30are for costs of contested case hearings
393.31and other unanticipated costs of legal
393.32proceedings involving health-related
393.33boards funded under this section. Upon
393.34certification of a health-related board to the
394.1administrative services unit that the costs
394.2will be incurred and that there is insufficient
394.3money available to pay for the costs out of
394.4money currently available to that board, the
394.5administrative services unit is authorized
394.6to transfer money from this appropriation
394.7to the board for payment of those costs
394.8with the approval of the commissioner of
394.9finance. This appropriation does not cancel.
394.10Any unencumbered and unspent balances
394.11remain available for these expenditures in
394.12subsequent fiscal years.
| 394.13 |
Subd. 9.Board of Optometry |
101,000 |
101,000 |
||||
| 394.14 |
Subd. 10.Board of Pharmacy |
1,413,000 |
1,413,000 |
||||
| 394.15 |
Subd. 11.Board of Physical Therapy |
295,000 |
295,000 |
||||
| 394.16 |
Subd. 12.Board of Podiatry |
56,000 |
56,000 |
||||
| 394.17 |
Subd. 13.Board of Psychology |
806,000 |
806,000 |
||||
| 394.18 |
Subd. 14.Board of Social Work |
1,022,000 |
1,022,000 |
||||
| 394.19 |
Subd. 15.Board of Veterinary Medicine |
195,000 |
195,000 |
||||
| 394.20 394.21 |
Subd. 16.Board of Behavioral Health and Therapy |
394,000 |
394,000 |
||||
| 394.22 394.23 |
Sec. 6. EMERGENCY MEDICAL SERVICES BOARD |
$ |
4,378,000 |
$ |
3,828,000 |
||
| 394.24 |
Appropriations by Fund |
||
| 394.25 |
2010 |
2011 |
|
| 394.26 |
General |
3,674,000 |
3,124,000 |
| 394.27 394.28 |
State Government Special Revenue |
704,000 |
704 ,000 |
394.30Of the general fund appropriation, $700,000
395.1in fiscal year 2010 and $700,000 in fiscal year
395.22011 are to the board for the Cooper/Sams
395.3volunteer ambulance program, under
395.4Minnesota Statutes, section 144E.40.
395.5Transfer. In fiscal year 2010, $6,182,000
395.6is transferred from the Cooper/Sams
395.7volunteer ambulance trust, established under
395.8Minnesota Statutes, section 144E.42, to the
395.9general fund.
395.10Health Professional Services Program.
395.11$704,000 in fiscal year 2010 and $704,000 in
395.12fiscal year 2011 from the state government
395.13special revenue fund are for the health
395.14professional services program.
395.15Comprehensive Advanced Life-Support
395.16Educational (CALS) Program. $100,000 in
395.17the first year from the Cooper/Sams volunteer
395.18ambulance trust is for the comprehensive
395.19advanced life-support educational (CALS)
395.20program established under Minnesota
395.21Statutes, section 144E.37. This appropriation
395.22is to extend availability and affordability
395.23of the CALS program for rural emergency
395.24medical personnel and to assist hospital staff
395.25in attaining the credentialing levels necessary
395.26for implementation of the statewide trauma
395.27system.
| 395.28 395.29 |
Sec. 7. DEPARTMENT OF VETERANS AFFAIRS |
$ |
200,000 |
$ |
0 |
||
395.31Program. Of this appropriation, $200,000
395.32in the first year is from the Cooper/Sams
395.33volunteer ambulance trust for transfer
395.34to the commissioner of veterans affairs
396.1for a grant to the Minnesota Ambulance
396.2Association to implement a veterans
396.3paramedic apprenticeship program to
396.4reintegrate returning military medics into
396.5Minnesota's workforce in the field of
396.6paramedic and emergency services, thereby
396.7guaranteeing returning military medics
396.8gainful employment with livable wages and
396.9benefits. This appropriation is available until
396.10expended.
| 396.11 |
Sec. 8. DEPARTMENT OF PUBLIC SAFETY |
$ |
250,000 |
$ |
0 |
||
396.13Pilot Program. (a) $250,000 in the first
396.14year is from the Cooper/Sams volunteer
396.15ambulance trust for a transfer to the
396.16Department of Public Safety for a medical
396.17response unit reimbursement pilot program.
396.18Of this appropriation, $75,000 is for
396.19administrative costs to the Department of
396.20Public Safety, including providing contract
396.21staff support and technical assistance to the
396.22pilot program partners if necessary.
396.23(b) Of the amount in paragraph (a), $175,000
396.24is to be used to provide a predetermined
396.25reimbursement amount to the participating
396.26medical response units. The Department
396.27of Public Safety or its contract designee
396.28will develop an agreement with the medical
396.29response units outlining reimbursement and
396.30program requirements to include HIPAA
396.31compliance while participating in the pilot
396.32program.
| 396.33 |
Sec. 9. COUNCIL ON DISABILITY |
$ |
524,000 |
$ |
524,000 |
||
| 397.1 397.2 397.3 |
Sec. 10. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES |
$ |
1,655,000 |
$ |
1,655,000 |
||
| 397.4 |
Sec. 11. OMBUDSPERSON FOR FAMILIES |
$ |
265,000 |
$ |
265,000 |
||
397.5 Sec. 12. Laws 2007, chapter 147, article 19, section 3, subdivision 4, as amended
397.6by Laws 2008, chapter 277, article 5, section 1; and Laws 2008, chapter 363, article
397.718, section 7, is amended to read:
| 397.8 397.9 |
Subd. 4. Children and Economic Assistance Grants |
||||||
397.11appropriation for each purpose are as follows:
| 397.12 |
(a) MFIP/DWP Grants |
||||||
| 397.13 |
Appropriations by Fund |
||
| 397.14 |
General |
62,069,000 |
62,405,000 |
| 397.15 |
Federal TANF |
75,904,000 |
80,841,000 |
| 397.16 |
(b) Support Services Grants |
||||||
| 397.17 |
Appropriations by Fund |
||
| 397.18 |
General |
8,715,000 |
8,715,000 |
| 397.19 |
Federal TANF |
113,429,000 |
115,902,000 |
397.21Notwithstanding Laws 2001, First Special
397.22Session chapter 9, article 17, section
397.232, subdivision 11, paragraph (b), any
397.24unexpended TANF funds appropriated to the
397.25commissioner to contract with the Board of
397.26Trustees of Minnesota State Colleges and
397.27Universities, to provide tuition waivers to
397.28employees of health care and human service
398.1providers that are members of qualifying
398.2consortia operating under Minnesota
398.3Statutes, sections
398.4cancel at the end of fiscal year 2007.
398.5MFIP Pilot Program. Of the TANF
398.6appropriation, $100,000 in fiscal year 2008
398.7and $750,000 in fiscal year 2009 are for a
398.8grant to the Stearns-Benton Employment and
398.9Training Council for the Workforce U pilot
398.10program. Base level funding for this program
398.11shall be $750,000 in 2010 and $0 in 2011.
398.12Supported Work. (1) Of the TANF
398.13appropriation, $5,468,000 in fiscal year 2008
398.14is for supported work for MFIP participants,
398.15to be allocated to counties and tribes based
398.16on the criteria under clauses (2) and (3), and
398.17is available until expended. Paid transitional
398.18work experience and other supported
398.19employment under this rider provides
398.20a continuum of employment assistance,
398.21including outreach and recruitment,
398.22program orientation and intake, testing and
398.23assessment, job development and marketing,
398.24preworksite training, supported worksite
398.25experience, job coaching, and postplacement
398.26follow-up, in addition to extensive case
398.27management and referral services. * (The
398.28preceding text "and $7,291,000 in fiscal
398.29year 2009" was indicated as vetoed by the
398.30governor.)
398.31(2) A county or tribe is eligible to receive an
398.32allocation under this rider if:
398.33(i) the county or tribe is not meeting the
398.34federal work participation rate;
399.1(ii) the county or tribe has participants who
399.2are required to perform work activities under
399.3Minnesota Statutes, chapter 256J, but are not
399.4meeting hourly work requirements; and
399.5(iii) the county or tribe has assessed
399.6participants who have completed six weeks
399.7of job search or are required to perform
399.8work activities and are not meeting the
399.9hourly requirements, and the county or tribe
399.10has determined that the participant would
399.11benefit from working in a supported work
399.12environment.
399.13(3) A county or tribe may also be eligible for
399.14funds in order to contract for supplemental
399.15hours of paid work at the participant's child's
399.16place of education, child care location, or the
399.17child's physical or mental health treatment
399.18facility or office. This grant to counties and
399.19tribes is specifically for MFIP participants
399.20who need to work up to five hours more
399.21per week in order to meet the hourly work
399.22requirement, and the participant's employer
399.23cannot or will not offer more hours to the
399.24participant.
399.25Work Study. Of the TANF appropriation,
399.26$750,000 each year are to the commissioner
399.27to contract with the Minnesota Office of
399.28Higher Education for the biennium beginning
399.29July 1, 2007, for work study grants under
399.30Minnesota Statutes, section
399.31specifically for low-income individuals who
399.32receive assistance under Minnesota Statutes,
399.33chapter 256J, and for grants to opportunities
399.34industrialization centers. * (The preceding
399.35text beginning "Work Study. Of the TANF
400.1appropriation," was indicated as vetoed
400.2by the governor.)
400.3Integrated Service Projects. $2,500,000
400.4in fiscal year 2008 and $2,500,000 in fiscal
400.5year 2009 are appropriated from the TANF
400.6fund to the commissioner to continue to
400.7fund the existing integrated services projects
400.8for MFIP families, and if funding allows,
400.9additional similar projects.
400.10Base Adjustment. The TANF base for fiscal
400.11year 2010 is $115,902,000 and for fiscal year
400.122011 is $115,152,000.
| 400.13 |
(c) MFIP Child Care Assistance Grants |
||||||
| 400.14 |
General |
74,654,000 |
71,951,000 |
| 400.15 400.16 |
(d) Basic Sliding Fee Child Care Assistance Grants |
||||||
| 400.17 |
General |
42,995,000 |
45,008,000 |
400.19is $44,881,000 for fiscal year 2010 and
400.20$44,852,000 for fiscal year 2011.
400.21At-Home Infant Care Program. No
400.22funding shall be allocated to or spent on
400.23the at-home infant care program under
400.24Minnesota Statutes, section
| 400.25 |
(e) Child Care Development Grants |
||||||
| 400.26 |
General |
4,390,000 |
6,390,000 |
400.28the general fund appropriation, $2,000,000
400.29the first year and $4,000,000 the second
401.1year are for grants to the city of St. Paul,
401.2Hennepin County, and Blue Earth County to
401.3establish scholarship demonstration projects
401.4to be conducted in partnership with the
401.5Minnesota Early Learning Foundation to
401.6promote children's school readiness. This
401.7appropriation is available until June 30, 2009.
401.8Child Care Services Grants. Of this
401.9appropriation, $250,000 each year are for
401.10the purpose of providing child care services
401.11grants under Minnesota Statutes, section
401.13is for the 2008-2009 biennium only, and does
401.14not increase the base funding.
401.15Early Childhood Professional
401.16Development System. Of this appropriation,
401.17$250,000 each year are for purposes of the
401.18early childhood professional development
401.19system, which increases the quality and
401.20continuum of professional development
401.21opportunities for child care practitioners.
401.22This appropriation is for the 2008-2009
401.23biennium only, and does not increase the
401.24base funding.
401.25Base Adjustment. The general fund base
401.26is $1,515,000 for each of fiscal years 2010
401.27and 2011.
| 401.28 |
(f) Child Support Enforcement Grants |
||||||
| 401.29 |
General |
11,038,000 |
3,705,000 |
401.31for fiscal year 2008 is to make grants to
401.32counties for child support enforcement
401.33programs to make up for the loss under the
402.12005 federal Deficit Reduction Act of federal
402.2matching funds for federal incentive funds
402.3passed on to the counties by the state.
402.4This appropriation is available until June 30,
402.52009.
| 402.6 |
(g) Children's Services Grants |
||||||
| 402.7 |
Appropriations by Fund |
||
| 402.8 |
General |
63,647,000 |
71,147,000 |
| 402.9 |
Health Care Access |
250,000 |
-0- |
| 402.10 |
TANF |
240,000 |
340,000 |
402.12Parents. Of the TANF fund appropriation,
402.13$140,000 each year is for a grant to a program
402.14or programs that provide comprehensive
402.15services through a private, nonprofit agency
402.16to young parents in Hennepin County who
402.17have dropped out of school and are receiving
402.18public assistance. The program administrator
402.19shall report annually to the commissioner on
402.20skills development, education, job training,
402.21and job placement outcomes for program
402.22participants.
402.23County Allocations for Rate Increases.
402.24County Children and Community Services
402.25Act allocations shall be increased by
402.26$197,000 effective October 1, 2007, and
402.27$696,000 effective October 1, 2008, to help
402.28counties pay for the rate adjustments to
402.29day training and habilitation providers for
402.30participants paid by county social service
402.31funds. Notwithstanding the provisions of
402.32Minnesota Statutes, section
402.33allocation to a county shall be based on
403.1the county's proportion of social services
403.2spending for day training and habilitation
403.3services as determined in the most recent
403.4social services expenditure and grant
403.5reconciliation report.
403.6Privatized Adoption Grants. Federal
403.7reimbursement for privatized adoption grant
403.8and foster care recruitment grant expenditures
403.9is appropriated to the commissioner for
403.10adoption grants and foster care and adoption
403.11administrative purposes.
403.12Adoption Assistance Incentive Grants.
403.13Federal funds available during fiscal year
403.142008 and fiscal year 2009 for the adoption
403.15incentive grants are appropriated to the
403.16commissioner for these purposes.
403.17Adoption Assistance and Relative Custody
403.18Assistance. The commissioner may transfer
403.19unencumbered appropriation balances for
403.20adoption assistance and relative custody
403.21assistance between fiscal years and between
403.22programs.
403.23Children's Mental Health Grants. Of the
403.24general fund appropriation, $5,913,000 in
403.25fiscal year 2008 and $6,825,000 in fiscal year
403.262009 are for children's mental health grants.
403.27The purpose of these grants is to increase and
403.28maintain the state's children's mental health
403.29service capacity, especially for school-based
403.30mental health services. The commissioner
403.31shall require grantees to utilize all available
403.32third party reimbursement sources as a
403.33condition of using state grant funds. At
403.34least 15 percent of these funds shall be
403.35used to encourage efficiencies through early
404.1intervention services. At least another 15
404.2percent shall be used to provide respite care
404.3services for children with severe emotional
404.4disturbance at risk of out-of-home placement.
404.5Mental Health Crisis Services. Of the
404.6general fund appropriation, $2,528,000 in
404.7fiscal year 2008 and $2,850,000 in fiscal year
404.82009 are for statewide funding of children's
404.9mental health crisis services. Providers must
404.10utilize all available funding streams.
404.11Children's Mental Health Evidence-Based
404.12and Best Practices. Of the general fund
404.13appropriation, $375,000 in fiscal year 2008
404.14and $750,000 in fiscal year 2009 are for
404.15children's mental health evidence-based and
404.16best practices including, but not limited
404.17to: Adolescent Integrated Dual Diagnosis
404.18Treatment services; school-based mental
404.19health services; co-location of mental
404.20health and physical health care, and; the
404.21use of technological resources to better
404.22inform diagnosis and development of
404.23treatment plan development by mental
404.24health professionals. The commissioner
404.25shall require grantees to utilize all available
404.26third-party reimbursement sources as a
404.27condition of using state grant funds.
404.28Culturally Specific Mental Health
404.29Treatment Grants. Of the general fund
404.30appropriation, $75,000 in fiscal year 2008
404.31and $300,000 in fiscal year 2009 are for
404.32children's mental health grants to support
404.33increased availability of mental health
404.34services for persons from cultural and
404.35ethnic minorities within the state. The
405.1commissioner shall use at least 20 percent
405.2of these funds to help members of cultural
405.3and ethnic minority communities to become
405.4qualified mental health professionals and
405.5practitioners. The commissioner shall assist
405.6grantees to meet third-party credentialing
405.7requirements and require them to utilize all
405.8available third-party reimbursement sources
405.9as a condition of using state grant funds.
405.10Mental Health Services for Children with
405.11Special Treatment Needs. Of the general
405.12fund appropriation, $50,000 in fiscal year
405.132008 and $200,000 in fiscal year 2009 are
405.14for children's mental health grants to support
405.15increased availability of mental health
405.16services for children with special treatment
405.17needs. These shall include, but not be limited
405.18to: victims of trauma, including children
405.19subjected to abuse or neglect, veterans and
405.20their families, and refugee populations;
405.21persons with complex treatment needs, such
405.22as eating disorders; and those with low
405.23incidence disorders.
405.24MFIP and Children's Mental Health
405.25Pilot Project. Of the TANF appropriation,
405.26$100,000 in fiscal year 2008 and $200,000
405.27in fiscal year 2009 are to fund the MFIP
405.28and children's mental health pilot project.
405.29Of these amounts, up to $100,000 may be
405.30expended on evaluation of this pilot.
405.31Prenatal Alcohol or Drug Use. Of the
405.32general fund appropriation, $75,000
405.33
405.34
405.35
406.1
406.2the second year is for a grant to A Circle
406.3of Women for program services. This
406.4appropriation shall become part of the base
406.5appropriation.
406.6Base Adjustment. The general fund base
406.7is $62,572,000 in fiscal year 2010 and
406.8$62,575,000 in fiscal year 2011.
| 406.9 |
(h) Children and Community Services Grants |
||||||
| 406.10 |
General |
101,369,000 |
69,208,000 |
406.12is $69,274,000 in each of fiscal years 2010
406.13and 2011.
406.14Targeted Case Management Temporary
406.15Funding. (a) Of the general fund
406.16appropriation, $32,667,000 in fiscal year
406.172008 is transferred to the targeted case
406.18management contingency reserve account in
406.19the general fund to be allocated to counties
406.20and tribes affected by reductions in targeted
406.21case management federal Medicaid revenue
406.22as a result of the provisions in the federal
406.23Deficit Reduction Act of 2005, Public Law
406.24109-171.
406.25(b) Contingent upon (1) publication by the
406.26federal Centers for Medicare and Medicaid
406.27Services of final regulations implementing
406.28the targeted case management provisions
406.29of the federal Deficit Reduction Act of
406.302005, Public Law 109-171, or (2) the
406.31issuance of a finding by the Centers for
406.32Medicare and Medicaid Services of federal
406.33Medicaid overpayments for targeted case
407.1management expenditures, up to $32,667,000
407.2is appropriated to the commissioner of human
407.3services. Prior to distribution of funds, the
407.4commissioner shall estimate and certify the
407.5amount by which the federal regulations or
407.6federal disallowance will reduce targeted
407.7case management Medicaid revenue over the
407.82008-2009 biennium.
407.9(c) Within 60 days of a contingency described
407.10in paragraph (b), the commissioner shall
407.11distribute the grants proportionate to each
407.12affected county or tribe's targeted case
407.13management federal earnings for calendar
407.14year 2005, not to exceed the lower of (1) the
407.15amount of the estimated reduction in federal
407.16revenue or (2) $32,667,000.
407.17(d) These funds are available in either year of
407.18the biennium. Counties and tribes shall use
407.19these funds to pay for social service-related
407.20costs, but the funds are not subject to
407.21provisions of the Children and Community
407.22Services Act grant under Minnesota Statutes,
407.23chapter 256M.
407.24(e) This appropriation shall be available to
407.25pay counties and tribes for expenses incurred
407.26on or after July 1, 2007. The appropriation
407.27shall be available until expended.
| 407.28 |
(i) General Assistance Grants |
||||||
| 407.29 |
General |
37,876,000 |
38,253,000 |
407.31commissioner shall set the monthly standard
407.32of assistance for general assistance units
407.33consisting of an adult recipient who is
408.1childless and unmarried or living apart
408.2from parents or a legal guardian at $203.
408.3The commissioner may reduce this amount
408.4according to Laws 1997, chapter 85, article
408.53, section 54.
408.6Emergency General Assistance. The
408.7amount appropriated for emergency general
408.8assistance funds is limited to no more
408.9than $7,889,812 in fiscal year 2008 and
408.10$7,889,812 in fiscal year 2009. Funds
408.11to counties must be allocated by the
408.12commissioner using the allocation method
408.13specified in Minnesota Statutes, section
| 408.15 |
(j) Minnesota Supplemental Aid Grants |
||||||
| 408.16 |
General |
30,505,000 |
30,812,000 |
408.18Aid Funds. The amount appropriated for
408.19emergency Minnesota supplemental aid
408.20funds is limited to no more than $1,100,000
408.21in fiscal year 2008 and $1,100,000 in fiscal
408.22year 2009. Funds to counties must be
408.23allocated by the commissioner using the
408.24allocation method specified in Minnesota
408.25Statutes, section
| 408.26 |
(k) Group Residential Housing Grants |
||||||
| 408.27 |
General |
91,069,000 |
98,671,000 |
408.29appropriation, $460,000 each year is to
408.30augment community support and mental
408.31health services provided to individuals
409.1residing in facilities under Minnesota
409.2Statutes, section
| 409.3 409.4 |
(l) Other Children and Economic Assistance Grants |
||||||
| 409.5 |
General |
20,183,000 |
16,333,000 |
| 409.6 |
Federal TANF |
1,500,000 |
1,500,000 |
409.8shall be $16,033,000 in fiscal year 2010 and
409.9$15,533,000 in fiscal year 2011. The TANF
409.10base shall be $1,500,000 in fiscal year 2010
409.11and $1,181,000 in fiscal year 2011.
409.12Homeless and Runaway Youth. Of the
409.13general fund appropriation, $500,000 each
409.14year are for the Runaway and Homeless
409.15Youth Act under Minnesota Statutes, section
409.17of the continuum of care to ensure that
409.18programs are meeting the greatest need. This
409.19is a onetime appropriation.
409.20Long-Term Homelessness. Of the general
409.21fund appropriation, $2,000,000 in fiscal year
409.222008 is for implementation of programs
409.23to address long-term homelessness and is
409.24available in either year of the biennium. This
409.25is a onetime appropriation.
409.26Minnesota Community Action Grants. (a)
409.27Of the general fund appropriation, $250,000
409.28each year is for the purposes of Minnesota
409.29community action grants under Minnesota
409.30Statutes, sections
409.31is a onetime appropriation.
409.32(b) Of the TANF appropriation, $1,500,000
409.33each year is for community action agencies
410.1for auto repairs, auto loans, and auto
410.2purchase grants to individuals who are
410.3eligible to receive benefits under Minnesota
410.4Statutes, chapter 256J, or who have lost
410.5eligibility for benefits under Minnesota
410.6Statutes, chapter 256J, due to earnings in the
410.7prior 12 months. Base level funding for this
410.8activity shall be $1,500,000 in fiscal year
410.92010 and $1,181,000 in fiscal year 2011. *
410.10(The preceding text beginning "(b) Of the
410.11TANF appropriation," was indicated as
410.12vetoed by the governor.)
410.13(c) Money appropriated under paragraphs (a)
410.14and (b) that is not spent in the first year does
410.15not cancel but is available for the second
410.16year.
410.17EFFECTIVE DATE.This section is effective the day following final enactment.
410.18 Sec. 13. EMERGENCY SERVICES SHELTER GRANTS FROM AMERICAN
410.19RECOVERY AND REINVESTMENT ACT.
410.20 (a) To the extent permitted under federal law, the commissioner of human services,
410.21when determining the uses of the emergency services shelter grants provided under the
410.22American Recovery and Reinvestment Act, shall give priority to programs that serve
410.23the following:
410.24 (1) homeless youth;
410.25 (2) American Indian women who are victims of trafficking;
410.26 (3) high-risk adult males considered to be very likely to enter or reenter state or
410.27county correctional programs, or chemical and mental health programs;
410.28 (4) battered women; and
410.29 (5) families affected by foreclosure.
410.30(b) Paragraph (a) does not supersede use of ARRA funds as otherwise provided
410.31in this act.
410.32 Sec. 14. TRANSFERS.
410.33 Subdivision 1. Grants. The commissioner of human services, with the approval
410.34of the commissioner of finance, and after notification of the chairs of the relevant senate
411.1budget division and house of representatives finance division committee, may transfer
411.2unencumbered appropriation balances for the biennium ending June 30, 2011, within
411.3fiscal years among the MFIP, general assistance, general assistance medical care, medical
411.4assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section
411.5119B.05, Minnesota supplemental aid, and group residential housing programs, and the
411.6entitlement portion of the chemical dependency consolidated treatment fund, and between
411.7fiscal years of the biennium.
411.8 Subd. 2. Administration. Positions, salary money, and nonsalary administrative
411.9money may be transferred within the Departments of Human Services and Health as the
411.10commissioners consider necessary, with the advance approval of the commissioner of
411.11finance. The commissioner shall inform the chairs of the relevant house and senate health
411.12committees quarterly about transfers made under this provision.
411.13 Sec. 15. 2007 AND 2008 APPROPRIATION AMENDMENTS.
411.14(a) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4,
411.15paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF
411.16fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph
411.17is effective retroactively from July 1, 2008.
411.18(b) The appropriation for patient incentive programs under Laws 2007, chapter 147,
411.19article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective
411.20retroactively from July 1, 2007.
411.21(c) The onetime general fund base reduction for Child Care Development Grants
411.22under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is
411.23increased by $4,000. This paragraph is effective retroactively from July 1, 2008.
411.24(d) The base for Children Services Grants under Laws 2008, chapter 363, article 18,
411.25section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year
411.262010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008.
411.27(e) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the
411.28general fund base adjustment for Children and Community Services Grants under Laws
411.292008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by
411.30$98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively
411.31from July 1, 2008.
411.32(f) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article
411.3318, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010.
411.34This paragraph is effective retroactively from July 1, 2008.
412.1 Sec. 16. INDIRECT COSTS NOT TO FUND PROGRAMS.
412.2The commissioners of health and human services shall not use indirect cost
412.3allocations to pay for the operational costs of any program for which they are responsible.
412.4 Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
412.5 All uncodified language contained in this article expires on June 30, 2011, unless a
412.6different expiration date is explicit.
412.7 Sec. 18. EFFECTIVE DATE.
412.8 The provisions in this article are effective July 1, 2009, unless a different effective
412.9date is specified."
412.10Delete the title and insert:
412.12relating to state government; making changes to health and human services;
412.13amending provisions related to licensing, the Minnesota family investment
412.14program, child care, adult supports; fraud prevention, state-operated services,
412.15the Minnesota sex offender program, the Department of Health, health care
412.16programs, chemical and mental health; continuing care programs, and public
412.17health; establishing the State-County Results, Accountability, and Service
412.18Delivery Redesign; making technical changes; making forecast adjustments;
412.19requiring reports; establishing and increasing fees; appropriating money;
412.20amending Minnesota Statutes 2008, sections 60A.092, subdivision 2; 62D.03,
412.21subdivision 4; 62D.05, subdivision 3; 62J.495; 62J.496; 62J.497, subdivisions
412.221, 2, by adding subdivisions; 62J.692, subdivision 7; 103I.208, subdivision
412.232; 119B.09, subdivision 7; 119B.13, subdivision 6; 119B.21, subdivisions 5,
412.2410; 119B.231, subdivisions 2, 3, 4; 144.0724, subdivisions 2, 4, 8, by adding
412.25subdivisions; 144.121, subdivisions 1a, 1b; 144.122; 144.1222, subdivision
412.261a; 144.125, subdivision 1; 144.226, subdivision 4; 144.72, subdivisions 1, 3;
412.27144.9501, subdivisions 22b, 26a, by adding subdivisions; 144.9505, subdivisions
412.281g, 4; 144.9508, subdivisions 2, 3, 4; 144.9512, subdivision 2; 144.966, by
412.29adding a subdivision; 144.97, subdivisions 2, 4, 6, by adding subdivisions;
412.30144.98, subdivisions 1, 2, 3, by adding subdivisions; 144.99, subdivision
412.311; 144A.073, by adding a subdivision; 144A.44, subdivision 2; 144A.46,
412.32subdivision 1; 145A.17, by adding a subdivision; 148.6445, by adding a
412.33subdivision; 148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5;
412.34152.126, subdivisions 1, 2, 6; 153A.17; 157.15, by adding a subdivision; 157.16;
412.35157.22; 176.011, subdivision 9; 245.462, subdivision 18; 245.470, subdivision
412.361; 245.4871, subdivision 27; 245.488, subdivision 1; 245A.03, by adding a
412.37subdivision; 245A.10, subdivisions 2, 3; 245A.11, subdivision 2a, by adding
412.38subdivisions; 245A.16, subdivisions 1, 3; 245C.03, subdivision 2; 245C.04,
412.39subdivisions 1, 3; 245C.05, subdivision 4, by adding a subdivision; 245C.08,
412.40subdivision 2; 245C.10, subdivision 3, by adding subdivisions; 245C.17, by
412.41adding a subdivision; 245C.20; 245C.21, subdivision 1a; 245C.23, subdivision 2;
412.42246.50, subdivision 5, by adding subdivisions; 246.51, by adding subdivisions;
412.43246.511; 246.52; 246.54, subdivision 2; 246B.01, by adding subdivisions;
412.44252.025, subdivision 7; 252.46, by adding a subdivision; 252.50, subdivision 1;
412.45254A.02, by adding a subdivision; 254A.16, by adding a subdivision; 254B.03,
412.46subdivisions 1, 3, by adding a subdivision; 254B.05, subdivision 1; 254B.09,
412.47subdivision 2; 256.01, subdivision 2b, by adding subdivisions; 256.045,
412.48subdivision 3; 256.476, subdivisions 5, 11; 256.962, subdivisions 2, 6; 256.969,
412.49subdivisions 2b, 3a, by adding subdivisions; 256.975, subdivision 7; 256.983,
413.1subdivision 1; 256B.04, subdivision 16; 256B.055, subdivisions 7, 12; 256B.056,
413.2subdivisions 3c, 3d; 256B.057, by adding a subdivision; 256B.0575; 256B.0595,
413.3subdivisions 1, 2; 256B.06, subdivisions 4, 5; 256B.0621, subdivision 2;
413.4256B.0622, subdivision 2; 256B.0623, subdivision 5; 256B.0624, subdivisions
413.55, 8; 256B.0625, subdivisions 3, 3c, 6a, 7, 9, 11, 13, 13e, 13h, 17, 17a, 19a,
413.619c, 26, 42, 47, by adding subdivisions; 256B.0641, subdivision 3; 256B.0651;
413.7256B.0652; 256B.0653; 256B.0654; 256B.0655, subdivisions 1b, 4; 256B.0657,
413.8subdivisions 2, 6, 8, by adding a subdivision; 256B.08, by adding a subdivision;
413.9256B.0911, subdivisions 1, 1a, 3, 3a, 3b, 3c, 4a, 5, 6, 7, by adding subdivisions;
413.10256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h, 5, by adding a
413.11subdivision; 256B.0916, subdivision 2; 256B.0917, by adding a subdivision;
413.12256B.092, subdivision 8a, by adding subdivisions; 256B.0943, subdivisions 1,
413.1312; 256B.0944, by adding a subdivision; 256B.0947, subdivision 1; 256B.15,
413.14subdivisions 1, 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37,
413.15subdivisions 1, 5; 256B.434, subdivision 4, by adding a subdivision; 256B.437,
413.16subdivision 6; 256B.441, subdivisions 55, 58, by adding a subdivision; 256B.49,
413.17subdivisions 12, 13, 14, 17, by adding subdivisions; 256B.501, subdivision
413.184a; 256B.5011, subdivision 2; 256B.5012, by adding a subdivision; 256B.69,
413.19subdivisions 5a, 5c, 5f, 23; 256B.76, subdivision 1; 256D.03, subdivision 4;
413.20256D.44, subdivision 5; 256G.02, subdivision 6; 256I.03, subdivision 7; 256I.05,
413.21subdivisions 1a, 7c; 256J.08, subdivision 73a; 256J.24, subdivision 5; 256J.425,
413.22subdivisions 2, 3; 256J.45, subdivision 3; 256J.49, subdivisions 1, 4; 256J.521,
413.23subdivision 2; 256J.545; 256J.561, subdivisions 2, 3; 256J.57, subdivision
413.241; 256J.575, subdivisions 3, 4, 6, 7; 256J.621; 256J.626, subdivision 7;
413.25256J.95, subdivisions 3, 11, 12, 13; 256L.03, by adding a subdivision; 256L.04,
413.26subdivisions 1, 7a, 10a, by adding a subdivision; 256L.05, subdivisions 1, 3, 3a,
413.27by adding a subdivision; 256L.07, subdivisions 1, 2, 3, by adding a subdivision;
413.28256L.11, subdivision 1; 256L.15, subdivisions 2, 3; 256L.17, subdivisions 3, 5;
413.29259.67, by adding a subdivision; 270A.09, by adding a subdivision; 327.14,
413.30by adding a subdivision; 327.15; 327.16; 327.20, subdivision 1, by adding a
413.31subdivision; 501B.89, by adding a subdivision; 519.05; 604A.33, subdivision
413.321; 609.232, subdivision 11; 626.556, subdivision 3c; 626.5572, subdivisions
413.336, 13, 21; Laws 2003, First Special Session chapter 14, article 13C, section
413.342, subdivision 1, as amended; Laws 2007, chapter 147, article 19, section 3,
413.35subdivision 4, as amended; proposing coding for new law in Minnesota Statutes,
413.36chapters 62Q; 246B; 254B; 256; 256B; proposing coding for new law as
413.37Minnesota Statutes, chapter 402A; repealing Minnesota Statutes 2008, sections
413.38103I.112; 144.9501, subdivision 17b; 148D.180, subdivision 8; 245C.11,
413.39subdivisions 1, 2; 246.51, subdivision 1; 246.53, subdivision 3; 256.962,
413.40subdivision 7; 256B.0655, subdivisions 1, 1a, 1c, 1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6,
413.417, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2, 3, 4; 256B.092, subdivision
413.425a; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256I.06, subdivision
413.439; 256L.17, subdivision 6; 327.14, subdivisions 5, 6; Minnesota Rules, parts
413.444626.2015, subpart 9; 9555.6125, subpart 4, item B."
We request the adoption of this report and repassage of the bill.House Conferees: (Signed) Thomas Huntley, Paul Thissen, Larry Hosch, Karen Clark, Jim AbelerSenate Conferees: (Signed) Linda Berglin, Tony Lourey, Kathy Sheran, Julie Rosen, Yvonne Prettner Solon