Minnesota Legislature
HF 1832
2nd Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to human services; modifying provisions 1.3 relating to health department; health care; continuing 1.4 care and home care; consumer information and 1.5 assistance and community-based care; long-term care 1.6 reform and reimbursement; work force; regulation of 1.7 supplemental nursing services agencies; long-term 1.8 insurance; mental health and civil commitment; 1.9 assistance programs; licensing; appropriating money; 1.10 amending Minnesota Statutes 2000, sections 13.46, 1.11 subdivision 4; 62A.48, subdivision 4, by adding 1.12 subdivisions; 62S.01, by adding subdivisions; 62S.26; 1.13 103I.101, subdivision 6; 103I.112; 103I.208, 1.14 subdivisions 1, 2; 103I.235, subdivision 1; 103I.525, 1.15 subdivisions 2, 6, 8, 9; 103I.531, subdivisions 2, 6, 1.16 8, 9; 103I.535, subdivisions 2, 6, 8, 9; 103I.541, 1.17 subdivisions 2b, 4, 5; 103I.545; 121A.15, subdivision 1.18 6; 135A.14, by adding a subdivision; 144.057; 1.19 144.1202, subdivision 4; 144.122; 144.1222, by adding 1.20 a subdivision; 144.1464; 144.226, subdivision 4; 1.21 144.98, subdivision 3; 144A.071, subdivisions 1, 1a, 1.22 2, 4a; 144A.073, subdivisions 2, 4; 144A.44, 1.23 subdivision 1; 144A.62, subdivisions 1, 2, 3, 4; 1.24 145.881, subdivision 2; 145.882, subdivision 7, by 1.25 adding a subdivision; 145.885, subdivision 2; 145.924; 1.26 145.925, subdivisions 1, 1a; 145A.15, subdivision 1, 1.27 by adding a subdivision; 145A.16, subdivision 1, by 1.28 adding a subdivision; 148.212; 157.16, subdivision 3; 1.29 157.22; 214.104; 245.462, subdivisions 8, 18, by 1.30 adding a subdivision; 245.4871, subdivisions 10, 27; 1.31 245.4876, subdivision 1, by adding a subdivision; 1.32 245.4885, subdivision 1; 245.4886, subdivision 1; 1.33 245.99, subdivision 4; 245A.03, subdivision 2b; 1.34 245A.04, subdivisions 3, 3a, 3b, 3c, 3d; 245A.05; 1.35 245A.06; 245A.07; 245A.08; 245A.13, subdivisions 7, 8; 1.36 245A.14, by adding a subdivision; 245A.16, subdivision 1.37 1; 245B.08, subdivision 3; 246.57, by adding a 1.38 subdivision; 252.275, subdivision 4b; 252A.02, 1.39 subdivisions 12, 13, by adding a subdivision; 1.40 252A.111, subdivision 6; 252A.16, subdivision 1; 1.41 252A.19, subdivision 2; 252A.20, subdivision 1; 1.42 254B.02, subdivision 3; 254B.03, subdivision 1; 1.43 254B.04, subdivision 1; 254B.09, by adding a 1.44 subdivision; 256.01, subdivisions 2, 18, by adding a 1.45 subdivision; 256.045, subdivisions 3, 3b, 4; 256.476, 1.46 subdivisions 1, 2, 3, 4, 5, 8; 256.482, subdivision 8; 2.1 256.955, subdivision 2b; 256.9657, subdivision 2; 2.2 256.969, subdivisions 2b, 3a, by adding a subdivision; 2.3 256.973, by adding a subdivision; 256.975, by adding 2.4 subdivisions; 256B.04, by adding a subdivision; 2.5 256B.055, subdivision 3a; 256B.056, subdivisions 1a, 2.6 3, 4, 5; 256B.057, subdivision 9, by adding a 2.7 subdivision; 256B.0625, subdivisions 3b, 7, 13, 13a, 2.8 17, 17a, 18a, 19a, 19c, 20, 30, 34, by adding 2.9 subdivisions; 256B.0627, subdivisions 1, 2, 4, 5, 7, 2.10 8, 10, 11, by adding subdivisions; 256B.0635, 2.11 subdivisions 1, 2; 256B.0911, subdivisions 1, 3, 5, 6, 2.12 7, by adding subdivisions; 256B.0913, subdivisions 1, 2.13 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14; 256B.0915, 2.14 subdivisions 1d, 3, 5; 256B.0916, subdivisions 1, 7, 2.15 9, by adding a subdivision; 256B.0917, subdivision 7; 2.16 256B.092, subdivisions 2a, 5; 256B.093, subdivision 3; 2.17 256B.095; 256B.0951, subdivisions 1, 3, 4, 5, 7, by 2.18 adding subdivisions; 256B.0952, subdivisions 1, 4; 2.19 256B.431, subdivision 17, by adding subdivisions; 2.20 256B.434, subdivisions 4, 10, by adding subdivisions; 2.21 256B.49, by adding subdivisions; 256B.501, by adding a 2.22 subdivision; 256B.69, subdivisions 4, 5, 5b, 23, by 2.23 adding a subdivision; 256B.75; 256B.76; 256D.03, 2.24 subdivisions 3, 4; 256D.053, subdivision 1; 256D.35, 2.25 by adding subdivisions; 256D.44, subdivision 5; 2.26 256I.05, subdivision 1e; 256J.09, subdivisions 1, 2, 2.27 3, by adding subdivisions; 256J.15, by adding a 2.28 subdivision; 256J.24, subdivision 10; 256J.26, 2.29 subdivision 1; 256J.31, subdivisions 4, 12; 256J.32, 2.30 subdivision 7a; 256J.42, by adding a subdivision; 2.31 256J.45, subdivision 1; 256J.46, subdivisions 1, 2a, 2.32 by adding a subdivision; 256J.50, subdivisions 1, 7; 2.33 256J.56; 256J.57, subdivision 2; 256J.62, subdivision 2.34 9; 256J.625, subdivisions 1, 2, 4; 256J.751; 256K.03, 2.35 subdivision 1; 256K.07; 256K.25, subdivisions 1, 3, 4, 2.36 5, 6; 256L.06, subdivision 3; 256L.12, subdivision 9, 2.37 by adding a subdivision; 256L.16; 260C.201, 2.38 subdivision 1; 268.0122, subdivision 2; 626.556, 2.39 subdivisions 3, 3c, 10b, 10i; 626.557, subdivisions 3, 2.40 9d; 626.5572, subdivision 17; Laws 1995, chapter 178, 2.41 article 2, section 36; Laws 1995, chapter 207, article 2.42 3, section 21, as amended; Laws 1997, chapter 203, 2.43 article 9, section 21, as amended; Laws 1999, chapter 2.44 152, sections 1, 4; Laws 1999, chapter 245, article 3, 2.45 section 45, as amended; Laws 1999, chapter 245, 2.46 article 4, section 110; proposing coding for new law 2.47 in Minnesota Statutes, chapters 62S; 144; 144A; 145; 2.48 145A; 246; 256; 256B; 256I; 256J; 299A; repealing 2.49 Minnesota Statutes 2000, sections 144.0721, 2.50 subdivision 1; 144.148, subdivision 8; 145.882, 2.51 subdivisions 3, 4; 145.9245; 145.927; 252A.111, 2.52 subdivision 3; 256.476, subdivision 7; 256B.037, 2.53 subdivision 5; 256B.0635, subdivision 3; 256B.0911, 2.54 subdivisions 2, 2a, 4, 8, 9; 256B.0912; 256B.0913, 2.55 subdivisions 3, 15a, 15b, 15c, 16; 256B.0915, 2.56 subdivisions 3a, 3b, 3c; 256B.0951, subdivision 6; 2.57 256B.434, subdivision 5; 256B.49, subdivisions 1, 2, 2.58 3, 4, 5, 6, 7, 8, 9, 10; 256E.06, subdivision 2b; 2.59 256J.42, subdivision 4; 256J.44; 256J.46, subdivision 2.60 1a; Laws 1995, chapter 178, article 2, section 48, 2.61 subdivision 6; Minnesota Rules, parts 9505.2390; 2.62 9505.2395; 9505.2396; 9505.2400; 9505.2405; 9505.2410; 2.63 9505.2413; 9505.2415; 9505.2420; 9505.2425; 9505.2426; 2.64 9505.2430; 9505.2435; 9505.2440; 9505.2445; 9505.2450; 2.65 9505.2455; 9505.2458; 9505.2460; 9505.2465; 9505.2470; 2.66 9505.2473; 9505.2475; 9505.2480; 9505.2485; 9505.2486; 2.67 9505.2490; 9505.2495; 9505.2496; 9505.2500; 9505.3010; 2.68 9505.3015; 9505.3020; 9505.3025; 9505.3030; 9505.3035; 2.69 9505.3040; 9505.3065; 9505.3085; 9505.3135; 9505.3500; 2.70 9505.3510; 9505.3520; 9505.3530; 9505.3535; 9505.3540; 2.71 9505.3545; 9505.3550; 9505.3560; 9505.3570; 9505.3575; 3.1 9505.3580; 9505.3585; 9505.3600; 9505.3610; 9505.3620; 3.2 9505.3622; 9505.3624; 9505.3626; 9505.3630; 9505.3635; 3.3 9505.3640; 9505.3645; 9505.3650; 9505.3660; 9505.3670. 3.4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.5 ARTICLE 1 3.6 HEALTH DEPARTMENT 3.7 Section 1. Minnesota Statutes 2000, section 103I.101, 3.8 subdivision 6, is amended to read: 3.9 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall 3.10 charge a nonrefundable application fee of$120$150 to cover the 3.11 administrative cost of processing a request for a variance or 3.12 modification of rules adopted by the commissioner under this 3.13 chapter. 3.14 Sec. 2. Minnesota Statutes 2000, section 103I.112, is 3.15 amended to read: 3.16 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 3.17 (a) The commissioner of health may not charge fees required 3.18 under this chapter to a federal agency, state agency, or a local 3.19 unit of government or to a subcontractor performing work for the 3.20 state agency or local unit of government. 3.21 (b) "Local unit of government" means a statutory or home 3.22 rule charter city, town, county, or soil and water conservation 3.23 district, watershed district, an organization formed for the 3.24 joint exercise of powers under section 471.59, a board of health 3.25 or community health board, or other special purpose district or 3.26 authority with local jurisdiction in water and related land 3.27 resources management. 3.28 Sec. 3. Minnesota Statutes 2000, section 103I.208, 3.29 subdivision 1, is amended to read: 3.30 Subdivision 1. [WELL NOTIFICATION FEE.] The well 3.31 notification fee to be paid by a property owner is: 3.32 (1) for a new well,$120$150, which includes the state 3.33 core function fee; 3.34 (2) for a well sealing,$20$30 for each well, which 3.35 includes the state core function fee, except that for monitoring 3.36 wells constructed on a single property, having depths within a 3.37 25 foot range, and sealed within 48 hours of start of 4.1 construction, a single fee of$20$30; and 4.2 (3) for construction of a dewatering well,$120$150, which 4.3 includes the state core function fee, for each well except a 4.4 dewatering project comprising five or more wells shall be 4.5 assessed a single fee of$600$750 for the wells recorded on the 4.6 notification. 4.7 Sec. 4. Minnesota Statutes 2000, section 103I.208, 4.8 subdivision 2, is amended to read: 4.9 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 4.10 property owner is: 4.11 (1) for a well that is not in use under a maintenance 4.12 permit,$100$125 annually; 4.13 (2) for construction of a monitoring well,$120$150, which 4.14 includes the state core function fee; 4.15 (3) for a monitoring well that is unsealed under a 4.16 maintenance permit,$100$125 annually; 4.17 (4) for monitoring wells used as a leak detection device at 4.18 a single motor fuel retail outlet, a single petroleum bulk 4.19 storage site excluding tank farms, or a single agricultural 4.20 chemical facility site, the construction permit fee 4.21 is$120$150, which includes the state core function fee, per 4.22 site regardless of the number of wells constructed on the site, 4.23 and the annual fee for a maintenance permit for unsealed 4.24 monitoring wells is$100$125 per site regardless of the number 4.25 of monitoring wells located on site; 4.26 (5) for a groundwater thermal exchange device, in addition 4.27 to the notification fee for wells,$120$150, which includes the 4.28 state core function fee; 4.29 (6) for a vertical heat exchanger,$120$150; 4.30 (7) for a dewatering well that is unsealed under a 4.31 maintenance permit,$100$125 annually for each well, except a 4.32 dewatering project comprising more than five wells shall be 4.33 issued a single permit for$500$625 annually for wells recorded 4.34 on the permit; and 4.35 (8) for excavating holes for the purpose of installing 4.36 elevator shafts,$120$150 for each hole. 5.1 Sec. 5. Minnesota Statutes 2000, section 103I.235, 5.2 subdivision 1, is amended to read: 5.3 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before 5.4 signing an agreement to sell or transfer real property, the 5.5 seller must disclose in writing to the buyer information about 5.6 the status and location of all known wells on the property, by 5.7 delivering to the buyer either a statement by the seller that 5.8 the seller does not know of any wells on the property, or a 5.9 disclosure statement indicating the legal description and 5.10 county, and a map drawn from available information showing the 5.11 location of each well to the extent practicable. In the 5.12 disclosure statement, the seller must indicate, for each well, 5.13 whether the well is in use, not in use, or sealed. 5.14 (b) At the time of closing of the sale, the disclosure 5.15 statement information, name and mailing address of the buyer, 5.16 and the quartile, section, township, and range in which each 5.17 well is located must be provided on a well disclosure 5.18 certificate signed by the seller or a person authorized to act 5.19 on behalf of the seller. 5.20 (c) A well disclosure certificate need not be provided if 5.21 the seller does not know of any wells on the property and the 5.22 deed or other instrument of conveyance contains the statement: 5.23 "The Seller certifies that the Seller does not know of any wells 5.24 on the described real property." 5.25 (d) If a deed is given pursuant to a contract for deed, the 5.26 well disclosure certificate required by this subdivision shall 5.27 be signed by the buyer or a person authorized to act on behalf 5.28 of the buyer. If the buyer knows of no wells on the property, a 5.29 well disclosure certificate is not required if the following 5.30 statement appears on the deed followed by the signature of the 5.31 grantee or, if there is more than one grantee, the signature of 5.32 at least one of the grantees: "The Grantee certifies that the 5.33 Grantee does not know of any wells on the described real 5.34 property." The statement and signature of the grantee may be on 5.35 the front or back of the deed or on an attached sheet and an 5.36 acknowledgment of the statement by the grantee is not required 6.1 for the deed to be recordable. 6.2 (e) This subdivision does not apply to the sale, exchange, 6.3 or transfer of real property: 6.4 (1) that consists solely of a sale or transfer of severed 6.5 mineral interests; or 6.6 (2) that consists of an individual condominium unit as 6.7 described in chapters 515 and 515B. 6.8 (f) For an area owned in common under chapter 515 or 515B 6.9 the association or other responsible person must report to the 6.10 commissioner by July 1, 1992, the location and status of all 6.11 wells in the common area. The association or other responsible 6.12 person must notify the commissioner within 30 days of any change 6.13 in the reported status of wells. 6.14 (g) For real property sold by the state under section 6.15 92.67, the lessee at the time of the sale is responsible for 6.16 compliance with this subdivision. 6.17 (h) If the seller fails to provide a required well 6.18 disclosure certificate, the buyer, or a person authorized to act 6.19 on behalf of the buyer, may sign a well disclosure certificate 6.20 based on the information provided on the disclosure statement 6.21 required by this section or based on other available information. 6.22 (i) A county recorder or registrar of titles may not record 6.23 a deed or other instrument of conveyance dated after October 31, 6.24 1990, for which a certificate of value is required under section 6.25 272.115, or any deed or other instrument of conveyance dated 6.26 after October 31, 1990, from a governmental body exempt from the 6.27 payment of state deed tax, unless the deed or other instrument 6.28 of conveyance contains the statement made in accordance with 6.29 paragraph (c) or (d) or is accompanied by the well disclosure 6.30 certificate containing all the information required by paragraph 6.31 (b) or (d). The county recorder or registrar of titles must not 6.32 accept a certificate unless it contains all the required 6.33 information. The county recorder or registrar of titles shall 6.34 note on each deed or other instrument of conveyance accompanied 6.35 by a well disclosure certificate that the well disclosure 6.36 certificate was received. The notation must include the 7.1 statement "No wells on property" if the disclosure certificate 7.2 states there are no wells on the property. The well disclosure 7.3 certificate shall not be filed or recorded in the records 7.4 maintained by the county recorder or registrar of titles. After 7.5 noting "No wells on property" on the deed or other instrument of 7.6 conveyance, the county recorder or registrar of titles shall 7.7 destroy or return to the buyer the well disclosure certificate. 7.8 The county recorder or registrar of titles shall collect from 7.9 the buyer or the person seeking to record a deed or other 7.10 instrument of conveyance, a fee of$20$30 for receipt of a 7.11 completed well disclosure certificate. By the tenth day of each 7.12 month, the county recorder or registrar of titles shall transmit 7.13 the well disclosure certificates to the commissioner of health. 7.14 By the tenth day after the end of each calendar quarter, the 7.15 county recorder or registrar of titles shall transmit to the 7.16 commissioner of health$17.50$27.50 of the fee for each well 7.17 disclosure certificate received during the quarter. The 7.18 commissioner shall maintain the well disclosure certificate for 7.19 at least six years. The commissioner may store the certificate 7.20 as an electronic image. A copy of that image shall be as valid 7.21 as the original. 7.22 (j) No new well disclosure certificate is required under 7.23 this subdivision if the buyer or seller, or a person authorized 7.24 to act on behalf of the buyer or seller, certifies on the deed 7.25 or other instrument of conveyance that the status and number of 7.26 wells on the property have not changed since the last previously 7.27 filed well disclosure certificate. The following statement, if 7.28 followed by the signature of the person making the statement, is 7.29 sufficient to comply with the certification requirement of this 7.30 paragraph: "I am familiar with the property described in this 7.31 instrument and I certify that the status and number of wells on 7.32 the described real property have not changed since the last 7.33 previously filed well disclosure certificate." The 7.34 certification and signature may be on the front or back of the 7.35 deed or on an attached sheet and an acknowledgment of the 7.36 statement is not required for the deed or other instrument of 8.1 conveyance to be recordable. 8.2 (k) The commissioner in consultation with county recorders 8.3 shall prescribe the form for a well disclosure certificate and 8.4 provide well disclosure certificate forms to county recorders 8.5 and registrars of titles and other interested persons. 8.6 (l) Failure to comply with a requirement of this 8.7 subdivision does not impair: 8.8 (1) the validity of a deed or other instrument of 8.9 conveyance as between the parties to the deed or instrument or 8.10 as to any other person who otherwise would be bound by the deed 8.11 or instrument; or 8.12 (2) the record, as notice, of any deed or other instrument 8.13 of conveyance accepted for filing or recording contrary to the 8.14 provisions of this subdivision. 8.15 Sec. 6. Minnesota Statutes 2000, section 103I.525, 8.16 subdivision 2, is amended to read: 8.17 Subd. 2. [APPLICATION FEE.] The application fee for a well 8.18 contractor's license is$50$75. The commissioner may not act 8.19 on an application until the application fee is paid. 8.20 Sec. 7. Minnesota Statutes 2000, section 103I.525, 8.21 subdivision 6, is amended to read: 8.22 Subd. 6. [LICENSE FEE.] The fee for a well contractor's 8.23 license is $250, except the fee for an individual well 8.24 contractor's license is$50$75. 8.25 Sec. 8. Minnesota Statutes 2000, section 103I.525, 8.26 subdivision 8, is amended to read: 8.27 Subd. 8. [RENEWAL.] (a) A licensee must file an 8.28 application and a renewal application fee to renew the license 8.29 by the date stated in the license. 8.30 (b) The renewal application feeshall be set by the8.31commissioner under section 16A.1285for a well contractor's 8.32 license is $250. 8.33 (c) The renewal application must include information that 8.34 the applicant has met continuing education requirements 8.35 established by the commissioner by rule. 8.36 (d) At the time of the renewal, the commissioner must have 9.1 on file all properly completed well reports, well sealing 9.2 reports, reports of excavations to construct elevator shafts, 9.3 well permits, and well notifications for work conducted by the 9.4 licensee since the last license renewal. 9.5 Sec. 9. Minnesota Statutes 2000, section 103I.525, 9.6 subdivision 9, is amended to read: 9.7 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 9.8 to submit all information required for renewal in subdivision 8 9.9 or submits the application and information after the required 9.10 renewal date: 9.11 (1) the licensee must includean additionala late feeset9.12by the commissionerof $75; and 9.13 (2) the licensee may not conduct activities authorized by 9.14 the well contractor's license until the renewal application, 9.15 renewal application fee, late fee, and all other information 9.16 required in subdivision 8 are submitted. 9.17 Sec. 10. Minnesota Statutes 2000, section 103I.531, 9.18 subdivision 2, is amended to read: 9.19 Subd. 2. [APPLICATION FEE.] The application fee for a 9.20 limited well/boring contractor's license is$50$75. The 9.21 commissioner may not act on an application until the application 9.22 fee is paid. 9.23 Sec. 11. Minnesota Statutes 2000, section 103I.531, 9.24 subdivision 6, is amended to read: 9.25 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring 9.26 contractor's license is$50$75. 9.27 Sec. 12. Minnesota Statutes 2000, section 103I.531, 9.28 subdivision 8, is amended to read: 9.29 Subd. 8. [RENEWAL.] (a) A person must file an application 9.30 and a renewal application fee to renew the limited well/boring 9.31 contractor's license by the date stated in the license. 9.32 (b) The renewal application feeshall be set by the9.33commissioner under section 16A.1285for a limited well/boring 9.34 contractor's license is $75. 9.35 (c) The renewal application must include information that 9.36 the applicant has met continuing education requirements 10.1 established by the commissioner by rule. 10.2 (d) At the time of the renewal, the commissioner must have 10.3 on file all properly completed well sealing reports, well 10.4 permits, vertical heat exchanger permits, and well notifications 10.5 for work conducted by the licensee since the last license 10.6 renewal. 10.7 Sec. 13. Minnesota Statutes 2000, section 103I.531, 10.8 subdivision 9, is amended to read: 10.9 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 10.10 to submit all information required for renewal in subdivision 8 10.11 or submits the application and information after the required 10.12 renewal date: 10.13 (1) the licensee must includean additionala late feeset10.14by the commissionerof $75; and 10.15 (2) the licensee may not conduct activities authorized by 10.16 the limited well/boring contractor's license until the renewal 10.17 application, renewal application fee, and late fee, and all 10.18 other information required in subdivision 8 are submitted. 10.19 Sec. 14. Minnesota Statutes 2000, section 103I.535, 10.20 subdivision 2, is amended to read: 10.21 Subd. 2. [APPLICATION FEE.] The application fee for an 10.22 elevator shaft contractor's license is$50$75. The 10.23 commissioner may not act on an application until the application 10.24 fee is paid. 10.25 Sec. 15. Minnesota Statutes 2000, section 103I.535, 10.26 subdivision 6, is amended to read: 10.27 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft 10.28 contractor's license is$50$75. 10.29 Sec. 16. Minnesota Statutes 2000, section 103I.535, 10.30 subdivision 8, is amended to read: 10.31 Subd. 8. [RENEWAL.] (a) A person must file an application 10.32 and a renewal application fee to renew the license by the date 10.33 stated in the license. 10.34 (b) The renewal application feeshall be set by the10.35commissioner under section 16A.1285for an elevator shaft 10.36 contractor's license is $75. 11.1 (c) The renewal application must include information that 11.2 the applicant has met continuing education requirements 11.3 established by the commissioner by rule. 11.4 (d) At the time of renewal, the commissioner must have on 11.5 file all reports and permits for elevator shaft work conducted 11.6 by the licensee since the last license renewal. 11.7 Sec. 17. Minnesota Statutes 2000, section 103I.535, 11.8 subdivision 9, is amended to read: 11.9 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 11.10 to submit all information required for renewal in subdivision 8 11.11 or submits the application and information after the required 11.12 renewal date: 11.13 (1) the licensee must includean additionala late feeset11.14by the commissionerof $75; and 11.15 (2) the licensee may not conduct activities authorized by 11.16 the elevator shaft contractor's license until the renewal 11.17 application, renewal application fee, and late fee, and all 11.18 other information required in subdivision 8 are submitted. 11.19 Sec. 18. Minnesota Statutes 2000, section 103I.541, 11.20 subdivision 2b, is amended to read: 11.21 Subd. 2b. [APPLICATION FEE.] The application fee for a 11.22 monitoring well contractor registration is$50$75. The 11.23 commissioner may not act on an application until the application 11.24 fee is paid. 11.25 Sec. 19. Minnesota Statutes 2000, section 103I.541, 11.26 subdivision 4, is amended to read: 11.27 Subd. 4. [RENEWAL.] (a) A person must file an application 11.28 and a renewal application fee to renew the registration by the 11.29 date stated in the registration. 11.30 (b) The renewal application feeshall be set by the11.31commissioner under section 16A.1285for a monitoring well 11.32 contractor's registration is $75. 11.33 (c) The renewal application must include information that 11.34 the applicant has met continuing education requirements 11.35 established by the commissioner by rule. 11.36 (d) At the time of the renewal, the commissioner must have 12.1 on file all well reports, well sealing reports, well permits, 12.2 and notifications for work conducted by the registered person 12.3 since the last registration renewal. 12.4 Sec. 20. Minnesota Statutes 2000, section 103I.541, 12.5 subdivision 5, is amended to read: 12.6 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered 12.7 person submits a renewal application after the required renewal 12.8 date: 12.9 (1) the registered person must includean additionala late 12.10 feeset by the commissionerof $75; and 12.11 (2) the registered person may not conduct activities 12.12 authorized by the monitoring well contractor's registration 12.13 until the renewal application, renewal application fee, late 12.14 fee, and all other information required in subdivision 4 are 12.15 submitted. 12.16 Sec. 21. Minnesota Statutes 2000, section 103I.545, is 12.17 amended to read: 12.18 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 12.19 Subdivision 1. [DRILLING MACHINE.] (a) A person may not 12.20 use a drilling machine such as a cable tool, rotary tool, hollow 12.21 rod tool, or auger for a drilling activity requiring a license 12.22 or registration under this chapter unless the drilling machine 12.23 is registered with the commissioner. 12.24 (b) A person must apply for the registration on forms 12.25 prescribed by the commissioner and submit a$50$75 registration 12.26 fee. 12.27 (c) A registration is valid for one year. 12.28 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine 12.29 such as a pump hoist for an activity requiring a license or 12.30 registration under this chapter to repair wells or borings, seal 12.31 wells or borings, or install pumps unless the machine is 12.32 registered with the commissioner. 12.33 (b) A person must apply for the registration on forms 12.34 prescribed by the commissioner and submit a$50$75 registration 12.35 fee. 12.36 (c) A registration is valid for one year. 13.1 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.2 Sec. 22. Minnesota Statutes 2000, section 121A.15, 13.3 subdivision 6, is amended to read: 13.4 Subd. 6. [SUSPENSION OF IMMUNIZATION REQUIREMENT; 13.5 MODIFICATION TO SCHEDULE.] (a) The commissioner of health, on 13.6 finding that an immunization required pursuant to this section 13.7 is not necessary to protect the public's health, may suspend for 13.8 one year the requirement that children receive that immunization. 13.9 (b) During portions of the year in which the legislature is 13.10 not meeting in regular or special session, the commissioner of 13.11 health may modify the immunization requirements of this section. 13.12 A modification made under this paragraph must be part of the 13.13 current immunization recommendations of each of the following 13.14 organizations: the United States Public Health Service's 13.15 Advisory Committee on Immunization Practices, the American 13.16 Academy of Family Physicians, and the American Academy of 13.17 Pediatrics. The commissioner shall modify the immunization 13.18 requirements through rulemaking using the expedited process in 13.19 section 14.389. A rule adopted under this paragraph shall be in 13.20 effect until the adjournment of the next regular legislative 13.21 session held after the rule is adopted. The commissioner shall 13.22 report to the legislature on any rules adopted under this 13.23 paragraph during the previous calendar year. Such reports are 13.24 due by January 15 of the year following the calendar year in 13.25 which the rule is adopted, except that if a rule is adopted in 13.26 January, a report on that rule is due by February 15 of that 13.27 year. 13.28 Sec. 23. Minnesota Statutes 2000, section 135A.14, is 13.29 amended by adding a subdivision to read: 13.30 Subd. 7. [MODIFICATIONS TO SCHEDULE.] During portions of 13.31 the year in which the legislature is not meeting in regular or 13.32 special session, the commissioner of health may modify the 13.33 immunization requirements of this section. A modification made 13.34 under this subdivision must be part of the current immunization 13.35 recommendations of each of the following organizations: the 13.36 United States Public Health Service's Advisory Committee on 14.1 Immunization Practices, the American Academy of Family 14.2 Physicians, and the American Academy of Pediatrics. The 14.3 commissioner shall modify the immunization requirements through 14.4 rulemaking using the expedited process in section 14.389. A 14.5 rule adopted under this subdivision shall be in effect until the 14.6 adjournment of the next regular legislative session held after 14.7 the rule is adopted. The commissioner shall report to the 14.8 legislature on any rules adopted under this subdivision during 14.9 the previous calendar year. Such reports are due by January 15 14.10 of the year following the calendar year in which the rule is 14.11 adopted, except that if a rule is adopted in January, a report 14.12 on that rule is due by February 15 of that year. 14.13 Sec. 24. Minnesota Statutes 2000, section 144.1202, 14.14 subdivision 4, is amended to read: 14.15 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 14.16 agreement entered into before August 2,20022003, must remain 14.17 in effect until terminated under the Atomic Energy Act of 1954, 14.18 United States Code, title 42, section 2021, paragraph (j). The 14.19 governor may not enter into an initial agreement with the 14.20 Nuclear Regulatory Commission after August 1,20022003. If an 14.21 agreement is not entered into by August 1,20022003, any rules 14.22 adopted under this section are repealed effective August 1,200214.23 2003. 14.24 (b) An agreement authorized under subdivision 1 must be 14.25 approved by law before it may be implemented. 14.26 Sec. 25. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 14.27 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 14.28 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When 14.29 a license is required for radioactive material or source or 14.30 special nuclear material by a rule adopted under section 14.31 144.1202, subdivision 2, an application fee according to 14.32 subdivision 4 must be paid upon initial application for a 14.33 license. The licensee must renew the license 60 days before the 14.34 expiration date of the license by paying a license renewal fee 14.35 equal to the application fee under subdivision 4. The 14.36 expiration date of a license is the date set by the United 15.1 States Nuclear Regulatory Commission before transfer of the 15.2 licensing program under section 144.1202 and thereafter as 15.3 specified by rule of the commissioner of health. 15.4 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee 15.5 at least 60 days before the anniversary date of the issuance of 15.6 the license. The annual fee is an amount equal to 80 percent of 15.7 the application fee under subdivision 4, rounded to the nearest 15.8 whole dollar. 15.9 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL 15.10 LICENSING CATEGORIES.] (a) Fee categories under this section are 15.11 equivalent to the licensing categories used by the United States 15.12 Nuclear Regulatory Commission under Code of Federal Regulations, 15.13 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 15.14 provided in paragraph (b). 15.15 (b) The category of "Academic, small" is the type of 15.16 license required for the use of radioactive materials in a 15.17 teaching institution. Radioactive materials are limited to ten 15.18 radionuclides not to exceed a total activity amount of one curie. 15.19 Subd. 4. [APPLICATION FEE.] A licensee must pay an 15.20 application fee as follows: 15.21 Radioactive material, Application U.S. Nuclear Regulatory 15.22 source and fee Commission licensing 15.23 special material category as reference 15.25 Type A broadscope $20,000 Medical institution type A 15.26 Type B broadscope $15,000 Research and development 15.27 type B 15.28 Type C broadscope $10,000 Academic type C 15.29 Medical use $4,000 Medical 15.30 Medical institution 15.31 Medical private practice 15.32 Mobile nuclear 15.33 medical laboratory $4,000 Mobile medical laboratory 15.34 Medical special use 15.35 sealed sources $6,000 Teletherapy 15.36 High dose rate remote 16.1 afterloaders 16.2 Stereotactic 16.3 radiosurgery devices 16.4 In vitro testing $2,300 In vitro testing 16.5 laboratories 16.6 Measuring gauge, 16.7 sealed sources $2,000 Fixed gauges 16.8 Portable gauges 16.9 Analytical instruments 16.10 Measuring systems - other 16.11 Gas chromatographs $1,200 Gas chromatographs 16.12 Manufacturing and 16.13 distribution $14,700 Manufacturing and 16.14 distribution - other 16.15 Distribution only $8,800 Distribution of 16.16 radioactive material 16.17 for commercial use only 16.18 Other services $1,500 Other services 16.19 Nuclear medicine 16.20 pharmacy $4,100 Nuclear pharmacy 16.21 Waste disposal $9,400 Waste disposal service 16.22 prepackage 16.23 Waste disposal service 16.24 processing/repackage 16.25 Waste storage only $7,000 To receive and store 16.26 radioactive material waste 16.27 Industrial 16.28 radiography $8,400 Industrial radiography 16.29 fixed location 16.30 Industrial radiography 16.31 portable/temporary sites 16.32 Irradiator - 16.33 self-shielded $4,100 Irradiators self-shielded 16.34 less than 10,000 curies 16.35 Irradiator - 16.36 less than 10,000 Ci $7,500 Irradiators less than 17.1 10,000 curies 17.2 Irradiator - 17.3 more than 10,000 Ci $11,500 Irradiators greater than 17.4 10,000 curies 17.5 Research and 17.6 development, 17.7 no distribution $4,100 Research and development 17.8 Radioactive material 17.9 possession only $1,000 By-product possession only 17.10 Source material $1,000 Source material shielding 17.11 Special nuclear 17.12 material, less than 17.13 200 grams $1,000 Special nuclear material 17.14 plutonium-neutron sources 17.15 less than 200 grams 17.16 Pacemaker 17.17 manufacturing $1,000 Pacemaker by-product 17.18 and/or special nuclear 17.19 material - medical 17.20 institution 17.21 General license 17.22 distribution $2,100 General license 17.23 distribution 17.24 General license 17.25 distribution, exempt $1,500 General license 17.26 distribution - 17.27 certain exempt items 17.28 Academic, small $1,000 Possession limit of ten 17.29 radionuclides, not to 17.30 exceed a total of one curie 17.31 of activity 17.32 Veterinary $2,000 Veterinary use 17.33 Well logging $5,000 Well logging 17.34 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a 17.35 license renewal fee submitted to the commissioner after the due 17.36 date specified by rule must be accompanied by an additional 18.1 amount equal to 25 percent of the fee due. 18.2 Subd. 6. [INSPECTIONS.] The commissioner of health shall 18.3 make periodic safety inspections of the radioactive material and 18.4 source and special nuclear material of a licensee. The 18.5 commissioner shall prescribe the frequency of safety inspections 18.6 by rule. 18.7 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the 18.8 commissioner finds serious violations of public health standards 18.9 during an inspection under subdivision 6, the licensee must pay 18.10 all costs associated with subsequent reinspection of the 18.11 source. The costs shall be the actual costs incurred by the 18.12 commissioner and include, but are not limited to, labor, 18.13 transportation, per diem, materials, legal fees, testing, and 18.14 monitoring costs. 18.15 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an 18.16 application for reciprocal recognition of a materials license 18.17 issued by another agreement state or the United States Nuclear 18.18 Regulatory Commission for a period of 180 days or less during a 18.19 calendar year must pay one-half of the application fee specified 18.20 under subdivision 4. For a period of 181 days or more, the 18.21 licensee must pay the entire application fee under subdivision 4. 18.22 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must 18.23 pay a fee to amend a license as follows: 18.24 (1) to amend a license requiring no license review 18.25 including, but not limited to, facility name change or removal 18.26 of a previously authorized user, no fee; 18.27 (2) to amend a license requiring review including, but not 18.28 limited to, addition of isotopes, procedure changes, new 18.29 authorized users, or a new radiation safety officer, $200; and 18.30 (3) to amend a license requiring review and a site visit 18.31 including, but not limited to, facility move or addition of 18.32 processes, $400. 18.33 [EFFECTIVE DATE.] This section is effective July 1, 2002. 18.34 Sec. 26. Minnesota Statutes 2000, section 144.122, is 18.35 amended to read: 18.36 144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 19.1 (a) The state commissioner of health, by rule, may 19.2 prescribe reasonable procedures and fees for filing with the 19.3 commissioner as prescribed by statute and for the issuance of 19.4 original and renewal permits, licenses, registrations, and 19.5 certifications issued under authority of the commissioner. The 19.6 expiration dates of the various licenses, permits, 19.7 registrations, and certifications as prescribed by the rules 19.8 shall be plainly marked thereon. Fees may include application 19.9 and examination fees and a penalty fee for renewal applications 19.10 submitted after the expiration date of the previously issued 19.11 permit, license, registration, and certification. The 19.12 commissioner may also prescribe, by rule, reduced fees for 19.13 permits, licenses, registrations, and certifications when the 19.14 application therefor is submitted during the last three months 19.15 of the permit, license, registration, or certification period. 19.16 Fees proposed to be prescribed in the rules shall be first 19.17 approved by the department of finance. All fees proposed to be 19.18 prescribed in rules shall be reasonable. The fees shall be in 19.19 an amount so that the total fees collected by the commissioner 19.20 will, where practical, approximate the cost to the commissioner 19.21 in administering the program. All fees collected shall be 19.22 deposited in the state treasury and credited to the state 19.23 government special revenue fund unless otherwise specifically 19.24 appropriated by law for specific purposes. 19.25 (b) The commissioner may charge a fee for voluntary 19.26 certification of medical laboratories and environmental 19.27 laboratories, and for environmental and medical laboratory 19.28 services provided by the department, without complying with 19.29 paragraph (a) or chapter 14. Fees charged for environment and 19.30 medical laboratory services provided by the department must be 19.31 approximately equal to the costs of providing the services. 19.32 (c) The commissioner may develop a schedule of fees for 19.33 diagnostic evaluations conducted at clinics held by the services 19.34 for children with handicaps program. All receipts generated by 19.35 the program are annually appropriated to the commissioner for 19.36 use in the maternal and child health program. 20.1 (d) The commissioner, for fiscal years 1996 and beyond,20.2 shall set license fees for hospitals and nursing homes that are 20.3 not boarding care homes at the following levels: 20.4 Joint Commission on Accreditation of Healthcare 20.5 Organizations (JCAHO hospitals)$1,01720.6 $7,055 20.7 Non-JCAHO hospitals$762 plus $34 per bed20.8 $4,680 plus $234 per bed 20.9 Nursing home$78 plus $19 per bed20.10 $183 plus $91 per bed 20.11For fiscal years 1996 and beyond,The commissioner shall 20.12 set license fees for outpatient surgical centers, boarding care 20.13 homes, and supervised living facilities at the following levels: 20.14 Outpatient surgical centers$51720.15 $1,512 20.16 Boarding care homes$78 plus $19 per bed20.17 $183 plus $91 per bed 20.18 Supervised living facilities$78 plus $19 per bed20.19 $183 plus $91 per bed. 20.20 (e) Unless prohibited by federal law, the commissioner of 20.21 health shall charge applicants the following fees to cover the 20.22 cost of any initial certification surveys required to determine 20.23 a provider's eligibility to participate in the Medicare or 20.24 Medicaid program: 20.25 Prospective payment surveys for $ 900 20.26 hospitals 20.28 Swing bed surveys for nursing homes $1,200 20.30 Psychiatric hospitals $1,400 20.32 Rural health facilities $1,100 20.34 Portable X-ray providers $ 500 20.36 Home health agencies $1,800 20.38 Outpatient therapy agencies $ 800 20.40 End stage renal dialysis providers $2,100 20.42 Independent therapists $ 800 20.44 Comprehensive rehabilitation $1,200 20.45 outpatient facilities 20.47 Hospice providers $1,700 21.2 Ambulatory surgical providers $1,800 21.4 Hospitals $4,200 21.6 Other provider categories or Actual surveyor costs: 21.7 additional resurveys required average surveyor cost x 21.8 to complete initial certification number of hours for the 21.9 survey process. 21.10 These fees shall be submitted at the time of the 21.11 application for federal certification and shall not be 21.12 refunded. All fees collected after the date that the imposition 21.13 of fees is not prohibited by federal law shall be deposited in 21.14 the state treasury and credited to the state government special 21.15 revenue fund. 21.16 Sec. 27. Minnesota Statutes 2000, section 144.226, 21.17 subdivision 4, is amended to read: 21.18 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 21.19 prescribed under subdivision 1, there is a nonrefundable 21.20 surcharge of$3$2 for each certified and noncertified birth or 21.21 death record, and for a certification that the record cannot be 21.22 found. The local or state registrar shall forward this amount 21.23 to the state treasurer to be deposited into the state government 21.24 special revenue fund. This surcharge shall not be charged under 21.25 those circumstances in which no fee for a birth or death record 21.26 is permitted under subdivision 1, paragraph (a).This surcharge21.27requirement expires June 30, 2002.21.28 Sec. 28. [144.585] [HOSPITAL CHARITY CARE AID.] 21.29 Subdivision 1. [PURPOSE.] The purpose of charity care aid 21.30 is to help offset excess charity care burdens at Minnesota acute 21.31 care, short-term hospitals. 21.32 Subd. 2. [DEFINITIONS.] (a) For purposes of this section, 21.33 the terms in this subdivision have the meanings given to them. 21.34 (b) "Charity care" is the dollar amount of charity care 21.35 adjustments as determined under subdivision 3. 21.36 (c) "Cost-to-charge ratio" means a hospital's total 21.37 operating expenses over the sum of gross patient revenue and 21.38 other operating revenue, as reported to the commissioner of 21.39 health under rules adopted under sections 144.695 to 144.703. 21.40 The commissioner shall use the most recently available data to 22.1 calculate the cost-to-charge ratio. 22.2 Subd. 3. [CHARITY CARE REPORTING.] (a) For a hospital to 22.3 report amounts as charity care adjustments, the hospital: 22.4 (1) must generate and record a charge; 22.5 (2) have a policy on the provision of charity care and must 22.6 communicate the policy to the public; 22.7 (3) have made a reasonable effort to identify a third party 22.8 payer, encourage the patient to enroll in public programs, and 22.9 should, to the extent possible, aid the patient in the 22.10 enrollment process; and 22.11 (4) ensure that the patient meets the charity care criteria 22.12 of this subdivision, which must be consistent with statewide 22.13 income standards set out in paragraph (c). 22.14 (b) In determining whether to classify care as charity 22.15 care, the hospital must consider the following: 22.16 (1) charity care may include services which the provider is 22.17 obligated to render independently of the ability to collect; 22.18 (2) charity care may include care provided to low-income 22.19 patients who meet the charity care income standards under 22.20 paragraph (c) and have partial coverage, but are unable to pay 22.21 the remainder of their medical bills. This does not apply to 22.22 that portion of the bill which has been determined to be the 22.23 patient's responsibility after a partial charity care 22.24 classification; 22.25 (3) charity care may include care provided to low-income 22.26 patients who may qualify for a public health insurance program 22.27 and meet the statewide eligibility criteria for charity care, 22.28 but who do not complete the application process for public 22.29 insurance despite the facility's best efforts; 22.30 (4) charity care may include care to individuals whose 22.31 eligibility for charity care was determined through third party 22.32 services employed by the hospital for information gathering 22.33 purposes only; 22.34 (5) charity care may not include contractual allowances, 22.35 which is the difference between gross charges and payments 22.36 received under contractual arrangements with insurance companies 23.1 and payers; 23.2 (6) charity care may not include bad debt; 23.3 (7) charity care may not include what may be perceived as 23.4 underpayments for operating public programs; 23.5 (8) charity care may not include cases which are paid 23.6 through a charitable contribution through a third party or 23.7 facility-related foundation; 23.8 (9) charity care may not include unreimbursed costs of 23.9 basic or clinical research and of professional education and 23.10 training; 23.11 (10) charity care may not include professional courtesy 23.12 discounts; 23.13 (11) charity care may not include community service or 23.14 outreach activities; and 23.15 (12) charity care may not include services for patients 23.16 against whom collection actions where taken which result in a 23.17 credit report. 23.18 (c) The hospital must use the income standards in this 23.19 paragraph for determining charity care eligibility for reporting 23.20 purposes. The hospital does not need to make a patient asset 23.21 determination in order to apply charity care income standards. 23.22 (1) Care to a patient with a family income at or below 150 23.23 percent of the Federal Poverty Guideline (FPG) may be reported 23.24 as full charity care or free care. 23.25 (2) The hospital's share of discounted charges for care to 23.26 a patient with family income below 275 percent of the FPG 23.27 qualifies for classification as charity care. The following 23.28 sliding fee schedules apply: 23.29 income as charges paid corresponding 23.30 % of FPG by patient charity care 23.31 151-200% 20% 80% 23.32 201-225% 40% 60% 23.33 226-250% 60% 40% 23.34 251-275% 80% 20% 23.35 (3) Care to a patient is considered medical hardship when 23.36 qualified medical expenses, as defined for the purposes of 24.1 federal income tax deductibility, exceeds 30 percent of family 24.2 income. Qualified medical expenses may be counted as charity 24.3 care in the amount that exceeds 30 percent of family income. 24.4 This clause applies even if the patient's family income exceeds 24.5 the charity care income standards in clauses (1) and (2). 24.6 Subd. 4. [APPLICATION.] To be eligible for funds under 24.7 this section, hospitals must submit an application to the 24.8 commissioner of health by the deadline established by the 24.9 commissioner. Applications must meet the criteria as 24.10 established by the commissioner, but must contain: 24.11 (1) the dollar amount of charity care in the previous year, 24.12 as defined in subdivision 3, paragraphs (b) and (c); 24.13 (2) a list with the most common diagnoses for which charity 24.14 care is provided; and 24.15 (3) descriptive aggregate statistics of the characteristics 24.16 of patients who receive charity care. 24.17 Subd. 5. [ALLOCATION OF FUNDS.] A hospital's share of the 24.18 available charity care aid is equal to that hospital's share of 24.19 charity care relative to the total charity care provided by 24.20 applicants. 24.21 Sec. 29. Minnesota Statutes 2000, section 144.98, 24.22 subdivision 3, is amended to read: 24.23 Subd. 3. [FEES.] (a) An application for certification 24.24 under subdivision 1 must be accompanied by the biennial fee 24.25 specified in this subdivision. The fees are for: 24.26 (1) nonrefundable base certification fee,$500$1,200; and 24.27 (2) test category certification fees: 24.28 Test Category Certification Fee 24.29 Clean water program bacteriology$200$600 24.30 Safe drinking water program bacteriology $600 24.31 Clean water program inorganic chemistry,24.32fewer than four constituents$100$600 24.33 Safe drinking water program inorganic chemistry,24.34four or more constituents$300$600 24.35 Clean water program chemistry metals,24.36fewer than four constituents$200$800 25.1 Safe drinking water program chemistry metals,25.2four or more constituents$500$800 25.3 Resource conservation and recovery program 25.4 chemistry metals $800 25.5 Clean water program volatile organic compounds$600$1,200 25.6 Safe drinking water program 25.7 volatile organic compounds $1,200 25.8 Resource conservation and recovery program 25.9 volatile organic compounds $1,200 25.10 Underground storage tank program 25.11 volatile organic compounds $1,200 25.12 Clean water program other organic compounds$600$1,200 25.13 Safe drinking water program other organic compounds $1,200 25.14 Resource conservation and recovery program 25.15 other organic compounds $1,200 25.16 (b) The total biennial certification fee is the base fee 25.17 plus the applicable test category fees.The biennial25.18certification fee for a contract laboratory is 1.5 times the25.19total certification fee.25.20 (c) Laboratories located outside of this state that require 25.21 an on-site survey will be assessed an additional$1,200$2,500 25.22 fee. 25.23 (d) Fees must be set so that the total fees support the 25.24 laboratory certification program. Direct costs of the 25.25 certification service include program administration, 25.26 inspections, the agency's general support costs, and attorney 25.27 general costs attributable to the fee function. 25.28 (e) A change fee shall be assessed if a laboratory requests 25.29 additional analytes or methods at any time other than when 25.30 applying for or renewing its certification. The change fee is 25.31 equal to the test category certification fee for the analyte. 25.32 (f) A variance fee shall be assessed if a laboratory 25.33 requests and is granted a variance from a rule adopted under 25.34 this section. The variance fee is $500 per variance. 25.35 (g) Refunds or credits shall not be made for analytes or 25.36 methods requested but not approved. 26.1 (h) Certification of a laboratory shall not be awarded 26.2 until all fees are paid. 26.3 Sec. 30. Minnesota Statutes 2000, section 144A.44, 26.4 subdivision 1, is amended to read: 26.5 Subdivision 1. [STATEMENT OF RIGHTS.] A person who 26.6 receives home care services has these rights: 26.7 (1) the right to receive written information about rights 26.8 in advance of receiving care or during the initial evaluation 26.9 visit before the initiation of treatment, including what to do 26.10 if rights are violated; 26.11 (2) the right to receive care and services according to a 26.12 suitable and up-to-date plan, and subject to accepted medical or 26.13 nursing standards, to take an active part in creating and 26.14 changing the plan and evaluating care and services; 26.15 (3) the right to be told in advance of receiving care about 26.16 the services that will be provided, the disciplines that will 26.17 furnish care, the frequency of visits proposed to be furnished, 26.18 other choices that are available, and the consequences of these 26.19 choices including the consequences of refusing these services; 26.20 (4) the right to be told in advance of any change in the 26.21 plan of care and to take an active part in any change; 26.22 (5) the right to refuse services or treatment; 26.23 (6) the right to know, in advance, any limits to the 26.24 services available from a provider, and the provider's grounds 26.25 for a termination of services; 26.26 (7) the right to know in advance of receiving care whether 26.27 the services are covered by health insurance, medical 26.28 assistance, or other health programs, the charges for services 26.29 that will not be covered by Medicare, and the charges that the 26.30 individual may have to pay; 26.31 (8) the right to know what the charges are for services, no 26.32 matter who will be paying the bill; 26.33 (9) the right to know that there may be other services 26.34 available in the community, including other home care services 26.35 and providers, and to know where to go for information about 26.36 these services; 27.1 (10) the right to choose freely among available providers 27.2 and to change providers after services have begun, within the 27.3 limits of health insurance, medical assistance, or other health 27.4 programs; 27.5 (11) the right to have personal, financial, and medical 27.6 information kept private, and to be advised of the provider's 27.7 policies and procedures regarding disclosure of such 27.8 information; 27.9 (12) the right to be allowed access to records and written 27.10 information from records in accordance with section 144.335; 27.11 (13) the right to be served by people who are properly 27.12 trained and competent to perform their duties; 27.13 (14) the right to be treated with courtesy and respect, and 27.14 to have the patient's property treated with respect; 27.15 (15) the right to be free from physical and verbal abuse; 27.16 (16) the right to reasonable, advance notice of changes in 27.17 services or charges, including at least ten days' advance notice 27.18 of the termination of a service by a provider, except in cases 27.19 where: 27.20 (i) the recipient of services engages in conduct that 27.21 alters the conditions of employment as specified in the 27.22 employment contract between the home care provider and the 27.23 individual providing home care services, or creates an abusive 27.24 or unsafe work environment for the individual providing home 27.25 care services; or 27.26 (ii) an emergency for the informal caregiver or a 27.27 significant change in the recipient's condition has resulted in 27.28 service needs that exceed the current service provider agreement 27.29 and that cannot be safely met by the home care provider; 27.30 (17) the right to a coordinated transfer when there will be 27.31 a change in the provider of services; 27.32 (18) the right to voice grievances regarding treatment or 27.33 care that is, or fails to be, furnished, or regarding the lack 27.34 of courtesy or respect to the patient or the patient's property; 27.35 (19) the right to know how to contact an individual 27.36 associated with the provider who is responsible for handling 28.1 problems and to have the provider investigate and attempt to 28.2 resolve the grievance or complaint; 28.3 (20) the right to know the name and address of the state or 28.4 county agency to contact for additional information or 28.5 assistance; and 28.6 (21) the right to assert these rights personally, or have 28.7 them asserted by the patient's family or guardian when the 28.8 patient has been judged incompetent, without retaliation. 28.9 Sec. 31. [145.4241] [DEFINITIONS.] 28.10 Subdivision 1. [APPLICABILITY.] As used in sections 28.11 145.4241 to 145.4246, the following terms have the meaning given 28.12 them. 28.13 Subd. 2. [ABORTION.] "Abortion" means the use or 28.14 prescription of any instrument, medicine, drug, or any other 28.15 substance or device to intentionally terminate the pregnancy of 28.16 a female known to be pregnant, with an intention other than to 28.17 increase the probability of a live birth, to preserve the life 28.18 or health of the child after live birth, or to remove a dead 28.19 fetus. 28.20 Subd. 3. [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to 28.21 perform an abortion" means an act, or an omission of a 28.22 statutorily required act, that, under the circumstances as the 28.23 actor believes them to be, constitutes a substantial step in a 28.24 course of conduct planned to culminate in the performance of an 28.25 abortion in Minnesota in violation of sections 145.4241 to 28.26 145.4246. 28.27 Subd. 4. [MEDICAL EMERGENCY.] "Medical emergency" means 28.28 any condition that, on the basis of the physician's good faith 28.29 clinical judgment, complicates the medical condition of a 28.30 pregnant female to the extent that: 28.31 (1) an immediate abortion of her pregnancy is necessary to 28.32 avert her death; or 28.33 (2) a 24-hour delay in performing an abortion creates a 28.34 serious risk of substantial and irreversible impairment of a 28.35 major bodily function. 28.36 Subd. 5. [PHYSICIAN.] "Physician" means a person licensed 29.1 under chapter 147. 29.2 Subd. 6. [PROBABLE GESTATIONAL AGE OF THE UNBORN 29.3 CHILD.] "Probable gestational age of the unborn child" means 29.4 what will, in the judgment of the physician, with reasonable 29.5 probability, be the gestational age of the unborn child at the 29.6 time the abortion is planned to be performed. 29.7 Sec. 32. [145.4242] [INFORMED CONSENT.] 29.8 No abortion shall be performed in this state except with 29.9 the voluntary and informed consent of the female upon whom the 29.10 abortion is to be performed. Except in the case of a medical 29.11 emergency, consent to an abortion is voluntary and informed only 29.12 if: 29.13 (1) the female is told the following, by telephone or in 29.14 person, by the physician who is to perform the abortion or by a 29.15 referring physician, at least 24 hours before the abortion: 29.16 (i) the name of the physician who will perform the 29.17 abortion; 29.18 (ii) the particular medical risks associated with the 29.19 particular abortion procedure to be employed including, when 29.20 medically accurate, the risks of infection, hemorrhage, breast 29.21 cancer, danger to subsequent pregnancies, and infertility; 29.22 (iii) the probable gestational age of the unborn child at 29.23 the time the abortion is to be performed; and 29.24 (iv) the medical risks associated with carrying her child 29.25 to term. 29.26 The information required by this clause may be provided by 29.27 telephone without conducting a physical examination or tests of 29.28 the patient, in which case the information required to be 29.29 provided may be based on facts supplied the physician by the 29.30 female and whatever other relevant information is reasonably 29.31 available to the physician. It may not be provided by a tape 29.32 recording, but must be provided during a consultation in which 29.33 the physician is able to ask questions of the female and the 29.34 female is able to ask questions of the physician. If a physical 29.35 examination, tests, or the availability of other information to 29.36 the physician subsequently indicate, in the medical judgment of 30.1 the physician, a revision of the information previously supplied 30.2 to the patient, that revised information may be communicated to 30.3 the patient at any time prior to the performance of the 30.4 abortion. Nothing in this section may be construed to preclude 30.5 provision of required information in a language understood by 30.6 the patient through a translator; 30.7 (2) the female is informed, by telephone or in person, by 30.8 the physician who is to perform the abortion, by a referring 30.9 physician, or by an agent of either physician at least 24 hours 30.10 before the abortion: 30.11 (i) that medical assistance benefits may be available for 30.12 prenatal care, childbirth, and neonatal care; 30.13 (ii) that the father is liable to assist in the support of 30.14 her child, even in instances when the father has offered to pay 30.15 for the abortion; and 30.16 (iii) that she has the right to review the printed 30.17 materials described in section 145.4243. The physician or the 30.18 physician's agent shall orally inform the female that the 30.19 materials have been provided by the state of Minnesota and that 30.20 they describe the unborn child and list agencies that offer 30.21 alternatives to abortion. If the female chooses to view the 30.22 materials, they shall either be given to her at least 24 hours 30.23 before the abortion or mailed to her at least 72 hours before 30.24 the abortion by certified mail, restricted delivery to 30.25 addressee, which means the postal employee can only deliver the 30.26 mail to the addressee. 30.27 The information required by this clause may be provided by 30.28 a tape recording if provision is made to record or otherwise 30.29 register specifically whether the female does or does not choose 30.30 to review the printed materials; 30.31 (3) the female certifies in writing, prior to the abortion, 30.32 that the information described in this section has been 30.33 furnished her, and that she has been informed of her opportunity 30.34 to review the information referred to in clause (2); and 30.35 (4) prior to the performance of the abortion, the physician 30.36 who is to perform the abortion or the physician's agent receives 31.1 a copy of the written certification prescribed by clause (3). 31.2 Sec. 33. [145.4243] [PRINTED INFORMATION.] 31.3 (a) Within 90 days after the effective date of sections 31.4 145.4241 to 145.4246, the department of health shall cause to be 31.5 published, in English and in each language that is the primary 31.6 language of two percent or more of the state's population, the 31.7 following printed materials in such a way as to ensure that the 31.8 information is easily comprehensible: 31.9 (1) geographically indexed materials designed to inform the 31.10 female of public and private agencies and services available to 31.11 assist a female through pregnancy, upon childbirth, and while 31.12 the child is dependent, including adoption agencies, which shall 31.13 include a comprehensive list of the agencies available, a 31.14 description of the services they offer, and a description of the 31.15 manner, including telephone numbers, in which they might be 31.16 contacted or, at the option of the department of health, printed 31.17 materials including a toll-free, 24-hours-a-day telephone number 31.18 that may be called to obtain, orally, such a list and 31.19 description of agencies in the locality of the caller and of the 31.20 services they offer; and 31.21 (2) materials designed to inform the female of the probable 31.22 anatomical and physiological characteristics of the unborn child 31.23 at two-week gestational increments from the time when a female 31.24 can be known to be pregnant to full term, including any relevant 31.25 information on the possibility of the unborn child's survival 31.26 and pictures or drawings representing the development of unborn 31.27 children at two-week gestational increments, provided that any 31.28 such pictures or drawings must contain the dimensions of the 31.29 fetus and must be realistic and appropriate for the stage of 31.30 pregnancy depicted. The materials shall be objective, 31.31 nonjudgmental, and designed to convey only accurate scientific 31.32 information about the unborn child at the various gestational 31.33 ages. The material shall also contain objective information 31.34 describing the methods of abortion procedures commonly employed, 31.35 the medical risks commonly associated with each procedure, the 31.36 possible detrimental psychological effects of abortion, the 32.1 medical risks commonly associated with each procedure, and the 32.2 medical risks commonly associated with carrying a child to term. 32.3 (b) The materials referred to in this section must be 32.4 printed in a typeface large enough to be clearly legible. The 32.5 materials required under this section must be available at no 32.6 cost from the department of health upon request and in 32.7 appropriate number to any person, facility, or hospital. 32.8 Sec. 34. [145.4244] [PROCEDURE IN CASE OF MEDICAL 32.9 EMERGENCY.] 32.10 When a medical emergency compels the performance of an 32.11 abortion, the physician shall inform the female, prior to the 32.12 abortion if possible, of the medical indications supporting the 32.13 physician's judgment that an abortion is necessary to avert her 32.14 death or that a 24-hour delay in conformance with section 32.15 145.4242 creates a serious risk of substantial and irreversible 32.16 impairment of a major bodily function. 32.17 Sec. 35. [145.4245] [REMEDIES.] 32.18 Subdivision 1. [CIVIL REMEDIES.] Any person upon whom an 32.19 abortion has been performed or the parent of a minor upon whom 32.20 an abortion has been performed may maintain an action against 32.21 the person who performed the abortion in knowing or reckless 32.22 violation of sections 145.4241 to 145.4246 for actual and 32.23 punitive damages. Any person upon whom an abortion has been 32.24 attempted without complying with sections 145.4241 to 145.4246 32.25 may maintain an action against the person who attempted to 32.26 perform the abortion in knowing or reckless violation of 32.27 sections 145.4241 to 145.4246 for actual and punitive damages. 32.28 Subd. 2. [ATTORNEY FEES.] If judgment is rendered in favor 32.29 of the plaintiff in any action described in this section, the 32.30 court shall also render judgment for a reasonable attorney's fee 32.31 in favor of the plaintiff against the defendant. If judgment is 32.32 rendered in favor of the defendant and the court finds that the 32.33 plaintiff's suit was frivolous and brought in bad faith, the 32.34 court shall also render judgment for a reasonable attorney's fee 32.35 in favor of the defendant against the plaintiff. 32.36 Subd. 3. [PROTECTION OF PRIVACY IN COURT PROCEEDINGS.] In 33.1 every civil action brought under sections 145.4241 to 145.4246, 33.2 the court shall rule whether the anonymity of any female upon 33.3 whom an abortion has been performed or attempted shall be 33.4 preserved from public disclosure if she does not give her 33.5 consent to such disclosure. The court, upon motion or sua 33.6 sponte, shall make such a ruling and, upon determining that her 33.7 anonymity should be preserved, shall issue orders to the 33.8 parties, witnesses, and counsel and shall direct the sealing of 33.9 the record and exclusion of individuals from courtrooms or 33.10 hearing rooms to the extent necessary to safeguard her identity 33.11 from public disclosure. Each order must be accompanied by 33.12 specific written findings explaining why the anonymity of the 33.13 female should be preserved from public disclosure, why the order 33.14 is essential to that end, how the order is narrowly tailored to 33.15 serve that interest, and why no reasonable, less restrictive 33.16 alternative exists. In the absence of written consent of the 33.17 female upon whom an abortion has been performed or attempted, 33.18 anyone, other than a public official, who brings an action under 33.19 subdivision 1, shall do so under a pseudonym. This section may 33.20 not be construed to conceal the identity of the plaintiff or of 33.21 witnesses from the defendant. 33.22 Sec. 36. [145.4246] [SEVERABILITY.] 33.23 If any one or more provision, section, subsection, 33.24 sentence, clause, phrase, or word of sections 145.4241 to 33.25 145.4246 or the application thereof to any person or 33.26 circumstance is found to be unconstitutional, the same is hereby 33.27 declared to be severable and the balance of sections 145.4241 to 33.28 145.4246 shall remain effective notwithstanding such 33.29 unconstitutionality. The legislature hereby declares that it 33.30 would have passed sections 145.4241 to 145.4246, and each 33.31 provision, section, subsection, sentence, clause, phrase, or 33.32 word thereof, irrespective of the fact that any one or more 33.33 provision, section, subsection, sentence, clause, phrase, or 33.34 word be declared unconstitutional. 33.35 Sec. 37. Minnesota Statutes 2000, section 145.881, 33.36 subdivision 2, is amended to read: 34.1 Subd. 2. [DUTIES.] The advisory task force shall meet on a 34.2 regular basis to perform the following duties: 34.3 (a) review and report on the health care needs of mothers 34.4 and children throughout the state of Minnesota; 34.5 (b) review and report on the type, frequency and impact of 34.6 maternal and child health care services provided to mothers and 34.7 children under existing maternal and child health care programs, 34.8 including programs administered by the commissioner of health; 34.9 (c) establish, review, and report to the commissioner a 34.10 list of program guidelines and criteria which the advisory task 34.11 force considers essential to providing an effective maternal and 34.12 child health care program to low income populations and high 34.13 risk persons and fulfilling the purposes defined in section 34.14 145.88; 34.15 (d) review staff recommendations of the department of 34.16 health regarding maternal and child health grant awards before 34.17 the awards are made; 34.18 (e) make recommendations to the commissioner for the use of 34.19 other federal and state funds available to meet maternal and 34.20 child health needs; 34.21 (f) make recommendations to the commissioner of health on 34.22 priorities for funding the following maternal and child health 34.23 services: (1) prenatal, delivery and postpartum care, (2) 34.24 comprehensive health care for children, especially from birth 34.25 through five years of age, (3) adolescent health services, (4) 34.26 family planning services, (5) preventive dental care, (6) 34.27 special services for chronically ill and handicapped children 34.28 and (7) any other services which promote the health of mothers 34.29 and children;and34.30 (g) make recommendations to the commissioner of health on 34.31 the process to distribute, award and administer the maternal and 34.32 child health block grant funds; and 34.33 (h) review the measures that are used to define the 34.34 variables of the funding distribution formula in section 34.35 145.882, subdivision 4a, every two years and make 34.36 recommendations to the commissioner of health for changes based 35.1 upon principles established by the advisory task force for this 35.2 purpose. 35.3 Sec. 38. Minnesota Statutes 2000, section 145.882, is 35.4 amended by adding a subdivision to read: 35.5 Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 35.6 Federal maternal and child health block grant money remaining 35.7 after distributions made under subdivision 2 and money 35.8 appropriated for allocation to community health boards must be 35.9 allocated according to paragraphs (b) to (d) to community health 35.10 boards as defined in section 145A.02, subdivision 5. 35.11 (b) All community health boards must receive 95 percent of 35.12 the funding awarded to them for the 1998-1999 funding cycle. If 35.13 the amount of state and federal funding available is less than 35.14 95 percent of the amount awarded to community health boards for 35.15 the 1998-1999 funding cycle, the available funding must be 35.16 apportioned to reflect a proportional decrease for each 35.17 recipient. 35.18 (c) The federal and state funding remaining after 35.19 distributions made under paragraph (b) must be allocated to each 35.20 community health board based on the following three variables: 35.21 (1) 25 percent based on the maternal and child population 35.22 in the area served by the community health board; 35.23 (2) 50 percent based on the following factors, as 35.24 determined by averaging the data available for the three most 35.25 recent years: 35.26 (i) the proportion of infants in the area served by the 35.27 community health board whose weight at birth was less than 2,500 35.28 grams; 35.29 (ii) the proportion of mothers in the area served by the 35.30 community health board who received inadequate or no prenatal 35.31 care; 35.32 (iii) the proportion of births in the area served by the 35.33 community health board to women under age 19; and 35.34 (iv) the proportion of births in the area served by the 35.35 community health board to American Indian women and women of 35.36 color; and 36.1 (3) 25 percent based on the income of the maternal and 36.2 child population in the area served by the community health 36.3 board. 36.4 (d) Each variable must be expressed as a city or county 36.5 score consisting of the city or county frequency of each 36.6 variable in relation to the statewide frequency of the 36.7 variable. A total score for each city or county jurisdiction 36.8 must be computed by totaling the scores of the three variables. 36.9 Each community health board must be allocated an amount equal to 36.10 the total score obtained for the city, county, or counties in 36.11 its area multiplied by the amount of money available. 36.12 Sec. 39. Minnesota Statutes 2000, section 145.882, 36.13 subdivision 7, is amended to read: 36.14 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 36.15 child health block grant money allocated to a community health 36.16 board or community health services area under this section must 36.17 be used for qualified programs for high risk and low-income 36.18 individuals. Block grant money must be used for programs that: 36.19 (1) specifically address the highest risk populations, 36.20 particularly low-income and minority groups with a high rate of 36.21 infant mortality and children with low birth weight, by 36.22 providing services,includingexcluding prepregnancy family 36.23 planning services, calculated to produce measurable decreases in 36.24 infant mortality rates, instances of children with low birth 36.25 weight, and medical complications associated with pregnancy and 36.26 childbirth, including infant mortality, low birth rates, and 36.27 medical complications arising from chemical abuse by a mother 36.28 during pregnancy; 36.29 (2) specifically target pregnant women whose age, medical 36.30 condition, maternal history, or chemical abuse substantially 36.31 increases the likelihood of complications associated with 36.32 pregnancy and childbirth or the birth of a child with an 36.33 illness, disability, or special medical needs; 36.34 (3) specifically address the health needs of young children 36.35 who have or are likely to have a chronic disease or disability 36.36 or special medical needs, including physical, neurological, 37.1 emotional, and developmental problems that arise from chemical 37.2 abuse by a mother during pregnancy; 37.3 (4) providefamily planning andpreventive medical care, 37.4 excluding prepregnancy family planning services, for 37.5 specifically identified target populations, such as minority and 37.6 low-income teenagers, in a manner calculated todecrease the37.7occurrence of inappropriate pregnancy andminimize the risk of 37.8 complications associated with pregnancy and childbirth; or 37.9 (5) specifically address the frequency and severity of 37.10 childhood injuries and other child and adolescent health 37.11 problems in high-risk target populations by providing services, 37.12 excluding prepregnancy family planning services, calculated to 37.13 produce measurable decreases in mortality and 37.14 morbidity.However, money may be used for this purpose only if37.15the community health board's application includes program37.16components for the purposes in clauses (1) to (4) in the37.17proposed geographic service area and the total expenditure for37.18injury-related programs under this clause does not exceed ten37.19percent of the total allocation under subdivision 3.37.20(b) Maternal and child health block grant money may be used37.21for purposes other than the purposes listed in this subdivision37.22only under the following conditions:37.23(1) the community health board or community health services37.24area can demonstrate that existing programs fully address the37.25needs of the highest risk target populations described in this37.26subdivision; or37.27(2) the money is used to continue projects that received37.28funding before creation of the maternal and child health block37.29grant in 1981.37.30(c) Projects that received funding before creation of the37.31maternal and child health block grant in 1981, must be allocated37.32at least the amount of maternal and child health special project37.33grant funds received in 1989, unless (1) the local board of37.34health provides equivalent alternative funding for the project37.35from another source; or (2) the local board of health37.36demonstrates that the need for the specific services provided by38.1the project has significantly decreased as a result of changes38.2in the demographic characteristics of the population, or other38.3factors that have a major impact on the demand for services. If38.4the amount of federal funding to the state for the maternal and38.5child health block grant is decreased, these projects must38.6receive a proportional decrease as required in subdivision 1.38.7Increases in allocation amounts to local boards of health under38.8subdivision 4 may be used to increase funding levels for these38.9projects.38.10 Sec. 40. Minnesota Statutes 2000, section 145.885, 38.11 subdivision 2, is amended to read: 38.12 Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 38.13 HEALTH.] Applications by community health boards as defined in 38.14 section 145A.02, subdivision 5, under section 145.882, 38.15 subdivision34a, must also contain a summary of the process 38.16 used to develop the local program, including evidence that the 38.17 community health board notified local public and private 38.18 providers of the availability of funding through the community 38.19 health board for maternal and child health services; a list of 38.20 all public and private agency requests for grants submitted to 38.21 the community health board indicating which requests were 38.22 included in the grant application; and an explanation of how 38.23 priorities were established for selecting the requests to be 38.24 included in the grant application. The community health board 38.25 shall include, with the grant application, a written statement 38.26 of the criteria to be applied to public and private agency 38.27 requests for funding. 38.28 Sec. 41. Minnesota Statutes 2000, section 145.924, is 38.29 amended to read: 38.30 145.924 [AIDS PREVENTION GRANTS.] 38.31 Subdivision 1. [GRANT AWARDS.] (a) The commissioner may 38.32 award grants to boards of health as defined in section 145A.02, 38.33 subdivision 2, state agencies, state councils, or nonprofit 38.34 corporations to provide evaluation and counseling services to 38.35 populations at risk for acquiring human immunodeficiency virus 38.36 infection, including, but not limited to, minorities, 39.1 adolescents, intravenous drug users, and homosexual men. 39.2 (b) The commissioner may award grants to agencies 39.3 experienced in providing services to communities of color, for 39.4 the design of innovative outreach and education programs for 39.5 targeted groups within the community who may be at risk of 39.6 acquiring the human immunodeficiency virus infection, including 39.7 intravenous drug users and their partners, adolescents, gay and 39.8 bisexual individuals and women. Grants shall be awarded on a 39.9 request for proposal basis and shall include funds for 39.10 administrative costs. Priority for grants shall be given to 39.11 agencies or organizations that have experience in providing 39.12 service to the particular community which the grantee proposes 39.13 to serve; that have policymakers representative of the targeted 39.14 population; that have experience in dealing with issues relating 39.15 to HIV/AIDS; and that have the capacity to deal effectively with 39.16 persons of differing sexual orientations. For purposes of this 39.17 paragraph, the "communities of color" are: the American-Indian 39.18 community; the Hispanic community; the African-American 39.19 community; and the Asian-Pacific community. 39.20 (c) All state grants awarded under thissectionsubdivision 39.21 for programs targeted to adolescents shall include the promotion 39.22 of abstinence from sexual activity and drug use. 39.23 Subd. 2. [OUTCOMES.] The commissioner, in consultation 39.24 with boards of health, agencies, councils, and nonprofit 39.25 organizations involved in human immunodeficiency virus infection 39.26 prevention efforts shall establish measurable outcomes to 39.27 determine the effectiveness of the grants provided under this 39.28 section in reducing the number of people who acquire human 39.29 immunodeficiency virus, the rates of infection, and average 39.30 numbers of sexual partners for populations served by grants 39.31 funded under this section. 39.32 Subd. 3. [EVALUATION.] (a) Using the outcomes established 39.33 according to subdivision 2, the commissioner shall conduct a 39.34 biennial evaluation of activities funded under this section. 39.35 The evaluation must include: 39.36 (1) the effect of these activities on the number of people 40.1 who acquire human immunodeficiency virus and the rates of 40.2 infection; 40.3 (2) the effect of these activities on average numbers of 40.4 sexual partners for populations served by grants funded under 40.5 this section; and 40.6 (3) a longitudinal tracking of outcomes for targeted 40.7 populations who are served under subdivision 1, paragraphs (a) 40.8 and (b). 40.9 (b) Grant recipients shall cooperate with the commissioner 40.10 in the evaluation and shall provide the commissioner with the 40.11 information needed to conduct the evaluation. Beginning January 40.12 15, 2003, the results of each evaluation must be submitted to 40.13 the chairs of the policy and finance committees in the house and 40.14 senate with jurisdiction over health and human services. 40.15 Sec. 42. Minnesota Statutes 2000, section 145.925, 40.16 subdivision 1, is amended to read: 40.17 Subdivision 1. [ELIGIBLE ORGANIZATIONS; PURPOSE.] The 40.18 commissioner of health may make special grants to cities, 40.19 counties, tribal governments, or groups of citiesor, counties, 40.20or nonprofit corporationsor tribal governments to provide 40.21 prepregnancy family planning services.targeted to low-income 40.22 and minority populations. A city, county, tribal government, or 40.23 group of cities, counties, or tribal governments that receives a 40.24 grant is responsible for ensuring that the grant funds are used 40.25 for services targeted to low-income and minority populations, 40.26 and must establish a goal for reducing specific pregnancy rates 40.27 in the service area. In determining populations to serve and 40.28 services to provide, a city, county, tribal government, or group 40.29 of cities, counties, or tribal governments must consider the 40.30 spacing of pregnancies in low-income and minority populations in 40.31 the service area, teen birth rates in the service area, and the 40.32 needs of populations of color in the service area. A city, 40.33 county, tribal government, or group of cities, counties, or 40.34 tribal governments may contract for the provision of 40.35 prepregnancy family planning services using grant funds provided 40.36 under this section only if the contract is specifically 41.1 authorized by the governing body of the city, county, or tribal 41.2 government that is contracting for the services. 41.3 Any organization or an affiliate of an organization which 41.4 provides abortions, promotes abortions, or directly refers for 41.5 abortions, shall be ineligible to receive funds under this 41.6 subdivision. 41.7 Sec. 43. Minnesota Statutes 2000, section 145.925, 41.8 subdivision 1a, is amended to read: 41.9 Subd. 1a. [FAMILY PLANNING SERVICES; DEFINED.] "Family 41.10 planning services" means counseling by trained personnel 41.11 regarding family planning; distribution of information relating 41.12 to family planning, referral to licensed physicians or local 41.13 health agencies for consultation, examination, medical 41.14 treatment, genetic counseling, and prescriptions for the purpose 41.15 of family planning; and the distribution of family planning 41.16 products, such as charts, thermometers, drugs, medical 41.17 preparations, and contraceptive devices. Family planning 41.18 services do not include services that, directly or indirectly, 41.19 encourage, counsel, refer, or provide abortions or abortion 41.20 referrals. For purposes of sections 145A.01 to 145A.14, family 41.21 planning shall mean voluntary action by individuals to prevent 41.22 or aid conception but does not includethe performance, or make41.23referrals for encouragement of voluntary termination of41.24pregnancyservices that, directly or indirectly, encourage, 41.25 counsel, refer, or provide abortions or abortion referrals. 41.26 Sec. 44. [145.9257] [TEEN PREGNANCY PREVENTION.] 41.27 Subdivision 1. [GOAL.] It is the goal of the state to 41.28 reduce teen pregnancy rates by 24 percent by 2006. To do so, 41.29 the commissioner of health shall establish a grant program to 41.30 reduce the rates of unintended teen pregnancies in the state. 41.31 If this goal of reducing teen pregnancy rates by 24 percent is 41.32 not met by December 31, 2006, this section expires June 30, 41.33 2007. No funds awarded under this section may be used for 41.34 medical services or family planning services or for services 41.35 that, directly or indirectly, encourage, counsel, refer, or 41.36 provide abortions or abortion referrals. 42.1 Any organization or an affiliate of an organization which 42.2 provides abortions, promotes abortions, or directly refers for 42.3 abortions, shall be ineligible to receive funds under this 42.4 section. 42.5 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 42.6 commissioner, in consultation with the commissioner of children, 42.7 families, and learning; the commissioner of human services; the 42.8 maternal and child health advisory task force under section 42.9 145.881; the Indian affairs council under section 3.922; the 42.10 council on affairs of Chicano/Latino people under section 42.11 3.9223; the council on Black Minnesotans under section 3.9225; 42.12 the council on Asian-Pacific Minnesotans under section 3.9226; 42.13 community health boards as defined in section 145A.02; tribal 42.14 governments; nonprofit community organizations; and others 42.15 interested in teen pregnancy prevention, shall develop and 42.16 implement a comprehensive, coordinated plan to reduce the number 42.17 of teen pregnancies. 42.18 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in 42.19 consultation with the commissioners and community partners 42.20 listed in subdivision 2, shall establish measurable outcomes to 42.21 achieve the goal specified in subdivision 1 and to determine the 42.22 effectiveness of the grants provided under this section in 42.23 reducing teen pregnancies. The development of measurable 42.24 outcomes must be completed before any funds are distributed 42.25 under this section. 42.26 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall 42.27 use and enhance current statewide assessments of teen pregnancy 42.28 risk behaviors and attitudes among youth to establish a baseline 42.29 to measure the statewide effect of teen pregnancy prevention 42.30 activities. To the extent feasible, the commissioner shall 42.31 conduct the assessment so that the results may be compared to 42.32 national data. 42.33 Subd. 5. [PROCESS.] The commissioner, in consultation with 42.34 the commissioners and community partners listed in subdivision 42.35 2, shall develop the criteria and procedures used to allocate 42.36 grants under this section. In developing the criteria, the 43.1 commissioner shall establish an administrative cost limit for 43.2 grant recipients. At the time a grant is awarded, the 43.3 commissioner shall provide a grant recipient with information on 43.4 the outcomes established according to subdivision 3. 43.5 Subd. 6. [TEEN PREGNANCY PREVENTION DISPARITY GRANTS.] (a) 43.6 The commissioner shall award competitive grants to eligible 43.7 applicants for projects to reduce disparities in unintended teen 43.8 pregnancy rates for American Indians and populations of color, 43.9 as compared with unintended teen pregnancy rates for whites. 43.10 (b) No funds awarded under this subdivision may be used for 43.11 medical services or family planning services or for services 43.12 that, directly or indirectly, encourage, counsel, refer, or 43.13 provide abortions or abortion referrals. 43.14 Any organization or an affiliate of an organization which 43.15 provides abortions, promotes abortions, or directly refers for 43.16 abortions, shall be ineligible to receive funds under this 43.17 subdivision. 43.18 (c) Eligible applicants may include, but are not limited 43.19 to, nonprofit organizations, school districts, faith-based 43.20 organizations, community health boards, and tribal governments. 43.21 Applicants must submit proposals to the commissioner. A 43.22 proposal must specify the strategies to be implemented and must 43.23 take into account the need for a coordinated, statewide teen 43.24 pregnancy prevention effort. Strategies may include youth 43.25 development programs, after-school enrichment programs, youth 43.26 mentoring programs, academic support programs, and abstinence 43.27 until marriage education programs. 43.28 (d) The commissioner shall give priority to applicants who 43.29 demonstrate that their proposed project: 43.30 (1) emphasizes abstinence until marriage; 43.31 (2) is research-based or based on proven, effective 43.32 strategies; 43.33 (3) is designed to coordinate with related youth risk 43.34 behavior reduction activities; 43.35 (4) involves youth and parents in the project's development 43.36 and implementation; 44.1 (5) reflects racially and ethnically appropriate 44.2 approaches; and 44.3 (6) will be implemented through or with persons or 44.4 community-based organizations that reflect the race or ethnicity 44.5 of the population to be reached. 44.6 Subd. 7. [HIGH-RISK COMMUNITY TEEN PREGNANCY PREVENTION 44.7 GRANTS.] (a) The commissioner shall award grants to communities 44.8 that have significant risk factors for teen pregnancies, that 44.9 currently have in place youth development programs, and that are 44.10 interested in expanding existing efforts to prevent teen 44.11 pregnancies. 44.12 (b) No funds awarded under this subdivision may be used for 44.13 medical services or family planning services or for services 44.14 that, directly or indirectly, encourage, counsel, refer, or 44.15 provide abortions or abortion referrals. 44.16 Any organization or an affiliate of an organization which 44.17 provides abortions, promotes abortions, or directly refers for 44.18 abortions, shall be ineligible to receive funds under this 44.19 subdivision. 44.20 (c) To be eligible for a grant under this subdivision, an 44.21 applicant must be a tribal government or a community health 44.22 board as defined in section 145A.02. Applicants must submit 44.23 proposals to the commissioner. A proposal must specify the 44.24 strategies to be implemented. Strategies may include, but are 44.25 not limited to, youth development programs, youth mentoring 44.26 programs, academic support programs, and abstinence until 44.27 marriage education programs. Applicants must demonstrate that a 44.28 proposed project: 44.29 (1) emphasizes abstinence until marriage; 44.30 (2) is research-based or based on proven, effective 44.31 strategies; 44.32 (3) is designed to coordinate with related youth risk 44.33 behavior reduction activities; 44.34 (4) involves youth and parents in the project's development 44.35 and implementation; 44.36 (5) reflects racially and ethnically appropriate 45.1 approaches; and 45.2 (6) will be implemented through or with persons or 45.3 community-based organizations that reflect the race or ethnicity 45.4 of the population to be reached. 45.5 (d) Grants may be awarded to up to 15 community health 45.6 boards and three tribal governments based on areas having the 45.7 highest risk factors for teen pregnancies. The commissioner 45.8 shall award grants based on the following risk factors: 45.9 (1) the proportion of teens in the applicant's service area 45.10 who are sexually active; 45.11 (2) the proportion of births to teens in the applicant's 45.12 service area; and 45.13 (3) the proportion of births to teens who are American 45.14 Indian or of a population of color in the applicant's service 45.15 area. 45.16 Subd. 8. [ADOLESCENT PARENT GRANTS.] The commissioner 45.17 shall transfer funds to the commissioner of children, families, 45.18 and learning to increase the number of adolescent parent grants 45.19 currently provided by the commissioner of children, families, 45.20 and learning under section 124D.33. 45.21 Subd. 9. [COORDINATION.] The commissioner shall coordinate 45.22 the projects and initiatives funded under this section with 45.23 other efforts at the local, state, and national levels to avoid 45.24 duplication and promote complementary efforts. 45.25 Subd. 10. [EVALUATION.] Using the outcomes established 45.26 according to subdivision 3, the commissioner shall conduct a 45.27 biennial evaluation of the impact of each teen pregnancy 45.28 prevention initiative in this section. Grant recipients and the 45.29 commissioner of children, families, and learning shall cooperate 45.30 with the commissioner in the evaluation and shall provide the 45.31 commissioner with the information needed to conduct the 45.32 evaluation. 45.33 Subd. 11. [REPORT.] By January 15, 2002, and January 15 of 45.34 each even-numbered year thereafter, the commissioner shall 45.35 submit a report to the legislature on the projects funded under 45.36 this section and the results of the biennial evaluation. 46.1 Sec. 45. [145.9268] [COMMUNITY CLINIC GRANTS.] 46.2 Subdivision 1. [DEFINITION.] For purposes of this section, 46.3 "eligible community clinic" means: 46.4 (1) a clinic that provides services under conditions as 46.5 defined in Minnesota Rules, part 9505.0255 or 9505.0380, and 46.6 utilizes a sliding fee scale to determine eligibility for 46.7 charity care; 46.8 (2) an Indian tribal government or Indian health service 46.9 unit; or 46.10 (3) a consortium of clinics comprised of entities under 46.11 clause (1) or (2). 46.12 Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health 46.13 shall award grants to eligible community clinics to improve the 46.14 ongoing viability of Minnesota's clinic-based safety net 46.15 providers. Grants shall be awarded to support the capacity of 46.16 eligible community clinics to serve low-income populations, 46.17 reduce current or future uncompensated care burdens, or provide 46.18 for improved care delivery infrastructure. 46.19 Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant 46.20 under this section, an eligible community clinic must submit an 46.21 application to the commissioner of health by the deadline 46.22 established by the commissioner. A grant may be awarded upon 46.23 the signing of a grant contract. 46.24 (b) An application must be on a form and contain 46.25 information as specified by the commissioner but at a minimum 46.26 must contain: 46.27 (1) a description of the project for which grant funds will 46.28 be used; 46.29 (2) a description of the problem the proposed project will 46.30 address; and 46.31 (3) a description of achievable objectives, a workplan, and 46.32 a timeline for project completion. 46.33 (c) The commissioner shall review each application to 46.34 determine whether the application is complete and whether the 46.35 applicant and the project are eligible for a grant. In 46.36 evaluating applications according to paragraph (e), the 47.1 commissioner shall establish criteria including, but not limited 47.2 to: the priority level of the project; the applicant's 47.3 thoroughness and clarity in describing the problem; a 47.4 description of the applicant's proposed project; the manner in 47.5 which the applicant will demonstrate the effectiveness of the 47.6 project; and evidence of efficiencies and effectiveness gained 47.7 through collaborative efforts. The commissioner may also take 47.8 into account other relevant factors, including, but not limited 47.9 to, the percentage for which uninsured patients represent the 47.10 applicant's patient base. During application review, the 47.11 commissioner may request additional information about a proposed 47.12 project, including information on project cost. Failure to 47.13 provide the information requested disqualifies an applicant. 47.14 (d) A grant awarded to an eligible community clinic may not 47.15 exceed $300,000 per eligible community clinic. For an applicant 47.16 applying as a consortium of clinics, a grant may not exceed 47.17 $300,000 per clinic included in the consortium. The 47.18 commissioner has discretion over the number of grants awarded. 47.19 (e) In determining which eligible community clinics will 47.20 receive grants under this section, the commissioner shall give 47.21 preference to those grant applications that show evidence of 47.22 collaboration with other eligible community clinics, hospitals, 47.23 health care providers, or community organizations. In addition, 47.24 the commissioner shall give priority, in declining order, to 47.25 grant applications for projects that: 47.26 (1) establish, update, or improve information, data 47.27 collection, or billing systems; 47.28 (2) procure, modernize, remodel, or replace equipment used 47.29 an the delivery of direct patient care at a clinic; 47.30 (3) provide improvements for care delivery, such as 47.31 increased translation and interpretation services; 47.32 (4) provide a direct offset to expenses incurred for 47.33 charity care services; or 47.34 (5) other projects determined by the commissioner to 47.35 improve the ability of applicants to provide care to the 47.36 vulnerable populations they serve. 48.1 Subd. 4. [EVALUATION.] The commissioner of health shall 48.2 evaluate the overall effectiveness of the grant program. The 48.3 commissioner shall collect progress reports to evaluate the 48.4 grant program from the eligible community clinics receiving 48.5 grants. 48.6 Sec. 46. [145.928] [ELIMINATING HEALTH DISPARITIES.] 48.7 Subdivision 1. [GOAL; ESTABLISHMENT.] It is the goal of 48.8 the state, by 2010, to decrease by 50 percent the disparities in 48.9 infant mortality rates and adult and child immunization rates 48.10 for American Indians and populations of color, as compared with 48.11 rates for whites. To do so and to achieve other measurable 48.12 outcomes, the commissioner of health shall establish a program 48.13 to close the gap in the health status of American Indians and 48.14 populations of color as compared with whites in the following 48.15 priority areas: infant mortality, breast and cervical cancer 48.16 screening, HIV/AIDS and sexually transmitted infections, adult 48.17 and child immunizations, cardiovascular disease, diabetes, and 48.18 accidental injuries and violence. If this goal of reducing 48.19 disparities in infant mortality rates and adult and child 48.20 immunization rates is not met by December 31, 2010, this section 48.21 expires June 30, 2011. 48.22 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 48.23 commissioner, in partnership with culturally-based community 48.24 organizations; the Indian affairs council under section 3.922; 48.25 the council on affairs of Chicano/Latino people under section 48.26 3.9223; the council on Black Minnesotans under section 3.9225; 48.27 the council on Asian-Pacific Minnesotans under section 3.9226; 48.28 community health boards as defined in section 145A.02; and 48.29 tribal governments, shall develop and implement a comprehensive, 48.30 coordinated plan to reduce health disparities in the health 48.31 disparity priority areas identified in subdivision 1. 48.32 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in 48.33 consultation with the community partners listed in subdivision 48.34 2, shall establish measurable outcomes to achieve the goal 48.35 specified in subdivision 1 and to determine the effectiveness of 48.36 the grants and other activities funded under this section in 49.1 reducing health disparities in the priority areas identified in 49.2 subdivision 1. The development of measurable outcomes must be 49.3 completed before any funds are distributed under this section. 49.4 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall 49.5 enhance current data tools to ensure a statewide assessment of 49.6 the risk behaviors associated with the health disparity priority 49.7 areas identified in subdivision 1. The statewide assessment 49.8 must be used to establish a baseline to measure the effect of 49.9 activities funded under this section. To the extent feasible, 49.10 the commissioner shall conduct the assessment so that the 49.11 results may be compared to national data. 49.12 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall 49.13 provide the necessary expertise to grant applicants to ensure 49.14 that submitted proposals are likely to be successful in reducing 49.15 the health disparities identified in subdivision 1. The 49.16 commissioner shall provide grant recipients with guidance and 49.17 training on best or most promising strategies to use to reduce 49.18 the health disparities identified in subdivision 1. The 49.19 commissioner shall also assist grant recipients in the 49.20 development of materials and procedures to evaluate local 49.21 community activities. 49.22 Subd. 6. [PROCESS.] (a) The commissioner, in consultation 49.23 with the community partners listed in subdivision 2, shall 49.24 develop the criteria and procedures used to allocate grants 49.25 under this section. In developing the criteria, the 49.26 commissioner shall establish an administrative cost limit for 49.27 grant recipients. At the time a grant is awarded, the 49.28 commissioner must provide a grant recipient with information on 49.29 the outcomes established according to subdivision 3. 49.30 (b) A grant recipient must coordinate its activities to 49.31 reduce health disparities with other entities receiving funds 49.32 under this section that are in the grant recipient's service 49.33 area. 49.34 Subd. 7. [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND 49.35 INFANT MORTALITY RATES.] (a) The commissioner shall award grants 49.36 to eligible applicants for local or regional projects and 50.1 initiatives directed at reducing health disparities in one or 50.2 both of the following priority areas: 50.3 (1) decreasing racial and ethnic disparities in infant 50.4 mortality rates; or 50.5 (2) increasing adult and child immunization rates in 50.6 nonwhite racial and ethnic populations. 50.7 (b) The commissioner may award up to 20 percent of the 50.8 funds available as planning grants. Planning grants must be 50.9 used to address such areas as community assessment, coordination 50.10 activities, and development of community supported strategies. 50.11 (c) Eligible applicants may include, but are not limited 50.12 to, faith-based organizations, social service organizations, 50.13 community nonprofit organizations, community health boards, 50.14 tribal governments, and community clinics. Applicants must 50.15 submit proposals to the commissioner. A proposal must specify 50.16 the strategies to be implemented to address one or both of the 50.17 priority areas listed in paragraph (a) and must be targeted to 50.18 achieve the outcomes established according to subdivision 3. 50.19 (d) The commissioner shall give priority to applicants who 50.20 demonstrate that their proposed project or initiative: 50.21 (1) is supported by the community the applicant will serve; 50.22 (2) is research-based or based on promising strategies; 50.23 (3) is designed to complement other related community 50.24 activities; 50.25 (4) utilizes strategies that positively impact both 50.26 priority areas; 50.27 (5) reflects racially and ethnically appropriate 50.28 approaches; and 50.29 (6) will be implemented through or with community-based 50.30 organizations that reflect the race or ethnicity of the 50.31 population to be reached. 50.32 Subd. 8. [COMMUNITY GRANT PROGRAM; OTHER HEALTH 50.33 DISPARITIES.] (a) The commissioner shall award grants to 50.34 eligible applicants for local or regional projects and 50.35 initiatives directed at reducing health disparities in one or 50.36 more of the following priority areas: 51.1 (1) decreasing racial and ethnic disparities in morbidity 51.2 and mortality rates from breast and cervical cancer; 51.3 (2) decreasing racial and ethnic disparities in morbidity 51.4 and mortality rates from HIV/AIDS and sexually transmitted 51.5 infections; 51.6 (3) decreasing racial and ethnic disparities in morbidity 51.7 and mortality rates from cardiovascular disease; 51.8 (4) decreasing racial and ethnic disparities in morbidity 51.9 and mortality rates from diabetes; or 51.10 (5) decreasing racial and ethnic disparities in morbidity 51.11 and mortality rates from accidental injuries or violence. 51.12 (b) The commissioner may award up to 20 percent of the 51.13 funds available as planning grants. Planning grants must be 51.14 used to address such areas as community assessment, determining 51.15 community priority areas, coordination activities, and 51.16 development of community supported strategies. 51.17 (c) Eligible applicants may include, but are not limited 51.18 to, faith-based organizations, social service organizations, 51.19 community nonprofit organizations, community health boards, 51.20 tribal governments, and community clinics. Applicants shall 51.21 submit proposals to the commissioner. A proposal must specify 51.22 the strategies to be implemented to address one or more of the 51.23 priority areas listed in paragraph (a) and must be targeted to 51.24 achieve the outcomes established according to subdivision 3. 51.25 (d) The commissioner shall give priority to applicants who 51.26 demonstrate that their proposed project or initiative: 51.27 (1) is supported by the community the applicant will serve; 51.28 (2) is research-based or based on promising strategies; 51.29 (3) is designed to complement other related community 51.30 activities; 51.31 (4) utilizes strategies that positively impact more than 51.32 one priority area; 51.33 (5) reflects racially and ethnically appropriate 51.34 approaches; and 51.35 (6) will be implemented through or with community-based 51.36 organizations that reflect the race or ethnicity of the 52.1 population to be reached. 52.2 Subd. 9. [REFUGEE AND IMMIGRANT HEALTH.] (a) The 52.3 commissioner shall distribute funds to community health boards 52.4 for health screening and follow-up services for tuberculosis for 52.5 refugees. Funds shall be distributed based on the following 52.6 formula: 52.7 (1) $1,500 per refugee with pulmonary tuberculosis in the 52.8 community health board's service area; 52.9 (2) $500 per refugee with extrapulmonary tuberculosis in 52.10 the community health board's service area; 52.11 (3) $500 per month of directly observed therapy provided by 52.12 the community health board for each uninsured refugee with 52.13 pulmonary or extrapulmonary tuberculosis; and 52.14 (4) $50 per refugee in the community health board's service 52.15 area. 52.16 (b) Payments must be made at the end of each state fiscal 52.17 year. The amount paid per tuberculosis case, per month of 52.18 directly observed therapy, and per refugee must be 52.19 proportionately increased or decreased to fit the actual amount 52.20 appropriated for that fiscal year. 52.21 Subd. 10. [COORDINATION.] The commissioner shall 52.22 coordinate the projects and initiatives funded under this 52.23 section with other efforts at the local, state, or national 52.24 level to avoid duplication and promote complementary efforts. 52.25 Subd. 11. [EVALUATION.] Using the outcomes established 52.26 according to subdivision 3, the commissioner shall conduct a 52.27 biennial evaluation of the community grant programs under 52.28 subdivisions 7 and 8. Grant recipients shall cooperate with the 52.29 commissioner in the evaluation and shall provide the 52.30 commissioner with the information needed to conduct the 52.31 evaluation. 52.32 Subd. 12. [REPORT.] By January 15, 2002, and January 15 of 52.33 each even-numbered year thereafter, the commissioner shall 52.34 submit a report to the legislature on the local community 52.35 projects and community health board activities funded under this 52.36 section. The report must include information on grant 53.1 recipients, activities conducted using grant funds, and 53.2 evaluation data and outcome measures if available. 53.3 Sec. 47. Minnesota Statutes 2000, section 145A.15, 53.4 subdivision 1, is amended to read: 53.5 Subdivision 1. [ESTABLISHMENT.] (a) The commissioner of 53.6 health shall expand the current grant program to fund additional 53.7 projects designed to prevent child abuse and neglect and reduce 53.8 juvenile delinquency by promoting positive parenting, resiliency 53.9 in children, and a healthy beginning for children by providing 53.10 early intervention services for families in need. Grant dollars 53.11 shall be available to train paraprofessionals to provide in-home 53.12 intervention services and to allow public health nurses to do 53.13 case management of services. The grant program shall provide 53.14 early intervention services for families in need and will 53.15 include: 53.16 (1) expansion of current public health nurse and family 53.17 aide home visiting programs and public health home visiting 53.18 projects which prevent child abuse and neglect, prevent juvenile 53.19 delinquency, and build resiliency in children; 53.20 (2) early intervention to promote a healthy and nurturing 53.21 beginning; 53.22 (3) distribution of educational and public information 53.23 programs and materials in hospital maternity divisions, 53.24 well-baby clinics, obstetrical clinics, and community clinics; 53.25 and 53.26 (4) training of home visitors in skills necessary for 53.27 comprehensive home visiting which promotes a healthy and 53.28 nurturing beginning for the child. 53.29 (b) No new grants shall be awarded under this section after 53.30 June 30, 2001. Grant contracts awarded and in effect under this 53.31 section as of July 1, 2001, shall continue until their 53.32 expiration date. 53.33 Sec. 48. Minnesota Statutes 2000, section 145A.15, is 53.34 amended by adding a subdivision to read: 53.35 Subd. 5. [EXPIRATION.] This section expires June 30, 2003. 53.36 Sec. 49. Minnesota Statutes 2000, section 145A.16, 54.1 subdivision 1, is amended to read: 54.2 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 54.3 establish a grant program to fund universally offered home 54.4 visiting programs designed to serve all live births in 54.5 designated geographic areas. The commissioner shall designate 54.6 the geographic area to be served by each program. At least one 54.7 program must provide home visiting services to families within 54.8 the seven-county metropolitan area, and at least one program 54.9 must provide home visiting services to families outside the 54.10 metropolitan area. The purpose of the program is to strengthen 54.11 families and to promote positive parenting and healthy child 54.12 development. No new grants shall be awarded under this section 54.13 after June 30, 2001. Competitive grant contracts awarded and in 54.14 effect under this section as of July 1, 2001, shall expire 54.15 December 31, 2003. 54.16 Sec. 50. Minnesota Statutes 2000, section 145A.16, is 54.17 amended by adding a subdivision to read: 54.18 Subd. 10. [EXPIRATION.] This section expires December 31, 54.19 2003. 54.20 Sec. 51. [145A.17] [FAMILY HOME VISITING PROGRAMS.] 54.21 Subdivision 1. [ESTABLISHMENT; GOALS.] The commissioner 54.22 shall establish a program to fund family home visiting programs 54.23 designed to foster a healthy beginning for children in families 54.24 at or below 200 percent of the federal poverty guidelines, 54.25 prevent child abuse and neglect, reduce juvenile delinquency, 54.26 promote positive parenting and resiliency in children, and 54.27 promote family health and economic self-sufficiency. A program 54.28 funded under this section must serve families at or below 200 54.29 percent of the federal poverty guidelines, and other families 54.30 determined to be at risk for child abuse, neglect, or juvenile 54.31 delinquency. Programs must give priority for services to 54.32 families considered to be in need of services, including but not 54.33 limited to families with: 54.34 (1) adolescent parents; 54.35 (2) a history of alcohol or other drug abuse; 54.36 (3) a history of child abuse, domestic abuse, or other 55.1 types of violence; 55.2 (4) a history of domestic abuse, rape, or other forms of 55.3 victimization; 55.4 (5) reduced cognitive functioning; 55.5 (6) a lack of knowledge of child growth and development 55.6 stages; 55.7 (7) low resiliency to adversities and environmental 55.8 stresses; or 55.9 (8) insufficient financial resources to meet family needs. 55.10 Subd. 2. [ALLOCATION OF FUNDS.] The commissioner shall 55.11 distribute funds available under this section to community 55.12 health boards, as defined in section 145A.02, and to tribal 55.13 governments. Funds shall be distributed to community health 55.14 boards as follows: (1) each community health board shall 55.15 receive an allocation of $25,000 per year; and (2) remaining 55.16 funds available to community health boards shall be distributed 55.17 according to the formula in section 256J.625, subdivision 3. 55.18 The commissioner, in consultation with tribal governments, shall 55.19 establish a formula for distributing funds to tribal governments. 55.20 Subd. 3. [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) Before 55.21 a community health board or tribal government may receive an 55.22 allocation under subdivision 2, a community health board or 55.23 tribal government must submit a proposal to the commissioner 55.24 that includes identification, based on a community assessment, 55.25 of the populations at or below 200 percent of the federal 55.26 poverty guidelines that will be served and the other populations 55.27 that will be served. Each program that receives funds must: 55.28 (1) use either a broad community-based or selective 55.29 community-based strategy to provide preventive and early 55.30 intervention home visiting services; 55.31 (2) offer a home visit by a trained home visitor. If a 55.32 home visit is accepted, the first home visit must occur 55.33 prenatally or as soon after birth as possible and must include a 55.34 public health nursing assessment by a public health nurse; 55.35 (3) offer, at a minimum, information on infant care, child 55.36 growth and development, positive parenting, preventing diseases, 56.1 preventing exposure to environmental hazards, and support 56.2 services available in the community; 56.3 (4) provide information on and referrals to health care 56.4 services, if needed, including information on health care 56.5 coverage for which the child or family may be eligible; and 56.6 provide information on preventive services, developmental 56.7 assessments, and the availability of public assistance programs 56.8 as appropriate; 56.9 (5) recruit home visitors who will represent, to the extent 56.10 possible, the races, cultures, and languages spoken by families 56.11 that may be served; 56.12 (6) train and supervise home visitors in accordance with 56.13 the requirements established under subdivision 4; 56.14 (7) maximize resources and minimize duplication by 56.15 coordinating activities with local social and human services 56.16 organizations, education organizations, and other appropriate 56.17 governmental entities and community-based organizations and 56.18 agencies; and 56.19 (8) utilize appropriate racial and ethnic approaches to 56.20 providing home visiting services. 56.21 (b) Funds available under this section shall not be used 56.22 for medical services. The commissioner shall establish an 56.23 administrative cost limit for recipients of funds. The outcome 56.24 measures established under subdivision 6 must be specified to 56.25 recipients of funds at the time the funds are distributed. 56.26 Subd. 4. [TRAINING.] The commissioner shall establish 56.27 training requirements for home visitors and minimum requirements 56.28 for supervision by a public health nurse. The requirements for 56.29 nurses must be consistent with chapter 148. Training must 56.30 include child development, positive parenting techniques, and 56.31 diverse cultural practices in child rearing and family systems. 56.32 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall 56.33 provide administrative and technical assistance to each program, 56.34 including assistance in data collection and other activities 56.35 related to conducting short- and long-term evaluations of the 56.36 programs as required under subdivision 7. The commissioner may 57.1 request research and evaluation support from the University of 57.2 Minnesota. 57.3 Subd. 6. [OUTCOME MEASURES.] The commissioner shall 57.4 establish outcomes to determine the impact of family home 57.5 visiting programs funded under this section on the following 57.6 areas: 57.7 (1) appropriate utilization of preventive health care; 57.8 (2) rates of substantiated child abuse and neglect; 57.9 (3) rates of unintentional child injuries; and 57.10 (4) any additional qualitative goals and quantitative 57.11 measures established by the commissioner. 57.12 Subd. 7. [EVALUATION.] Using the qualitative goals and 57.13 quantitative outcome measures established under subdivisions 1 57.14 and 6, the commissioner shall conduct ongoing evaluations of the 57.15 programs funded under this section. Community health boards and 57.16 tribal governments shall cooperate with the commissioner in the 57.17 evaluations and shall provide the commissioner with the 57.18 information necessary to conduct the evaluations. As part of 57.19 the ongoing evaluations, the commissioner shall rate the impact 57.20 of the programs on the outcome measures listed in subdivision 6, 57.21 and shall periodically determine whether home visiting programs 57.22 are the best way to achieve the qualitative goals established in 57.23 subdivision 1 and by the commissioner. If the commissioner 57.24 determines that home visiting programs are not the best way to 57.25 achieve these goals, the commissioner shall provide the 57.26 legislature with alternative methods for achieving them. 57.27 Subd. 8. [REPORT.] By January 15, 2002, and January 15 of 57.28 each even-numbered year thereafter, the commissioner shall 57.29 submit a report to the legislature on the family home visiting 57.30 programs funded under this section and on the results of the 57.31 evaluations conducted under subdivision 7. 57.32 Subd. 9. [NO SUPPLANTING OF EXISTING FUNDS.] Funding 57.33 available under this section may be used only to supplement, not 57.34 to replace, nonstate funds being used for home visiting services 57.35 as of July 1, 2001. 57.36 Sec. 52. Minnesota Statutes 2000, section 157.16, 58.1 subdivision 3, is amended to read: 58.2 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 58.3 following fees are required for food and beverage service 58.4 establishments, hotels, motels, lodging establishments, and 58.5 resorts licensed under this chapter. Food and beverage service 58.6 establishments must pay the highest applicable fee under 58.7 paragraph (e), clause (1), (2), (3), or (4), and establishments 58.8 serving alcohol must pay the highest applicable fee under 58.9 paragraph (e), clause (6) or (7). The license fee for new 58.10 operators previously licensed under this chapter for the same 58.11 calendar year is one-half of the appropriate annual license fee, 58.12 plus any penalty that may be required. The license fee for 58.13 operators opening on or after October 1 is one-half of the 58.14 appropriate annual license fee, plus any penalty that may be 58.15 required. The fees in paragraphs (b), (c), and (d) effective 58.16 until June 30, 2001, shall be phased up as specified in section 58.17 55 to the fee amounts effective beginning July 1, 2004. 58.18 Notwithstanding section 16A.1285, in fiscal years 2002, 2003, 58.19 and 2004, the commissioner shall regulate food and beverage 58.20 service establishments, hotels, motels, lodging establishments, 58.21 and resorts with the fees collected for that purpose. 58.22 (b) All food and beverage service establishments, except 58.23 special event food stands, and all hotels, motels, lodging 58.24 establishments, and resorts shall pay an annual base fee of $100 58.25 until June 30, 2001. Effective July 1, 2004, the annual base 58.26 fee shall be $145. 58.27 (c) A special event food stand shall pay a flat fee of $30 58.28 annually until June 30, 2001. Effective July 1, 2004, the 58.29 annual flat fee shall be $35. "Special event food stand" means 58.30 a fee category where food is prepared or served in conjunction 58.31 with celebrations, county fairs, or special events from a 58.32 special event food stand as defined in section 157.15. 58.33 (d) In addition to the base fee in paragraph (b), each food 58.34 and beverage service establishment, other than a special event 58.35 food stand, and each hotel, motel, lodging establishment, and 58.36 resort shall pay an additional annual fee for each fee category 59.1 as specified in this paragraph: 59.2 (1) Limited food menu selection, $30 until June 30, 2001. 59.3 Effective July 1, 2004, the annual fee shall be $40. "Limited 59.4 food menu selection" means a fee category that provides one or 59.5 more of the following: 59.6 (i) prepackaged food that receives heat treatment and is 59.7 served in the package; 59.8 (ii) frozen pizza that is heated and served; 59.9 (iii) a continental breakfast such as rolls, coffee, juice, 59.10 milk, and cold cereal; 59.11 (iv) soft drinks, coffee, or nonalcoholic beverages; or 59.12 (v) cleaning for eating, drinking, or cooking utensils, 59.13 when the only food served is prepared off site. 59.14 (2) Small establishment, including boarding establishments, 59.15 $55 until June 30, 2001. Effective July 1, 2004, the annual fee 59.16 shall be $75. "Small establishment" means a fee category that 59.17 has no salad bar and meets one or more of the following: 59.18 (i) possesses food service equipment that consists of no 59.19 more than a deep fat fryer, a grill, two hot holding containers, 59.20 and one or more microwave ovens; 59.21 (ii) serves dipped ice cream or soft serve frozen desserts; 59.22 (iii) serves breakfast in an owner-occupied bed and 59.23 breakfast establishment; 59.24 (iv) is a boarding establishment; or 59.25 (v) meets the equipment criteria in clause (3), item (i) or 59.26 (ii), and has a maximum patron seating capacity of not more than 59.27 50. 59.28 (3) Medium establishment, $150 until June 30, 2001. 59.29 Effective July 1, 2004, the annual fee shall be $210. "Medium 59.30 establishment" means a fee category that meets one or more of 59.31 the following: 59.32 (i) possesses food service equipment that includes a range, 59.33 oven, steam table, salad bar, or salad preparation area; 59.34 (ii) possesses food service equipment that includes more 59.35 than one deep fat fryer, one grill, or two hot holding 59.36 containers; or 60.1 (iii) is an establishment where food is prepared at one 60.2 location and served at one or more separate locations. 60.3 Establishments meeting criteria in clause (2), item (v), 60.4 are not included in this fee category. 60.5 (4) Large establishment, $250 until June 30, 2001. 60.6 Effective July 1, 2004, the annual fee shall be $350. "Large 60.7 establishment" means either: 60.8 (i) a fee category that (A) meets the criteria in clause 60.9 (3), items (i) or (ii), for a medium establishment, (B) seats 60.10 more than 175 people, and (C) offers the full menu selection an 60.11 average of five or more days a week during the weeks of 60.12 operation; or 60.13 (ii) a fee category that (A) meets the criteria in clause 60.14 (3), item (iii), for a medium establishment, and (B) prepares 60.15 and serves 500 or more meals per day. 60.16 (5) Other food and beverage service, including food carts, 60.17 mobile food units, seasonal temporary food stands, and seasonal 60.18 permanent food stands, $30 until June 30, 2001. Effective July 60.19 1, 2004, the annual fee shall be $40. 60.20 (6) Beer or wine table service, $30 until June 30, 2001. 60.21 Effective July 1, 2004, the annual fee shall be $40. "Beer or 60.22 wine table service" means a fee category where the only 60.23 alcoholic beverage service is beer or wine, served to customers 60.24 seated at tables. 60.25 (7) Alcoholic beverage service, other than beer or wine 60.26 table service, $75 until June 30, 2001. Effective July 1, 2004, 60.27 the annual fee shall be $105. 60.28 "Alcohol beverage service, other than beer or wine table 60.29 service" means a fee category where alcoholic mixed drinks are 60.30 served or where beer or wine are served from a bar. 60.31 (8) Until June 30, 2001, lodging per sleeping accommodation 60.32 unit, $4, including hotels, motels, lodging establishments, and 60.33 resorts, up to a maximum of $400. Effective July 1, 2004, 60.34 lodging per sleeping accommodation unit, $6, including hotels, 60.35 motels, lodging establishments, and resorts, up to a maximum of 60.36 $600. "Lodging per sleeping accommodation unit" means a fee 61.1 category including the number of guest rooms, cottages, or other 61.2 rental units of a hotel, motel, lodging establishment, or 61.3 resort; or the number of beds in a dormitory. 61.4 (9) First public swimming pool, $100 until June 30, 2001; 61.5 each additional public swimming pool, $50 until June 30, 2001. 61.6 Effective July 1, 2004, first public swimming pool, $140; each 61.7 additional public swimming pool, $80. "Public swimming pool" 61.8 means a fee category that has the meaning given in Minnesota 61.9 Rules, part 4717.0250, subpart 8. 61.10 (10) First spa, $50 until June 30, 2001; each additional 61.11 spa, $25 until June 30, 2001. Effective July 1, 2004, first 61.12 spa, $80; each additional spa, $40. "Spa pool" means a fee 61.13 category that has the meaning given in Minnesota Rules, part 61.14 4717.0250, subpart 9. 61.15 (11) Private sewer or water, $30 until June 30, 2001. 61.16 Effective July 1, 2004, private sewer or water, $40. 61.17 "Individual private water" means a fee category with a water 61.18 supply other than a community public water supply as defined in 61.19 Minnesota Rules, chapter 4720. "Individual private sewer" means 61.20 a fee category with an individual sewage treatment system which 61.21 uses subsurface treatment and disposal. 61.22 (e)A fee is not required for a food and beverage service61.23establishment operated by a school as defined in sections61.24120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.61.25(f)A fee of $150 for review of the construction plans must 61.26 accompany the initial license application for food and beverage 61.27 service establishments, hotels, motels, lodging establishments, 61.28 or resorts. 61.29(g)(f) When existing food and beverage service 61.30 establishments, hotels, motels, lodging establishments, or 61.31 resorts are extensively remodeled, a fee of $150 must be 61.32 submitted with the remodeling plans. 61.33(h)(g) Seasonal temporary food stands and special event 61.34 food stands are not required to submit construction or 61.35 remodeling plans for review. 61.36 Sec. 53. Minnesota Statutes 2000, section 157.22, is 62.1 amended to read: 62.2 157.22 [EXEMPTIONS.] 62.3 This chapter shall not be construed to apply to: 62.4 (1) interstate carriers under the supervision of the United 62.5 States Department of Health and Human Services; 62.6 (2) any building constructed and primarily used for 62.7 religious worship; 62.8 (3) any building owned, operated, and used by a college or 62.9 university in accordance with health regulations promulgated by 62.10 the college or university under chapter 14; 62.11 (4) any person, firm, or corporation whose principal mode 62.12 of business is licensed under sections 28A.04 and 28A.05, is 62.13 exempt at that premises from licensure as a food or beverage 62.14 establishment; provided that the holding of any license pursuant 62.15 to sections 28A.04 and 28A.05 shall not exempt any person, firm, 62.16 or corporation from the applicable provisions of this chapter or 62.17 the rules of the state commissioner of health relating to food 62.18 and beverage service establishments; 62.19 (5) family day care homes and group family day care homes 62.20 governed by sections 245A.01 to 245A.16; 62.21 (6) nonprofit senior citizen centers for the sale of 62.22 home-baked goods;and62.23 (7) food not prepared at an establishment and brought in by 62.24 individuals attending a potluck event for consumption at the 62.25 potluck event. An organization sponsoring a potluck event under 62.26 this clause may advertise the potluck event to the public 62.27 through any means. Individuals who are not members of an 62.28 organization sponsoring a potluck event under this clause may 62.29 attend the potluck event and consume the food at the event. 62.30 Licensed food establishments cannot be sponsors of potluck 62.31 events. Potluck event food shall not be brought into a licensed 62.32 food establishment kitchen; and 62.33 (8) a home school in which a child is provided instruction 62.34 at home. 62.35 Sec. 54. [ESTABLISHMENT FEES DURING TRANSITION PERIOD.] 62.36 For fiscal years 2002, 2003, and 2004, the following fees 63.1 shall apply to food and beverage service establishments, hotels, 63.2 motels, lodging establishments, and resorts for which fees are 63.3 established under Minnesota Statutes, section 157.16, 63.4 subdivision 3, paragraphs (b), (c), and (d): 63.5 Fiscal Year Fiscal Year Fiscal Year 63.6 Fee Category 2002 2003 2004 63.7 Annual base fee, all $111.25 $122.50 $133.75 63.8 food and beverage 63.9 service establishments 63.10 except special event 63.11 food stands and all 63.12 hotels, motels, lodging 63.13 establishments, and 63.14 resorts 63.15 Special event food $ 31.25 $ 32.50 $ 33.75 63.16 stand 63.17 Establishment with $ 32.50 $ 35.00 $ 37.50 63.18 limited food menu 63.19 selection 63.20 Small establishment $ 60.00 $ 65.00 $ 70.00 63.21 Medium establishment $165.00 $180.00 $195.00 63.22 Large establishment $275.00 $300.00 $325.00 63.23 Other food and $ 32.50 $ 35.00 $ 37.50 63.24 beverage service 63.25 Beer or wine table $ 32.50 $ 35.00 $ 37.50 63.26 service 63.27 Alcoholic beverage $ 82.50 $ 90.00 $ 97.50 63.28 service other than 63.29 beer or wine table 63.30 service 63.31 Lodging per sleeping $4.50 per $5.00 per $5.50 per 63.32 accommodation unit, unit, $450 unit, $500 unit, $550 63.33 up to a specified maximum maximum maximum 63.34 maximum 63.35 First public $110.00 $120.00 $130.00 63.36 swimming pool 64.1 Each additional $ 57.50 $ 65.00 $ 72.50 64.2 public swimming pool 64.3 First spa $ 57.50 $ 65.00 $ 72.50 64.4 Each additional spa $ 28.75 $ 32.50 $ 36.25 64.5 Private sewer or $ 32.50 $ 35.00 $ 37.50 64.6 water 64.7 Sec. 55. [REPEALER.] 64.8 (a) Minnesota Statutes 2000, sections 145.882, subdivisions 64.9 3 and 4; and 145.927, are repealed. 64.10 (b) Minnesota Statutes 2000, section 144.148, subdivision 64.11 8, is repealed. 64.12 [EFFECTIVE DATE.] Paragraph (b) of this section is 64.13 effective the day following final enactment. 64.14 ARTICLE 2 64.15 HEALTH CARE 64.16 Section 1. Minnesota Statutes 2000, section 256.01, 64.17 subdivision 2, is amended to read: 64.18 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 64.19 section 241.021, subdivision 2, the commissioner of human 64.20 services shall: 64.21 (1) Administer and supervise all forms of public assistance 64.22 provided for by state law and other welfare activities or 64.23 services as are vested in the commissioner. Administration and 64.24 supervision of human services activities or services includes, 64.25 but is not limited to, assuring timely and accurate distribution 64.26 of benefits, completeness of service, and quality program 64.27 management. In addition to administering and supervising human 64.28 services activities vested by law in the department, the 64.29 commissioner shall have the authority to: 64.30 (a) require county agency participation in training and 64.31 technical assistance programs to promote compliance with 64.32 statutes, rules, federal laws, regulations, and policies 64.33 governing human services; 64.34 (b) monitor, on an ongoing basis, the performance of county 64.35 agencies in the operation and administration of human services, 64.36 enforce compliance with statutes, rules, federal laws, 65.1 regulations, and policies governing welfare services and promote 65.2 excellence of administration and program operation; 65.3 (c) develop a quality control program or other monitoring 65.4 program to review county performance and accuracy of benefit 65.5 determinations; 65.6 (d) require county agencies to make an adjustment to the 65.7 public assistance benefits issued to any individual consistent 65.8 with federal law and regulation and state law and rule and to 65.9 issue or recover benefits as appropriate; 65.10 (e) delay or deny payment of all or part of the state and 65.11 federal share of benefits and administrative reimbursement 65.12 according to the procedures set forth in section 256.017; 65.13 (f) make contracts with and grants to public and private 65.14 agencies and organizations, both profit and nonprofit, and 65.15 individuals, using appropriated funds; and 65.16 (g) enter into contractual agreements with federally 65.17 recognized Indian tribes with a reservation in Minnesota to the 65.18 extent necessary for the tribe to operate a federally approved 65.19 family assistance program or any other program under the 65.20 supervision of the commissioner. The commissioner shall consult 65.21 with the affected county or counties in the contractual 65.22 agreement negotiations, if the county or counties wish to be 65.23 included, in order to avoid the duplication of county and tribal 65.24 assistance program services. The commissioner may establish 65.25 necessary accounts for the purposes of receiving and disbursing 65.26 funds as necessary for the operation of the programs. 65.27 (2) Inform county agencies, on a timely basis, of changes 65.28 in statute, rule, federal law, regulation, and policy necessary 65.29 to county agency administration of the programs. 65.30 (3) Administer and supervise all child welfare activities; 65.31 promote the enforcement of laws protecting handicapped, 65.32 dependent, neglected and delinquent children, and children born 65.33 to mothers who were not married to the children's fathers at the 65.34 times of the conception nor at the births of the children; 65.35 license and supervise child-caring and child-placing agencies 65.36 and institutions; supervise the care of children in boarding and 66.1 foster homes or in private institutions; and generally perform 66.2 all functions relating to the field of child welfare now vested 66.3 in the state board of control. 66.4 (4) Administer and supervise all noninstitutional service 66.5 to handicapped persons, including those who are visually 66.6 impaired, hearing impaired, or physically impaired or otherwise 66.7 handicapped. The commissioner may provide and contract for the 66.8 care and treatment of qualified indigent children in facilities 66.9 other than those located and available at state hospitals when 66.10 it is not feasible to provide the service in state hospitals. 66.11 (5) Assist and actively cooperate with other departments, 66.12 agencies and institutions, local, state, and federal, by 66.13 performing services in conformity with the purposes of Laws 66.14 1939, chapter 431. 66.15 (6) Act as the agent of and cooperate with the federal 66.16 government in matters of mutual concern relative to and in 66.17 conformity with the provisions of Laws 1939, chapter 431, 66.18 including the administration of any federal funds granted to the 66.19 state to aid in the performance of any functions of the 66.20 commissioner as specified in Laws 1939, chapter 431, and 66.21 including the promulgation of rules making uniformly available 66.22 medical care benefits to all recipients of public assistance, at 66.23 such times as the federal government increases its participation 66.24 in assistance expenditures for medical care to recipients of 66.25 public assistance, the cost thereof to be borne in the same 66.26 proportion as are grants of aid to said recipients. 66.27 (7) Establish and maintain any administrative units 66.28 reasonably necessary for the performance of administrative 66.29 functions common to all divisions of the department. 66.30 (8) Act as designated guardian of both the estate and the 66.31 person of all the wards of the state of Minnesota, whether by 66.32 operation of law or by an order of court, without any further 66.33 act or proceeding whatever, except as to persons committed as 66.34 mentally retarded. For children under the guardianship of the 66.35 commissioner whose interests would be best served by adoptive 66.36 placement, the commissioner may contract with a licensed 67.1 child-placing agency to provide adoption services. A contract 67.2 with a licensed child-placing agency must be designed to 67.3 supplement existing county efforts and may not replace existing 67.4 county programs, unless the replacement is agreed to by the 67.5 county board and the appropriate exclusive bargaining 67.6 representative or the commissioner has evidence that child 67.7 placements of the county continue to be substantially below that 67.8 of other counties. Funds encumbered and obligated under an 67.9 agreement for a specific child shall remain available until the 67.10 terms of the agreement are fulfilled or the agreement is 67.11 terminated. 67.12 (9) Act as coordinating referral and informational center 67.13 on requests for service for newly arrived immigrants coming to 67.14 Minnesota. 67.15 (10) The specific enumeration of powers and duties as 67.16 hereinabove set forth shall in no way be construed to be a 67.17 limitation upon the general transfer of powers herein contained. 67.18 (11) Establish county, regional, or statewide schedules of 67.19 maximum fees and charges which may be paid by county agencies 67.20 for medical, dental, surgical, hospital, nursing and nursing 67.21 home care and medicine and medical supplies under all programs 67.22 of medical care provided by the state and for congregate living 67.23 care under the income maintenance programs. 67.24 (12) Have the authority to conduct and administer 67.25 experimental projects to test methods and procedures of 67.26 administering assistance and services to recipients or potential 67.27 recipients of public welfare. To carry out such experimental 67.28 projects, it is further provided that the commissioner of human 67.29 services is authorized to waive the enforcement of existing 67.30 specific statutory program requirements, rules, and standards in 67.31 one or more counties. The order establishing the waiver shall 67.32 provide alternative methods and procedures of administration, 67.33 shall not be in conflict with the basic purposes, coverage, or 67.34 benefits provided by law, and in no event shall the duration of 67.35 a project exceed four years. It is further provided that no 67.36 order establishing an experimental project as authorized by the 68.1 provisions of this section shall become effective until the 68.2 following conditions have been met: 68.3 (a) The secretary of health and human services of the 68.4 United States has agreed, for the same project, to waive state 68.5 plan requirements relative to statewide uniformity. 68.6 (b) A comprehensive plan, including estimated project 68.7 costs, shall be approved by the legislative advisory commission 68.8 and filed with the commissioner of administration. 68.9 (13) According to federal requirements, establish 68.10 procedures to be followed by local welfare boards in creating 68.11 citizen advisory committees, including procedures for selection 68.12 of committee members. 68.13 (14) Allocate federal fiscal disallowances or sanctions 68.14 which are based on quality control error rates for the aid to 68.15 families with dependent children program formerly codified in 68.16 sections 256.72 to 256.87, medical assistance, or food stamp 68.17 program in the following manner: 68.18 (a) One-half of the total amount of the disallowance shall 68.19 be borne by the county boards responsible for administering the 68.20 programs. For the medical assistance and the AFDC program 68.21 formerly codified in sections 256.72 to 256.87, disallowances 68.22 shall be shared by each county board in the same proportion as 68.23 that county's expenditures for the sanctioned program are to the 68.24 total of all counties' expenditures for the AFDC program 68.25 formerly codified in sections 256.72 to 256.87, and medical 68.26 assistance programs. For the food stamp program, sanctions 68.27 shall be shared by each county board, with 50 percent of the 68.28 sanction being distributed to each county in the same proportion 68.29 as that county's administrative costs for food stamps are to the 68.30 total of all food stamp administrative costs for all counties, 68.31 and 50 percent of the sanctions being distributed to each county 68.32 in the same proportion as that county's value of food stamp 68.33 benefits issued are to the total of all benefits issued for all 68.34 counties. Each county shall pay its share of the disallowance 68.35 to the state of Minnesota. When a county fails to pay the 68.36 amount due hereunder, the commissioner may deduct the amount 69.1 from reimbursement otherwise due the county, or the attorney 69.2 general, upon the request of the commissioner, may institute 69.3 civil action to recover the amount due. 69.4 (b) Notwithstanding the provisions of paragraph (a), if the 69.5 disallowance results from knowing noncompliance by one or more 69.6 counties with a specific program instruction, and that knowing 69.7 noncompliance is a matter of official county board record, the 69.8 commissioner may require payment or recover from the county or 69.9 counties, in the manner prescribed in paragraph (a), an amount 69.10 equal to the portion of the total disallowance which resulted 69.11 from the noncompliance, and may distribute the balance of the 69.12 disallowance according to paragraph (a). 69.13 (15) Develop and implement special projects that maximize 69.14 reimbursements and result in the recovery of money to the 69.15 state. For the purpose of recovering state money, the 69.16 commissioner may enter into contracts with third parties. Any 69.17 recoveries that result from projects or contracts entered into 69.18 under this paragraph shall be deposited in the state treasury 69.19 and credited to a special account until the balance in the 69.20 account reaches $1,000,000. When the balance in the account 69.21 exceeds $1,000,000, the excess shall be transferred and credited 69.22 to the general fund. All money in the account is appropriated 69.23 to the commissioner for the purposes of this paragraph. 69.24 (16) Have the authority to make direct payments to 69.25 facilities providing shelter to women and their children 69.26 according to section 256D.05, subdivision 3. Upon the written 69.27 request of a shelter facility that has been denied payments 69.28 under section 256D.05, subdivision 3, the commissioner shall 69.29 review all relevant evidence and make a determination within 30 69.30 days of the request for review regarding issuance of direct 69.31 payments to the shelter facility. Failure to act within 30 days 69.32 shall be considered a determination not to issue direct payments. 69.33 (17) Have the authority to establish and enforce the 69.34 following county reporting requirements: 69.35 (a) The commissioner shall establish fiscal and statistical 69.36 reporting requirements necessary to account for the expenditure 70.1 of funds allocated to counties for human services programs. 70.2 When establishing financial and statistical reporting 70.3 requirements, the commissioner shall evaluate all reports, in 70.4 consultation with the counties, to determine if the reports can 70.5 be simplified or the number of reports can be reduced. 70.6 (b) The county board shall submit monthly or quarterly 70.7 reports to the department as required by the commissioner. 70.8 Monthly reports are due no later than 15 working days after the 70.9 end of the month. Quarterly reports are due no later than 30 70.10 calendar days after the end of the quarter, unless the 70.11 commissioner determines that the deadline must be shortened to 70.12 20 calendar days to avoid jeopardizing compliance with federal 70.13 deadlines or risking a loss of federal funding. Only reports 70.14 that are complete, legible, and in the required format shall be 70.15 accepted by the commissioner. 70.16 (c) If the required reports are not received by the 70.17 deadlines established in clause (b), the commissioner may delay 70.18 payments and withhold funds from the county board until the next 70.19 reporting period. When the report is needed to account for the 70.20 use of federal funds and the late report results in a reduction 70.21 in federal funding, the commissioner shall withhold from the 70.22 county boards with late reports an amount equal to the reduction 70.23 in federal funding until full federal funding is received. 70.24 (d) A county board that submits reports that are late, 70.25 illegible, incomplete, or not in the required format for two out 70.26 of three consecutive reporting periods is considered 70.27 noncompliant. When a county board is found to be noncompliant, 70.28 the commissioner shall notify the county board of the reason the 70.29 county board is considered noncompliant and request that the 70.30 county board develop a corrective action plan stating how the 70.31 county board plans to correct the problem. The corrective 70.32 action plan must be submitted to the commissioner within 45 days 70.33 after the date the county board received notice of noncompliance. 70.34 (e) The final deadline for fiscal reports or amendments to 70.35 fiscal reports is one year after the date the report was 70.36 originally due. If the commissioner does not receive a report 71.1 by the final deadline, the county board forfeits the funding 71.2 associated with the report for that reporting period and the 71.3 county board must repay any funds associated with the report 71.4 received for that reporting period. 71.5 (f) The commissioner may not delay payments, withhold 71.6 funds, or require repayment under paragraph (c) or (e) if the 71.7 county demonstrates that the commissioner failed to provide 71.8 appropriate forms, guidelines, and technical assistance to 71.9 enable the county to comply with the requirements. If the 71.10 county board disagrees with an action taken by the commissioner 71.11 under paragraph (c) or (e), the county board may appeal the 71.12 action according to sections 14.57 to 14.69. 71.13 (g) Counties subject to withholding of funds under 71.14 paragraph (c) or forfeiture or repayment of funds under 71.15 paragraph (e) shall not reduce or withhold benefits or services 71.16 to clients to cover costs incurred due to actions taken by the 71.17 commissioner under paragraph (c) or (e). 71.18 (18) Allocate federal fiscal disallowances or sanctions for 71.19 audit exceptions when federal fiscal disallowances or sanctions 71.20 are based on a statewide random sample for the foster care 71.21 program under title IV-E of the Social Security Act, United 71.22 States Code, title 42, in direct proportion to each county's 71.23 title IV-E foster care maintenance claim for that period. 71.24 (19) Be responsible for ensuring the detection, prevention, 71.25 investigation, and resolution of fraudulent activities or 71.26 behavior by applicants, recipients, and other participants in 71.27 the human services programs administered by the department. 71.28 (20) Require county agencies to identify overpayments, 71.29 establish claims, and utilize all available and cost-beneficial 71.30 methodologies to collect and recover these overpayments in the 71.31 human services programs administered by the department. 71.32 (21) Have the authority to administer a drug rebate program 71.33 for drugs purchased pursuant to the prescription drug program 71.34 established under section 256.955 after the beneficiary's 71.35 satisfaction of any deductible established in the program. The 71.36 commissioner shall require a rebate agreement from all 72.1 manufacturers of covered drugs as defined in section 256B.0625, 72.2 subdivision 13. Rebate agreements for prescription drugs 72.3 delivered on or after July 1, 2002, must include rebates for 72.4 individuals covered under the prescription drug program who are 72.5 under 65 years of age. For each drug, the amount of the rebate 72.6 shall be equal to the basic rebate as defined for purposes of 72.7 the federal rebate program in United States Code, title 42, 72.8 section 1396r-8(c)(1). This basic rebate shall be applied to 72.9 single-source and multiple-source drugs. The manufacturers must 72.10 provide full payment within 30 days of receipt of the state 72.11 invoice for the rebate within the terms and conditions used for 72.12 the federal rebate program established pursuant to section 1927 72.13 of title XIX of the Social Security Act. The manufacturers must 72.14 provide the commissioner with any information necessary to 72.15 verify the rebate determined per drug. The rebate program shall 72.16 utilize the terms and conditions used for the federal rebate 72.17 program established pursuant to section 1927 of title XIX of the 72.18 Social Security Act. 72.19 (22) Have the authority to administer the federal drug 72.20 rebate program for drugs purchased under the medical assistance 72.21 program as allowed by section 1927 of title XIX of the Social 72.22 Security Act and according to the terms and conditions of 72.23 section 1927. Rebates shall be collected for all drugs that 72.24 have been dispensed or administered in an outpatient setting and 72.25 that are from manufacturers who have signed a rebate agreement 72.26 with the United States Department of Health and Human Services. 72.27(22)(23) Operate the department's communication systems 72.28 account established in Laws 1993, First Special Session chapter 72.29 1, article 1, section 2, subdivision 2, to manage shared 72.30 communication costs necessary for the operation of the programs 72.31 the commissioner supervises. A communications account may also 72.32 be established for each regional treatment center which operates 72.33 communications systems. Each account must be used to manage 72.34 shared communication costs necessary for the operations of the 72.35 programs the commissioner supervises. The commissioner may 72.36 distribute the costs of operating and maintaining communication 73.1 systems to participants in a manner that reflects actual usage. 73.2 Costs may include acquisition, licensing, insurance, 73.3 maintenance, repair, staff time and other costs as determined by 73.4 the commissioner. Nonprofit organizations and state, county, 73.5 and local government agencies involved in the operation of 73.6 programs the commissioner supervises may participate in the use 73.7 of the department's communications technology and share in the 73.8 cost of operation. The commissioner may accept on behalf of the 73.9 state any gift, bequest, devise or personal property of any 73.10 kind, or money tendered to the state for any lawful purpose 73.11 pertaining to the communication activities of the department. 73.12 Any money received for this purpose must be deposited in the 73.13 department's communication systems accounts. Money collected by 73.14 the commissioner for the use of communication systems must be 73.15 deposited in the state communication systems account and is 73.16 appropriated to the commissioner for purposes of this section. 73.17(23)(24) Receive any federal matching money that is made 73.18 available through the medical assistance program for the 73.19 consumer satisfaction survey. Any federal money received for 73.20 the survey is appropriated to the commissioner for this 73.21 purpose. The commissioner may expend the federal money received 73.22 for the consumer satisfaction survey in either year of the 73.23 biennium. 73.24(24)(25) Incorporate cost reimbursement claims from First 73.25 Call Minnesota into the federal cost reimbursement claiming 73.26 processes of the department according to federal law, rule, and 73.27 regulations. Any reimbursement received is appropriated to the 73.28 commissioner and shall be disbursed to First Call Minnesota 73.29 according to normal department payment schedules. 73.30(25)(26) Develop recommended standards for foster care 73.31 homes that address the components of specialized therapeutic 73.32 services to be provided by foster care homes with those services. 73.33 Sec. 2. Minnesota Statutes 2000, section 256.955, 73.34 subdivision 2b, is amended to read: 73.35 Subd. 2b. [ELIGIBILITY.] Effective July 1, 2002, an 73.36 individual satisfying the following requirements and the 74.1 requirements described in subdivision 2, paragraph (d), is 74.2 eligible for the prescription drug program: 74.3 (1) is under 65 years of age; and 74.4 (2) is eligible as a qualified Medicare beneficiary 74.5 according to section 256B.057, subdivision 3 or 3a, or is 74.6 eligible under section 256B.057, subdivision 3 or 3a, and is 74.7 also eligible for medical assistance or general assistance 74.8 medical care with a spenddown as defined in section 256B.056, 74.9 subdivision 5. 74.10 Sec. 3. [256.958] [RETIRED DENTIST PROGRAM.] 74.11 Subdivision 1. [PROGRAM.] The commissioner of human 74.12 services shall establish a program to reimburse a retired 74.13 dentist for the dentist's license fee and for the cost of 74.14 malpractice insurance in exchange for the dentist providing 100 74.15 hours of dental services on a volunteer basis within a 12-month 74.16 period at a community dental clinic or a dental training clinic 74.17 located at a Minnesota state college or university. 74.18 Subd. 2. [DOCUMENTATION.] Upon completion of the required 74.19 hours, the retired dentist shall submit to the commissioner the 74.20 following: 74.21 (1) documentation of service provided; 74.22 (2) the cost of malpractice insurance for the 12-month 74.23 period; and 74.24 (3) the cost of the license. 74.25 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information 74.26 described in subdivision 2, the commissioner shall provide 74.27 reimbursement to the retired dentist for the cost of malpractice 74.28 insurance for the previous 12-month period and the cost of the 74.29 license. 74.30 Sec. 4. Minnesota Statutes 2000, section 256.9657, 74.31 subdivision 2, is amended to read: 74.32 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 74.33 1992, each Minnesota hospital except facilities of the federal 74.34 Indian Health Service and regional treatment centers shall pay 74.35 to the medical assistance account a surcharge equal to 1.4 74.36 percent of net patient revenues excluding net Medicare revenues 75.1 reported by that provider to the health care cost information 75.2 system according to the schedule in subdivision 4. 75.3 (b) Effective July 1, 1994, the surcharge under paragraph 75.4 (a) is increased to 1.56 percent. 75.5 (c) Notwithstanding the Medicare cost finding and allowable 75.6 cost principles, the hospital surcharge is not an allowable cost 75.7 for purposes of rate setting under sections 256.9685 to 256.9695. 75.8 Sec. 5. Minnesota Statutes 2000, section 256.969, 75.9 subdivision 2b, is amended to read: 75.10 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 75.11 operating payment rates for admissions occurring on or after the 75.12 rate year beginning January 1, 1991, and every two years after, 75.13 or more frequently as determined by the commissioner, the 75.14 commissioner shall obtain operating data from an updated base 75.15 year and, within the limits of available appropriations, 75.16 establish operating payment rates per admission for each 75.17 hospital based on the cost-finding methods and allowable costs 75.18 of the Medicare program in effect during the base year. Rates 75.19 under the general assistance medical care, medical assistance, 75.20 and MinnesotaCare programs shall not be rebased to more current 75.21 data on January 1, 1997. The base year operating payment rate 75.22 per admission is standardized by the case mix index and adjusted 75.23 by the hospital cost index, relative values, and 75.24 disproportionate population adjustment. The cost and charge 75.25 data used to establish operating rates shall only reflect 75.26 inpatient services covered by medical assistance and shall not 75.27 include property cost information and costs recognized in 75.28 outlier payments. 75.29 Sec. 6. Minnesota Statutes 2000, section 256.969, is 75.30 amended by adding a subdivision to read: 75.31 Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 75.32 30, 2001.] (a) For admissions occurring after June 30, 2001, the 75.33 commissioner shall pay all medical assistance inpatient 75.34 fee-for-service admissions for the diagnosis-related groups 75.35 specified in paragraph (b) at hospitals located outside of the 75.36 seven-county metropolitan area at the higher of: 76.1 (1) the hospital's current payment rate for the diagnostic 76.2 category to which the diagnosis-related group belongs, exclusive 76.3 of disproportionate population adjustments received under 76.4 subdivision 9 and hospital payment adjustments received under 76.5 subdivision 23; or 76.6 (2) the rate in clause (1) plus a proportion of the 76.7 difference between the current average payment rate for that 76.8 diagnostic category for hospitals located within the 76.9 seven-county metropolitan area, exclusive of disproportionate 76.10 population adjustments received under subdivision 9 and hospital 76.11 payment adjustments received under subdivision 23, and the 76.12 current rate in clause (1). This proportion shall be 12.5 76.13 percent for the fiscal year beginning July 1, 2001, and shall 76.14 increase by 12.5 percentage points for each of the next seven 76.15 fiscal years, such that the proportion is 100 percent for the 76.16 fiscal year beginning July 1, 2008. 76.17 (b) The reimbursement increases provided in paragraph (a) 76.18 apply to the following diagnosis-related groups as they fall 76.19 within the diagnostic categories: 76.20 (1) 370 C-section with complicating diagnosis; 76.21 (2) 371 C-section without complicating diagnosis; 76.22 (3) 372 vaginal delivery with complicating diagnosis; 76.23 (4) 373 vaginal delivery without complicating diagnosis; 76.24 (5) 386 extreme immaturity, weight greater than 1,500 76.25 grams; 76.26 (6) 388 full-term neonates with other problems; 76.27 (7) 390 prematurity without major problems; 76.28 (8) 391 normal newborn case; 76.29 (9) 385 neonate, died or transferred to another health care 76.30 facility; 76.31 (10) 425 acute adjustment reaction and psychosocial 76.32 dysfunctioning; 76.33 (11) 430 psychosis; 76.34 (12) 431 childhood mental disorders; and 76.35 (13) 164-167 appendectomy. 76.36 Sec. 7. Minnesota Statutes 2000, section 256B.04, is 77.1 amended by adding a subdivision to read: 77.2 Subd. 1b. [CONTRACT FOR SERVICES FOR AMERICAN INDIAN 77.3 CHILDREN.] Notwithstanding subdivision 1, the commissioner may 77.4 contract with federally recognized Indian tribes with a 77.5 reservation in Minnesota for the provision of early and periodic 77.6 screening, diagnosis, and treatment administrative services for 77.7 American Indian children, according to Code of Federal 77.8 Regulations, title 42, section 441, subpart B, and Minnesota 77.9 Rules, part 9505.1693 et seq., when the tribe chooses to provide 77.10 such services. For purposes of this subdivision, "American 77.11 Indian" has the meaning given to persons to whom services will 77.12 be provided for in Code of Federal Regulations, title 42, 77.13 section 36.12. Notwithstanding Minnesota Rules, part 9505.1748, 77.14 subpart 1, the commissioner, the local agency, and the tribe may 77.15 contract with any entity for the provision of early and periodic 77.16 screening, diagnosis, and treatment administrative services. 77.17 [EFFECTIVE DATE.] This section is effective the day 77.18 following final enactment. 77.19 Sec. 8. Minnesota Statutes 2000, section 256B.055, 77.20 subdivision 3a, is amended to read: 77.21 Subd. 3a. [MFIP-S FAMILIES;FAMILIES ELIGIBLE UNDER PRIOR 77.22 AFDC RULES.] (a)Beginning January 1, 1998, or on the date that77.23MFIP-S is implemented in counties, medical assistance may be77.24paid for a person receiving public assistance under the MFIP-S77.25program.Beginning July 1, 2002, medical assistance may be paid 77.26 for a person who would have been eligible, but for excess income 77.27 or assets, under the state's AFDC plan in effect as of July 16, 77.28 1996, with the base AFDC standard increased according to section 77.29 256B.056, subdivision 4. 77.30 (b) BeginningJanuary 1, 1998,July 1, 2002, medical 77.31 assistance may be paid for a person who would have been eligible 77.32 for public assistance under the income andresourceassets 77.33 standards, or who would have been eligible but for excess income77.34or assets,under the state's AFDC plan in effect as of July 16, 77.35 1996,as required by the Personal Responsibility and Work77.36Opportunity Reconciliation Act of 1996 (PRWORA), Public Law78.1Number 104-193with the base AFDC rate increased according to 78.2 section 256B.056, subdivision 4. 78.3 [EFFECTIVE DATE.] This section is effective July 1, 2002. 78.4 Sec. 9. Minnesota Statutes 2000, section 256B.056, 78.5 subdivision 1a, is amended to read: 78.6 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 78.7 specifically required by state law or rule or federal law or 78.8 regulation, the methodologies used in counting income and assets 78.9 to determine eligibility for medical assistance for persons 78.10 whose eligibility category is based on blindness, disability, or 78.11 age of 65 or more years, the methodologies for the supplemental 78.12 security income program shall be used. Effective upon federal 78.13 approval, for children eligible under section 256B.055, 78.14 subdivision 12, or for home and community-based waiver services 78.15 whose eligibility for medical assistance is determined without 78.16 regard to parental income, child support payments, including any 78.17 payments made by an obligor in satisfaction of or in addition to 78.18 a temporary or permanent order for child support, social 78.19 security payments, and other benefits for basic needs are not 78.20 counted as income. For families and children, which includes 78.21 all other eligibility categories, the methodologies under the 78.22 state's AFDC plan in effect as of July 16, 1996, as required by 78.23 the Personal Responsibility and Work Opportunity Reconciliation 78.24 Act of 1996 (PRWORA), Public Law Number 104-193, shall be used. 78.25 Effective upon federal approval, in-kind contributions to, and 78.26 payments made on behalf of, a recipient, by an obligor, in 78.27 satisfaction of or in addition to a temporary or permanent order 78.28 for child support or maintenance, shall be considered income to 78.29 the recipient. For these purposes, a "methodology" does not 78.30 include an asset or income standard, or accounting method, or 78.31 method of determining effective dates. 78.32 Sec. 10. Minnesota Statutes 2000, section 256B.056, 78.33 subdivision 3, is amended to read: 78.34 Subd. 3. [ASSET LIMITATIONS.] To be eligible for medical 78.35 assistance, a person must not individually own more than $3,000 78.36 in assets, or if a member of a household with two family 79.1 members, husband and wife, or parent and child, the household 79.2 must not own more than $6,000 in assets, plus $200 for each 79.3 additional legal dependent. In addition to these maximum 79.4 amounts, an eligible individual or family may accrue interest on 79.5 these amounts, but they must be reduced to the maximum at the 79.6 time of an eligibility redetermination. The accumulation of the 79.7 clothing and personal needs allowance according to section 79.8 256B.35 must also be reduced to the maximum at the time of the 79.9 eligibility redetermination. The value of assets that are not 79.10 considered in determining eligibility for medical assistance is 79.11 the value of those assets excluded under the AFDC state plan as 79.12 of July 16, 1996, as required by the Personal Responsibility and 79.13 Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 79.14 Number 104-193, for families and children, and the supplemental 79.15 security income program for aged, blind, and disabled persons, 79.16 with the following exceptions: 79.17 (a) Household goods and personal effects are not considered. 79.18 (b) Capital and operating assets of a trade or business 79.19 that the local agency determines are necessary to the person's 79.20 ability to earn an income are not considered. 79.21 (c) Motor vehicles are excluded to the same extent excluded 79.22 by the supplemental security income program. 79.23 (d) Assets designated as burial expenses are excluded to 79.24 the same extent excluded by the supplemental security income 79.25 program. 79.26 (e) Effective upon federal approval, for a person who no 79.27 longer qualifies as an employed person with a disability due to 79.28 loss of earnings, assets allowed while eligible for medical 79.29 assistance under section 256B.057, subdivision 9, are not 79.30 considered for 12 months, beginning with the first month of 79.31 ineligibility as an employed person with a disability, to the 79.32 extent that the person's total assets remain within the allowed 79.33 limits of section 256B.057, subdivision 9, paragraph (b). 79.34 Sec. 11. Minnesota Statutes 2000, section 256B.056, 79.35 subdivision 4, is amended to read: 79.36 Subd. 4. [INCOME.] (a) To be eligible for medical 80.1 assistance, a person eligible under section 256B.055, 80.2subdivisionsubdivisions 7, 7a, and 12,not receiving80.3supplemental security income program payments, andmay have 80.4 income up to the following specified percentages of the federal 80.5 poverty guidelines for the family size effective on April 1 of 80.6 each year: 80.7 (1) 80 percent, effective July 1, 2002; 80.8 (2) 90 percent, effective July 1, 2003; 80.9 (3) 100 percent, effective July 1, 2004. 80.10 Increases in benefits under title II of the Social Security Act 80.11 shall not be counted as income for purposes of this subdivision 80.12 until the first day of the second full month following 80.13 publication of the change in the federal poverty guidelines. 80.14 (b) To be eligible for medical assistance, families and 80.15 children may have an income up to 133-1/3 percent of the AFDC 80.16 income standard in effect under the July 16, 1996, AFDC state 80.17 plan. Effective July 1, 2000, the base AFDC standard in effect 80.18 on July 16, 1996, shall be increased by three percent. Effective 80.19 January 1, 2000, and each successive January, recipients of 80.20 supplemental security income may have an income up to the 80.21 supplemental security income standard in effect on that date. 80.22 (c) Effective July 1, 2002, to be eligible for medical 80.23 assistance, families and children may have an income up to 100 80.24 percent of the federal poverty guidelines for the family size 80.25 effective on April 1 of each year. 80.26 (d) In computing income to determine eligibility of persons 80.27 under paragraphs (a) to (c) who are not residents of long-term 80.28 care facilities, the commissioner shall disregard increases in 80.29 income as required by Public Law Numbers 94-566, section 503; 80.30 99-272; and 99-509. Veterans aid and attendance benefits and 80.31 Veterans Administration unusual medical expense payments are 80.32 considered income to the recipient. 80.33 Sec. 12. Minnesota Statutes 2000, section 256B.056, 80.34 subdivision 5, is amended to read: 80.35 Subd. 5. [EXCESS INCOME.] A person who has excess income 80.36 is eligible for medical assistance if the person has expenses 81.1 for medical care that are more than the amount of the person's 81.2 excess income, computed by deducting incurred medical expenses 81.3 from the excess income to reduce the excess to the income 81.4 standard specified in subdivision 4, except that if federal 81.5 authorization to use the standard in subdivision 4 is not 81.6 obtained, the medically needy standard for purposes of a 81.7 spenddown shall be 133 and 1/3 percent of the AFDC income 81.8 standard in effect under the July 16, 1996, AFDC state plan, 81.9 increased by three percent. The person shall elect to have the 81.10 medical expenses deducted at the beginning of a one-month budget 81.11 period or at the beginning of a six-month budget period. The 81.12 commissioner shall allow persons eligible for assistance on a 81.13 one-month spenddown basis under this subdivision to elect to pay 81.14 the monthly spenddown amount in advance of the month of 81.15 eligibility to the state agency in order to maintain eligibility 81.16 on a continuous basis. If the recipient does not pay the 81.17 spenddown amount on or before the 20th of the month, the 81.18 recipient is ineligible for this option for the following 81.19 month. The local agency shall code the Medicaid Management 81.20 Information System (MMIS) to indicate that the recipient has 81.21 elected this option. The state agency shall convey recipient 81.22 eligibility information relative to the collection of the 81.23 spenddown to providers through the Electronic Verification 81.24 System (EVS). A recipient electing advance payment must pay the 81.25 state agency the monthly spenddown amount on or before the 20th 81.26 of the month in order to be eligible for this option in the 81.27 following month. 81.28 Sec. 13. Minnesota Statutes 2000, section 256B.057, 81.29 subdivision 9, is amended to read: 81.30 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 81.31 assistance may be paid for a person who is employed and who: 81.32 (1) meets the definition of disabled under the supplemental 81.33 security income program; 81.34 (2) is at least 16 but less than 65 years of age; 81.35 (3) meets the asset limits in paragraph (b); and 81.36 (4) pays a premium, if required, under paragraph (c). 82.1 Any spousal income or assets shall be disregarded for purposes 82.2 of eligibility and premium determinations. 82.3 (b) For purposes of determining eligibility under this 82.4 subdivision, a person's assets must not exceed $20,000, 82.5 excluding: 82.6 (1) all assets excluded under section 256B.056; 82.7 (2) retirement accounts, including individual accounts, 82.8 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 82.9 (3) medical expense accounts set up through the person's 82.10 employer. 82.11 (c) A person whose earned and unearned income is equal to 82.12 or greater than200100 percent of federal poverty guidelines 82.13 for the applicable family size must pay a premium to be eligible 82.14 for medical assistance under this subdivision. The premium 82.15 shall beequal to ten percent ofbased on the person's gross 82.16 earned and unearned incomeabove 200 percent of federal poverty82.17guidelines forand the applicable family sizeup to the cost of82.18coverage, using a sliding fee scale established by the 82.19 commissioner which begins at one percent of income at 100 82.20 percent of the federal poverty guidelines and gradually 82.21 increases to 7.5 percent of income for those with incomes at or 82.22 above 300 percent of the federal poverty guidelines. 82.23 (d) A person's eligibility and premium shall be determined 82.24 by the local county agency. Premiums must be paid to the 82.25 commissioner. All premiums are dedicated to the commissioner. 82.26 (e) Any required premium shall be determined at application 82.27 and redetermined annually at recertification or when a change in 82.28 income or family size occurs. 82.29 (f) Premium payment is due upon notification from the 82.30 commissioner of the premium amount required. Premiums may be 82.31 paid in installments at the discretion of the commissioner. 82.32 (g) Nonpayment of the premium shall result in denial or 82.33 termination of medical assistance unless the person demonstrates 82.34 good cause for nonpayment. Good cause exists if the 82.35 requirements specified in Minnesota Rules, part 9506.0040, 82.36 subpart 7, items B to D, are met. Nonpayment shall include 83.1 payment with a returned, refused, or dishonored instrument. The 83.2 commissioner may require a guaranteed form of payment as the 83.3 only means to replace a returned, refused, or dishonored 83.4 instrument. 83.5 [EFFECTIVE DATE.] This section is effective September 1, 83.6 2001. 83.7 Sec. 14. Minnesota Statutes 2000, section 256B.057, is 83.8 amended by adding a subdivision to read: 83.9 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 83.10 CERVICAL CANCER.] (a) Medical assistance may be paid for a 83.11 person who: 83.12 (1) has been screened for breast or cervical cancer by the 83.13 Minnesota breast and cervical cancer control program, and 83.14 program funds have been used to pay for the person's screening; 83.15 (2) according to the person's treating health professional, 83.16 needs treatment, including diagnostic services necessary to 83.17 determine the extent and proper course of treatment, for breast 83.18 or cervical cancer, including precancerous conditions and early 83.19 stage cancer; 83.20 (3) meets the income eligibility guidelines for the 83.21 Minnesota breast and cervical cancer control program; 83.22 (4) is under age 65; 83.23 (5) is not otherwise eligible for medical assistance under 83.24 United States Code, title 42, section 1396(a)(10)(A)(i); and 83.25 (6) is not otherwise covered under creditable coverage, as 83.26 defined under United States Code, title 42, section 300gg(c). 83.27 (b) Medical assistance provided for an eligible person 83.28 under this subdivision shall be limited to services provided 83.29 during the period that the person receives treatment for breast 83.30 or cervical cancer. 83.31 (c) A person meeting the criteria in paragraph (a) is 83.32 eligible for medical assistance without meeting the eligibility 83.33 criteria relating to income and assets in section 256B.056, 83.34 subdivisions 1a to 5b. 83.35 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 83.36 subdivision 3b, is amended to read: 84.1 Subd. 3b. [TELEMEDICINE CONSULTATIONS.](a)Medical 84.2 assistance covers telemedicine consultations. Telemedicine 84.3 consultations must be made via two-way, interactive video or 84.4 store-and-forward technology. Store-and-forward technology 84.5 includes telemedicine consultations that do not occur in real 84.6 time via synchronous transmissions, and that do not require a 84.7 face-to-face encounter with the patient for all or any part of 84.8 any such telemedicine consultation. The patient record must 84.9 include a written opinion from the consulting physician 84.10 providing the telemedicine consultation. A communication 84.11 between two physicians that consists solely of a telephone 84.12 conversation is not a telemedicine consultation. Coverage is 84.13 limited to three telemedicine consultations per recipient per 84.14 calendar week. Telemedicine consultations shall be paid at the 84.15 full allowable rate. 84.16(b) This subdivision expires July 1, 2001.84.17 Sec. 16. Minnesota Statutes 2000, section 256B.0625, is 84.18 amended by adding a subdivision to read: 84.19 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 84.20 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a) 84.21 [COVERAGE.] Medical assistance covers home-based intensive early 84.22 intervention behavior therapy for children with autism spectrum 84.23 disorders. Children with autism spectrum disorder, and their 84.24 custodial parents or foster parents, may access other covered 84.25 services to treat autism spectrum disorder, and are not required 84.26 to receive intensive early intervention behavior therapy 84.27 services under this subdivision. Intensive early intervention 84.28 behavior therapy does not include coverage for services to treat 84.29 developmental disorders of language, early onset psychosis, 84.30 Rett's disorder, selective mutism, social anxiety disorder, 84.31 stereotypic movement disorder, dementia, obsessive compulsive 84.32 disorder, schizoid personality disorder, avoidant personality 84.33 disorder, or reactive attachment disorder. If a child with 84.34 autism spectrum disorder is diagnosed to have one or more of 84.35 these conditions, intensive early intervention behavior therapy 84.36 includes coverage only for services necessary to treat the 85.1 autism spectrum disorder. 85.2 (b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR 85.3 THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve 85.4 the child's behavioral functioning, to prevent development of 85.5 challenging behaviors, to eliminate autistic behaviors, to 85.6 reduce the risk of out-of-home placement, and to establish 85.7 independent typical functioning in language and social 85.8 behavior. The procedures used to accomplish these goals are 85.9 based upon research in applied behavior analysis. 85.10 (c) [ELIGIBLE CHILDREN.] A child is eligible to initiate 85.11 IEIBTS if, the child meets the additional eligibility criteria 85.12 in paragraph (d) and in a diagnostic assessment by a mental 85.13 health professional who is not under the employ of the service 85.14 provider, the child: 85.15 (1) is found to have an autism spectrum disorder; 85.16 (2) has a current IQ of either untestable, or at least 30; 85.17 (3) if nonverbal, initiated behavior therapy by 42 months 85.18 of age; 85.19 (4) if verbal, initiated behavior therapy by 48 months of 85.20 age; or 85.21 (5) if having an IQ of at least 50, initiated behavior 85.22 therapy by 84 months of age. 85.23 To continue in IEIBTS, at least one of the child's custodial 85.24 parents or foster parents must participate in an average of at 85.25 least five hours of documented behavior therapy per week for six 85.26 months, and consistently implement behavior therapy 85.27 recommendations 24 hours a day. To continue after six-month 85.28 individualized treatment plan (ITP) reviews, the child must show 85.29 documented progress toward mastery of six-month benchmark 85.30 behavior objectives. The maximum number of months during which 85.31 services may be billed is 54. If significant progress towards 85.32 treatment goals has not been achieved after 24 months of 85.33 treatment, treatment must be discontinued. 85.34 (d) [ADDITIONAL ELIGIBLITY CRITERIA.] A child is eligible 85.35 to initiate IEIBTS if: 85.36 (1) in medical and diagnostic assessments by medical and 86.1 mental health professionals, it is determined that the child 86.2 does not have severe or profound mental retardation; 86.3 (2) an accurate assessment of the child's hearing has been 86.4 performed, including audiometry if the brain stem auditory 86.5 evokes response; 86.6 (3) a blood lead test has been performed prior to 86.7 initiation of treatment; and 86.8 (4) an EEG or neurologic evaluation is done, prior to 86.9 initiation of treatment, if the child has a history of staring 86.10 spells or developmental regression. 86.11 (e) [COVERED SERVICES.] The focus of IEIBTS must be to 86.12 treat the principal diagnostic features of the autism spectrum 86.13 disorder. All IEIBTS must be delivered by a team of 86.14 practitioners under the consistent supervision of a single 86.15 clinical supervisor. A mental health professional must develop 86.16 the ITP for IEIBTS. The ITP must include six-month benchmark 86.17 behavior objectives. All behavior therapy must be based upon 86.18 research in applied behavior analysis, with an emphasis upon 86.19 positive reinforcement of carefully task-analyzed skills for 86.20 optimum rates of progress. All behavior therapy must be 86.21 consistently applied and generalized throughout the 24-hour day 86.22 and seven-day week by all of the child's regular care 86.23 providers. When placing the child in school activities, a 86.24 majority of the peers must have no mental health diagnosis, and 86.25 the child must have sufficient social skills to succeed with 80 86.26 percent of the school activities. Reactive consequences, such 86.27 as redirection, correction, positive practice, or time-out, must 86.28 be used only when necessary to improve the child's success when 86.29 proactive procedures alone have not been effective. IEIBTS must 86.30 be delivered by a team of behavior therapy practitioners who are 86.31 employed under the direction of the same agency. The team may 86.32 deliver up to 200 billable hours per year of direct clinical 86.33 supervisor services, up to 750 billable hours per year of senior 86.34 behavior therapist services, and up to 1,800 billable hours per 86.35 year of direct behavior therapist services. A one-hour clinical 86.36 review meeting for the child, parents, and staff must be 87.1 scheduled 50 weeks a year, at which behavior therapy is reviewed 87.2 and planned. At least one-quarter of the annual clinical 87.3 supervisor billable hours shall consist of on-site clinical 87.4 meeting time. At least one-half of the annual senior behavior 87.5 therapist billable hours shall consist of direct services to the 87.6 child or parents. All of the behavioral therapist billable 87.7 hours shall consist of direct on-site services to the child or 87.8 parents. None of the senior behavior therapist billable hours 87.9 or behavior therapist billable hours shall consist of clinical 87.10 meeting time. If there is any regression of the autistic 87.11 spectrum disorder after 12 months of therapy, a neurologic 87.12 consultation must be performed. 87.13 (f) [PROVIDER QUALIFICATIONS.] The provider agency must be 87.14 capable of delivering consistent applied behavior analysis 87.15 (ABA)-based behavior therapy in the home. The site director of 87.16 the agency must be a mental health professional certified as a 87.17 behavior analyst by the Association for Behavior Analysis. Each 87.18 clinical supervisor must be certified as a behavior analyst by 87.19 the Association for Behavior Analysis. 87.20 (g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist 87.21 practitioner must be continuously supervised while in the home 87.22 until the practitioner has mastered competencies for independent 87.23 practice. Each behavior therapist must have mastered three 87.24 credits of academic content and practice in an ABA sequence at 87.25 an accredited university. A college degree or minimum hours of 87.26 experience are not required. Each behavior therapist must 87.27 continue training through weekly direct observation by the 87.28 senior behavior therapist, through demonstrated performance in 87.29 clinical meetings with the clinical supervisor, and annual 87.30 training in ABA. 87.31 (2) Each senior behavior therapist practitioner must have 87.32 mastered the senior behavior therapy competencies, completed one 87.33 year of practice as a behavior therapist, and six months of 87.34 co-therapy training with another senior behavior therapist or 87.35 have an equivalent amount of experience in ABA. Each senior 87.36 behavior therapist must have mastered 12 credits of academic 88.1 content and practice in an ABA sequence at an accredited 88.2 university. Each senior behavior therapist must continue 88.3 training through demonstrated performance in clinical meetings 88.4 with the clinical supervisor, and annual training in ABA. 88.5 (3) Each clinical supervisor practitioner must have 88.6 mastered the clinical supervisor and family consultation 88.7 competencies, completed two years of practice as a senior 88.8 behavior therapist and one year of co-therapy training with 88.9 another clinical supervisor, or equivalent experience in ABA. 88.10 Each clinical supervisor must continue training through annual 88.11 training in ABA. 88.12 (h) [PLACE OF SERVICE.] IEIBTS are provided primarily in 88.13 the child's home and community. Services may be provided in the 88.14 child's natural school or preschool classroom, home of a 88.15 relative, natural recreational setting, or day care. 88.16 (i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization 88.17 shall be required for services provided after 200 hours of 88.18 clinical supervisor, 750 hours of senior behavior therapist, or 88.19 1,800 hours of behavior therapist services per year. 88.20 (j) [PAYMENT RATES.] The following payment rates apply: 88.21 (1) for an IEIBTS clinical supervisor practitioner under 88.22 supervision of a mental health professional, the lower of the 88.23 submitted charge or $137 per hour unit; 88.24 (2) for an IEIBTS senior behavior therapist practitioner 88.25 under supervision of a mental health professional, the lower of 88.26 the submitted charge or $56 per hour unit; or 88.27 (3) for an IEIBTS behavior therapist practitioner under 88.28 supervision of a mental health professional, the lower of the 88.29 submitted charge or $19 per hour unit. 88.30 An IEIBTS practitioner may receive payment for travel time which 88.31 exceeds 50 minutes one-way. The maximum payment allowed will be 88.32 $0.51 per minute for up to a maximum of 300 hours per year. 88.33 For any week during which the above charges are made to 88.34 medical assistance, payments for the following services are 88.35 excluded: supervising mental health professional hours and 88.36 personal care attendant, home-based mental health, 89.1 family-community support, or mental health behavioral aide hours. 89.2 (k) [REPORT.] The commissioner shall collect evidence of 89.3 the effectiveness of intensive early intervention behavior 89.4 therapy services and present a report to the legislature by July 89.5 1, 2006. 89.6 [EFFECTIVE DATE.] This section is effective January 1, 2002. 89.7 Sec. 17. Minnesota Statutes 2000, section 256B.0625, 89.8 subdivision 13, is amended to read: 89.9 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 89.10 except for fertility drugs when specifically used to enhance 89.11 fertility, if prescribed by a licensed practitioner and 89.12 dispensed by a licensed pharmacist, by a physician enrolled in 89.13 the medical assistance program as a dispensing physician, or by 89.14 a physician or a nurse practitioner employed by or under 89.15 contract with a community health board as defined in section 89.16 145A.02, subdivision 5, for the purposes of communicable disease 89.17 control. The commissioner, after receiving recommendations from 89.18 professional medical associations and professional pharmacist 89.19 associations, shall designate a formulary committee to advise 89.20 the commissioner on the names of drugs for which payment is 89.21 made, recommend a system for reimbursing providers on a set fee 89.22 or charge basis rather than the present system, and develop 89.23 methods encouraging use of generic drugs when they are less 89.24 expensive and equally effective as trademark drugs. The 89.25 formulary committee shall consist of nine members, four of whom 89.26 shall be physicians who are not employed by the department of 89.27 human services, and a majority of whose practice is for persons 89.28 paying privately or through health insurance, three of whom 89.29 shall be pharmacists who are not employed by the department of 89.30 human services, and a majority of whose practice is for persons 89.31 paying privately or through health insurance, a consumer 89.32 representative, and a nursing home representative. Committee 89.33 members shall serve three-year terms and shall serve without 89.34 compensation. Members may be reappointed once. 89.35 (b) The commissioner shall establish a drug formulary. Its 89.36 establishment and publication shall not be subject to the 90.1 requirements of the Administrative Procedure Act, but the 90.2 formulary committee shall review and comment on the formulary 90.3 contents. The formulary committee shall review and recommend 90.4 drugs which require prior authorization. The formulary 90.5 committee may recommend drugs for prior authorization directly 90.6 to the commissioner, as long as opportunity for public input is 90.7 provided. Prior authorization may be requested by the 90.8 commissioner based on medical and clinical criteria before 90.9 certain drugs are eligible for payment. Before a drug may be 90.10 considered for prior authorization at the request of the 90.11 commissioner: 90.12 (1) the drug formulary committee must develop criteria to 90.13 be used for identifying drugs; the development of these criteria 90.14 is not subject to the requirements of chapter 14, but the 90.15 formulary committee shall provide opportunity for public input 90.16 in developing criteria; 90.17 (2) the drug formulary committee must hold a public forum 90.18 and receive public comment for an additional 15 days; and 90.19 (3) the commissioner must provide information to the 90.20 formulary committee on the impact that placing the drug on prior 90.21 authorization will have on the quality of patient care and 90.22 information regarding whether the drug is subject to clinical 90.23 abuse or misuse. Prior authorization may be required by the 90.24 commissioner before certain formulary drugs are eligible for 90.25 payment. The formulary shall not include: 90.26 (i) drugs or products for which there is no federal 90.27 funding; 90.28 (ii) over-the-counter drugs, except for antacids, 90.29 acetaminophen, family planning products, aspirin, insulin, 90.30 products for the treatment of lice, vitamins for adults with 90.31 documented vitamin deficiencies, vitamins for children under the 90.32 age of seven and pregnant or nursing women, and any other 90.33 over-the-counter drug identified by the commissioner, in 90.34 consultation with the drug formulary committee, as necessary, 90.35 appropriate, and cost-effective for the treatment of certain 90.36 specified chronic diseases, conditions or disorders, and this 91.1 determination shall not be subject to the requirements of 91.2 chapter 14; 91.3 (iii) anorectics, except that medically necessary 91.4 anorectics shall be covered for a recipient previously diagnosed 91.5 as having pickwickian syndrome and currently diagnosed as having 91.6 diabetes and being morbidly obese; 91.7 (iv) drugs for which medical value has not been 91.8 established; and 91.9 (v) drugs from manufacturers who have not signed a rebate 91.10 agreement with the Department of Health and Human Services 91.11 pursuant to section 1927 of title XIX of the Social Security Act. 91.12 The commissioner shall publish conditions for prohibiting 91.13 payment for specific drugs after considering the formulary 91.14 committee's recommendations. An honorarium of $100 per meeting 91.15 and reimbursement for mileage shall be paid to each committee 91.16 member in attendance. 91.17 (c) The basis for determining the amount of payment shall 91.18 be the lower of the actual acquisition costs of the drugs plus a 91.19 fixed dispensing fee; the maximum allowable cost set by the 91.20 federal government or by the commissioner plus the fixed 91.21 dispensing fee; or the usual and customary price charged to the 91.22 public. The pharmacy dispensing fee shall be $3.65, except that 91.23 the dispensing fee for intravenous solutions which must be 91.24 compounded by the pharmacist shall be $8 per bag, $14 per bag 91.25 for cancer chemotherapy products, and $30 per bag for total 91.26 parenteral nutritional products dispensed in one liter 91.27 quantities, or $44 per bag for total parenteral nutritional 91.28 products dispensed in quantities greater than one liter. Actual 91.29 acquisition cost includes quantity and other special discounts 91.30 except time and cash discounts. The actual acquisition cost of 91.31 a drug shall be estimated by the commissioner, at average 91.32 wholesale price minus nine percent, except that where a drug has 91.33 had its wholesale price reduced as a result of the actions of 91.34 the National Association of Medicaid Fraud Control Units, the 91.35 estimated actual acquisition cost shall be the reduced average 91.36 wholesale price, without the nine percent deduction. The 92.1 maximum allowable cost of a multisource drug may be set by the 92.2 commissioner and it shall be comparable to, but no higher than, 92.3 the maximum amount paid by other third-party payors in this 92.4 state who have maximum allowable cost programs. The 92.5 commissioner shall set maximum allowable costs for multisource 92.6 drugs that are not on the federal upper limit list as described 92.7 in United States Code, title 42, chapter 7, section 1396r-8(e), 92.8 the Social Security Act, and Code of Federal Regulations, title 92.9 42, part 447, section 447.332. Establishment of the amount of 92.10 payment for drugs shall not be subject to the requirements of 92.11 the Administrative Procedure Act. An additional dispensing fee 92.12 of $.30 may be added to the dispensing fee paid to pharmacists 92.13 for legend drug prescriptions dispensed to residents of 92.14 long-term care facilities when a unit dose blister card system, 92.15 approved by the department, is used. Under this type of 92.16 dispensing system, the pharmacist must dispense a 30-day supply 92.17 of drug. The National Drug Code (NDC) from the drug container 92.18 used to fill the blister card must be identified on the claim to 92.19 the department. The unit dose blister card containing the drug 92.20 must meet the packaging standards set forth in Minnesota Rules, 92.21 part 6800.2700, that govern the return of unused drugs to the 92.22 pharmacy for reuse. The pharmacy provider will be required to 92.23 credit the department for the actual acquisition cost of all 92.24 unused drugs that are eligible for reuse. Over-the-counter 92.25 medications must be dispensed in the manufacturer's unopened 92.26 package. The commissioner may permit the drug clozapine to be 92.27 dispensed in a quantity that is less than a 30-day supply. 92.28 Whenever a generically equivalent product is available, payment 92.29 shall be on the basis of the actual acquisition cost of the 92.30 generic drug, unless the prescriber specifically indicates 92.31 "dispense as written - brand necessary" on the prescription as 92.32 required by section 151.21, subdivision 2. 92.33 (d) For purposes of this subdivision, "multisource drugs" 92.34 means covered outpatient drugs, excluding innovator multisource 92.35 drugs for which there are two or more drug products, which: 92.36 (1) are related as therapeutically equivalent under the 93.1 Food and Drug Administration's most recent publication of 93.2 "Approved Drug Products with Therapeutic Equivalence 93.3 Evaluations"; 93.4 (2) are pharmaceutically equivalent and bioequivalent as 93.5 determined by the Food and Drug Administration; and 93.6 (3) are sold or marketed in Minnesota. 93.7 "Innovator multisource drug" means a multisource drug that was 93.8 originally marketed under an original new drug application 93.9 approved by the Food and Drug Administration. 93.10 (e) The basis for determining the amount of payment for 93.11 drugs administered in an outpatient setting shall be the lower 93.12 of the usual and customary cost submitted by the provider; the 93.13 average wholesale price minus five percent; or the maximum 93.14 allowable cost set by the federal government under United States 93.15 Code, title 42, chapter 7, section 1396r-8(e) and Code of 93.16 Federal Regulations, title 42, section 447.332, or by the 93.17 commissioner under paragraph (c). 93.18 Sec. 18. Minnesota Statutes 2000, section 256B.0625, 93.19 subdivision 13a, is amended to read: 93.20 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member 93.21 drug utilization review board is established. The board is 93.22 comprised of at least three but no more than four licensed 93.23 physicians actively engaged in the practice of medicine in 93.24 Minnesota; at least three licensed pharmacists actively engaged 93.25 in the practice of pharmacy in Minnesota; and one consumer 93.26 representative; the remainder to be made up of health care 93.27 professionals who are licensed in their field and have 93.28 recognized knowledge in the clinically appropriate prescribing, 93.29 dispensing, and monitoring of covered outpatient drugs. The 93.30 board shall be staffed by an employee of the department who 93.31 shall serve as an ex officio nonvoting member of the board. The 93.32 members of the board shall be appointed by the commissioner and 93.33 shall serve three-year terms. The members shall be selected 93.34 from lists submitted by professional associations. The 93.35 commissioner shall appoint the initial members of the board for 93.36 terms expiring as follows: three members for terms expiring 94.1 June 30, 1996; three members for terms expiring June 30, 1997; 94.2 and three members for terms expiring June 30, 1998. Members may 94.3 be reappointed once. The board shall annually elect a chair 94.4 from among the members. 94.5 The commissioner shall, with the advice of the board: 94.6 (1) implement a medical assistance retrospective and 94.7 prospective drug utilization review program as required by 94.8 United States Code, title 42, section 1396r-8(g)(3); 94.9 (2) develop and implement the predetermined criteria and 94.10 practice parameters for appropriate prescribing to be used in 94.11 retrospective and prospective drug utilization review; 94.12 (3) develop, select, implement, and assess interventions 94.13 for physicians, pharmacists, and patients that are educational 94.14 and not punitive in nature; 94.15 (4) establish a grievance and appeals process for 94.16 physicians and pharmacists under this section; 94.17 (5) publish and disseminate educational information to 94.18 physicians and pharmacists regarding the board and the review 94.19 program; 94.20 (6) adopt and implement procedures designed to ensure the 94.21 confidentiality of any information collected, stored, retrieved, 94.22 assessed, or analyzed by the board, staff to the board, or 94.23 contractors to the review program that identifies individual 94.24 physicians, pharmacists, or recipients; 94.25 (7) establish and implement an ongoing process to (i) 94.26 receive public comment regarding drug utilization review 94.27 criteria and standards, and (ii) consider the comments along 94.28 with other scientific and clinical information in order to 94.29 revise criteria and standards on a timely basis; and 94.30 (8) adopt any rules necessary to carry out this section. 94.31 The board may establish advisory committees. The 94.32 commissioner may contract with appropriate organizations to 94.33 assist the board in carrying out the board's duties. The 94.34 commissioner may enter into contracts for services to develop 94.35 and implement a retrospective and prospective review program. 94.36 The board shall report to the commissioner annually on the 95.1 date the Drug Utilization Review Annual Report is due to the 95.2 Health Care Financing Administration. This report is to cover 95.3 the preceding federal fiscal year. The commissioner shall make 95.4 the report available to the public upon request. The report 95.5 must include information on the activities of the board and the 95.6 program; the effectiveness of implemented interventions; 95.7 administrative costs; and any fiscal impact resulting from the 95.8 program. An honorarium of$50$100 per meeting and 95.9 reimbursement for mileage shall be paid to each board member in 95.10 attendance. 95.11 Sec. 19. Minnesota Statutes 2000, section 256B.0625, 95.12 subdivision 17, is amended to read: 95.13 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 95.14 covers transportation costs incurred solely for obtaining 95.15 emergency medical care or transportation costs incurred by 95.16 nonambulatory persons in obtaining emergency or nonemergency 95.17 medical care when paid directly to an ambulance company, common 95.18 carrier, or other recognized providers of transportation 95.19 services. For the purpose of this subdivision, a person who is 95.20 incapable of transport by taxicab or bus shall be considered to 95.21 be nonambulatory. 95.22 (b) Medical assistance covers special transportation, as 95.23 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 95.24 if the provider receives and maintains a current physician's 95.25 order by the recipient's attending physician certifying that the 95.26 recipient has a physical or mental impairment that would 95.27 prohibit the recipient from safely accessing and using a bus, 95.28 taxi, other commercial transportation, or private automobile. 95.29 Special transportation includes driver-assisted service to 95.30 eligible individuals. Driver-assisted service includes 95.31 passenger pickup at and return to the individual's residence or 95.32 place of business, assistance with admittance of the individual 95.33 to the medical facility, and assistance in passenger securement 95.34 or in securing of wheelchairs or stretchers in the vehicle. The 95.35 commissioner shall establish maximum medical assistance 95.36 reimbursement rates for special transportation services for 96.1 persons who need a wheelchairliftaccessible van or 96.2 stretcher-equipped vehicle and for those who do not need a 96.3 wheelchairliftaccessible van or stretcher-equipped vehicle. 96.4 The average of these two rates per trip must not exceed $15 for 96.5 the base rate and$1.20$1.50 per mile. Special transportation 96.6 provided tononambulatoryambulatory persons who do not need a 96.7 wheelchair lift van or stretcher-equipped vehicle, may be 96.8 reimbursed at a lower rate than special transportation provided 96.9 to persons who need a wheelchair lift van or stretcher-equipped 96.10 vehicle. 96.11 Sec. 20. Minnesota Statutes 2000, section 256B.0625, 96.12 subdivision 17a, is amended to read: 96.13 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 96.14 services rendered on or after July 1,19992001, medical 96.15 assistance payments for ambulance services shall beincreased by96.16five percentpaid at the greater of: (1) the medical assistance 96.17 reimbursement rate in effect on June 30, 2000; or (2) the 96.18 current Medicare reimbursement rate for ambulance services. 96.19 Sec. 21. Minnesota Statutes 2000, section 256B.0625, 96.20 subdivision 18a, is amended to read: 96.21 Subd. 18a. [PAYMENT FOR MEALS AND LODGINGACCESS TO 96.22 MEDICAL SERVICES.] (a) Medical assistance reimbursement for 96.23 meals for persons traveling to receive medical care may not 96.24 exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner. 96.25 (b) Medical assistance reimbursement for lodging for 96.26 persons traveling to receive medical care may not exceed $50 per 96.27 day unless prior authorized by the local agency. 96.28 (c) Medical assistance direct mileage reimbursement to the 96.29 eligible person or the eligible person's driver may not exceed 96.30 20 cents per mile. 96.31 (d) Medical assistance covers oral language interpreter 96.32 services when provided by an enrolled health care provider 96.33 during the course of providing a direct, person-to-person 96.34 covered health care service to an enrolled recipient with 96.35 limited English proficiency. 96.36 Sec. 22. Minnesota Statutes 2000, section 256B.0625, 97.1 subdivision 30, is amended to read: 97.2 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance 97.3 covers rural health clinic services, federally qualified health 97.4 center services, nonprofit community health clinic services, 97.5 public health clinic services, and the services of a clinic 97.6 meeting the criteria established in rule by the commissioner. 97.7 Rural health clinic services and federally qualified health 97.8 center services mean services defined in United States Code, 97.9 title 42, section 1396d(a)(2)(B) and (C). Payment for rural 97.10 health clinic and federally qualified health center services 97.11 shall be made according to applicable federal law and regulation. 97.12 (b) A federally qualified health center that is beginning 97.13 initial operation shall submit an estimate of budgeted costs and 97.14 visits for the initial reporting period in the form and detail 97.15 required by the commissioner. A federally qualified health 97.16 center that is already in operation shall submit an initial 97.17 report using actual costs and visits for the initial reporting 97.18 period. Within 90 days of the end of its reporting period, a 97.19 federally qualified health center shall submit, in the form and 97.20 detail required by the commissioner, a report of its operations, 97.21 including allowable costs actually incurred for the period and 97.22 the actual number of visits for services furnished during the 97.23 period, and other information required by the commissioner. 97.24 Federally qualified health centers that file Medicare cost 97.25 reports shall provide the commissioner with a copy of the most 97.26 recent Medicare cost report filed with the Medicare program 97.27 intermediary for the reporting year which support the costs 97.28 claimed on their cost report to the state. 97.29 (c) In order to continue cost-based payment under the 97.30 medical assistance program according to paragraphs (a) and (b), 97.31 a federally qualified health center or rural health clinic must 97.32 apply for designation as an essential community provider within 97.33 six months of final adoption of rules by the department of 97.34 health according to section 62Q.19, subdivision 7. For those 97.35 federally qualified health centers and rural health clinics that 97.36 have applied for essential community provider status within the 98.1 six-month time prescribed, medical assistance payments will 98.2 continue to be made according to paragraphs (a) and (b) for the 98.3 first three years after application. For federally qualified 98.4 health centers and rural health clinics that either do not apply 98.5 within the time specified above or who have had essential 98.6 community provider status for three years, medical assistance 98.7 payments for health services provided by these entities shall be 98.8 according to the same rates and conditions applicable to the 98.9 same service provided by health care providers that are not 98.10 federally qualified health centers or rural health clinics. 98.11 (d) Effective July 1, 1999, the provisions of paragraph (c) 98.12 requiring a federally qualified health center or a rural health 98.13 clinic to make application for an essential community provider 98.14 designation in order to have cost-based payments made according 98.15 to paragraphs (a) and (b) no longer apply. 98.16 (e) Effective January 1, 2000, payments made according to 98.17 paragraphs (a) and (b) shall be limited to the cost phase-out 98.18 schedule of the Balanced Budget Act of 1997. 98.19 (f) Effective January 1, 2001, each federally qualified 98.20 health center and rural health clinic may elect to be paid 98.21 either under the prospective payment system established in 98.22 United States Code, title 42, section 1396a, paragraph (a) or 98.23 under an alternative payment methodology consistent with the 98.24 requirements of United States Code, title 42, section 1392a, 98.25 paragraph (a) and approved by the health care financing 98.26 administration. The alternative payment methodology shall be 98.27 100 percent of cost as determined according to Medicare cost 98.28 principles. 98.29 Sec. 23. Minnesota Statutes 2000, section 256B.0625, 98.30 subdivision 34, is amended to read: 98.31 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical 98.32 assistance payments and MinnesotaCare payments to facilities of 98.33 the Indian health service and facilities operated by a tribe or 98.34 tribal organization under funding authorized by United States 98.35 Code, title 25, sections 450f to 450n, or title III of the 98.36 Indian Self-Determination and Education Assistance Act, Public 99.1 Law Number 93-638, for enrollees who are eligible for federal 99.2 financial participation, shall be at the option of the facility 99.3 in accordance with the rate published by the United States 99.4 Assistant Secretary for Health under the authority of United 99.5 States Code, title 42, sections 248(a) and 249(b). General 99.6 assistance medical care payments to facilities of the Indian 99.7 health services and facilities operated by a tribe or tribal 99.8 organization for the provision of outpatient medical care 99.9 services billed after June 30, 1990, must be in accordance with 99.10 the general assistance medical care rates paid for the same 99.11 services when provided in a facility other than a facility of 99.12 the Indian health service or a facility operated by a tribe or 99.13 tribal organization. MinnesotaCare payments for enrollees who 99.14 are not eligible for federal financial participation at 99.15 facilities of the Indian Health Service and facilities operated 99.16 by a tribe or tribal organization for the provision of 99.17 outpatient medical services must be in accordance with the 99.18 medical assistance rates paid for the same services when 99.19 provided in a facility other than a facility of the Indian 99.20 Health Service or a facility operated by a tribe or tribal 99.21 organization. 99.22 [EFFECTIVE DATE.] This section is effective the day 99.23 following final enactment. 99.24 Sec. 24. Minnesota Statutes 2000, section 256B.0635, 99.25 subdivision 1, is amended to read: 99.26 Subdivision 1. [INCREASED EMPLOYMENT.]Beginning January99.271, 1998(a) Until June 30, 2002, medical assistance may be paid 99.28 for persons who received MFIP-S or medical assistance for 99.29 families and children in at least three of six months preceding 99.30 the month in which the person became ineligible for MFIP-S or 99.31 medical assistance, if the ineligibility was due to an increase 99.32 in hours of employment or employment income or due to the loss 99.33 of an earned income disregard. In addition, to receive 99.34 continued assistance under this section, persons who received 99.35 medical assistance for families and children but did not receive 99.36 MFIP-S must have had income less than or equal to the assistance 100.1 standard for their family size under the state's AFDC plan in 100.2 effect as of July 16, 1996,as required by the Personal100.3Responsibility and Work Opportunity Reconciliation Act of 1996100.4(PRWORA), Public Law Number 104-193,increased according to 100.5 section 256B.056, subdivision 4, at the time medical assistance 100.6 eligibility began. A person who is eligible for extended 100.7 medical assistance is entitled to six months of assistance 100.8 without reapplication, unless the assistance unit ceases to 100.9 include a dependent child. For a person under 21 years of age, 100.10 medical assistance may not be discontinued within the six-month 100.11 period of extended eligibility until it has been determined that 100.12 the person is not otherwise eligible for medical assistance. 100.13 Medical assistance may be continued for an additional six months 100.14 if the person meets all requirements for the additional six 100.15 months, according to title XIX of the Social Security Act, as 100.16 amended by section 303 of the Family Support Act of 1988, Public 100.17 Law Number 100-485. 100.18 (b) Beginning July 1, 2002, medical assistance for families 100.19 and children may be paid for persons who were eligible under 100.20 section 256B.055, subdivision 3a, paragraph (b), in at least 100.21 three of six months preceding the month in which the person 100.22 became ineligible under that section if the ineligibility was 100.23 due to an increase in hours of employment or employment income 100.24 or due to the loss of an earned income disregard. A person who 100.25 is eligible for extended medical assistance is entitled to six 100.26 months of assistance without reapplication, unless the 100.27 assistance unit ceases to include a dependent child, except 100.28 medical assistance may not be discontinued for that dependent 100.29 child under 21 years of age within the six-month period of 100.30 extended eligibility until it has been determined that the 100.31 person is not otherwise eligible for medical assistance. 100.32 Medical assistance may be continued for an additional six months 100.33 if the person meets all requirements for the additional six 100.34 months, according to title XIX of the Social Security Act, as 100.35 amended by section 303 of the Family Support Act of 1988, Public 100.36 Law Number 100-485. 101.1 [EFFECTIVE DATE.] This section is effective July 1, 2001. 101.2 Sec. 25. Minnesota Statutes 2000, section 256B.0635, 101.3 subdivision 2, is amended to read: 101.4 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.]Beginning101.5January 1, 1998(a) Until June 30, 2002, medical assistance may 101.6 be paid for persons who received MFIP-S or medical assistance 101.7 for families and children in at least three of the six months 101.8 preceding the month in which the person became ineligible for 101.9 MFIP-S or medical assistance, if the ineligibility was the 101.10 result of the collection of child or spousal support under part 101.11 D of title IV of the Social Security Act. In addition, to 101.12 receive continued assistance under this section, persons who 101.13 received medical assistance for families and children but did 101.14 not receive MFIP-S must have had income less than or equal to 101.15 the assistance standard for their family size under the state's 101.16 AFDC plan in effect as of July 16, 1996,as required by the101.17Personal Responsibility and Work Opportunity Reconciliation Act101.18of 1996 (PRWORA), Public Law Number 104-193increased according 101.19 to section 256B.056, subdivision 4, at the time medical 101.20 assistance eligibility began. A person who is eligible for 101.21 extended medical assistance under this subdivision is entitled 101.22 to four months of assistance without reapplication, unless the 101.23 assistance unit ceases to include a dependent child. For a101.24person under 21 years of age, except medical assistance may not 101.25 be discontinued for that dependent child under 21 years of age 101.26 within the four-month period of extended eligibility until it 101.27 has been determined that the person is not otherwise eligible 101.28 for medical assistance. 101.29 (b) Beginning July 1, 2002, medical assistance for families 101.30 and children may be paid for persons who were eligible under 101.31 section 256B.055, subdivision 3a, paragraph (b), in at least 101.32 three of the six months preceding the month in which the person 101.33 became ineligible under that section if the ineligibility was 101.34 the result of the collection of child or spousal support under 101.35 part D of title IV of the Social Security Act. A person who is 101.36 eligible for extended medical assistance under this subdivision 102.1 is entitled to four months of assistance without reapplication, 102.2 unless the assistance unit ceases to include a dependent child, 102.3 except medical assistance may not be discontinued for that 102.4 dependent child under 21 years of age within the four-month 102.5 period of extended eligibility until it has been determined that 102.6 the person is not otherwise eligible for medical assistance. 102.7 [EFFECTIVE DATE.] This section is effective July 1, 2001. 102.8 Sec. 26. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 102.9 PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 102.10 Medical assistance is available during a presumptive 102.11 eligibility period for persons who meet the criteria in section 102.12 256B.057, subdivision 10. For purposes of this section, the 102.13 presumptive eligibility period begins on the date on which an 102.14 entity designated by the commissioner determines, based on 102.15 preliminary information, that the person meets the criteria in 102.16 section 256B.057, subdivision 10. The presumptive eligibility 102.17 period ends on the day on which a determination is made as to 102.18 the person's eligibility, except that if an application is not 102.19 submitted by the last day of the month following the month 102.20 during which the determination based on preliminary information 102.21 is made, the presumptive eligibility period ends on that last 102.22 day of the month. 102.23 Sec. 27. [256B.195] [HEALTH CARE SAFETY NET PRESERVATION.] 102.24 Subdivision 1. [INTERGOVERNMENTAL TRANSFERS AND RELATED 102.25 PAYMENTS.] (a) This section is contingent on federal approval of 102.26 the intergovernmental transfers and payments to safety net 102.27 hospitals authorized under this section. 102.28 (b) In addition to the percentage contribution paid by a 102.29 county under section 256B.19, subdivision 1, the governmental 102.30 units designated in this subdivision shall be responsible for an 102.31 additional portion of the nonfederal share of medical assistance 102.32 costs attributable to them. For purposes of this section, 102.33 "designated governmental unit" means Hennepin county, Ramsey 102.34 county, or the University of Minnesota. For purposes of this 102.35 section, "nonstate, government hospital" means Hennepin County 102.36 Medical Center, the successor or assignee to St. Paul-Ramsey 103.1 Medical Center as described in section 383A.91, or Fairview 103.2 University Medical Center. 103.3 (c) Effective July 1, 2001, the governmental units 103.4 designated in paragraph (a) shall in total transfer $2,833,333 103.5 on a monthly basis to the state Medicaid agency. The 103.6 commissioner shall allocate this assessment between the 103.7 governmental units based on the proportion of the Medicare upper 103.8 payment limit for each nonstate, government hospital located 103.9 within the governmental unit to the total Medicare upper payment 103.10 limit of all participating hospitals in paragraph (b). 103.11 (d) The commissioner shall distribute the proceeds of this 103.12 intergovernmental transfer, including the federal Medicaid 103.13 match, as follows: 103.14 (1) Proceeds may be no less than the amount of the 103.15 intergovernmental transfer in paragraph (c) multiplied by 1.75. 103.16 (2) The remaining proceeds provide funding for hospital 103.17 charity care aid under section 144.585. The commissioner of 103.18 human services shall work with the commissioner of health to 103.19 assure that hospital charity care aid payments are administered 103.20 in a manner that generates Medicaid matching funds. 103.21 (e) The successor or assignee to St. Paul-Ramsey Medical 103.22 Center shall transfer on a monthly basis to Ramsey county an 103.23 amount equal to the county assessment under paragraph (c). 103.24 Subd. 2. [DETERMINATION OF INTERGOVERNMENTAL TRANSFER 103.25 AMOUNTS.] Medicaid rate changes, including those required to 103.26 obtain federal financial participation under section 62J.692, 103.27 subdivision 8, enacted prior to the effective date of this 103.28 legislation, shall precede the determination of 103.29 intergovernmental transfer amounts determined in this section. 103.30 Participation in the intergovernmental transfer program shall 103.31 not result in the offset of any nonstate, government hospital's 103.32 receipt of Medicaid payment increases. 103.33 Subd. 3. [STATE PLAN AMENDMENTS.] The commissioner shall 103.34 amend the state Medicaid plan as necessary to implement this 103.35 section. 103.36 Subd. 4. [PROPORTIONATE ADJUSTMENTS.] (a) The commissioner 104.1 shall adjust the intergovernmental transfers under subdivision 104.2 1, paragraph (c), and the payments under subdivision 1, 104.3 paragraph (d), upon the approval of the designated governmental 104.4 unit named in subdivision 1, paragraph (b), based on the 104.5 commissioner's determination of Medicare upper payment limits, 104.6 hospital-specific federal limitations on disproportionate share 104.7 payments or to maximize additional federal reimbursements. 104.8 (b) In the event that: (i) federal approval is not 104.9 received for the total intergovernmental transfer amount 104.10 specified in subdivision 1, paragraph (d), or, (ii) federal 104.11 rules regarding the establishment of the 150 percent Medicare 104.12 upper payment limit, section 1102 of the Social Security Act, 104.13 United States Code, title 42, section 1302, enacted on March 13, 104.14 2001, are rescinded or, (iii) the federal 150 percent Medicare 104.15 upper payment limit is reduced to 100 percent, the amount of the 104.16 intergovernmental transfers and Medicaid payments to the 104.17 nonstate, government hospitals named in subdivision 1, paragraph 104.18 (b), shall be adjusted for each hospital based on the proportion 104.19 of each hospital's Medicaid inpatient hospital days to the total 104.20 Medicaid inpatient hospital days provided by all participating 104.21 hospitals. 104.22 [EFFECTIVE DATE.] This section is effective July 1, 2001. 104.23 Sec. 28. Minnesota Statutes 2000, section 256B.69, 104.24 subdivision 4, is amended to read: 104.25 Subd. 4. [LIMITATION OF CHOICE.] The commissioner shall 104.26 develop criteria to determine when limitation of choice may be 104.27 implemented in the experimental counties. The criteria shall 104.28 ensure that all eligible individuals in the county have 104.29 continuing access to the full range of medical assistance 104.30 services as specified in subdivision 6. The commissioner shall 104.31 exempt the following persons from participation in the project, 104.32 in addition to those who do not meet the criteria for limitation 104.33 of choice: 104.34 (1) persons eligible for medical assistance according to 104.35 section 256B.055, subdivision 1; 104.36 (2) persons eligible for medical assistance due to 105.1 blindness or disability as determined by the social security 105.2 administration or the state medical review team, unless: 105.3 (i) they are 65 years of age or older,; or 105.4 (ii) they reside in Itasca county or they reside in a 105.5 county in which the commissioner conducts a pilot project under 105.6 a waiver granted pursuant to section 1115 of the Social Security 105.7 Act; 105.8 (3) recipients who currently have private coverage through 105.9 a health maintenance organization; 105.10 (4) recipients who are eligible for medical assistance by 105.11 spending down excess income for medical expenses other than the 105.12 nursing facility per diem expense; 105.13 (5) recipients who receive benefits under the Refugee 105.14 Assistance Program, established under United States Code, title 105.15 8, section 1522(e); 105.16 (6) children who are both determined to be severely 105.17 emotionally disturbed and receiving case management services 105.18 according to section 256B.0625, subdivision 20;and105.19 (7) adults who are both determined to be seriously and 105.20 persistently mentally ill and received case management services 105.21 according to section 256B.0625, subdivision 20; and 105.22 (8) persons eligible for medical assistance according to 105.23 section 256B.057, subdivision 10. 105.24 Children under age 21 who are in foster placement may enroll in 105.25 the project on an elective basis. Individuals excluded under 105.26 clauses (6) and (7) may choose to enroll on an elective basis. 105.27 The commissioner may allow persons with a one-month spenddown 105.28 who are otherwise eligible to enroll to voluntarily enroll or 105.29 remain enrolled, if they elect to prepay their monthly spenddown 105.30 to the state.Beginning on or after July 1, 1997,The 105.31 commissioner may require those individuals to enroll in the 105.32 prepaid medical assistance program who otherwise would have been 105.33 excluded under clauses (1)and, (3), and (8), and under 105.34 Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 105.35 Before limitation of choice is implemented, eligible individuals 105.36 shall be notified and after notification, shall be allowed to 106.1 choose only among demonstration providers. The commissioner may 106.2 assign an individual with private coverage through a health 106.3 maintenance organization, to the same health maintenance 106.4 organization for medical assistance coverage, if the health 106.5 maintenance organization is under contract for medical 106.6 assistance in the individual's county of residence. After 106.7 initially choosing a provider, the recipient is allowed to 106.8 change that choice only at specified times as allowed by the 106.9 commissioner. If a demonstration provider ends participation in 106.10 the project for any reason, a recipient enrolled with that 106.11 provider must select a new provider but may change providers 106.12 without cause once more within the first 60 days after 106.13 enrollment with the second provider. 106.14 Sec. 29. Minnesota Statutes 2000, section 256B.69, 106.15 subdivision 5, is amended to read: 106.16 Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The 106.17 commissioner shall establish the method and amount of payments 106.18 for services. The commissioner shall annually contract with 106.19 demonstration providers to provide services consistent with 106.20 these established methods and amounts for payment. Payment 106.21 rates established by the commissioner must be within the limits 106.22 of available appropriations. 106.23 If allowed by the commissioner, a demonstration provider 106.24 may contract with an insurer, health care provider, nonprofit 106.25 health service plan corporation, or the commissioner, to provide 106.26 insurance or similar protection against the cost of care 106.27 provided by the demonstration provider or to provide coverage 106.28 against the risks incurred by demonstration providers under this 106.29 section. The recipients enrolled with a demonstration provider 106.30 are a permissible group under group insurance laws and chapter 106.31 62C, the Nonprofit Health Service Plan Corporations Act. Under 106.32 this type of contract, the insurer or corporation may make 106.33 benefit payments to a demonstration provider for services 106.34 rendered or to be rendered to a recipient. Any insurer or 106.35 nonprofit health service plan corporation licensed to do 106.36 business in this state is authorized to provide this insurance 107.1 or similar protection. 107.2 Payments to providers participating in the project are 107.3 exempt from the requirements of sections 256.966 and 256B.03, 107.4 subdivision 2. The commissioner shall complete development of 107.5 capitation rates for payments before delivery of services under 107.6 this section is begun. For payments made during calendar year 107.7 1990 and later years, the commissioner shall contract with an 107.8 independent actuary to establish prepayment rates. 107.9 By January 15, 1996, the commissioner shall report to the 107.10 legislature on the methodology used to allocate to participating 107.11 counties available administrative reimbursement for advocacy and 107.12 enrollment costs. The report shall reflect the commissioner's 107.13 judgment as to the adequacy of the funds made available and of 107.14 the methodology for equitable distribution of the funds. The 107.15 commissioner must involve participating counties in the 107.16 development of the report. 107.17 Sec. 30. Minnesota Statutes 2000, section 256B.69, 107.18 subdivision 5b, is amended to read: 107.19 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 107.20 prepaid medical assistance and general assistance medical care 107.21 program contract rates set by the commissioner under subdivision 107.22 5 and effective on or after January 1, 1998, capitation rates 107.23 for nonmetropolitan counties shall on a weighted average be no 107.24 less than 88 percent of the capitation rates for metropolitan 107.25 counties, excluding Hennepin county. The commissioner shall 107.26 make a pro rata adjustment in capitation rates paid to counties 107.27 other than nonmetropolitan counties in order to make this 107.28 provision budget neutral. 107.29 (b) For prepaid medical assistance program contract rates 107.30 set by the commissioner under subdivision 5 and effective on or 107.31 after January 1,20012002, capitation rates for nonmetropolitan 107.32 counties shall, on a weighted average, be no less than8995 107.33 percent of the capitation rates for metropolitan counties, 107.34 excluding Hennepin county. The commissioner shall make a pro 107.35 rata adjustment in capitation rates paid to Hennepin county in 107.36 order to make the portion of the increase between 89 and 95 108.1 percent budget neutral. 108.2 (c) This subdivision shall not affect the nongeographically 108.3 based risk adjusted rates established under section 62Q.03, 108.4 subdivision 5a, paragraph (f). 108.5 (d) The commissioner shall require prepaid health plans to 108.6 use all revenue received from the increase in capitation rates 108.7 for nonmetropolitan counties from 89 to no less than 95 percent 108.8 of the capitation rate for metropolitan counties, excluding 108.9 Hennepin county, to increase reimbursement rates, effective 108.10 January 1, 2002, for providers under contract with the prepaid 108.11 health plan to serve enrollees from nonmetropolitan counties. 108.12 Sec. 31. Minnesota Statutes 2000, section 256B.69, is 108.13 amended by adding a subdivision to read: 108.14 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The 108.15 commissioner shall establish a dental services demonstration 108.16 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 108.17 for provision of dental services to medical assistance, general 108.18 assistance medical care, and MinnesotaCare recipients. The 108.19 commissioner may contract on a prospective per capita payment 108.20 basis for these dental services with an organization licensed 108.21 under chapter 62C, 62D, or 62N in accordance with section 108.22 256B.037 or may establish and administer a fee-for-service 108.23 system for the reimbursement of dental services. 108.24 [EFFECTIVE DATE.] This section is effective January 1, 2002. 108.25 Sec. 32. Minnesota Statutes 2000, section 256B.75, is 108.26 amended to read: 108.27 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 108.28 (a) For outpatient hospital facility fee payments for 108.29 services rendered on or after October 1, 1992, the commissioner 108.30 of human services shall pay the lower of (1) submitted charge, 108.31 or (2) 32 percent above the rate in effect on June 30, 1992, 108.32 except for those services for which there is a federal maximum 108.33 allowable payment. Effective for services rendered on or after 108.34 January 1, 2000, payment rates for nonsurgical outpatient 108.35 hospital facility fees and emergency room facility fees shall be 108.36 increased by eight percent over the rates in effect on December 109.1 31, 1999, except for those services for which there is a federal 109.2 maximum allowable payment. Services for which there is a 109.3 federal maximum allowable payment shall be paid at the lower of 109.4 (1) submitted charge, or (2) the federal maximum allowable 109.5 payment. Total aggregate payment for outpatient hospital 109.6 facility fee services shall not exceed the Medicare upper 109.7 limit. If it is determined that a provision of this section 109.8 conflicts with existing or future requirements of the United 109.9 States government with respect to federal financial 109.10 participation in medical assistance, the federal requirements 109.11 prevail. The commissioner may, in the aggregate, prospectively 109.12 reduce payment rates to avoid reduced federal financial 109.13 participation resulting from rates that are in excess of the 109.14 Medicare upper limitations. 109.15 (b) Notwithstanding paragraph (a), payment for outpatient, 109.16 emergency, and ambulatory surgery hospital facility fee services 109.17 for critical access hospitals designated under section 144.1483, 109.18 clause (11), shall be paid on a cost-based payment system that 109.19 is based on the cost-finding methods and allowable costs of the 109.20 Medicare program. 109.21 (c) Effective for services provided on or after July 1, 109.22 2002, rates that are based on the Medicare outpatient 109.23 prospective payment system shall be replaced by a budget neutral 109.24 prospective payment system that is derived using medical 109.25 assistance data. The department shall provide a proposal to the 109.26 2002 legislature to define and implement this provision. 109.27 Sec. 33. Minnesota Statutes 2000, section 256B.76, is 109.28 amended to read: 109.29 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 109.30 (a) Effective for services rendered on or after October 1, 109.31 1992, the commissioner shall make payments for physician 109.32 services as follows: 109.33 (1) payment for level one Health Care Finance 109.34 Administration's common procedural coding system (HCPCS) codes 109.35 titled "office and other outpatient services," "preventive 109.36 medicine new and established patient," "delivery, antepartum, 110.1 and postpartum care," "critical care,"Caesareancesarean 110.2 delivery and pharmacologic management provided to psychiatric 110.3 patients, and HCPCS level three codes for enhanced services for 110.4 prenatal high risk, shall be paid at the lower of (i) submitted 110.5 charges, or (ii) 25 percent above the rate in effect on June 30, 110.6 1992. If the rate on any procedure code within these categories 110.7 is different than the rate that would have been paid under the 110.8 methodology in section 256B.74, subdivision 2, then the larger 110.9 rate shall be paid; 110.10 (2) payments for all other services shall be paid at the 110.11 lower of (i) submitted charges, or (ii) 15.4 percent above the 110.12 rate in effect on June 30, 1992; 110.13 (3) all physician rates shall be converted from the 50th 110.14 percentile of 1982 to the 50th percentile of 1989, less the 110.15 percent in aggregate necessary to equal the above increases 110.16 except that payment rates for home health agency services shall 110.17 be the rates in effect on September 30, 1992; 110.18 (4) effective for services rendered on or after January 1, 110.19 2000, payment rates for physician and professional services 110.20 shall be increased by three percent over the rates in effect on 110.21 December 31, 1999, except for home health agency and family 110.22 planning agency services; and 110.23 (5) the increases in clause (4) shall be implemented 110.24 January 1, 2000, for managed care. 110.25 (b) Effective for services rendered on or after October 1, 110.26 1992, the commissioner shall make payments for dental services 110.27 as follows: 110.28 (1) dental services shall be paid at the lower of (i) 110.29 submitted charges, or (ii) 25 percent above the rate in effect 110.30 on June 30, 1992; 110.31 (2) dental rates shall be converted from the 50th 110.32 percentile of 1982 to the 50th percentile of 1989, less the 110.33 percent in aggregate necessary to equal the above increases; 110.34 (3) effective for services rendered on or after January 1, 110.35 2000, payment rates for dental services shall be increased by 110.36 three percent over the rates in effect on December 31, 1999; 111.1 (4) the commissioner shall award grants to community 111.2 clinics or other nonprofit community organizations, political 111.3 subdivisions, professional associations, or other organizations 111.4 that demonstrate the ability to provide dental services 111.5 effectively to public program recipients. Grants may be used to 111.6 fund the costs related to coordinating access for recipients, 111.7 developing and implementing patient care criteria, upgrading or 111.8 establishing new facilities, acquiring furnishings or equipment, 111.9 recruiting new providers, or other development costs that will 111.10 improve access to dental care in a region. In awarding grants, 111.11 the commissioner shall give priority to applicants that plan to 111.12 serve areas of the state in which the number of dental providers 111.13 is not currently sufficient to meet the needs of recipients of 111.14 public programs or uninsured individuals. The commissioner 111.15 shall consider the following in awarding the grants: (i) 111.16 potential to successfully increase access to an underserved 111.17 population; (ii) the ability to raise matching funds; (iii) the 111.18 long-term viability of the project to improve access beyond the 111.19 period of initial funding; (iv) the efficiency in the use of the 111.20 funding; and (v) the experience of the proposers in providing 111.21 services to the target population. 111.22 The commissioner shall monitor the grants and may terminate 111.23 a grant if the grantee does not increase dental access for 111.24 public program recipients. The commissioner shall consider 111.25 grants for the following: 111.26 (i) implementation of new programs or continued expansion 111.27 of current access programs that have demonstrated success in 111.28 providing dental services in underserved areas; 111.29 (ii) a pilot program for utilizing hygienists outside of a 111.30 traditional dental office to provide dental hygiene services; 111.31 and 111.32 (iii) a program that organizes a network of volunteer 111.33 dentists, establishes a system to refer eligible individuals to 111.34 volunteer dentists, and through that network provides donated 111.35 dental care services to public program recipients or uninsured 111.36 individuals. 112.1 (5) beginning October 1, 1999, the payment for tooth 112.2 sealants and fluoride treatments shall be the lower of (i) 112.3 submitted charge, or (ii) 80 percent of median 1997 charges;and112.4 (6) the increases listed in clauses (3) and (5) shall be 112.5 implemented January 1, 2000, for managed care; and 112.6 (7) effective for services provided on or after October 1, 112.7 2001, payment for diagnostic examinations and dental x-rays 112.8 provided to children under age 21 shall be the lower of (i) the 112.9 submitted charge, or (ii) 85 percent of median 1999 charges. 112.10 (c) Effective for dental services rendered on or after July 112.11 1, 2001, the commissioner may increase reimbursements to 112.12 dentists and dental clinics deemed by the commissioner to be 112.13 critical access dental providers. Reimbursement to a critical 112.14 access dental provider may be increased by not more than 50 112.15 percent above the reimbursement rate that would otherwise be 112.16 paid to the provider. Payments to health plan companies shall 112.17 be adjusted to reflect increased reimbursements to critical 112.18 access dental providers as approved by the commissioner. In 112.19 determining which dentists and dental clinics shall be deemed 112.20 critical access dental providers, the commissioner shall review: 112.21 (1) the utilization rate in the service area in which the 112.22 dentist or dental clinic operates for dental services to 112.23 patients covered by medical assistance, general assistance 112.24 medical care, or MinnesotaCare as their primary source of 112.25 coverage; 112.26 (2) the level of services provided by the dentist or dental 112.27 clinic to patients covered by medical assistance, general 112.28 assistance medical care, or MinnesotaCare as their primary 112.29 source of coverage; and 112.30 (3) whether the level of services provided by the dentist 112.31 or dental clinic is critical to maintaining adequate levels of 112.32 patient access within the service area. 112.33 In the absence of a critical access dental provider in a service 112.34 area, the commissioner may designate a dentist or dental clinic 112.35 as a critical access dental provider if the dentist or dental 112.36 clinic is willing to provide care to patients covered by medical 113.1 assistance, general assistance medical care, or MinnesotaCare at 113.2 a level which significantly increases access to dental care in 113.3 the service area. 113.4 (d) An entity that operates both a Medicare certified 113.5 comprehensive outpatient rehabilitation facility and a facility 113.6 which was certified prior to January 1, 1993, that is licensed 113.7 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 113.8 whom at least 33 percent of the clients receiving rehabilitation 113.9 services in the most recent calendar year are medical assistance 113.10 recipients, shall be reimbursed by the commissioner for 113.11 rehabilitation services at rates that are 38 percent greater 113.12 than the maximum reimbursement rate allowed under paragraph (a), 113.13 clause (2), when those services are (1) provided within the 113.14 comprehensive outpatient rehabilitation facility and (2) 113.15 provided to residents of nursing facilities owned by the entity. 113.16 [EFFECTIVE DATE.] This section is effective the day 113.17 following final enactment. 113.18 Sec. 34. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 113.19 PROJECT FOR FAMILY PLANNING SERVICES.] 113.20 (a) The commissioner of human services shall establish a 113.21 medical assistance demonstration project to determine whether 113.22 improved access to coverage of prepregnancy family planning 113.23 services reduces medical assistance and MFIP costs. 113.24 (b) This section is effective upon federal approval of the 113.25 demonstration project. 113.26 Sec. 35. Minnesota Statutes 2000, section 256D.03, 113.27 subdivision 3, is amended to read: 113.28 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 113.29 (a) General assistance medical care may be paid for any person 113.30 who is not eligible for medical assistance under chapter 256B, 113.31 including eligibility for medical assistance based on a 113.32 spenddown of excess income according to section 256B.056, 113.33 subdivision 5, or MinnesotaCare as defined in paragraph (b), 113.34 except as provided in paragraph (c); and: 113.35 (1) who is receiving assistance under section 256D.05, 113.36 except for families with children who are eligible under 114.1 Minnesota family investment program-statewide (MFIP-S), who is 114.2 having a payment made on the person's behalf under sections 114.3 256I.01 to 256I.06, or who resides in group residential housing 114.4 as defined in chapter 256I and can meet a spenddown using the 114.5 cost of remedial services received through group residential 114.6 housing; or 114.7 (2)(i) who is a resident of Minnesota; and whose equity in 114.8 assets is not in excess of $1,000 per assistance unit. Exempt 114.9 assets, the reduction of excess assets, and the waiver of excess 114.10 assets must conform to the medical assistance program in chapter 114.11 256B, with the following exception: the maximum amount of 114.12 undistributed funds in a trust that could be distributed to or 114.13 on behalf of the beneficiary by the trustee, assuming the full 114.14 exercise of the trustee's discretion under the terms of the 114.15 trust, must be applied toward the asset maximum; and 114.16 (ii) who has countable incomenot in excess of the114.17assistance standards established in section 256B.056,114.18subdivision 4that does not exceed 133 and 1/3 percent of the 114.19 AFDC income standard in effect under the July 16, 1996, AFDC 114.20 state plan, increased by three percent, or whose excess income 114.21 is spent down according to section 256B.056, subdivision 5, 114.22 using a six-month budget period. The method for calculating 114.23 earned income disregards and deductions for a person who resides 114.24 with a dependent child under age 21 shall follow section 114.25 256B.056, subdivision 1a. However, if a disregard of $30 and 114.26 one-third of the remainder has been applied to the wage earner's 114.27 income, the disregard shall not be applied again until the wage 114.28 earner's income has not been considered in an eligibility 114.29 determination for general assistance, general assistance medical 114.30 care, medical assistance, or MFIP-S for 12 consecutive months. 114.31 The earned income and work expense deductions for a person who 114.32 does not reside with a dependent child under age 21 shall be the 114.33 same as the method used to determine eligibility for a person 114.34 under section 256D.06, subdivision 1, except the disregard of 114.35 the first $50 of earned income is not allowed; 114.36 (3) who would be eligible for medical assistance except 115.1 that the person resides in a facility that is determined by the 115.2 commissioner or the federal Health Care Financing Administration 115.3 to be an institution for mental diseases; or 115.4 (4) who is ineligible for medical assistance under chapter 115.5 256B or general assistance medical care under any other 115.6 provision of this section, and is receiving care and 115.7 rehabilitation services from a nonprofit center established to 115.8 serve victims of torture. These individuals are eligible for 115.9 general assistance medical care only for the period during which 115.10 they are receiving services from the center. During this period 115.11 of eligibility, individuals eligible under this clause shall not 115.12 be required to participate in prepaid general assistance medical 115.13 care. 115.14 (b) Beginning January 1, 2000, applicants or recipients who 115.15 meet all eligibility requirements of MinnesotaCare as defined in 115.16 sections 256L.01 to 256L.16, and are: 115.17 (i) adults with dependent children under 21 whose gross 115.18 family income is equal to or less than 275 percent of the 115.19 federal poverty guidelines; or 115.20 (ii) adults without children with earned income and whose 115.21 family gross income is between 75 percent of the federal poverty 115.22 guidelines and the amount set by section 256L.04, subdivision 7, 115.23 shall be terminated from general assistance medical care upon 115.24 enrollment in MinnesotaCare. 115.25 (c) For services rendered on or after July 1, 1997, 115.26 eligibility is limited to one month prior to application if the 115.27 person is determined eligible in the prior month. A 115.28 redetermination of eligibility must occur every 12 months. 115.29 Beginning January 1, 2000, Minnesota health care program 115.30 applications completed by recipients and applicants who are 115.31 persons described in paragraph (b), may be returned to the 115.32 county agency to be forwarded to the department of human 115.33 services or sent directly to the department of human services 115.34 for enrollment in MinnesotaCare. If all other eligibility 115.35 requirements of this subdivision are met, eligibility for 115.36 general assistance medical care shall be available in any month 116.1 during which a MinnesotaCare eligibility determination and 116.2 enrollment are pending. Upon notification of eligibility for 116.3 MinnesotaCare, notice of termination for eligibility for general 116.4 assistance medical care shall be sent to an applicant or 116.5 recipient. If all other eligibility requirements of this 116.6 subdivision are met, eligibility for general assistance medical 116.7 care shall be available until enrollment in MinnesotaCare 116.8 subject to the provisions of paragraph (e). 116.9 (d) The date of an initial Minnesota health care program 116.10 application necessary to begin a determination of eligibility 116.11 shall be the date the applicant has provided a name, address, 116.12 and social security number, signed and dated, to the county 116.13 agency or the department of human services. If the applicant is 116.14 unable to provide an initial application when health care is 116.15 delivered due to a medical condition or disability, a health 116.16 care provider may act on the person's behalf to complete the 116.17 initial application. The applicant must complete the remainder 116.18 of the application and provide necessary verification before 116.19 eligibility can be determined. The county agency must assist 116.20 the applicant in obtaining verification if necessary. On the 116.21 basis of information provided on the completed application, an 116.22 applicant who meets the following criteria shall be determined 116.23 eligible beginning in the month of application: 116.24 (1) has gross income less than 90 percent of the applicable 116.25 income standard; 116.26 (2) has liquid assets that total within $300 of the asset 116.27 standard; 116.28 (3) does not reside in a long-term care facility; and 116.29 (4) meets all other eligibility requirements. 116.30 The applicant must provide all required verifications within 30 116.31 days' notice of the eligibility determination or eligibility 116.32 shall be terminated. 116.33 (e) County agencies are authorized to use all automated 116.34 databases containing information regarding recipients' or 116.35 applicants' income in order to determine eligibility for general 116.36 assistance medical care or MinnesotaCare. Such use shall be 117.1 considered sufficient in order to determine eligibility and 117.2 premium payments by the county agency. 117.3 (f) General assistance medical care is not available for a 117.4 person in a correctional facility unless the person is detained 117.5 by law for less than one year in a county correctional or 117.6 detention facility as a person accused or convicted of a crime, 117.7 or admitted as an inpatient to a hospital on a criminal hold 117.8 order, and the person is a recipient of general assistance 117.9 medical care at the time the person is detained by law or 117.10 admitted on a criminal hold order and as long as the person 117.11 continues to meet other eligibility requirements of this 117.12 subdivision. 117.13 (g) General assistance medical care is not available for 117.14 applicants or recipients who do not cooperate with the county 117.15 agency to meet the requirements of medical assistance. General 117.16 assistance medical care is limited to payment of emergency 117.17 services only for applicants or recipients as described in 117.18 paragraph (b), whose MinnesotaCare coverage is denied or 117.19 terminated for nonpayment of premiums as required by sections 117.20 256L.06 and 256L.07. 117.21 (h) In determining the amount of assets of an individual, 117.22 there shall be included any asset or interest in an asset, 117.23 including an asset excluded under paragraph (a), that was given 117.24 away, sold, or disposed of for less than fair market value 117.25 within the 60 months preceding application for general 117.26 assistance medical care or during the period of eligibility. 117.27 Any transfer described in this paragraph shall be presumed to 117.28 have been for the purpose of establishing eligibility for 117.29 general assistance medical care, unless the individual furnishes 117.30 convincing evidence to establish that the transaction was 117.31 exclusively for another purpose. For purposes of this 117.32 paragraph, the value of the asset or interest shall be the fair 117.33 market value at the time it was given away, sold, or disposed 117.34 of, less the amount of compensation received. For any 117.35 uncompensated transfer, the number of months of ineligibility, 117.36 including partial months, shall be calculated by dividing the 118.1 uncompensated transfer amount by the average monthly per person 118.2 payment made by the medical assistance program to skilled 118.3 nursing facilities for the previous calendar year. The 118.4 individual shall remain ineligible until this fixed period has 118.5 expired. The period of ineligibility may exceed 30 months, and 118.6 a reapplication for benefits after 30 months from the date of 118.7 the transfer shall not result in eligibility unless and until 118.8 the period of ineligibility has expired. The period of 118.9 ineligibility begins in the month the transfer was reported to 118.10 the county agency, or if the transfer was not reported, the 118.11 month in which the county agency discovered the transfer, 118.12 whichever comes first. For applicants, the period of 118.13 ineligibility begins on the date of the first approved 118.14 application. 118.15 (i) When determining eligibility for any state benefits 118.16 under this subdivision, the income and resources of all 118.17 noncitizens shall be deemed to include their sponsor's income 118.18 and resources as defined in the Personal Responsibility and Work 118.19 Opportunity Reconciliation Act of 1996, title IV, Public Law 118.20 Number 104-193, sections 421 and 422, and subsequently set out 118.21 in federal rules. 118.22 (j)(1) An undocumented noncitizen or a nonimmigrant is 118.23 ineligible for general assistance medical care other than 118.24 emergency services. For purposes of this subdivision, a 118.25 nonimmigrant is an individual in one or more of the classes 118.26 listed in United States Code, title 8, section 1101(a)(15), and 118.27 an undocumented noncitizen is an individual who resides in the 118.28 United States without the approval or acquiescence of the 118.29 Immigration and Naturalization Service. 118.30 (2) This paragraph does not apply to a child under age 18, 118.31 to a Cuban or Haitian entrant as defined in Public Law Number 118.32 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 118.33 aged, blind, or disabled as defined in Code of Federal 118.34 Regulations, title 42, sections 435.520, 435.530, 435.531, 118.35 435.540, and 435.541, or effective October 1, 1998, to an 118.36 individual eligible for general assistance medical care under 119.1 paragraph (a), clause (4), who cooperates with the Immigration 119.2 and Naturalization Service to pursue any applicable immigration 119.3 status, including citizenship, that would qualify the individual 119.4 for medical assistance with federal financial participation. 119.5 (k) For purposes of paragraphs (g) and (j), "emergency 119.6 services" has the meaning given in Code of Federal Regulations, 119.7 title 42, section 440.255(b)(1), except that it also means 119.8 services rendered because of suspected or actual pesticide 119.9 poisoning. 119.10 (l) Notwithstanding any other provision of law, a 119.11 noncitizen who is ineligible for medical assistance due to the 119.12 deeming of a sponsor's income and resources, is ineligible for 119.13 general assistance medical care. 119.14 Sec. 36. Minnesota Statutes 2000, section 256D.03, 119.15 subdivision 4, is amended to read: 119.16 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 119.17 For a person who is eligible under subdivision 3, paragraph (a), 119.18 clause (3), general assistance medical care covers, except as 119.19 provided in paragraph (c): 119.20 (1) inpatient hospital services; 119.21 (2) outpatient hospital services; 119.22 (3) services provided by Medicare certified rehabilitation 119.23 agencies; 119.24 (4) prescription drugs and other products recommended 119.25 through the process established in section 256B.0625, 119.26 subdivision 13; 119.27 (5) equipment necessary to administer insulin and 119.28 diagnostic supplies and equipment for diabetics to monitor blood 119.29 sugar level; 119.30 (6) eyeglasses and eye examinations provided by a physician 119.31 or optometrist; 119.32 (7) hearing aids; 119.33 (8) prosthetic devices; 119.34 (9) laboratory and X-ray services; 119.35 (10) physician's services; 119.36 (11) medical transportation; 120.1 (12) chiropractic services as covered under the medical 120.2 assistance program; 120.3 (13) podiatric services; 120.4 (14) dental services; 120.5 (15) outpatient services provided by a mental health center 120.6 or clinic that is under contract with the county board and is 120.7 established under section 245.62; 120.8 (16) day treatment services for mental illness provided 120.9 under contract with the county board; 120.10 (17) prescribed medications for persons who have been 120.11 diagnosed as mentally ill as necessary to prevent more 120.12 restrictive institutionalization; 120.13 (18) psychological services, medical supplies and 120.14 equipment, and Medicare premiums, coinsurance and deductible 120.15 payments; 120.16 (19) medical equipment not specifically listed in this 120.17 paragraph when the use of the equipment will prevent the need 120.18 for costlier services that are reimbursable under this 120.19 subdivision; 120.20 (20) services performed by a certified pediatric nurse 120.21 practitioner, a certified family nurse practitioner, a certified 120.22 adult nurse practitioner, a certified obstetric/gynecological 120.23 nurse practitioner, a certified neonatal nurse practitioner, or 120.24 a certified geriatric nurse practitioner in independent 120.25 practice, if (1) the service is otherwise covered under this 120.26 chapter as a physician service, (2) the service provided on an 120.27 inpatient basis is not included as part of the cost for 120.28 inpatient services included in the operating payment rate, and 120.29 (3) the service is within the scope of practice of the nurse 120.30 practitioner's license as a registered nurse, as defined in 120.31 section 148.171; 120.32 (21) services of a certified public health nurse or a 120.33 registered nurse practicing in a public health nursing clinic 120.34 that is a department of, or that operates under the direct 120.35 authority of, a unit of government, if the service is within the 120.36 scope of practice of the public health nurse's license as a 121.1 registered nurse, as defined in section 148.171; and 121.2 (22) telemedicine consultations, to the extent they are 121.3 covered under section 256B.0625, subdivision 3b. 121.4 (b) Except as provided in paragraph (c), for a recipient 121.5 who is eligible under subdivision 3, paragraph (a), clause (1) 121.6 or (2), general assistance medical care covers the services 121.7 listed in paragraph (a) with the exception of special 121.8 transportation services. 121.9 (c) Gender reassignment surgery and related services are 121.10 not covered services under this subdivision unless the 121.11 individual began receiving gender reassignment services prior to 121.12 July 1, 1995. 121.13 (d) In order to contain costs, the commissioner of human 121.14 services shall select vendors of medical care who can provide 121.15 the most economical care consistent with high medical standards 121.16 and shall where possible contract with organizations on a 121.17 prepaid capitation basis to provide these services. The 121.18 commissioner shall consider proposals by counties and vendors 121.19 for prepaid health plans, competitive bidding programs, block 121.20 grants, or other vendor payment mechanisms designed to provide 121.21 services in an economical manner or to control utilization, with 121.22 safeguards to ensure that necessary services are provided. 121.23 Before implementing prepaid programs in counties with a county 121.24 operated or affiliated public teaching hospital or a hospital or 121.25 clinic operated by the University of Minnesota, the commissioner 121.26 shall consider the risks the prepaid program creates for the 121.27 hospital and allow the county or hospital the opportunity to 121.28 participate in the program in a manner that reflects the risk of 121.29 adverse selection and the nature of the patients served by the 121.30 hospital, provided the terms of participation in the program are 121.31 competitive with the terms of other participants considering the 121.32 nature of the population served. Payment for services provided 121.33 pursuant to this subdivision shall be as provided to medical 121.34 assistance vendors of these services under sections 256B.02, 121.35 subdivision 8, and 256B.0625. For payments made during fiscal 121.36 year 1990 and later years, the commissioner shall consult with 122.1 an independent actuary in establishing prepayment rates, but 122.2 shall retain final control over the rate methodology. Payment 122.3 rates established by the commissioner must be within the limits 122.4 of available appropriations. Notwithstanding the provisions of 122.5 subdivision 3, an individual who becomes ineligible for general 122.6 assistance medical care because of failure to submit income 122.7 reports or recertification forms in a timely manner, shall 122.8 remain enrolled in the prepaid health plan and shall remain 122.9 eligible for general assistance medical care coverage through 122.10 the last day of the month in which the enrollee became 122.11 ineligible for general assistance medical care. 122.12 (e) There shall be no copayment required of any recipient 122.13 of benefits for any services provided under this subdivision. A 122.14 hospital receiving a reduced payment as a result of this section 122.15 may apply the unpaid balance toward satisfaction of the 122.16 hospital's bad debts. 122.17 (f) Any county may, from its own resources, provide medical 122.18 payments for which state payments are not made. 122.19 (g) Chemical dependency services that are reimbursed under 122.20 chapter 254B must not be reimbursed under general assistance 122.21 medical care. 122.22 (h) The maximum payment for new vendors enrolled in the 122.23 general assistance medical care program after the base year 122.24 shall be determined from the average usual and customary charge 122.25 of the same vendor type enrolled in the base year. 122.26 (i) The conditions of payment for services under this 122.27 subdivision are the same as the conditions specified in rules 122.28 adopted under chapter 256B governing the medical assistance 122.29 program, unless otherwise provided by statute or rule. 122.30 Sec. 37. Minnesota Statutes 2000, section 256J.31, 122.31 subdivision 12, is amended to read: 122.32 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 122.33 participant who is not in vendor payment status may discontinue 122.34 receipt of the cash assistance portion of the MFIP assistance 122.35 grant and retain eligibility for child care assistance under 122.36 section 119B.05and for medical assistance under sections123.1256B.055, subdivision 3a, and 256B.0635. For the months a 123.2 participant chooses to discontinue the receipt of the cash 123.3 portion of the MFIP grant, the assistance unit accrues months of 123.4 eligibility to be applied toward eligibility for child care 123.5 under section 119B.05and for medical assistance under sections123.6256B.055, subdivision 3a, and 256B.0635. 123.7 [EFFECTIVE DATE.] This section is effective July 1, 2002. 123.8 Sec. 38. Minnesota Statutes 2000, section 256K.03, 123.9 subdivision 1, is amended to read: 123.10 Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the 123.11 provisions in this section, the provisions for the MFIP 123.12 application process shall be followed. Within two days after 123.13 receipt of a completed combined application form, the county 123.14 agency must refer to the provider the applicant who meets the 123.15 conditions under section 256K.02, and notify the applicant in 123.16 writing of the program including the following provisions: 123.17 (1) notification that, as part of the application process, 123.18 applicants are required to attend orientation, to be followed 123.19 immediately by a job search; 123.20 (2) the program provider, the date, time, and location of 123.21 the scheduled program orientation; 123.22 (3) the procedures for qualifying for and receiving 123.23 benefits under the program; 123.24 (4) the immediate availability of supportive services, 123.25 including, but not limited to, child care, transportation, 123.26medical assistance,and other work-related aid; and 123.27 (5) the rights, responsibilities, and obligations of 123.28 participants in the program, including, but not limited to, the 123.29 grounds for exemptions and deferrals, the consequences for 123.30 refusing or failing to participate fully, and the appeal process. 123.31 [EFFECTIVE DATE.] This section is effective July 1, 2002. 123.32 Sec. 39. Minnesota Statutes 2000, section 256K.07, is 123.33 amended to read: 123.34 256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE,123.35 AND CHILD CARE.] 123.36 The participant shall be treated as an MFIP recipient for 124.1 food stamps, medical assistance,and child care eligibility 124.2 purposes. The participant who leaves the program as a result of 124.3 increased earnings from employment shall be eligible for 124.4transitional medical assistance andchild care without regard to 124.5 MFIP receipt in three of the six months preceding ineligibility. 124.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 124.7 Sec. 40. Minnesota Statutes 2000, section 256L.06, 124.8 subdivision 3, is amended to read: 124.9 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 124.10 Premiums are dedicated to the commissioner for MinnesotaCare. 124.11 (b) The commissioner shall develop and implement procedures 124.12 to: (1) require enrollees to report changes in income; (2) 124.13 adjust sliding scale premium payments, based upon changes in 124.14 enrollee income; and (3) disenroll enrollees from MinnesotaCare 124.15 for failure to pay required premiums. Failure to pay includes 124.16 payment with a dishonored check, a returned automatic bank 124.17 withdrawal, or a refused credit card or debit card payment. The 124.18 commissioner may demand a guaranteed form of payment, including 124.19 a cashier's check or a money order, as the only means to replace 124.20 a dishonored, returned, or refused payment. 124.21 (c) Premiums are calculated on a calendar month basis and 124.22 may be paid on a monthly, quarterly, or annual basis, with the 124.23 first payment due upon notice from the commissioner of the 124.24 premium amount required. The commissioner shall inform 124.25 applicants and enrollees of these premium payment options. 124.26 Premium payment is required before enrollment is complete and to 124.27 maintain eligibility in MinnesotaCare. 124.28 (d) Nonpayment of the premium will result in disenrollment 124.29 from the planwithin one calendar month after the due date124.30 effective for the calendar month for which the premium was due. 124.31 Persons disenrolled for nonpayment or who voluntarily terminate 124.32 coverage from the program may not reenroll until four calendar 124.33 months have elapsed. Persons disenrolled for nonpayment who pay 124.34 all past due premiums as well as current premiums due, including 124.35 premiums due for the period of disenrollment, within 20 days of 124.36 disenrollment, shall be reenrolled retroactively to the first 125.1 day of disenrollment. Persons disenrolled for nonpayment or who 125.2 voluntarily terminate coverage from the program may not reenroll 125.3 for four calendar months unless the person demonstrates good 125.4 cause for nonpayment. Good cause does not exist if a person 125.5 chooses to pay other family expenses instead of the premium. 125.6 The commissioner shall define good cause in rule. 125.7 [EFFECTIVE DATE.] This section is effective July 1, 2002. 125.8 Sec. 41. Minnesota Statutes 2000, section 256L.12, 125.9 subdivision 9, is amended to read: 125.10 Subd. 9. [RATE SETTING.] Rates will be prospective, per 125.11 capita, where possible. The commissioner may allow health plans 125.12 to arrange for inpatient hospital services on a risk or nonrisk 125.13 basis. The commissioner shall consult with an independent 125.14 actuary to determine appropriate rates. Rates established by 125.15 the commissioner must be within the limits of available 125.16 appropriations. 125.17 Sec. 42. Minnesota Statutes 2000, section 256L.12, is 125.18 amended by adding a subdivision to read: 125.19 Subd. 11. [COVERAGE AT INDIAN HEALTH SERVICE 125.20 FACILITIES.] For American Indian enrollees of MinnesotaCare, 125.21 MinnesotaCare shall cover health care services provided at 125.22 Indian Health Service facilities and facilities operated by a 125.23 tribe or tribal organization under funding authorized by United 125.24 States Code, title 25, sections 450f to 450n, or title III of 125.25 the Indian Self-Determination and Education Act, Public Law 125.26 Number 93-638, if those services would otherwise be covered 125.27 under section 256L.03. Payments for services provided under 125.28 this subdivision shall be made on a fee-for-service basis, and 125.29 may, at the option of the tribe or organization, be made at the 125.30 rates authorized under sections 256.969, subdivision 16, and 125.31 256B.0625, subdivision 34, for those MinnesotaCare enrollees 125.32 eligible for coverage at medical assistance rates. For purposes 125.33 of this subdivision, "American Indian" has the meaning given to 125.34 persons to whom services will be provided for in the Code of 125.35 Federal Regulations, title 42, section 36.12. 125.36 Sec. 43. Minnesota Statutes 2000, section 256L.16, is 126.1 amended to read: 126.2 256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 126.3 UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 126.4 Section 256L.11, subdivision 2, shall not apply to services 126.5 provided tochildrenfamilies with children who are eligibleto126.6receive expanded servicesaccording to section256L.03,126.7subdivision 1a256L.04, subdivision 1, paragraph (a). 126.8 Sec. 44. Laws 1995, chapter 178, article 2, section 36, is 126.9 amended to read: 126.10 Sec. 36. [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION 126.11 OF WELFARE LAWS.] 126.12 (a) The commissioner of human services shall make 126.13 recommendations to effectuate the changes in federal laws and 126.14 regulations, state laws and rules, and the state plan to improve 126.15 the administrative efficiency of the aid to families with 126.16 dependent children, general assistance, work readiness, family 126.17 general assistance, medical assistance, general assistance 126.18 medical care, and food stamp programs. At a minimum, the 126.19 following administrative standards and procedures must be 126.20 changed. 126.21 The commissioner shall: 126.22 (1) require income or eligibility reviews no more 126.23 frequently than annually for cases in which income is normally 126.24 invariant, as in aid to families with dependent children cases 126.25 where the only source of household income is Supplemental Social 126.26 Security Income; 126.27 (2) permit households to report income annually when the 126.28 source of income is excluded, such as a minor's earnings; 126.29 (3)require income or eligibility reviews no more126.30frequently than annually for extended medical assistance cases;126.31(4)require income or eligibility reviews no more 126.32 frequently than annually for a medical assistance postpartum 126.33 client, where the client previously had eligibility under a 126.34 different basis prior to pregnancy or if other household members 126.35 have eligibility with the same income/basis that applies to the 126.36 client; 127.1(5)(4) permit all income or eligibility reviews for foster 127.2 care medical assistance cases to use the short application form; 127.3 and 127.4(6)(5) make dependent care expenses declaratory for 127.5 medical assistance; and127.6(7) permit households to only report gifts worth $100 or127.7more per month. 127.8 (b) The county's administrative savings resulting from 127.9 these changes may be allocated to fund any lawful purpose. 127.10 (c) The recommendations must be provided in a report to the 127.11 chairs of the appropriate legislative committees by August 1, 127.12 1995. The recommendations must include a list of the 127.13 administrative standards and procedures that require approval by 127.14 the federal government before implementation, and also which 127.15 administrative simplification standards and procedures may be 127.16 implemented by a county prior to receiving a federal waiver. 127.17 (d) The commissioner shall seek the necessary waivers from 127.18 the federal government as soon as possible to implement the 127.19 administrative simplification standards and procedures. 127.20 Sec. 45. Laws 1999, chapter 245, article 4, section 110, 127.21 is amended to read: 127.22 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.] 127.23 The commissioner of human services shall study the 127.24 eligibility criteria of and benefits provided to persons age 65 127.25 and over through the array of cash assistance and health care 127.26 programs administered by the department, and the extent to which 127.27 these programs can be combined, simplified, or coordinated to 127.28 reduce administrative costs and improve access. The 127.29 commissioner shall also study potential barriers to enrollment 127.30 for low-income seniors who would otherwise deplete resources 127.31 necessary to maintain independent community living. At a 127.32 minimum, the study must include an evaluation of asset 127.33 requirements and enrollment sites. The commissioner shall 127.34 report study findings and recommendations to the legislature by 127.35JuneSeptember 30, 2001. 127.36 Sec. 46. [NOTICE OF NEW PREMIUM SCHEDULE.] 128.1 The commissioner of human services shall provide medical 128.2 assistance enrollees subject to premiums as employed persons 128.3 with disabilities with prior notice of the new premium schedule 128.4 established under the section 13 amendment to section 256B.057, 128.5 subdivision 9, paragraph (c). This notice must be provided at 128.6 least two months before the month in which the first premium 128.7 payment under the new schedule is due. 128.8 Sec. 47. [MEDICATION THERAPY MANAGEMENT PILOT PROGRAM.] 128.9 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 128.10 services, in consultation with the advisory committee 128.11 established under subdivision 2, shall implement, beginning July 128.12 1, 2001, a two-year medication therapy management pilot program 128.13 for medical assistance enrollees. Medication therapy management 128.14 must be provided by teams of physicians and pharmacists working 128.15 in collaborative practice, as defined in Minnesota Statutes, 128.16 section 151.01, subdivision 27, clause (5), to help patients use 128.17 medications safely and effectively. The commissioner may enroll 128.18 individual pharmacists who participate in the pilot program as 128.19 medical assistance providers and shall seek to ensure that 128.20 participating pharmacists represent all geographic regions of 128.21 the state. 128.22 Subd. 2. [ADVISORY COMMITTEE.] The commissioner shall 128.23 establish a ten-member medication therapy management advisory 128.24 committee, to advise the commissioner in the implementation and 128.25 administration of the program and the development of eligibility 128.26 criteria for enrollees and providers and requirements for 128.27 collaborative practice agreements. The committee shall be 128.28 comprised of: two licensed physicians; two licensed 128.29 pharmacists; two consumer representatives; three members with 128.30 expertise in the area of medication therapy management, who may 128.31 be licensed physicians or licensed pharmacists; and a 128.32 representative of the commissioner, who shall serve as an 128.33 ex-officio nonvoting member. In appointing members who are not 128.34 consumer representatives, the commissioner shall consider 128.35 recommendations of associations representing pharmacy and 128.36 medical practitioners. The committee is governed by section 129.1 15.059, except that committee members do not receive 129.2 compensation or reimbursement for expenses. 129.3 Subd. 3. [EVALUATION.] The commissioner shall evaluate the 129.4 cost-effectiveness of the pilot program and its effect on 129.5 patient outcomes and quality of care, and shall report to the 129.6 legislature by December 15, 2003. The commissioner may contract 129.7 with a vendor to conduct the evaluation. 129.8 Sec. 48. [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE 129.9 PROGRAM PROVIDERS.] 129.10 The commissioner of human services, in consultation with 129.11 providers participating in state health care programs, shall 129.12 identify nonfinancial barriers to increased provider enrollment 129.13 and provider retention in state health care programs, and shall 129.14 implement procedures to address these barriers. Areas to be 129.15 examined by the commissioner shall include, but are not limited 129.16 to, regulatory complexity and inconsistencies between state 129.17 health care programs, provider requirements, provision of 129.18 technical assistance to providers, responsiveness to provider 129.19 inquiries and complaints, claims processing turnaround times, 129.20 and policies for rejecting provider claims. The commissioner 129.21 shall report to the legislature by February 15, 2002, on any 129.22 changes to the administration of state health care programs that 129.23 will be implemented as a result of the study, and present 129.24 recommendations for any necessary changes in state law. 129.25 Sec. 49. [REPEALER.] 129.26 (a) Minnesota Statutes 2000, section 256B.037, subdivision 129.27 5, is repealed effective January 1, 2002. 129.28 (b) Minnesota Statutes 2000, section 256B.0635, subdivision 129.29 3, is repealed effective July 1, 2002. 129.30 ARTICLE 3 129.31 CONTINUING CARE AND HOME CARE 129.32 Section 1. Minnesota Statutes 2000, section 245A.13, 129.33 subdivision 7, is amended to read: 129.34 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human 129.35 services may review rates of a residential program participating 129.36 in the medical assistance program which is in receivership and 130.1 that has needs or deficiencies documented by the department of 130.2 health or the department of human services. If the commissioner 130.3 of human services determines that a review of the rate 130.4 established undersection 256B.501sections 256B.5012 and 130.5 256B.5013 is needed, the commissioner shall: 130.6 (1) review the order or determination that cites the 130.7 deficiencies or needs; and 130.8 (2) determine the need for additional staff, additional 130.9 annual hours by type of employee, and additional consultants, 130.10 services, supplies, equipment, repairs, or capital assets 130.11 necessary to satisfy the needs or deficiencies. 130.12 Sec. 2. Minnesota Statutes 2000, section 245A.13, 130.13 subdivision 8, is amended to read: 130.14 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates 130.15 under subdivision 7, the commissioner may adjust the residential 130.16 program's payment rate. The commissioner shall review the 130.17 circumstances, together with the residentialprogram cost report130.18 program's most recent income and expense report, to determine 130.19 whether or not the deficiencies or needs can be corrected or met 130.20 by reallocating residential program staff, costs, revenues, 130.21 or any other resources includinganyinvestments, efficiency130.22incentives, or allowances. If the commissioner determines that 130.23 any deficiency cannot be corrected or the need cannot be met 130.24 with the payment rate currently being paid, the commissioner 130.25 shall determine the payment rate adjustment by dividing the 130.26 additional annual costs established during the commissioner's 130.27 review by the residential program's actual resident days from 130.28 the most recentdesk-audited costincome and expense report or 130.29 the estimated resident days in the projected receivership 130.30 period. The payment rate adjustmentmust meet the conditions in130.31Minnesota Rules, parts 9553.0010 to 9553.0080, andremains in 130.32 effect during the period of the receivership or until another 130.33 date set by the commissioner. Upon the subsequent sale, 130.34 closure, or transfer of the residential program, the 130.35 commissioner may recover amounts that were paid as payment rate 130.36 adjustments under this subdivision. This recovery shall be 131.1 determined through a review of actual costs and resident days in 131.2 the receivership period. The costs the commissioner finds to be 131.3 allowable shall be divided by the actual resident days for the 131.4 receivership period. This rate shall be compared to the rate 131.5 paid throughout the receivership period, with the difference, 131.6 multiplied by resident days, being the amount to be repaid to 131.7 the commissioner. Allowable costs shall be determined by the 131.8 commissioner as those ordinary, necessary, and related to 131.9 resident care by prudent and cost-conscious management. The 131.10 buyer or transferee shall repay this amount to the commissioner 131.11 within 60 days after the commissioner notifies the buyer or 131.12 transferee of the obligation to repay. This provision does not 131.13 limit the liability of the seller to the commissioner pursuant 131.14 to section 256B.0641. 131.15 Sec. 3. Minnesota Statutes 2000, section 252.275, 131.16 subdivision 4b, is amended to read: 131.17 Subd. 4b. [GUARANTEED FLOOR.] Each countywith an original131.18allocation for the preceding year that is equal to or less than131.19the guaranteed floor minimum index shall have a guaranteed floor131.20equal to its original allocation for the preceding year. Each131.21county with an original allocation for the preceding year that131.22is greater than the guaranteed floor minimum indexshall have a 131.23 guaranteed floor equal to the lesser of clause (1) or (2): 131.24 (1) the county's original allocation for the preceding 131.25 year; or 131.26 (2) 70 percent of the county's reported expenditures 131.27 eligible for reimbursement during the 12 months ending on June 131.28 30 of the preceding calendar year. 131.29For calendar year 1993, the guaranteed floor minimum index131.30shall be $20,000. For each subsequent year, the index shall be131.31adjusted by the projected change in the average value in the131.32United States Department of Labor Bureau of Labor Statistics131.33consumer price index (all urban) for that year.131.34 Notwithstanding this subdivision, no county shall be 131.35 allocated a guaranteed floor of less than $1,000. 131.36 When the amount of funds available for allocation is less 132.1 than the amount available in the previous year, each county's 132.2 previous year allocation shall be reduced in proportion to the 132.3 reduction in the statewide funding, to establish each county's 132.4 guaranteed floor. 132.5 Sec. 4. Minnesota Statutes 2000, section 254B.02, 132.6 subdivision 3, is amended to read: 132.7 Subd. 3. [RESERVE ACCOUNT.] The commissioner shall 132.8 allocate money from the reserve account to counties that, during 132.9 the current fiscal year, have met or exceeded the base level of 132.10 expenditures for eligible chemical dependency services from 132.11 local money. The commissioner shall establish the base level 132.12 for fiscal year 1988 as the amount of local money used for 132.13 eligible services in calendar year 1986. In later years, the 132.14 base level must be increased in the same proportion as state 132.15 appropriations to implement Laws 1986, chapter 394, sections 8 132.16 to 20, are increased. The base level must be decreased if the 132.17 fund balance from which allocations are made under section 132.18 254B.02, subdivision 1, is decreased in later years. The local 132.19 match rate for the reserve account is the same rate as applied 132.20 to the initial allocation. Reserve account payments must not be 132.21 included when calculating the county adjustments made according 132.22 to subdivision 2. For counties providing medical assistance or 132.23 general assistance medical care through managed care plans on 132.24 January 1, 1996, the base year is fiscal year 1995. For 132.25 counties beginning provision of managed care after January 1, 132.26 1996, the base year is the most recent fiscal year before 132.27 enrollment in managed care begins. For counties providing 132.28 managed care, the base level will be increased or decreased in 132.29 proportion to changes in the fund balance from which allocations 132.30 are made under subdivision 2, but will be additionally increased 132.31 or decreased in proportion to the change in county adjusted 132.32 population made in subdivision 1, paragraphs (b) and 132.33 (c). Effective July 1, 2001, funds deposited in the reserve 132.34 account in excess of those needed to meet obligations for 132.35 services provided during the biennium under this section and 132.36 sections 254B.06 and 254B.09 shall cancel to the general fund. 133.1 Sec. 5. Minnesota Statutes 2000, section 254B.03, 133.2 subdivision 1, is amended to read: 133.3 Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local 133.4 agency shall provide chemical dependency services to persons 133.5 residing within its jurisdiction who meet criteria established 133.6 by the commissioner for placement in a chemical dependency 133.7 residential or nonresidential treatment service. Chemical 133.8 dependency money must be administered by the local agencies 133.9 according to law and rules adopted by the commissioner under 133.10 sections 14.001 to 14.69. 133.11 (b) In order to contain costs, the county board shall, with 133.12 the approval of the commissioner of human services, select 133.13 eligible vendors of chemical dependency services who can provide 133.14 economical and appropriate treatment. Unless the local agency 133.15 is a social services department directly administered by a 133.16 county or human services board, the local agency shall not be an 133.17 eligible vendor under section 254B.05. The commissioner may 133.18 approve proposals from county boards to provide services in an 133.19 economical manner or to control utilization, with safeguards to 133.20 ensure that necessary services are provided. If a county 133.21 implements a demonstration or experimental medical services 133.22 funding plan, the commissioner shall transfer the money as 133.23 appropriate. If a county selects a vendor located in another 133.24 state, the county shall ensure that the vendor is in compliance 133.25 with the rules governing licensure of programs located in the 133.26 state. 133.27 (c) The calendar year19982002 rate for vendors may not 133.28 increase more thanthreetwo percent above the rate approved in 133.29 effect on January 1,19972001. The calendar year19992003 133.30 rate for vendors may not increase more thanthreetwo percent 133.31 above the rate in effect on January 1,19982002. The calendar 133.32 years 2004 and 2005 rates may not exceed the rate in effect on 133.33 January 1, 2003. 133.34 (d) A culturally specific vendor that provides assessments 133.35 under a variance under Minnesota Rules, part 9530.6610, shall be 133.36 allowed to provide assessment services to persons not covered by 134.1 the variance. 134.2 Sec. 6. Minnesota Statutes 2000, section 254B.04, 134.3 subdivision 1, is amended to read: 134.4 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for 134.5 benefits under Code of Federal Regulations, title 25, part 20, 134.6 persons eligible for medical assistance benefits under sections 134.7 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 134.8 or who meet the income standards of section 256B.056, 134.9 subdivision 4, and persons eligible for general assistance 134.10 medical care under section 256D.03, subdivision 3, are entitled 134.11 to chemical dependency fund services. State money appropriated 134.12 for this paragraph must be placed in a separate account 134.13 established for this purpose. 134.14 Persons with dependent children who are determined to be in 134.15 need of chemical dependency treatment pursuant to an assessment 134.16 under section 626.556, subdivision 10, or a case plan under 134.17 section 260C.201, subdivision 6, or 260C.212, shall be assisted 134.18 by the local agency to access needed treatment services. 134.19 Treatment services must be appropriate for the individual or 134.20 family, which may include long-term care treatment or treatment 134.21 in a facility that allows the dependent children to stay in the 134.22 treatment facility. The county shall pay for out-of-home 134.23 placement costs, if applicable. 134.24 (b) A person not entitled to services under paragraph (a), 134.25 but with family income that is less than the 1997 federal 134.26 poverty guidelines equivalent of 60 percent of the state median 134.27 income for a family of like size and composition, shall be 134.28 eligible to receive chemical dependency fund services within the 134.29 limit of fundsavailable after persons entitled to services134.30under paragraph (a) have been servedappropriated for this group 134.31 for the fiscal year. If notified by the state agency of limited 134.32 funds, a county must give preferential treatment to persons with 134.33 dependent children who are in need of chemical dependency 134.34 treatment pursuant to an assessment under section 626.556, 134.35 subdivision 10, or a case plan under section 260C.201, 134.36 subdivision 6, or 260C.212. A county may spend money from its 135.1 own sources to serve persons under this paragraph. State money 135.2 appropriated for this paragraph must be placed in a separate 135.3 account established for this purpose. 135.4 (c) Persons whose income is between the 1997 federal 135.5 poverty guidelines equivalent of 60 percent and 115 percent of 135.6 the state median income shall be eligible for chemical 135.7 dependency services on a sliding fee basis, within the limit of 135.8 fundsavailable, after persons entitled to services under135.9paragraph (a) and persons eligible for services under paragraph135.10(b) have been servedappropriated for this group for the fiscal 135.11 year. Persons eligible under this paragraph must contribute to 135.12 the cost of services according to the sliding fee scale 135.13 established under subdivision 3. A county may spend money from 135.14 its own sources to provide services to persons under this 135.15 paragraph. State money appropriated for this paragraph must be 135.16 placed in a separate account established for this purpose. 135.17 Sec. 7. Minnesota Statutes 2000, section 254B.09, is 135.18 amended by adding a subdivision to read: 135.19 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 135.20 INDIANS.] The commissioner may set rates for chemical dependency 135.21 services according to the American Indian Health Improvement 135.22 Act, Public Law Number 94-437, for eligible vendors. These 135.23 rates shall supersede rates set in county purchase of service 135.24 agreements when payments are made on behalf of clients eligible 135.25 according to Public Law Number 94-437. 135.26 Sec. 8. Minnesota Statutes 2000, section 256.01, is 135.27 amended by adding a subdivision to read: 135.28 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 135.29 WITH HIV OR AIDS.] The commissioner may award grants to eligible 135.30 vendors for the development, implementation, and evaluation of 135.31 case management services for individuals infected with the human 135.32 immunodeficiency virus. HIV/AIDs case management services will 135.33 be provided to increase access to cost effective health care 135.34 services, to reduce the risk of HIV transmission, to ensure that 135.35 basic client needs are met, and to increase client access to 135.36 needed community supports or services. 136.1 Sec. 9. Minnesota Statutes 2000, section 256.476, 136.2 subdivision 1, is amended to read: 136.3 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 136.4 human services shall establish a consumer support grant 136.5 programto assistfor individuals with functional limitations 136.6 and their familiesin purchasing and securing supports which the136.7individuals need to live as independently and productively in136.8the community as possiblewho wish to purchase and secure their 136.9 own supports. The commissioner and local agencies shall jointly 136.10 develop an implementation plan which must include a way to 136.11 resolve the issues related to county liability. The program 136.12 shall: 136.13 (1) make support grants available to individuals or 136.14 families as an effective alternative to existing programs and 136.15 services, such as the developmental disability family support 136.16 program,the alternative care program,personal care attendant 136.17 services, home health aide services, and private duty nursing 136.18facilityservices; 136.19 (2) provide consumers more control, flexibility, and 136.20 responsibility overthe needed supportstheir services and 136.21 supports; 136.22 (3) promote local program management and decision making; 136.23 and 136.24 (4) encourage the use of informal and typical community 136.25 supports. 136.26 Sec. 10. Minnesota Statutes 2000, section 256.476, 136.27 subdivision 2, is amended to read: 136.28 Subd. 2. [DEFINITIONS.] For purposes of this section, the 136.29 following terms have the meanings given them: 136.30 (a) "County board" means the county board of commissioners 136.31 for the county of financial responsibility as defined in section 136.32 256G.02, subdivision 4, or its designated representative. When 136.33 a human services board has been established under sections 136.34 402.01 to 402.10, it shall be considered the county board for 136.35 the purposes of this section. 136.36 (b) "Family" means the person's birth parents, adoptive 137.1 parents or stepparents, siblings or stepsiblings, children or 137.2 stepchildren, grandparents, grandchildren, niece, nephew, aunt, 137.3 uncle, or spouse. For the purposes of this section, a family 137.4 member is at least 18 years of age. 137.5 (c) "Functional limitations" means the long-term inability 137.6 to perform an activity or task in one or more areas of major 137.7 life activity, including self-care, understanding and use of 137.8 language, learning, mobility, self-direction, and capacity for 137.9 independent living. For the purpose of this section, the 137.10 inability to perform an activity or task results from a mental, 137.11 emotional, psychological, sensory, or physical disability, 137.12 condition, or illness. 137.13 (d) "Informed choice" means a voluntary decision made by 137.14 the person or the person's legal representative, after becoming 137.15 familiarized with the alternatives to: 137.16 (1) select a preferred alternative from a number of 137.17 feasible alternatives; 137.18 (2) select an alternative which may be developed in the 137.19 future; and 137.20 (3) refuse any or all alternatives. 137.21 (e) "Local agency" means the local agency authorized by the 137.22 county board to carry out the provisions of this section. 137.23 (f) "Person" or "persons" means a person or persons meeting 137.24 the eligibility criteria in subdivision 3. 137.25 (g) "Authorized representative" means an individual 137.26 designated by the person or their legal representative to act on 137.27 their behalf. This individual may be a family member, guardian, 137.28 representative payee, or other individual designated by the 137.29 person or their legal representative, if any, to assist in 137.30 purchasing and arranging for supports. For the purposes of this 137.31 section, an authorized representative is at least 18 years of 137.32 age. 137.33 (h) "Screening" means the screening of a person's service 137.34 needs under sections 256B.0911 and 256B.092. 137.35 (i) "Supports" means services, care, aids,home137.36 environmental modifications, or assistance purchased by the 138.1 person or the person's family. Examples of supports include 138.2 respite care, assistance with daily living, andadaptive aids138.3 assistive technology. For the purpose of this section, 138.4 notwithstanding the provisions of section 144A.43, supports 138.5 purchased under the consumer support program are not considered 138.6 home care services. 138.7 (j) "Program of origination" means the program the 138.8 individual transferred from when approved for the consumer 138.9 support grant program. 138.10 Sec. 11. Minnesota Statutes 2000, section 256.476, 138.11 subdivision 3, is amended to read: 138.12 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 138.13 is eligible to apply for a consumer support grant if the person 138.14 meets all of the following criteria: 138.15 (1) the person is eligible for and has been approved to 138.16 receive services under medical assistance as determined under 138.17 sections 256B.055 and 256B.056or the person is eligible for and138.18has been approved to receive services under alternative care138.19services as determined under section 256B.0913or the person has 138.20 been approved to receive a grant under the developmental 138.21 disability family support program under section 252.32; 138.22 (2) the person is able to direct and purchase the person's 138.23 own care and supports, or the person has a family member, legal 138.24 representative, or other authorized representative who can 138.25 purchase and arrange supports on the person's behalf; 138.26 (3) the person has functional limitations, requires ongoing 138.27 supports to live in the community, and is at risk of or would 138.28 continue institutionalization without such supports; and 138.29 (4) the person will live in a home. For the purpose of 138.30 this section, "home" means the person's own home or home of a 138.31 person's family member. These homes are natural home settings 138.32 and are not licensed by the department of health or human 138.33 services. 138.34 (b) Persons may not concurrently receive a consumer support 138.35 grant if they are: 138.36 (1) receiving home and community-based services under 139.1 United States Code, title 42, section 1396h(c); personal care 139.2 attendant and home health aide services under section 256B.0625; 139.3 a developmental disability family support grant; or alternative 139.4 care services under section 256B.0913; or 139.5 (2) residing in an institutional or congregate care setting. 139.6 (c) A person or person's family receiving a consumer 139.7 support grant shall not be charged a fee or premium by a local 139.8 agency for participating in the program. 139.9 (d) The commissioner may limit the participation ofnursing139.10facility residents, residents of intermediate care facilities139.11for persons with mental retardation, and therecipients of 139.12 services from federal waiver programs in the consumer support 139.13 grant program if the participation of these individuals will 139.14 result in an increase in the cost to the state. 139.15 (e) The commissioner shall establish a budgeted 139.16 appropriation each fiscal year for the consumer support grant 139.17 program. The number of individuals participating in the program 139.18 will be adjusted so the total amount allocated to counties does 139.19 not exceed the amount of the budgeted appropriation. The 139.20 budgeted appropriation will be adjusted annually to accommodate 139.21 changes in demand for the consumer support grants. 139.22 Sec. 12. Minnesota Statutes 2000, section 256.476, 139.23 subdivision 4, is amended to read: 139.24 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 139.25 county board may choose to participate in the consumer support 139.26 grant program. If a county board chooses to participate in the 139.27 program, the local agency shall establish written procedures and 139.28 criteria to determine the amount and use of support grants. 139.29 These procedures must include, at least, the availability of 139.30 respite care, assistance with daily living, and adaptive aids. 139.31 The local agency may establish monthly or annual maximum amounts 139.32 for grants and procedures where exceptional resources may be 139.33 required to meet the health and safety needs of the person on a 139.34 time-limited basis, however, the total amount awarded to each 139.35 individual may not exceed the limits established in subdivision 139.36 5, paragraph (f). 140.1 (b) Support grants to a person or a person's family will be 140.2 provided through a monthly subsidy payment and be in the form of 140.3 cash, voucher, or direct county payment to vendor. Support 140.4 grant amounts must be determined by the local agency. Each 140.5 service and item purchased with a support grant must meet all of 140.6 the following criteria: 140.7 (1) it must be over and above the normal cost of caring for 140.8 the person if the person did not have functional limitations; 140.9 (2) it must be directly attributable to the person's 140.10 functional limitations; 140.11 (3) it must enable the person or the person's family to 140.12 delay or prevent out-of-home placement of the person; and 140.13 (4) it must be consistent with the needs identified in the 140.14 service plan, when applicable. 140.15 (c) Items and services purchased with support grants must 140.16 be those for which there are no other public or private funds 140.17 available to the person or the person's family. Fees assessed 140.18 to the person or the person's family for health and human 140.19 services are not reimbursable through the grant. 140.20 (d) In approving or denying applications, the local agency 140.21 shall consider the following factors: 140.22 (1) the extent and areas of the person's functional 140.23 limitations; 140.24 (2) the degree of need in the home environment for 140.25 additional support; and 140.26 (3) the potential effectiveness of the grant to maintain 140.27 and support the person in the family environment or the person's 140.28 own home. 140.29 (e) At the time of application to the program or screening 140.30 for other services, the person or the person's family shall be 140.31 provided sufficient information to ensure an informed choice of 140.32 alternatives by the person, the person's legal representative, 140.33 if any, or the person's family. The application shall be made 140.34 to the local agency and shall specify the needs of the person 140.35 and family, the form and amount of grant requested, the items 140.36 and services to be reimbursed, and evidence of eligibility for 141.1 medical assistanceor alternative care program. 141.2 (f) Upon approval of an application by the local agency and 141.3 agreement on a support plan for the person or person's family, 141.4 the local agency shall make grants to the person or the person's 141.5 family. The grant shall be in an amount for the direct costs of 141.6 the services or supports outlined in the service agreement. 141.7 (g) Reimbursable costs shall not include costs for 141.8 resources already available, such as special education classes, 141.9 day training and habilitation, case management, other services 141.10 to which the person is entitled, medical costs covered by 141.11 insurance or other health programs, or other resources usually 141.12 available at no cost to the person or the person's family. 141.13 (h) The state of Minnesota, the county boards participating 141.14 in the consumer support grant program, or the agencies acting on 141.15 behalf of the county boards in the implementation and 141.16 administration of the consumer support grant program shall not 141.17 be liable for damages, injuries, or liabilities sustained 141.18 through the purchase of support by the individual, the 141.19 individual's family, or the authorized representative under this 141.20 section with funds received through the consumer support grant 141.21 program. Liabilities include but are not limited to: workers' 141.22 compensation liability, the Federal Insurance Contributions Act 141.23 (FICA), or the Federal Unemployment Tax Act (FUTA). For 141.24 purposes of this section, participating county boards and 141.25 agencies acting on behalf of county boards are exempt from the 141.26 provisions of section 268.04. 141.27 Sec. 13. Minnesota Statutes 2000, section 256.476, 141.28 subdivision 5, is amended to read: 141.29 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 141.30 For the purpose of transferring persons to the consumer support 141.31 grant program from specific programs or services, such as the 141.32 developmental disability family support program andalternative141.33care program,personal careattendantassistant services, home 141.34 health aide services, ornursing facilityprivate duty nursing 141.35 services, the amount of funds transferred by the commissioner 141.36 between the developmental disability family support program 142.1 account,the alternative care account,the medical assistance 142.2 account, or the consumer support grant account shall be based on 142.3 each county's participation in transferring persons to the 142.4 consumer support grant program from those programs and services. 142.5 (b) At the beginning of each fiscal year, county 142.6 allocations for consumer support grants shall be based on: 142.7 (1) the number of persons to whom the county board expects 142.8 to provide consumer supports grants; 142.9 (2) their eligibility for current program and services; 142.10 (3) the amount of nonfederal dollars expended on those 142.11 individuals for those programs and services or, in situations 142.12 where an individual is unable to obtain the support needed from 142.13 the program of origination due to the unavailability of service 142.14 providers at the time or the location where the supports are 142.15 needed, the allocation will be based on the county's best 142.16 estimate of the nonfederal dollars that would have been expended 142.17 if the services had been available; and 142.18 (4) projected dates when persons will start receiving 142.19 grants. County allocations shall be adjusted periodically by 142.20 the commissioner based on the actual transfer of persons or 142.21 service openings, and the nonfederal dollars associated with 142.22 those persons or service openings, to the consumer support grant 142.23 program. 142.24 (c) The amount of funds transferred by the commissioner 142.25 fromthe alternative care account andthe medical assistance 142.26 account for an individual may be changed if it is determined by 142.27 the county or its agent that the individual's need for support 142.28 has changed. 142.29 (d) The authority to utilize funds transferred to the 142.30 consumer support grant account for the purposes of implementing 142.31 and administering the consumer support grant program will not be 142.32 limited or constrained by the spending authority provided to the 142.33 program of origination. 142.34 (e) The commissionershallmay use up to five percent of 142.35 each county's allocation, as adjusted, for payments to that 142.36 county for administrative expenses, to be paid as a 143.1 proportionate addition to reported direct service expenditures. 143.2 (f) Except as provided in this paragraph, the county 143.3 allocation for each individual or individual's family cannot 143.4 exceed 80 percent of the total nonfederal dollars expended on 143.5 the individual by the program of origination except for the 143.6 developmental disabilities family support grant program which 143.7 can be approved up to 100 percent of the nonfederal dollars and 143.8 in situations as described in paragraph (b), clause (3). In 143.9 situations where exceptional need exists or the individual's 143.10 need for support increases, up to 100 percent of the nonfederal 143.11 dollars expended by the consumer's program of origination may be 143.12 allocated to the county. Allocations that exceed 80 percent of 143.13 the nonfederal dollars expended on the individual by the program 143.14 of origination must be approved by the commissioner. The 143.15 remainder of the amount expended on the individual by the 143.16 program of origination will be used in the following 143.17 proportions: half will be made available to the consumer 143.18 support grant program and participating counties for consumer 143.19 training, resource development, and other costs, and half will 143.20 be returned to the state general fund. 143.21 (g) The commissioner may recover, suspend, or withhold 143.22 payments if the county board, local agency, or grantee does not 143.23 comply with the requirements of this section. 143.24 (h) Grant funds unexpended by consumers shall return to the 143.25 state once a year. The annual return of unexpended grant funds 143.26 shall occur in the quarter following the end of the state fiscal 143.27 year. 143.28 Sec. 14. Minnesota Statutes 2000, section 256.476, 143.29 subdivision 8, is amended to read: 143.30 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner 143.31 shall: 143.32 (1) transfer and allocate funds pursuant to this section; 143.33 (2) determine allocations based on projected and actual 143.34 local agency use; 143.35 (3) monitor and oversee overall program spending; 143.36 (4) evaluate the effectiveness of the program; 144.1 (5) provide training and technical assistance for local 144.2 agencies and consumers to help identify potential applicants to 144.3 the program; and 144.4 (6) develop guidelines for local agency program 144.5 administration and consumer information; and. 144.6(7) apply for a federal waiver or take any other action144.7necessary to maximize federal funding for the program by144.8September 1, 1999.144.9 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 144.10 subdivision 7, is amended to read: 144.11 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 144.12 private duty nursing services in a recipient's home. Recipients 144.13 who are authorized to receive private duty nursing services in 144.14 their home may use approved hours outside of the home during 144.15 hours when normal life activities take them outside of their 144.16 homeand when, without the provision of private duty nursing,144.17their health and safety would be jeopardized. To use private 144.18 duty nursing services at school, the recipient or responsible 144.19 party must provide written authorization in the care plan 144.20 identifying the chosen provider and the daily amount of services 144.21 to be used at school. Medical assistance does not cover private 144.22 duty nursing services for residents of a hospital, nursing 144.23 facility, intermediate care facility, or a health care facility 144.24 licensed by the commissioner of health, except as authorized in 144.25 section 256B.64 for ventilator-dependent recipients in hospitals 144.26 or unless a resident who is otherwise eligible is on leave from 144.27 the facility and the facility either pays for the private duty 144.28 nursing services or forgoes the facility per diem for the leave 144.29 days that private duty nursing services are used. Total hours 144.30 of service and payment allowed for services outside the home 144.31 cannot exceed that which is otherwise allowed in an in-home 144.32 setting according to section 256B.0627. All private duty 144.33 nursing services must be provided according to the limits 144.34 established under section 256B.0627. Private duty nursing 144.35 services may not be reimbursed if the nurse is thespouse of the144.36recipient or the parent orfoster care provider of a recipient 145.1 who is under age 18, or the recipient's legal guardian. 145.2 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 145.3 subdivision 19a, is amended to read: 145.4 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical 145.5 assistance covers personal care assistant services in a 145.6 recipient's home. To qualify for personal care assistant 145.7 services, recipients or responsible parties must be able to 145.8 identify the recipient's needs, direct and evaluate task 145.9 accomplishment, and provide for health and safety. Approved 145.10 hours may be used outside the home when normal life activities 145.11 take them outside the homeand when, without the provision of145.12personal care, their health and safety would be jeopardized. To 145.13 use personal care assistant services at school, the recipient or 145.14 responsible party must provide written authorization in the care 145.15 plan identifying the chosen provider and the daily amount of 145.16 services to be used at school. Total hours for services, 145.17 whether actually performed inside or outside the recipient's 145.18 home, cannot exceed that which is otherwise allowed for personal 145.19 care assistant services in an in-home setting according to 145.20 section 256B.0627. Medical assistance does not cover personal 145.21 care assistant services for residents of a hospital, nursing 145.22 facility, intermediate care facility, health care facility 145.23 licensed by the commissioner of health, or unless a resident who 145.24 is otherwise eligible is on leave from the facility and the 145.25 facility either pays for the personal care assistant services or 145.26 forgoes the facility per diem for the leave days that personal 145.27 care assistant services are used. All personal care services 145.28 must be provided according to section 256B.0627. Personal 145.29 care assistant services may not be reimbursed if the personal 145.30 care assistant is the spouse or legal guardian of the recipient 145.31 or the parent of a recipient under age 18, or the responsible 145.32 party or the foster care provider of a recipient who cannot 145.33 direct the recipient's own care unless, in the case of a foster 145.34 care provider, a county or state case manager visits the 145.35 recipient as needed, but not less than every six months, to 145.36 monitor the health and safety of the recipient and to ensure the 146.1 goals of the care plan are met. Parents of adult recipients, 146.2 adult children of the recipient or adult siblings of the 146.3 recipient may be reimbursed for personal care assistant services 146.4if they are not the recipient's legal guardian and, if they are 146.5 granted a waiver under section 256B.0627.Until July 1, 2001,146.6andNotwithstanding the provisions of section 256B.0627, 146.7 subdivision 4, paragraph (b), clause (4), the noncorporate legal 146.8 guardian or conservator of an adult, who is not the responsible 146.9 party and not the personal care provider organization, may be 146.10 granted a hardship waiver under section 256B.0627, to be 146.11 reimbursed to provide personal care assistant services to the 146.12 recipient, and shall not be considered to have a service 146.13 provider interest for purposes of participation on the screening 146.14 team under section 256B.092, subdivision 7. 146.15 Sec. 17. Minnesota Statutes 2000, section 256B.0625, 146.16 subdivision 19c, is amended to read: 146.17 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 146.18 personal care assistant services provided by an individual who 146.19 is qualified to provide the services according to subdivision 146.20 19a and section 256B.0627, where the services are prescribed by 146.21 a physician in accordance with a plan of treatment and are 146.22 supervised by the recipientunder the fiscal agent option146.23according to section 256B.0627, subdivision 10,or a qualified 146.24 professional. "Qualified professional" means a mental health 146.25 professional as defined in section 245.462, subdivision 18, or 146.26 245.4871, subdivision 27; or a registered nurse as defined in 146.27 sections 148.171 to 148.285. As part of the assessment, the 146.28 county public health nurse willconsult withassist the 146.29 recipient or responsible partyandto identify the most 146.30 appropriate person to provide supervision of the personal care 146.31 assistant. The qualified professional shall perform the duties 146.32 described in Minnesota Rules, part 9505.0335, subpart 4. 146.33 Sec. 18. Minnesota Statutes 2000, section 256B.0625, 146.34 subdivision 20, is amended to read: 146.35 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 146.36 extent authorized by rule of the state agency, medical 147.1 assistance covers case management services to persons with 147.2 serious and persistent mental illness and children with severe 147.3 emotional disturbance. Services provided under this section 147.4 must meet the relevant standards in sections 245.461 to 147.5 245.4888, the Comprehensive Adult and Children's Mental Health 147.6 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 147.7 9505.0322, excluding subpart 10. 147.8 (b) Entities meeting program standards set out in rules 147.9 governing family community support services as defined in 147.10 section 245.4871, subdivision 17, are eligible for medical 147.11 assistance reimbursement for case management services for 147.12 children with severe emotional disturbance when these services 147.13 meet the program standards in Minnesota Rules, parts 9520.0900 147.14 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 147.15 (c) Medical assistance and MinnesotaCare payment for mental 147.16 health case management shall be made on a monthly basis. In 147.17 order to receive payment for an eligible child, the provider 147.18 must document at least a face-to-face contact with the child, 147.19 the child's parents, or the child's legal representative. To 147.20 receive payment for an eligible adult, the provider must 147.21 document: 147.22 (1) at least a face-to-face contact with the adult or the 147.23 adult's legal representative; or 147.24 (2) at least a telephone contact with the adult or the 147.25 adult's legal representative and document a face-to-face contact 147.26 with the adult or the adult's legal representative within the 147.27 preceding two months. 147.28 (d) Payment for mental health case management provided by 147.29 county or state staff shall be based on the monthly rate 147.30 methodology under section 256B.094, subdivision 6, paragraph 147.31 (b), with separate rates calculated for child welfare and mental 147.32 health, and within mental health, separate rates for children 147.33 and adults. 147.34 (e) Payment for mental health case management provided by 147.35 county-contracted vendors shall be based on a monthly rate 147.36 negotiated by the host county. The negotiated rate must not 148.1 exceed the rate charged by the vendor for the same service to 148.2 other payers. If the service is provided by a team of 148.3 contracted vendors, the county may negotiate a team rate with a 148.4 vendor who is a member of the team. The team shall determine 148.5 how to distribute the rate among its members. No reimbursement 148.6 received by contracted vendors shall be returned to the county, 148.7 except to reimburse the county for advance funding provided by 148.8 the county to the vendor. 148.9 (f) If the service is provided by a team which includes 148.10 contracted vendors and county or state staff, the costs for 148.11 county or state staff participation in the team shall be 148.12 included in the rate for county-provided services. In this 148.13 case, the contracted vendor and the county may each receive 148.14 separate payment for services provided by each entity in the 148.15 same month. In order to prevent duplication of services, the 148.16 county must document, in the recipient's file, the need for team 148.17 case management and a description of the roles of the team 148.18 members. 148.19 (g) The commissioner shall calculate the nonfederal share 148.20 of actual medical assistance and general assistance medical care 148.21 payments for each county, based on the higher of calendar year 148.22 1995 or 1996, by service date, project that amount forward to 148.23 1999, and transfer one-half of the result from medical 148.24 assistance and general assistance medical care to each county's 148.25 mental health grants under sections 245.4886 and 256E.12 for 148.26 calendar year 1999. The annualized minimum amount added to each 148.27 county's mental health grant shall be $3,000 per year for 148.28 children and $5,000 per year for adults. The commissioner may 148.29 reduce the statewide growth factor in order to fund these 148.30 minimums. The annualized total amount transferred shall become 148.31 part of the base for future mental health grants for each county. 148.32 (h) Any net increase in revenue to the county as a result 148.33 of the change in this section must be used to provide expanded 148.34 mental health services as defined in sections 245.461 to 148.35 245.4888, the Comprehensive Adult and Children's Mental Health 148.36 Acts, excluding inpatient and residential treatment. For 149.1 adults, increased revenue may also be used for services and 149.2 consumer supports which are part of adult mental health projects 149.3 approved under Laws 1997, chapter 203, article 7, section 25. 149.4 For children, increased revenue may also be used for respite 149.5 care and nonresidential individualized rehabilitation services 149.6 as defined in section 245.492, subdivisions 17 and 23. 149.7 "Increased revenue" has the meaning given in Minnesota Rules, 149.8 part 9520.0903, subpart 3. 149.9 (i) Notwithstanding section 256B.19, subdivision 1, the 149.10 nonfederal share of costs for mental health case management 149.11 shall be provided by the recipient's county of responsibility, 149.12 as defined in sections 256G.01 to 256G.12, from sources other 149.13 than federal funds or funds used to match other federal funds. 149.14 (j) The commissioner may suspend, reduce, or terminate the 149.15 reimbursement to a provider that does not meet the reporting or 149.16 other requirements of this section. The county of 149.17 responsibility, as defined in sections 256G.01 to 256G.12, is 149.18 responsible for any federal disallowances. The county may share 149.19 this responsibility with its contracted vendors. 149.20 (k) The commissioner shall set aside a portion of the 149.21 federal funds earned under this section to repay the special 149.22 revenue maximization account under section 256.01, subdivision 149.23 2, clause (15). The repayment is limited to: 149.24 (1) the costs of developing and implementing this section; 149.25 and 149.26 (2) programming the information systems. 149.27 (l) Notwithstanding section 256.025, subdivision 2, 149.28 payments to counties for case management expenditures under this 149.29 section shall only be made from federal earnings from services 149.30 provided under this section. Payments to contracted vendors 149.31 shall include both the federal earnings and the county share. 149.32 (m) Notwithstanding section 256B.041, county payments for 149.33 the cost of mental health case management services provided by 149.34 county or state staff shall not be made to the state treasurer. 149.35 For the purposes of mental health case management services 149.36 provided by county or state staff under this section, the 150.1 centralized disbursement of payments to counties under section 150.2 256B.041 consists only of federal earnings from services 150.3 provided under this section. 150.4 (n) Case management services under this subdivision do not 150.5 include therapy, treatment, legal, or outreach services. 150.6 (o) If the recipient is a resident of a nursing facility, 150.7 intermediate care facility, or hospital, and the recipient's 150.8 institutional care is paid by medical assistance, payment for 150.9 case management services under this subdivision is limited to 150.10 the last30180 days of the recipient's residency in that 150.11 facility and may not exceed more thantwosix months in a 150.12 calendar year. 150.13 (p) Payment for case management services under this 150.14 subdivision shall not duplicate payments made under other 150.15 program authorities for the same purpose. 150.16 (q) By July 1, 2000, the commissioner shall evaluate the 150.17 effectiveness of the changes required by this section, including 150.18 changes in number of persons receiving mental health case 150.19 management, changes in hours of service per person, and changes 150.20 in caseload size. 150.21 (r) For each calendar year beginning with the calendar year 150.22 2001, the annualized amount of state funds for each county 150.23 determined under paragraph (g) shall be adjusted by the county's 150.24 percentage change in the average number of clients per month who 150.25 received case management under this section during the fiscal 150.26 year that ended six months prior to the calendar year in 150.27 question, in comparison to the prior fiscal year. 150.28 (s) For counties receiving the minimum allocation of $3,000 150.29 or $5,000 described in paragraph (g), the adjustment in 150.30 paragraph (r) shall be determined so that the county receives 150.31 the higher of the following amounts: 150.32 (1) a continuation of the minimum allocation in paragraph 150.33 (g); or 150.34 (2) an amount based on that county's average number of 150.35 clients per month who received case management under this 150.36 section during the fiscal year that ended six months prior to 151.1 the calendar year in question, in comparison to the prior fiscal 151.2 year, times the average statewide grant per person per month for 151.3 counties not receiving the minimum allocation. 151.4 (t) The adjustments in paragraphs (r) and (s) shall be 151.5 calculated separately for children and adults. 151.6 Sec. 19. Minnesota Statutes 2000, section 256B.0625, is 151.7 amended by adding a subdivision to read: 151.8 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of 151.9 subdivisions 43a to 43h, the following terms have the meanings 151.10 given them: 151.11 (1) "Home care service recipients" means those individuals 151.12 receiving the following services under section 256B.0627: 151.13 skilled nursing visits, home health aide visits, private duty 151.14 nursing, personal care assistants, or therapies provided through 151.15 a home health agency. 151.16 (2) "Home care targeted case management" means the 151.17 provision of targeted case management services for the purpose 151.18 of assisting home care service recipients to gain access to 151.19 needed services and supports so that they may remain in the 151.20 community. 151.21 (3) "Institutions" means hospitals, consistent with Code of 151.22 Federal Regulations, title 42, section 440.10; regional 151.23 treatment center inpatient services, consistent with section 151.24 245.474; nursing facilities; and intermediate care facilities 151.25 for persons with mental retardation. 151.26 (4) "Relocation targeted case management" means the 151.27 provision of targeted case management services for the purpose 151.28 of assisting recipients to gain access to needed services and 151.29 supports if they choose to move from an institution to the 151.30 community. Relocation targeted case management may be provided 151.31 during the last 180 consecutive days of an eligible recipient's 151.32 institutional stay. 151.33 (5) "Targeted case management" means case management 151.34 services provided to help recipients gain access to needed 151.35 medical, social, educational, and other services and supports. 151.36 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is 152.1 amended by adding a subdivision to read: 152.2 Subd. 43a. [ELIGIBILITY.] The following persons are 152.3 eligible for relocation targeted case management or home care 152.4 targeted case management: 152.5 (1) medical assistance eligible persons residing in 152.6 institutions who choose to move into the community are eligible 152.7 for relocation targeted case management services; and 152.8 (2) medical assistance eligible persons receiving home care 152.9 services, who are not eligible for any other medical assistance 152.10 reimbursable case management service, are eligible for home care 152.11 targeted case management services beginning January 1, 2003. 152.12 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is 152.13 amended by adding a subdivision to read: 152.14 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 152.15 QUALIFICATIONS.] The following qualifications and certification 152.16 standards must be met by providers of relocation targeted case 152.17 management: 152.18 (a) The commissioner must certify each provider of 152.19 relocation targeted case management before enrollment. The 152.20 certification process shall examine the provider's ability to 152.21 meet the requirements in this subdivision and other federal and 152.22 state requirements of this service. A certified relocation 152.23 targeted case management provider may subcontract with another 152.24 provider to deliver relocation targeted case management 152.25 services. Subcontracted providers must demonstrate the ability 152.26 to provide the services outlined in subdivision 43d. 152.27 (b) A relocation targeted case management provider is an 152.28 enrolled medical assistance provider who is determined by the 152.29 commissioner to have all of the following characteristics: 152.30 (1) the legal authority to provide public welfare under 152.31 sections 393.01, subdivision 7; and 393.07, or a federally 152.32 recognized Indian tribe; 152.33 (2) the demonstrated capacity and experience to provide the 152.34 components of case management to coordinate and link community 152.35 resources needed by the eligible population; 152.36 (3) the administrative capacity and experience to serve the 153.1 target population for whom it will provide services and ensure 153.2 quality of services under state and federal requirements; 153.3 (4) the legal authority to provide complete investigative 153.4 and protective services under section 626.556, subdivision 10, 153.5 and child welfare and foster care services under section 393.07, 153.6 subdivisions 1 and 2, or a federally recognized Indian tribe; 153.7 (5) a financial management system that provides accurate 153.8 documentation of services and costs under state and federal 153.9 requirements; and 153.10 (6) the capacity to document and maintain individual case 153.11 records under state and federal requirements. 153.12 A provider of targeted case management under subdivision 20 may 153.13 be deemed a certified provider of relocation targeted case 153.14 management. 153.15 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 153.16 amended by adding a subdivision to read: 153.17 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 153.18 QUALIFICATIONS.] The following qualifications and certification 153.19 standards must be met by providers of home care targeted case 153.20 management. 153.21 (a) The commissioner must certify each provider of home 153.22 care targeted case management before enrollment. The 153.23 certification process shall examine the provider's ability to 153.24 meet the requirements in this subdivision and other state and 153.25 federal requirements of this service. 153.26 (b) A home care targeted case management provider is an 153.27 enrolled medical assistance provider who has a minimum of a 153.28 bachelor's degree or a license in a health or human services 153.29 field, and is determined by the commissioner to have all of the 153.30 following characteristics: 153.31 (1) the demonstrated capacity and experience to provide the 153.32 components of case management to coordinate and link community 153.33 resources needed by the eligible population; 153.34 (2) the administrative capacity and experience to serve the 153.35 target population for whom it will provide services and ensure 153.36 quality of services under state and federal requirements; 154.1 (3) a financial management system that provides accurate 154.2 documentation of services and costs under state and federal 154.3 requirements; 154.4 (4) the capacity to document and maintain individual case 154.5 records under state and federal requirements; and 154.6 (5) the capacity to coordinate with county administrative 154.7 functions. 154.8 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is 154.9 amended by adding a subdivision to read: 154.10 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for 154.11 medical assistance reimbursement as targeted case management 154.12 include: 154.13 (1) assessment of the recipient's need for targeted case 154.14 management services; 154.15 (2) development, completion, and regular review of a 154.16 written individual service plan, which is based upon the 154.17 assessment of the recipient's needs and choices, and which will 154.18 ensure access to medical, social, educational, and other related 154.19 services and supports; 154.20 (3) routine contact or communication with the recipient, 154.21 recipient's family, primary caregiver, legal representative, 154.22 substitute care provider, service providers, or other relevant 154.23 persons identified as necessary to the development or 154.24 implementation of the goals of the individual service plan; 154.25 (4) coordinating referrals for, and the provision of, case 154.26 management services for the recipient with appropriate service 154.27 providers, consistent with section 1902(a)(23) of the Social 154.28 Security Act; 154.29 (5) coordinating and monitoring the overall service 154.30 delivery to ensure quality of services, appropriateness, and 154.31 continued need; 154.32 (6) completing and maintaining necessary documentation that 154.33 supports and verifies the activities in this subdivision; 154.34 (7) traveling to conduct a visit with the recipient or 154.35 other relevant person necessary to develop or implement the 154.36 goals of the individual service plan; and 155.1 (8) coordinating with the institution discharge planner in 155.2 the 180-day period before the recipient's discharge. 155.3 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is 155.4 amended by adding a subdivision to read: 155.5 Subd. 43e. [TIME LINES.] The following time lines must be 155.6 met for assigning a case manager: 155.7 (1) for relocation targeted case management, an eligible 155.8 recipient must be assigned a case manager who visits the person 155.9 within 20 working days of requesting a case manager from their 155.10 county of financial responsibility as determined under chapter 155.11 256G. If a county agency does not provide case management 155.12 services as required, the recipient may, after written notice to 155.13 the county agency, obtain targeted relocation case management 155.14 services from a home care targeted case management provider, as 155.15 defined in subdivision 43c; and 155.16 (2) for home care targeted case management, an eligible 155.17 recipient must be assigned a case manager within 20 working days 155.18 of requesting a case manager from a home care targeted case 155.19 management provider, as defined in subdivision 43c. 155.20 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is 155.21 amended by adding a subdivision to read: 155.22 Subd. 43f. [EVALUATION.] The commissioner shall evaluate 155.23 the delivery of targeted case management, including, but not 155.24 limited to, access to case management services, consumer 155.25 satisfaction with case management services, and quality of case 155.26 management services. 155.27 Sec. 26. Minnesota Statutes 2000, section 256B.0625, is 155.28 amended by adding a subdivision to read: 155.29 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must 155.30 document each face-to-face and telephone contact with the 155.31 recipient and others involved in the recipient's individual 155.32 service plan. 155.33 Sec. 27. Minnesota Statutes 2000, section 256B.0625, is 155.34 amended by adding a subdivision to read: 155.35 Subd. 43h. [PAYMENT RATES.] The commissioner shall set 155.36 payment rates for targeted case management under this 156.1 subdivision. Case managers may bill according to the following 156.2 criteria: 156.3 (1) for relocation targeted case management, case managers 156.4 may bill for direct case management activities, including 156.5 face-to-face and telephone contacts, in the 180 days preceding 156.6 an eligible recipient's discharge from an institution; 156.7 (2) for home care targeted case management, case managers 156.8 may bill for direct case management activities, including 156.9 face-to-face and telephone contacts; and 156.10 (3) billings for targeted case management services under 156.11 this subdivision shall not duplicate payments made under other 156.12 program authorities for the same purpose. 156.13 Sec. 28. Minnesota Statutes 2000, section 256B.0627, 156.14 subdivision 1, is amended to read: 156.15 Subdivision 1. [DEFINITION.] (a) "Activities of daily 156.16 living" includes eating, toileting, grooming, dressing, bathing, 156.17 transferring, mobility, and positioning. 156.18 (b) "Assessment" means a review and evaluation of a 156.19 recipient's need for home care services conducted in person. 156.20 Assessments for private duty nursing shall be conducted by a 156.21 registered private duty nurse. Assessments for home health 156.22 agency services shall be conducted by a home health agency 156.23 nurse. Assessments for personal care assistant services shall 156.24 be conducted by the county public health nurse or a certified 156.25 public health nurse under contract with the county. A 156.26 face-to-face assessment must include: documentation of health 156.27 status, determination of need, evaluation of service 156.28 effectiveness, identification of appropriate services, service 156.29 plan development or modification, coordination of services, 156.30 referrals and follow-up to appropriate payers and community 156.31 resources, completion of required reports, recommendation of 156.32 service authorization, and consumer education. Once the need 156.33 for personal care assistant services is determined under this 156.34 section, the county public health nurse or certified public 156.35 health nurse under contract with the county is responsible for 156.36 communicating this recommendation to the commissioner and the 157.1 recipient. A face-to-face assessment for personal 157.2 care assistant services is conducted on those recipients who 157.3 have never had a county public health nurse assessment. A 157.4 face-to-face assessment must occur at least annually or when 157.5 there is a significant change in the recipient's condition or 157.6 when there is a change in the need for personal care assistant 157.7 services. A service update may substitute for the annual 157.8 face-to-face assessment when there is not a significant change 157.9 in recipient condition or a change in the need for personal care 157.10 assistant service. A service update or review for temporary 157.11 increase includes a review of initial baseline data, evaluation 157.12 of service effectiveness, redetermination of service need, 157.13 modification of service plan and appropriate referrals, update 157.14 of initial forms, obtaining service authorization, and on going 157.15 consumer education. Assessments for medical assistance home 157.16 care services for mental retardation or related conditions and 157.17 alternative care services for developmentally disabled home and 157.18 community-based waivered recipients may be conducted by the 157.19 county public health nurse to ensure coordination and avoid 157.20 duplication. Assessments must be completed on forms provided by 157.21 the commissioner within 30 days of a request for home care 157.22 services by a recipient or responsible party. 157.23(b)(c) "Care plan" means a written description of personal 157.24 care assistant services developed by the qualified 157.25 professional or the recipient's physician with the recipient or 157.26 responsible party to be used by the personal care assistant with 157.27 a copy provided to the recipient or responsible party. 157.28 (d) "Complex and regular private duty nursing care" means, 157.29 effective July 1, 2001: 157.30 (1) complex care is private duty nursing provided to 157.31 recipients who are ventilator dependent or for whom a physician 157.32 has certified that were it not for private duty nursing the 157.33 recipient would meet the criteria for inpatient hospital 157.34 intensive care unit (ICU) level of care; and 157.35 (2) regular care is private duty nursing provided to all 157.36 other recipients. 158.1 (e) "Health-related functions" means functions that can be 158.2 delegated or assigned by a licensed health care professional 158.3 under state law to be performed by a personal care attendant. 158.4(c)(f) "Home care services" means a health service, 158.5 determined by the commissioner as medically necessary, that is 158.6 ordered by a physician and documented in a service plan that is 158.7 reviewed by the physician at least once every6260 days for the 158.8 provision of home health services, or private duty nursing, or 158.9 at least once every 365 days for personal care. Home care 158.10 services are provided to the recipient at the recipient's 158.11 residence that is a place other than a hospital or long-term 158.12 care facility or as specified in section 256B.0625. 158.13 (g) "Instrumental activities of daily living" includes meal 158.14 planning and preparation, managing finances, shopping for food, 158.15 clothing, and other essential items, performing essential 158.16 household chores, communication by telephone and other media, 158.17 and getting around and participating in the community. 158.18(d)(h) "Medically necessary" has the meaning given in 158.19 Minnesota Rules, parts 9505.0170 to 9505.0475. 158.20(e)(i) "Personal care assistant" means a person who: 158.21 (1) is at least 18 years old, except for persons 16 to 18 158.22 years of age who participated in a related school-based job 158.23 training program or have completed a certified home health aide 158.24 competency evaluation; 158.25 (2) is able to effectively communicate with the recipient 158.26 and personal care provider organization; 158.27 (3) effective July 1, 1996, has completed one of the 158.28 training requirements as specified in Minnesota Rules, part 158.29 9505.0335, subpart 3, items A to D; 158.30 (4) has the ability to, and provides covered personal care 158.31 assistant services according to the recipient's care plan, 158.32 responds appropriately to recipient needs, and reports changes 158.33 in the recipient's condition to the supervising qualified 158.34 professional or physician; 158.35 (5) is not a consumer of personal care assistant services; 158.36 and 159.1 (6) is subject to criminal background checks and procedures 159.2 specified in section 245A.04. 159.3(f)(j) "Personal care provider organization" means an 159.4 organization enrolled to provide personal care assistant 159.5 services under the medical assistance program that complies with 159.6 the following: (1) owners who have a five percent interest or 159.7 more, and managerial officials are subject to a background study 159.8 as provided in section 245A.04. This applies to currently 159.9 enrolled personal care provider organizations and those agencies 159.10 seeking enrollment as a personal care provider organization. An 159.11 organization will be barred from enrollment if an owner or 159.12 managerial official of the organization has been convicted of a 159.13 crime specified in section 245A.04, or a comparable crime in 159.14 another jurisdiction, unless the owner or managerial official 159.15 meets the reconsideration criteria specified in section 245A.04; 159.16 (2) the organization must maintain a surety bond and liability 159.17 insurance throughout the duration of enrollment and provides 159.18 proof thereof. The insurer must notify the department of human 159.19 services of the cancellation or lapse of policy; and (3) the 159.20 organization must maintain documentation of services as 159.21 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 159.22 as evidence of compliance with personal care assistant training 159.23 requirements. 159.24(g)(k) "Responsible party" means an individual residing 159.25 with a recipient of personal care assistant services who is 159.26 capable of providing the supportive care necessary to assist the 159.27 recipient to live in the community, is at least 18 years old, 159.28 and is not a personal care assistant. Responsible parties who 159.29 are parents of minors or guardians of minors or incapacitated 159.30 persons may delegate the responsibility to another adult during 159.31 a temporary absence of at least 24 hours but not more than six 159.32 months. The person delegated as a responsible party must be 159.33 able to meet the definition of responsible party, except that 159.34 the delegated responsible party is required to reside with the 159.35 recipient only while serving as the responsible party. Foster 159.36 care license holders may be designated the responsible party for 160.1 residents of the foster care home if case management is provided 160.2 as required in section 256B.0625, subdivision 19a. For persons 160.3 who, as of April 1, 1992, are sharing personal care assistant 160.4 services in order to obtain the availability of 24-hour 160.5 coverage, an employee of the personal care provider organization 160.6 may be designated as the responsible party if case management is 160.7 provided as required in section 256B.0625, subdivision 19a. 160.8(h)(l) "Service plan" means a written description of the 160.9 services needed based on the assessment developed by the nurse 160.10 who conducts the assessment together with the recipient or 160.11 responsible party. The service plan shall include a description 160.12 of the covered home care services, frequency and duration of 160.13 services, and expected outcomes and goals. The recipient and 160.14 the provider chosen by the recipient or responsible party must 160.15 be given a copy of the completed service plan within 30 calendar 160.16 days of the request for home care services by the recipient or 160.17 responsible party. 160.18(i)(m) "Skilled nurse visits" are provided in a 160.19 recipient's residence under a plan of care or service plan that 160.20 specifies a level of care which the nurse is qualified to 160.21 provide. These services are: 160.22 (1) nursing services according to the written plan of care 160.23 or service plan and accepted standards of medical and nursing 160.24 practice in accordance with chapter 148; 160.25 (2) services which due to the recipient's medical condition 160.26 may only be safely and effectively provided by a registered 160.27 nurse or a licensed practical nurse; 160.28 (3) assessments performed only by a registered nurse; and 160.29 (4) teaching and training the recipient, the recipient's 160.30 family, or other caregivers requiring the skills of a registered 160.31 nurse or licensed practical nurse. 160.32 (n) "Telehomecare" means the use of telecommunications 160.33 technology by a home health care professional to deliver home 160.34 health care services, within the professional's scope of 160.35 practice, to a patient located at a site other than the site 160.36 where the practitioner is located. 161.1 Sec. 29. Minnesota Statutes 2000, section 256B.0627, 161.2 subdivision 2, is amended to read: 161.3 Subd. 2. [SERVICES COVERED.] Home care services covered 161.4 under this section include: 161.5 (1) nursing services under section 256B.0625, subdivision 161.6 6a; 161.7 (2) private duty nursing services under section 256B.0625, 161.8 subdivision 7; 161.9 (3) home healthaideservices under section 256B.0625, 161.10 subdivision 6a; 161.11 (4) personal care assistant services under section 161.12 256B.0625, subdivision 19a; 161.13 (5) supervision of personal care assistant services 161.14 provided by a qualified professional under section 256B.0625, 161.15 subdivision 19a; 161.16 (6)consultingqualified professional of personal care 161.17 assistant services under the fiscalagentintermediary option as 161.18 specified in subdivision 10; 161.19 (7) face-to-face assessments by county public health nurses 161.20 for services under section 256B.0625, subdivision 19a; and 161.21 (8) service updates and review of temporary increases for 161.22 personal care assistant services by the county public health 161.23 nurse for services under section 256B.0625, subdivision 19a. 161.24 Sec. 30. Minnesota Statutes 2000, section 256B.0627, 161.25 subdivision 4, is amended to read: 161.26 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 161.27 personal care assistant services that are eligible for payment 161.28 arethe following:services and supports furnished to an 161.29 individual, as needed, to assist in accomplishing activities of 161.30 daily living; instrumental activities of daily living; 161.31 health-related functions through hands-on assistance, 161.32 supervision, and cuing; and redirection and intervention for 161.33 behavior including observation and monitoring. 161.34 (b) Payment for services will be made within the limits 161.35 approved using the prior authorized process established in 161.36 subdivision 5. 162.1 (c) The amount and type of services authorized shall be 162.2 based on an assessment of the recipient's needs in these areas: 162.3 (1) bowel and bladder care; 162.4 (2) skin care to maintain the health of the skin; 162.5 (3) repetitive maintenance range of motion, muscle 162.6 strengthening exercises, and other tasks specific to maintaining 162.7 a recipient's optimal level of function; 162.8 (4) respiratory assistance; 162.9 (5) transfers and ambulation; 162.10 (6) bathing, grooming, and hairwashing necessary for 162.11 personal hygiene; 162.12 (7) turning and positioning; 162.13 (8) assistance with furnishing medication that is 162.14 self-administered; 162.15 (9) application and maintenance of prosthetics and 162.16 orthotics; 162.17 (10) cleaning medical equipment; 162.18 (11) dressing or undressing; 162.19 (12) assistance with eating and meal preparation and 162.20 necessary grocery shopping; 162.21 (13) accompanying a recipient to obtain medical diagnosis 162.22 or treatment; 162.23 (14) assisting, monitoring, or prompting the recipient to 162.24 complete the services in clauses (1) to (13); 162.25 (15) redirection, monitoring, and observation that are 162.26 medically necessary and an integral part of completing the 162.27 personal care assistant services described in clauses (1) to 162.28 (14); 162.29 (16) redirection and intervention for behavior, including 162.30 observation and monitoring; 162.31 (17) interventions for seizure disorders, including 162.32 monitoring and observation if the recipient has had a seizure 162.33 that requires intervention within the past three months; 162.34 (18) tracheostomy suctioning using a clean procedure if the 162.35 procedure is properly delegated by a registered nurse. Before 162.36 this procedure can be delegated to a personal care assistant, a 163.1 registered nurse must determine that the tracheostomy suctioning 163.2 can be accomplished utilizing a clean rather than a sterile 163.3 procedure and must ensure that the personal care assistant has 163.4 been taught the proper procedure; and 163.5 (19) incidental household services that are an integral 163.6 part of a personal care service described in clauses (1) to (18). 163.7 For purposes of this subdivision, monitoring and observation 163.8 means watching for outward visible signs that are likely to 163.9 occur and for which there is a covered personal care service or 163.10 an appropriate personal care intervention. For purposes of this 163.11 subdivision, a clean procedure refers to a procedure that 163.12 reduces the numbers of microorganisms or prevents or reduces the 163.13 transmission of microorganisms from one person or place to 163.14 another. A clean procedure may be used beginning 14 days after 163.15 insertion. 163.16(b)(d) The personal care assistant services that are not 163.17 eligible for payment are the following: 163.18 (1) services not ordered by the physician; 163.19 (2) assessments by personal care assistant provider 163.20 organizations or by independently enrolled registered nurses; 163.21 (3) services that are not in the service plan; 163.22 (4) services provided by the recipient's spouse, legal 163.23 guardian for an adult or child recipient, or parent of a 163.24 recipient under age 18; 163.25 (5) services provided by a foster care provider of a 163.26 recipient who cannot direct the recipient's own care, unless 163.27 monitored by a county or state case manager under section 163.28 256B.0625, subdivision 19a; 163.29 (6) services provided by the residential or program license 163.30 holder in a residence for more than four persons; 163.31 (7) services that are the responsibility of a residential 163.32 or program license holder under the terms of a service agreement 163.33 and administrative rules; 163.34 (8) sterile procedures; 163.35 (9) injections of fluids into veins, muscles, or skin; 163.36 (10) services provided by parents of adult recipients, 164.1 adult children, or siblings of the recipient, unless these 164.2 relatives meet one of the following hardship criteria and the 164.3 commissioner waives this requirement: 164.4 (i) the relative resigns from a part-time or full-time job 164.5 to provide personal care for the recipient; 164.6 (ii) the relative goes from a full-time to a part-time job 164.7 with less compensation to provide personal care for the 164.8 recipient; 164.9 (iii) the relative takes a leave of absence without pay to 164.10 provide personal care for the recipient; 164.11 (iv) the relative incurs substantial expenses by providing 164.12 personal care for the recipient; or 164.13 (v) because of labor conditions, special language needs, or 164.14 intermittent hours of care needed, the relative is needed in 164.15 order to provide an adequate number of qualified personal care 164.16 assistants to meet the medical needs of the recipient; 164.17 (11) homemaker services that are not an integral part of a 164.18 personal care assistant services; 164.19 (12) home maintenance, or chore services; 164.20 (13) services not specified under paragraph (a); and 164.21 (14) services not authorized by the commissioner or the 164.22 commissioner's designee. 164.23 (e) The recipient or responsible party may choose to 164.24 supervise the personal care assistant or to have a qualified 164.25 professional, as defined in section 256B.0625, subdivision 19c, 164.26 provide the supervision. As required under section 256B.0625, 164.27 subdivision 19c, the county public health nurse, as a part of 164.28 the assessment, will assist the recipient or responsible party 164.29 to identify the most appropriate person to provide supervision 164.30 of the personal care assistant. Health-related delegated tasks 164.31 performed by the personal care assistant will be under the 164.32 supervision of a qualified professional or the direction of the 164.33 recipient's physician. If the recipient has a qualified 164.34 professional, Minnesota Rules, part 9505.0335, subpart 4, 164.35 applies. 164.36 Sec. 31. Minnesota Statutes 2000, section 256B.0627, 165.1 subdivision 5, is amended to read: 165.2 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 165.3 payments for home care services shall be limited according to 165.4 this subdivision. 165.5 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 165.6 recipient may receive the following home care services during a 165.7 calendar year: 165.8 (1) up to two face-to-face assessments to determine a 165.9 recipient's need for personal care assistant services; 165.10 (2) one service update done to determine a recipient's need 165.11 for personal care assistant services; and 165.12 (3) up tofivenine skilled nurse visits. 165.13 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 165.14 services above the limits in paragraph (a) must receive the 165.15 commissioner's prior authorization, except when: 165.16 (1) the home care services were required to treat an 165.17 emergency medical condition that if not immediately treated 165.18 could cause a recipient serious physical or mental disability, 165.19 continuation of severe pain, or death. The provider must 165.20 request retroactive authorization no later than five working 165.21 days after giving the initial service. The provider must be 165.22 able to substantiate the emergency by documentation such as 165.23 reports, notes, and admission or discharge histories; 165.24 (2) the home care services were provided on or after the 165.25 date on which the recipient's eligibility began, but before the 165.26 date on which the recipient was notified that the case was 165.27 opened. Authorization will be considered if the request is 165.28 submitted by the provider within 20 working days of the date the 165.29 recipient was notified that the case was opened; 165.30 (3) a third-party payor for home care services has denied 165.31 or adjusted a payment. Authorization requests must be submitted 165.32 by the provider within 20 working days of the notice of denial 165.33 or adjustment. A copy of the notice must be included with the 165.34 request; 165.35 (4) the commissioner has determined that a county or state 165.36 human services agency has made an error; or 166.1 (5) the professional nurse determines an immediate need for 166.2 up to 40 skilled nursing or home health aide visits per calendar 166.3 year and submits a request for authorization within 20 working 166.4 days of the initial service date, and medical assistance is 166.5 determined to be the appropriate payer. 166.6 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 166.7 authorization will be evaluated according to the same criteria 166.8 applied to prior authorization requests. 166.9 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 166.10 section 256B.0627, subdivision 1, paragraph (a), shall be 166.11 conducted initially, and at least annually thereafter, in person 166.12 with the recipient and result in a completed service plan using 166.13 forms specified by the commissioner. Within 30 days of 166.14 recipient or responsible party request for home care services, 166.15 the assessment, the service plan, and other information 166.16 necessary to determine medical necessity such as diagnostic or 166.17 testing information, social or medical histories, and hospital 166.18 or facility discharge summaries shall be submitted to the 166.19 commissioner. For personal care assistant services: 166.20 (1) The amount and type of service authorized based upon 166.21 the assessment and service plan will follow the recipient if the 166.22 recipient chooses to change providers. 166.23 (2) If the recipient's medical need changes, the 166.24 recipient's provider may assess the need for a change in service 166.25 authorization and request the change from the county public 166.26 health nurse. Within 30 days of the request, the public health 166.27 nurse will determine whether to request the change in services 166.28 based upon the provider assessment, or conduct a home visit to 166.29 assess the need and determine whether the change is appropriate. 166.30 (3) To continue to receive personal care assistant services 166.31 after the first year, the recipient or the responsible party, in 166.32 conjunction with the public health nurse, may complete a service 166.33 update on forms developed by the commissioner according to 166.34 criteria and procedures in subdivision 1. 166.35 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 166.36 commissioner's designee, shall review the assessment, service 167.1 update, request for temporary services, service plan, and any 167.2 additional information that is submitted. The commissioner 167.3 shall, within 30 days after receiving a complete request, 167.4 assessment, and service plan, authorize home care services as 167.5 follows: 167.6 (1) [HOME HEALTH SERVICES.] All home health services 167.7 provided by alicensed nurse or ahome health aide must be prior 167.8 authorized by the commissioner or the commissioner's designee. 167.9 Prior authorization must be based on medical necessity and 167.10 cost-effectiveness when compared with other care options. When 167.11 home health services are used in combination with personal care 167.12 and private duty nursing, the cost of all home care services 167.13 shall be considered for cost-effectiveness. The commissioner 167.14 shall limitnurse andhome health aide visits to no more than 167.15 one visit each per day. The commissioner, or the commissioner's 167.16 designee, may authorize up to two skilled nurse visits per day. 167.17 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 167.18 care assistant services and supervision by a qualified 167.19 professional, if requested by the recipient, must be prior 167.20 authorized by the commissioner or the commissioner's designee 167.21 except for the assessments established in paragraph (a). The 167.22 amount of personal care assistant services authorized must be 167.23 based on the recipient's home care rating. A child may not be 167.24 found to be dependent in an activity of daily living if because 167.25 of the child's age an adult would either perform the activity 167.26 for the child or assist the child with the activity and the 167.27 amount of assistance needed is similar to the assistance 167.28 appropriate for a typical child of the same age. Based on 167.29 medical necessity, the commissioner may authorize: 167.30 (A) up to two times the average number of direct care hours 167.31 provided in nursing facilities for the recipient's comparable 167.32 case mix level; or 167.33 (B) up to three times the average number of direct care 167.34 hours provided in nursing facilities for recipients who have 167.35 complex medical needs or are dependent in at least seven 167.36 activities of daily living and need physical assistance with 168.1 eating or have a neurological diagnosis; or 168.2 (C) up to 60 percent of the average reimbursement rate, as 168.3 of July 1, 1991, for care provided in a regional treatment 168.4 center for recipients who have Level I behavior, plus any 168.5 inflation adjustment as provided by the legislature for personal 168.6 care service; or 168.7 (D) up to the amount the commissioner would pay, as of July 168.8 1, 1991, plus any inflation adjustment provided for home care 168.9 services, for care provided in a regional treatment center for 168.10 recipients referred to the commissioner by a regional treatment 168.11 center preadmission evaluation team. For purposes of this 168.12 clause, home care services means all services provided in the 168.13 home or community that would be included in the payment to a 168.14 regional treatment center; or 168.15 (E) up to the amount medical assistance would reimburse for 168.16 facility care for recipients referred to the commissioner by a 168.17 preadmission screening team established under section 256B.0911 168.18 or 256B.092; and 168.19 (F) a reasonable amount of time for the provision of 168.20 supervision by a qualified professional of personal 168.21 care assistant services, if a qualified professional is 168.22 requested by the recipient or responsible party. 168.23 (ii) The number of direct care hours shall be determined 168.24 according to the annual cost report submitted to the department 168.25 by nursing facilities. The average number of direct care hours, 168.26 as established by May 1, 1992, shall be calculated and 168.27 incorporated into the home care limits on July 1, 1992. These 168.28 limits shall be calculated to the nearest quarter hour. 168.29 (iii) The home care rating shall be determined by the 168.30 commissioner or the commissioner's designee based on information 168.31 submitted to the commissioner by the county public health nurse 168.32 on forms specified by the commissioner. The home care rating 168.33 shall be a combination of current assessment tools developed 168.34 under sections 256B.0911 and 256B.501 with an addition for 168.35 seizure activity that will assess the frequency and severity of 168.36 seizure activity and with adjustments, additions, and 169.1 clarifications that are necessary to reflect the needs and 169.2 conditions of recipients who need home care including children 169.3 and adults under 65 years of age. The commissioner shall 169.4 establish these forms and protocols under this section and shall 169.5 use an advisory group, including representatives of recipients, 169.6 providers, and counties, for consultation in establishing and 169.7 revising the forms and protocols. 169.8 (iv) A recipient shall qualify as having complex medical 169.9 needs if the care required is difficult to perform and because 169.10 of recipient's medical condition requires more time than 169.11 community-based standards allow or requires more skill than 169.12 would ordinarily be required and the recipient needs or has one 169.13 or more of the following: 169.14 (A) daily tube feedings; 169.15 (B) daily parenteral therapy; 169.16 (C) wound or decubiti care; 169.17 (D) postural drainage, percussion, nebulizer treatments, 169.18 suctioning, tracheotomy care, oxygen, mechanical ventilation; 169.19 (E) catheterization; 169.20 (F) ostomy care; 169.21 (G) quadriplegia; or 169.22 (H) other comparable medical conditions or treatments the 169.23 commissioner determines would otherwise require institutional 169.24 care. 169.25 (v) A recipient shall qualify as having Level I behavior if 169.26 there is reasonable supporting evidence that the recipient 169.27 exhibits, or that without supervision, observation, or 169.28 redirection would exhibit, one or more of the following 169.29 behaviors that cause, or have the potential to cause: 169.30 (A) injury to the recipient's own body; 169.31 (B) physical injury to other people; or 169.32 (C) destruction of property. 169.33 (vi) Time authorized for personal care relating to Level I 169.34 behavior in subclause (v), items (A) to (C), shall be based on 169.35 the predictability, frequency, and amount of intervention 169.36 required. 170.1 (vii) A recipient shall qualify as having Level II behavior 170.2 if the recipient exhibits on a daily basis one or more of the 170.3 following behaviors that interfere with the completion of 170.4 personal care assistant services under subdivision 4, paragraph 170.5 (a): 170.6 (A) unusual or repetitive habits; 170.7 (B) withdrawn behavior; or 170.8 (C) offensive behavior. 170.9 (viii) A recipient with a home care rating of Level II 170.10 behavior in subclause (vii), items (A) to (C), shall be rated as 170.11 comparable to a recipient with complex medical needs under 170.12 subclause (iv). If a recipient has both complex medical needs 170.13 and Level II behavior, the home care rating shall be the next 170.14 complex category up to the maximum rating under subclause (i), 170.15 item (B). 170.16 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 170.17 nursing services shall be prior authorized by the commissioner 170.18 or the commissioner's designee. Prior authorization for private 170.19 duty nursing services shall be based on medical necessity and 170.20 cost-effectiveness when compared with alternative care options. 170.21 The commissioner may authorize medically necessary private duty 170.22 nursing services in quarter-hour units when: 170.23 (i) the recipient requires more individual and continuous 170.24 care than can be provided during a nurse visit; or 170.25 (ii) the cares are outside of the scope of services that 170.26 can be provided by a home health aide or personal care assistant. 170.27 The commissioner may authorize: 170.28 (A) up to two times the average amount of direct care hours 170.29 provided in nursing facilities statewide for case mix 170.30 classification "K" as established by the annual cost report 170.31 submitted to the department by nursing facilities in May 1992; 170.32 (B) private duty nursing in combination with other home 170.33 care services up to the total cost allowed under clause (2); 170.34 (C) up to 16 hours per day if the recipient requires more 170.35 nursing than the maximum number of direct care hours as 170.36 established in item (A) and the recipient meets the hospital 171.1 admission criteria established under Minnesota Rules, parts 171.29505.05009505.0501 to 9505.0540. 171.3 The commissioner may authorize up to 16 hours per day of 171.4 medically necessary private duty nursing services or up to 24 171.5 hours per day of medically necessary private duty nursing 171.6 services until such time as the commissioner is able to make a 171.7 determination of eligibility for recipients who are 171.8 cooperatively applying for home care services under the 171.9 community alternative care program developed under section 171.10 256B.49, or until it is determined by the appropriate regulatory 171.11 agency that a health benefit plan is or is not required to pay 171.12 for appropriate medically necessary health care services. 171.13 Recipients or their representatives must cooperatively assist 171.14 the commissioner in obtaining this determination. Recipients 171.15 who are eligible for the community alternative care program may 171.16 not receive more hours of nursing under this section than would 171.17 otherwise be authorized under section 256B.49. 171.18 Beginning July 1, 2001, private duty nursing services shall 171.19 be authorized for complex and regular care according to 171.20 subdivision 1. 171.21 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 171.22 ventilator-dependent, the monthly medical assistance 171.23 authorization for home care services shall not exceed what the 171.24 commissioner would pay for care at the highest cost hospital 171.25 designated as a long-term hospital under the Medicare program. 171.26 For purposes of this clause, home care services means all 171.27 services provided in the home that would be included in the 171.28 payment for care at the long-term hospital. 171.29 "Ventilator-dependent" means an individual who receives 171.30 mechanical ventilation for life support at least six hours per 171.31 day and is expected to be or has been dependent for at least 30 171.32 consecutive days. 171.33 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 171.34 or the commissioner's designee shall determine the time period 171.35 for which a prior authorization shall be effective. If the 171.36 recipient continues to require home care services beyond the 172.1 duration of the prior authorization, the home care provider must 172.2 request a new prior authorization. Under no circumstances, 172.3 other than the exceptions in paragraph (b), shall a prior 172.4 authorization be valid prior to the date the commissioner 172.5 receives the request or for more than 12 months. A recipient 172.6 who appeals a reduction in previously authorized home care 172.7 services may continue previously authorized services, other than 172.8 temporary services under paragraph (h), pending an appeal under 172.9 section 256.045. The commissioner must provide a detailed 172.10 explanation of why the authorized services are reduced in amount 172.11 from those requested by the home care provider. 172.12 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 172.13 the commissioner's designee shall determine the medical 172.14 necessity of home care services, the level of caregiver 172.15 according to subdivision 2, and the institutional comparison 172.16 according to this subdivision, the cost-effectiveness of 172.17 services, and the amount, scope, and duration of home care 172.18 services reimbursable by medical assistance, based on the 172.19 assessment, primary payer coverage determination information as 172.20 required, the service plan, the recipient's age, the cost of 172.21 services, the recipient's medical condition, and diagnosis or 172.22 disability. The commissioner may publish additional criteria 172.23 for determining medical necessity according to section 256B.04. 172.24 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 172.25 The agency nurse, the independently enrolled private duty nurse, 172.26 or county public health nurse may request a temporary 172.27 authorization for home care services by telephone. The 172.28 commissioner may approve a temporary level of home care services 172.29 based on the assessment, and service or care plan information, 172.30 and primary payer coverage determination information as required. 172.31 Authorization for a temporary level of home care services 172.32 including nurse supervision is limited to the time specified by 172.33 the commissioner, but shall not exceed 45 days, unless extended 172.34 because the county public health nurse has not completed the 172.35 required assessment and service plan, or the commissioner's 172.36 determination has not been made. The level of services 173.1 authorized under this provision shall have no bearing on a 173.2 future prior authorization. 173.3 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 173.4 Home care services provided in an adult or child foster care 173.5 setting must receive prior authorization by the department 173.6 according to the limits established in paragraph (a). 173.7 The commissioner may not authorize: 173.8 (1) home care services that are the responsibility of the 173.9 foster care provider under the terms of the foster care 173.10 placement agreement and administrative rules; 173.11 (2) personal care assistant services when the foster care 173.12 license holder is also the personal care provider or personal 173.13 care assistant unless the recipient can direct the recipient's 173.14 own care, or case management is provided as required in section 173.15 256B.0625, subdivision 19a; 173.16 (3) personal care assistant services when the responsible 173.17 party is an employee of, or under contract with, or has any 173.18 direct or indirect financial relationship with the personal care 173.19 provider or personal care assistant, unless case management is 173.20 provided as required in section 256B.0625, subdivision 19a; or 173.21 (4) personal care assistant and private duty nursing 173.22 services when the number of foster care residents is greater 173.23 than four unless the county responsible for the recipient's 173.24 foster placement made the placement prior to April 1, 1992, 173.25 requests that personal care assistant and private duty nursing 173.26 services be provided, and case management is provided as 173.27 required in section 256B.0625, subdivision 19a. 173.28 Sec. 32. Minnesota Statutes 2000, section 256B.0627, 173.29 subdivision 7, is amended to read: 173.30 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following 173.31 home care services are not eligible for payment under medical 173.32 assistance: 173.33 (1) skilled nurse visits for the sole purpose of 173.34 supervision of the home health aide; 173.35 (2) a skilled nursing visit: 173.36 (i) only for the purpose of monitoring medication 174.1 compliance with an established medication program for a 174.2 recipient; or 174.3 (ii) to administer or assist with medication 174.4 administration, including injections, prefilling syringes for 174.5 injections, or oral medication set-up of an adult recipient, 174.6 when as determined and documented by the registered nurse, the 174.7 need can be met by an available pharmacy or the recipient is 174.8 physically and mentally able to self-administer or prefill a 174.9 medication; 174.10 (3) home care services to a recipient who is eligible for 174.11 covered servicesincluding hospice, if elected by the recipient,174.12 under the Medicare program or any other insurance held by the 174.13 recipient; 174.14 (4) services to other members of the recipient's household; 174.15 (5) a visit made by a skilled nurse solely to train other 174.16 home health agency workers; 174.17 (6) any home care service included in the daily rate of the 174.18 community-based residential facility where the recipient is 174.19 residing; 174.20 (7) nursing and rehabilitation therapy services that are 174.21 reasonably accessible to a recipient outside the recipient's 174.22 place of residence, excluding the assessment, counseling and 174.23 education, and personal assistant care; 174.24 (8) any home health agency service, excluding personal care 174.25 assistant services and private duty nursing services, which are 174.26 performed in a place other than the recipient's residence; and 174.27 (9) Medicare evaluation or administrative nursing visits on 174.28 dual-eligible recipients that do not qualify for Medicare visit 174.29 billing. 174.30 Sec. 33. Minnesota Statutes 2000, section 256B.0627, 174.31 subdivision 8, is amended to read: 174.32 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 174.33 Medical assistance payments for shared personal care assistance 174.34 services shall be limited according to this subdivision. 174.35 (b) Recipients of personal care assistant services may 174.36 share staff and the commissioner shall provide a rate system for 175.1 shared personal care assistant services. For two persons 175.2 sharing services, the rate paid to a provider shall not exceed 175.3 1-1/2 times the rate paid for serving a single individual, and 175.4 for three persons sharing services, the rate paid to a provider 175.5 shall not exceed twice the rate paid for serving a single 175.6 individual. These rates apply only to situations in which all 175.7 recipients were present and received shared services on the date 175.8 for which the service is billed. No more than three persons may 175.9 receive shared services from a personal care assistant in a 175.10 single setting. 175.11 (c) Shared service is the provision of personal 175.12 care assistant services by a personal care assistant to two or 175.13 three recipients at the same time and in the same setting. For 175.14 the purposes of this subdivision, "setting" means: 175.15 (1) the home or foster care home of one of the individual 175.16 recipients; or 175.17 (2) a child care program in which all recipients served by 175.18 one personal care assistant are participating, which is licensed 175.19 under chapter 245A or operated by a local school district or 175.20 private school; or 175.21 (3) outside the home or foster care home of one of the 175.22 recipients when normal life activities take the recipients 175.23 outside the home. 175.24 The provisions of this subdivision do not apply when a 175.25 personal care assistant is caring for multiple recipients in 175.26 more than one setting. 175.27 (d) The recipient or the recipient's responsible party, in 175.28 conjunction with the county public health nurse, shall determine: 175.29 (1) whether shared personal care assistant services is an 175.30 appropriate option based on the individual needs and preferences 175.31 of the recipient; and 175.32 (2) the amount of shared services allocated as part of the 175.33 overall authorization of personal care assistant services. 175.34 The recipient or the responsible party, in conjunction with 175.35 the supervising qualified professional, if a qualified 175.36 professional is requested by any one of the recipients or 176.1 responsible parties, shall arrange the setting and grouping of 176.2 shared services based on the individual needs and preferences of 176.3 the recipients. Decisions on the selection of recipients to 176.4 share services must be based on the ages of the recipients, 176.5 compatibility, and coordination of their care needs. 176.6 (e) The following items must be considered by the recipient 176.7 or the responsible party and the supervising qualified 176.8 professional, if a qualified professional has been requested by 176.9 any one of the recipients or responsible parties, and documented 176.10 in the recipient's health service record: 176.11 (1) the additional qualifications needed by the personal 176.12 care assistant to provide care to several recipients in the same 176.13 setting; 176.14 (2) the additional training and supervision needed by the 176.15 personal care assistant to ensure that the needs of the 176.16 recipient are met appropriately and safely. The provider must 176.17 provide on-site supervision by a qualified professional within 176.18 the first 14 days of shared services, and monthly thereafter, if 176.19 supervision by a qualified provider has been requested by any 176.20 one of the recipients or responsible parties; 176.21 (3) the setting in which the shared services will be 176.22 provided; 176.23 (4) the ongoing monitoring and evaluation of the 176.24 effectiveness and appropriateness of the service and process 176.25 used to make changes in service or setting; and 176.26 (5) a contingency plan which accounts for absence of the 176.27 recipient in a shared services setting due to illness or other 176.28 circumstances and staffing contingencies. 176.29 (f) The provider must offer the recipient or the 176.30 responsible party the option of shared or one-on-one personal 176.31 care assistant services. The recipient or the responsible party 176.32 can withdraw from participating in a shared services arrangement 176.33 at any time. 176.34 (g) In addition to documentation requirements under 176.35 Minnesota Rules, part 9505.2175, a personal care provider must 176.36 meet documentation requirements for shared personal care 177.1 assistant services and must document the following in the health 177.2 service record for each individual recipient sharing services: 177.3 (1) permission by the recipient or the recipient's 177.4 responsible party, if any, for the maximum number of shared 177.5 services hours per week chosen by the recipient; 177.6 (2) permission by the recipient or the recipient's 177.7 responsible party, if any, for personal care assistant services 177.8 provided outside the recipient's residence; 177.9 (3) permission by the recipient or the recipient's 177.10 responsible party, if any, for others to receive shared services 177.11 in the recipient's residence; 177.12 (4) revocation by the recipient or the recipient's 177.13 responsible party, if any, of the shared service authorization, 177.14 or the shared service to be provided to others in the 177.15 recipient's residence, or the shared service to be provided 177.16 outside the recipient's residence; 177.17 (5) supervision of the shared personal care assistant 177.18 services by the qualified professional, if a qualified 177.19 professional is requested by one of the recipients or 177.20 responsible parties, including the date, time of day, number of 177.21 hours spent supervising the provision of shared services, 177.22 whether the supervision was face-to-face or another method of 177.23 supervision, changes in the recipient's condition, shared 177.24 services scheduling issues and recommendations; 177.25 (6) documentation by the qualified professional, if a 177.26 qualified professional is requested by one of the recipients or 177.27 responsible parties, of telephone calls or other discussions 177.28 with the personal care assistant regarding services being 177.29 provided to the recipient who has requested the supervision; and 177.30 (7) daily documentation of the shared services provided by 177.31 each identified personal care assistant including: 177.32 (i) the names of each recipient receiving shared services 177.33 together; 177.34 (ii) the setting for the shared services, including the 177.35 starting and ending times that the recipient received shared 177.36 services; and 178.1 (iii) notes by the personal care assistant regarding 178.2 changes in the recipient's condition, problems that may arise 178.3 from the sharing of services, scheduling issues, care issues, 178.4 and other notes as required by the qualified professional, if a 178.5 qualified professional is requested by one of the recipients or 178.6 responsible parties. 178.7 (h) Unless otherwise provided in this subdivision, all 178.8 other statutory and regulatory provisions relating to personal 178.9 care assistant services apply to shared services. 178.10 (i) In the event that supervision by a qualified 178.11 professional has been requested by one or more recipients, but 178.12 not by all of the recipients, the supervision duties of the 178.13 qualified professional shall be limited to only those recipients 178.14 who have requested the supervision. 178.15 Nothing in this subdivision shall be construed to reduce 178.16 the total number of hours authorized for an individual recipient. 178.17 Sec. 34. Minnesota Statutes 2000, section 256B.0627, 178.18 subdivision 10, is amended to read: 178.19 Subd. 10. [FISCALAGENTINTERMEDIARY OPTION AVAILABLE FOR 178.20 PERSONAL CARE ASSISTANT SERVICES.] (a)"Fiscal agent option" is178.21an option that allows the recipient to:178.22(1) use a fiscal agent instead of a personal care provider178.23organization;178.24(2) supervise the personal care assistant; and178.25(3) use a consulting professional.178.26 The commissioner may allow a recipient of personal care 178.27 assistant services to use a fiscalagentintermediary to assist 178.28 the recipient in paying and accounting for medically necessary 178.29 covered personal care assistant services authorized in 178.30 subdivision 4 and within the payment parameters of subdivision 178.31 5. Unless otherwise provided in this subdivision, all other 178.32 statutory and regulatory provisions relating to personal care 178.33 assistant services apply to a recipient using the fiscalagent178.34 intermediary option. 178.35 (b) The recipient or responsible party shall: 178.36 (1)hire, and terminate the personal care assistant and179.1consulting professional, with the fiscal agentrecruit, hire, 179.2 and terminate a qualified professional, if a qualified 179.3 professional is requested by the recipient or responsible party; 179.4 (2)recruit the personal care assistant and consulting179.5professional and orient and train the personal care assistant in179.6areas that do not require professional delegation as determined179.7by the county public health nurseverify and document the 179.8 credentials of the qualified professional, if a qualified 179.9 professional is requested by the recipient or responsible party; 179.10 (3)supervise and evaluate the personal care assistant in179.11areas that do not require professional delegation as determined179.12in the assessment;179.13(4) cooperate with a consultingdevelop a service plan 179.14 based on physician orders and public health nurse assessment 179.15 with the assistance of a qualified professionaland implement179.16recommendations pertaining to the health and safety of the179.17recipient, if a qualified professional is requested by the 179.18 recipient or responsible party, that addresses the health and 179.19 safety of the recipient; 179.20(5) hire a qualified professional to train and supervise179.21the performance of delegated tasks done by(4) recruit, hire, 179.22 and terminate the personal care assistant; 179.23(6) monitor services and verify in writing the hours worked179.24by the personal care assistant and the consulting(5) orient and 179.25 train the personal care assistant with assistance as needed from 179.26 the qualified professional; 179.27(7) develop and revise a care plan with assistance from a179.28consulting(6) supervise and evaluate the personal care 179.29 assistant with assistance as needed from the recipient's 179.30 physician or the qualified professional; 179.31(8) verify and document the credentials of the consulting179.32 (7) monitor and verify in writing and report to the fiscal 179.33 intermediary the number of hours worked by the personal care 179.34 assistant and the qualified professional; and 179.35(9)(8) enter into a written agreement, as specified in 179.36 paragraph (f). 180.1 (c) The duties of the fiscalagentintermediary shall be to: 180.2 (1) bill the medical assistance program for personal care 180.3 assistant andconsultingqualified professional services; 180.4 (2) request and secure background checks on personal care 180.5 assistants andconsultingqualified professionals according to 180.6 section 245A.04; 180.7 (3) pay the personal care assistant andconsulting180.8 qualified professional based on actual hours of services 180.9 provided; 180.10 (4) withhold and pay all applicable federal and state 180.11 taxes; 180.12 (5) verify anddocumentkeep records of hours worked by the 180.13 personal care assistant andconsultingqualified professional; 180.14 (6) make the arrangements and pay unemployment insurance, 180.15 taxes, workers' compensation, liability insurance, and other 180.16 benefits, if any; 180.17 (7) enroll in the medical assistance program as a fiscal 180.18agentintermediary; and 180.19 (8) enter into a written agreement as specified in 180.20 paragraph (f) before services are provided. 180.21 (d) The fiscalagentintermediary: 180.22 (1) may not be related to the recipient,consulting180.23 qualified professional, or the personal care assistant; 180.24 (2) must ensure arm's length transactions with the 180.25 recipient and personal care assistant; and 180.26 (3) shall be considered a joint employer of the personal 180.27 care assistant andconsultingqualified professional to the 180.28 extent specified in this section. 180.29 The fiscalagentintermediary or owners of the entity that 180.30 provides fiscalagentintermediary services under this 180.31 subdivision must pass a criminal background check as required in 180.32 section 256B.0627, subdivision 1, paragraph (e). 180.33 (e) If the recipient or responsible party requests a 180.34 qualified professional, theconsultingqualified professional 180.35 providing assistance to the recipient shall meet the 180.36 qualifications specified in section 256B.0625, subdivision 19c. 181.1 Theconsultingqualified professional shall assist the recipient 181.2 in developing and revising a plan to meet the 181.3 recipient'sassessedneeds,and supervise the performance of181.4delegated tasks, as determined by the public health nurseas 181.5 assessed by the public health nurse. In performing this 181.6 function, theconsultingqualified professional must visit the 181.7 recipient in the recipient's home at least once annually. 181.8 Theconsultingqualified professional must reportto the local181.9county public health nurse concerns relating to the health and181.10safety of the recipient, andany suspected abuse, neglect, or 181.11 financial exploitation of the recipient to the appropriate 181.12 authorities. 181.13 (f) The fiscalagentintermediary, recipient or responsible 181.14 party, personal care assistant, andconsultingqualified 181.15 professional shall enter into a written agreement before 181.16 services are started. The agreement shall include: 181.17 (1) the duties of the recipient, qualified professional, 181.18 personal care assistant, and fiscal agent based on paragraphs 181.19 (a) to (e); 181.20 (2) the salary and benefits for the personal care assistant 181.21 andthose providing professional consultationthe qualified 181.22 professional; 181.23 (3) the administrative fee of the fiscalagentintermediary 181.24 and services paid for with that fee, including background check 181.25 fees; 181.26 (4) procedures to respond to billing or payment complaints; 181.27 and 181.28 (5) procedures for hiring and terminating the personal care 181.29 assistant andthose providing professional consultationthe 181.30 qualified professional. 181.31 (g) The rates paid for personal care assistant services, 181.32 qualified professionalassistanceservices, and fiscalagency181.33 intermediary services under this subdivision shall be the same 181.34 rates paid for personal care assistant services and qualified 181.35 professional services under subdivision 2 respectively. Except 181.36 for the administrative fee of the fiscalagentintermediary 182.1 specified in paragraph (f), the remainder of the rates paid to 182.2 the fiscalagentintermediary must be used to pay for the salary 182.3 and benefits for the personal care assistant orthose providing182.4professional consultationthe qualified professional. 182.5 (h) As part of the assessment defined in subdivision 1, the 182.6 following conditions must be met to use or continue use of a 182.7 fiscalagentintermediary: 182.8 (1) the recipient must be able to direct the recipient's 182.9 own care, or the responsible party for the recipient must be 182.10 readily available to direct the care of the personal care 182.11 assistant; 182.12 (2) the recipient or responsible party must be 182.13 knowledgeable of the health care needs of the recipient and be 182.14 able to effectively communicate those needs; 182.15 (3) a face-to-face assessment must be conducted by the 182.16 local county public health nurse at least annually, or when 182.17 there is a significant change in the recipient's condition or 182.18 change in the need for personal care assistant services. The182.19county public health nurse shall determine the services that182.20require professional delegation, if any, and the amount and182.21frequency of related supervision; 182.22 (4) the recipient cannot select the shared services option 182.23 as specified in subdivision 8; and 182.24 (5) parties must be in compliance with the written 182.25 agreement specified in paragraph (f). 182.26 (i) The commissioner shall deny, revoke, or suspend the 182.27 authorization to use the fiscalagentintermediary option if: 182.28 (1) it has been determined by theconsultingqualified 182.29 professional or local county public health nurse that the use of 182.30 this option jeopardizes the recipient's health and safety; 182.31 (2) the parties have failed to comply with the written 182.32 agreement specified in paragraph (f); or 182.33 (3) the use of the option has led to abusive or fraudulent 182.34 billing for personal care assistant services. 182.35 The recipient or responsible party may appeal the 182.36 commissioner's action according to section 256.045. The denial, 183.1 revocation, or suspension to use the fiscalagentintermediary 183.2 option shall not affect the recipient's authorized level of 183.3 personal care assistant services as determined in subdivision 5. 183.4 Sec. 35. Minnesota Statutes 2000, section 256B.0627, 183.5 subdivision 11, is amended to read: 183.6 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 183.7 Medical assistance payments for shared private duty nursing 183.8 services by a private duty nurse shall be limited according to 183.9 this subdivision. For the purposes of this section, "private 183.10 duty nursing agency" means an agency licensed under chapter 144A 183.11 to provide private duty nursing services. 183.12 (b) Recipients of private duty nursing services may share 183.13 nursing staff and the commissioner shall provide a rate 183.14 methodology for shared private duty nursing. For two persons 183.15 sharing nursing care, the rate paid to a provider shall not 183.16 exceed 1.5 times thenonwaiveredregular private duty nursing 183.17 rates paid for serving a single individualwho is not ventilator183.18dependent,by a registered nurse or licensed practical nurse. 183.19 These rates apply only to situations in which both recipients 183.20 are present and receive shared private duty nursing care on the 183.21 date for which the service is billed. No more than two persons 183.22 may receive shared private duty nursing services from a private 183.23 duty nurse in a single setting. 183.24 (c) Shared private duty nursing care is the provision of 183.25 nursing services by a private duty nurse to two recipients at 183.26 the same time and in the same setting. For the purposes of this 183.27 subdivision, "setting" means: 183.28 (1) the home or foster care home of one of the individual 183.29 recipients; or 183.30 (2) a child care program licensed under chapter 245A or 183.31 operated by a local school district or private school; or 183.32 (3) an adult day care service licensed under chapter 245A; 183.33 or 183.34 (4) outside the home or foster care home of one of the 183.35 recipients when normal life activities take the recipients 183.36 outside the home. 184.1 This subdivision does not apply when a private duty nurse 184.2 is caring for multiple recipients in more than one setting. 184.3 (d) The recipient or the recipient's legal representative, 184.4 and the recipient's physician, in conjunction with the home 184.5 health care agency, shall determine: 184.6 (1) whether shared private duty nursing care is an 184.7 appropriate option based on the individual needs and preferences 184.8 of the recipient; and 184.9 (2) the amount of shared private duty nursing services 184.10 authorized as part of the overall authorization of nursing 184.11 services. 184.12 (e) The recipient or the recipient's legal representative, 184.13 in conjunction with the private duty nursing agency, shall 184.14 approve the setting, grouping, and arrangement of shared private 184.15 duty nursing care based on the individual needs and preferences 184.16 of the recipients. Decisions on the selection of recipients to 184.17 share services must be based on the ages of the recipients, 184.18 compatibility, and coordination of their care needs. 184.19 (f) The following items must be considered by the recipient 184.20 or the recipient's legal representative and the private duty 184.21 nursing agency, and documented in the recipient's health service 184.22 record: 184.23 (1) the additional training needed by the private duty 184.24 nurse to provide care to two recipients in the same setting and 184.25 to ensure that the needs of the recipients are met appropriately 184.26 and safely; 184.27 (2) the setting in which the shared private duty nursing 184.28 care will be provided; 184.29 (3) the ongoing monitoring and evaluation of the 184.30 effectiveness and appropriateness of the service and process 184.31 used to make changes in service or setting; 184.32 (4) a contingency plan which accounts for absence of the 184.33 recipient in a shared private duty nursing setting due to 184.34 illness or other circumstances; 184.35 (5) staffing backup contingencies in the event of employee 184.36 illness or absence; and 185.1 (6) arrangements for additional assistance to respond to 185.2 urgent or emergency care needs of the recipients. 185.3 (g) The provider must offer the recipient or responsible 185.4 party the option of shared or one-on-one private duty nursing 185.5 services. The recipient or responsible party can withdraw from 185.6 participating in a shared service arrangement at any time. 185.7 (h) The private duty nursing agency must document the 185.8 following in the health service record for each individual 185.9 recipient sharing private duty nursing care: 185.10 (1) permission by the recipient or the recipient's legal 185.11 representative for the maximum number of shared nursing care 185.12 hours per week chosen by the recipient; 185.13 (2) permission by the recipient or the recipient's legal 185.14 representative for shared private duty nursing services provided 185.15 outside the recipient's residence; 185.16 (3) permission by the recipient or the recipient's legal 185.17 representative for others to receive shared private duty nursing 185.18 services in the recipient's residence; 185.19 (4) revocation by the recipient or the recipient's legal 185.20 representative of the shared private duty nursing care 185.21 authorization, or the shared care to be provided to others in 185.22 the recipient's residence, or the shared private duty nursing 185.23 services to be provided outside the recipient's residence; and 185.24 (5) daily documentation of the shared private duty nursing 185.25 services provided by each identified private duty nurse, 185.26 including: 185.27 (i) the names of each recipient receiving shared private 185.28 duty nursing services together; 185.29 (ii) the setting for the shared services, including the 185.30 starting and ending times that the recipient received shared 185.31 private duty nursing care; and 185.32 (iii) notes by the private duty nurse regarding changes in 185.33 the recipient's condition, problems that may arise from the 185.34 sharing of private duty nursing services, and scheduling and 185.35 care issues. 185.36 (i) Unless otherwise provided in this subdivision, all 186.1 other statutory and regulatory provisions relating to private 186.2 duty nursing services apply to shared private duty nursing 186.3 services. 186.4 Nothing in this subdivision shall be construed to reduce 186.5 the total number of private duty nursing hours authorized for an 186.6 individual recipient under subdivision 5. 186.7 Sec. 36. Minnesota Statutes 2000, section 256B.0627, is 186.8 amended by adding a subdivision to read: 186.9 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 186.10 PROJECT.] (a) Upon the receipt of federal waiver authority, the 186.11 commissioner shall implement a consumer-directed home care 186.12 demonstration project. The consumer-directed home care 186.13 demonstration project must demonstrate and evaluate the outcomes 186.14 of a consumer-directed service delivery alternative to improve 186.15 access, increase consumer control and accountability over 186.16 available resources, and enable the use of supports that are 186.17 more individualized and cost-effective for eligible medical 186.18 assistance recipients receiving certain medical assistance home 186.19 care services. The consumer-directed home care demonstration 186.20 project will be administered locally by county agencies, tribal 186.21 governments, or administrative entities under contract with the 186.22 state in regions where counties choose not to provide this 186.23 service. 186.24 (b) Grant awards for persons who have been receiving 186.25 medical assistance covered personal care, home health aide, or 186.26 private duty nursing services for a period of 12 consecutive 186.27 months or more prior to enrollment in the consumer-directed home 186.28 care demonstration project will be established on a case-by-case 186.29 basis using historical service expenditure data. An average 186.30 monthly expenditure for each continuing enrollee will be 186.31 calculated based on historical expenditures made on behalf of 186.32 the enrollee for personal care, home health aide, or private 186.33 duty nursing services during the 12 month period directly prior 186.34 to enrollment in the project. The grant award will equal 90 186.35 percent of the average monthly expenditure. 186.36 (c) Grant awards for project enrollees who have been 187.1 receiving medical assistance covered personal care, home health 187.2 aide, or private duty nursing services for a period of less than 187.3 12 consecutive months prior to project enrollment will be 187.4 calculated on a case-by-case basis using the service 187.5 authorization in place at the time of enrollment. The total 187.6 number of units of personal care, home health aide, or private 187.7 duty nursing services the enrollee has been authorized to 187.8 receive will be converted to the total cost of the authorized 187.9 services in a given month using the statewide average service 187.10 payment rates. To determine an estimated monthly expenditure, 187.11 the total authorized monthly personal care, home health aide or 187.12 private duty nursing service costs will be reduced by a 187.13 percentage rate equivalent to the difference between the 187.14 statewide average service authorization and the statewide 187.15 average utilization rate for each of the services by medical 187.16 assistance eligibles during the most recent fiscal year for 187.17 which 12 months of data is available. The grant award will 187.18 equal 90 percent of the estimated monthly expenditure. 187.19 (d) The state of Minnesota, county agencies, tribal 187.20 governments, or administrative entities under contract with the 187.21 state that participate in the implementation and administration 187.22 of the consumer-directed home care demonstration project, shall 187.23 not be liable for damages, injuries, or liabilities sustained 187.24 through the purchase of support by the individual, the 187.25 individual's family, or the authorized representative under this 187.26 section with funds received through the consumer-directed home 187.27 care demonstration project. Liabilities include but are not 187.28 limited to: workers' compensation liability, the Federal 187.29 Insurance Contributions Act (FICA), or the Federal Unemployment 187.30 Tax Act (FUTA). 187.31 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is 187.32 amended by adding a subdivision to read: 187.33 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 187.34 assistance covers skilled nurse visits according to section 187.35 256B.0625, subdivision 6a, provided via telehomecare, for 187.36 services which do not require hands-on care between the home 188.1 care nurse and recipient. The provision of telehomecare must be 188.2 made via live, two-way interactive audiovisual technology and 188.3 may be augmented by utilizing store-and-forward technologies. 188.4 Store-and-forward technology includes telehomecare services that 188.5 do not occur in real time via synchronous transmissions, and 188.6 that do not require a face-to-face encounter with the recipient 188.7 for all or any part of any such telehomecare visit. A 188.8 communication between the home care nurse and recipient that 188.9 consists solely of a telephone conversation, facsimile, 188.10 electronic mail, or a consultation between two health care 188.11 practitioners, is not to be considered a telehomecare visit. 188.12 Multiple daily skilled nurse visits provided via telehomecare 188.13 are allowed. Coverage of telehomecare is limited to two visits 188.14 per day. All skilled nurse visits provided via telehomecare 188.15 must be prior authorized by the commissioner or the 188.16 commissioner's designee and will be covered at the same 188.17 allowable rate as skilled nurse visits provided in-person. 188.18 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is 188.19 amended by adding a subdivision to read: 188.20 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) 188.21 [PHYSICAL THERAPY.] Medical assistance covers physical therapy 188.22 and related services, including specialized maintenance 188.23 therapy. Services provided by a physical therapy assistant 188.24 shall be reimbursed at the same rate as services performed by a 188.25 physical therapist when the services of the physical therapy 188.26 assistant are provided under the direction of a physical 188.27 therapist who is on the premises. Services provided by a 188.28 physical therapy assistant that are provided under the direction 188.29 of a physical therapist who is not on the premises shall be 188.30 reimbursed at 65 percent of the physical therapist rate. 188.31 Direction of the physical therapy assistant must be provided by 188.32 the physical therapist as described in Minnesota Rules, part 188.33 9505.0390, subpart 1, item B. The physical therapist and 188.34 physical therapist assistant may not both bill for services 188.35 provided to a recipient on the same day. 188.36 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers 189.1 occupational therapy and related services, including specialized 189.2 maintenance therapy. Services provided by an occupational 189.3 therapy assistant shall be reimbursed at the same rate as 189.4 services performed by an occupational therapist when the 189.5 services of the occupational therapy assistant are provided 189.6 under the direction of the occupational therapist who is on the 189.7 premises. Services provided by an occupational therapy 189.8 assistant under the direction of an occupational therapist who 189.9 is not on the premises shall be reimbursed at 65 percent of the 189.10 occupational therapist rate. Direction of the occupational 189.11 therapy assistant must be provided by the occupational therapist 189.12 as described in Minnesota Rules, part 9505.0390, subpart 1, item 189.13 B. The occupational therapist and occupational therapist 189.14 assistant may not both bill for services provided to a recipient 189.15 on the same day. 189.16 Sec. 39. Minnesota Statutes 2000, section 256B.0627, is 189.17 amended by adding a subdivision to read: 189.18 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 189.19 Payment is allowed for extraordinary services that require 189.20 specialized nursing skills and are provided by parents of minor 189.21 children, spouses, and legal guardians who are providing private 189.22 duty nursing care under the following conditions: 189.23 (1) the provision of these services is not legally required 189.24 of the parents, spouses, or legal guardians; 189.25 (2) the services are necessary to prevent hospitalization 189.26 of the recipient; and 189.27 (3) the recipient is eligible for state plan home care or a 189.28 home and community-based waiver and one of the following 189.29 hardship criteria are met: 189.30 (i) the parent, spouse, or legal guardian resigns from a 189.31 part-time or full-time job to provide nursing care for the 189.32 recipient; or 189.33 (ii) the parent, spouse, or legal guardian goes from a 189.34 full-time to a part-time job with less compensation to provide 189.35 nursing care for the recipient; or 189.36 (iii) the parent, spouse, or legal guardian takes a leave 190.1 of absence without pay to provide nursing care for the 190.2 recipient; or 190.3 (iv) because of labor conditions, special language needs, 190.4 or intermittent hours of care needed, the parent, spouse, or 190.5 legal guardian is needed in order to provide adequate private 190.6 duty nursing services to meet the medical needs of the recipient. 190.7 (b) Private duty nursing may be provided by a parent, 190.8 spouse, or legal guardian who is a nurse licensed in Minnesota. 190.9 Private duty nursing services provided by a parent, spouse, or 190.10 legal guardian cannot be used in lieu of nursing services 190.11 covered and available under liable third-party payers, including 190.12 Medicare. The private duty nursing provided by a parent, 190.13 spouse, or legal guardian must be included in the service plan. 190.14 Authorized skilled nursing services provided by the parent, 190.15 spouse, or legal guardian may not exceed 50 percent of the total 190.16 approved nursing hours, or eight hours per day, whichever is 190.17 less, up to a maximum of 40 hours per week. Nothing in this 190.18 subdivision precludes the parent's, spouse's, or legal 190.19 guardian's obligation of assuming the nonreimbursed family 190.20 responsibilities of emergency backup caregiver and primary 190.21 caregiver. 190.22 (c) A parent or a spouse may not be paid to provide private 190.23 duty nursing care if the parent or spouse fails to pass a 190.24 criminal background check according to section 245A.04, or if it 190.25 has been determined by the home health agency, the case manager, 190.26 or the physician that the private duty nursing care provided by 190.27 the parent, spouse, or legal guardian is unsafe. 190.28 Sec. 40. Minnesota Statutes 2000, section 256B.0627, is 190.29 amended by adding a subdivision to read: 190.30 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 190.31 ASSISTANT SERVICES.] The commissioner shall establish a quality 190.32 assurance plan for personal care assistant services that 190.33 includes: 190.34 (1) performance-based provider agreements; 190.35 (2) meaningful consumer input, which may include consumer 190.36 surveys, that measure the extent to which participants receive 191.1 the services and supports described in the individual plan and 191.2 participant satisfaction with such services and supports; 191.3 (3) ongoing monitoring of the health and well-being of 191.4 consumers; and 191.5 (4) an ongoing public process for development, 191.6 implementation, and review of the quality assurance plan. 191.7 Sec. 41. Minnesota Statutes 2000, section 256B.0911, is 191.8 amended by adding a subdivision to read: 191.9 Subd. 4a. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 191.10 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 191.11 ensure that individuals with disabilities or chronic illness are 191.12 served in the most integrated setting appropriate to their needs 191.13 and have the necessary information to make informed choices 191.14 about home and community-based service options. 191.15 (b) Individuals under 65 years of age who are admitted to a 191.16 nursing facility from a hospital must be screened prior to 191.17 admission as outlined in subdivision 4. 191.18 (c) Individuals under 65 years of age who are admitted to 191.19 nursing facilities with only a telephone screening must receive 191.20 a face-to-face assessment from the long-term care consultation 191.21 team member of the county in which the facility is located or 191.22 from the recipient's county case manager within 20 working days 191.23 of admission. 191.24 (d) At the face-to-face assessment, the long-term care 191.25 consultation team member or county case manager must perform the 191.26 activities required under subdivision 3. 191.27 (e) For individuals under 21 years of age, the screening or 191.28 assessment which recommends nursing facility admission must be 191.29 approved by the commissioner before the individual is admitted 191.30 to the nursing facility. 191.31 (f) In the event that an individual under 65 years of age 191.32 is admitted to a nursing facility on an emergency basis, the 191.33 county must be notified of the admission on the next working 191.34 day, and a face-to-face assessment as described in paragraph (c) 191.35 must be conducted within 20 working days of admission. 191.36 (g) At the face-to-face assessment, the long-term care 192.1 consultation team member or the case manager must present 192.2 information about home and community-based options so the 192.3 individual can make informed choices. If the individual chooses 192.4 home and community-based services, the long-term care 192.5 consultation team member or case manager must complete a written 192.6 relocation plan within 20 working days of the visit. The plan 192.7 shall describe the services needed to move out of the facility 192.8 and a time line for the move which is designed to ensure a 192.9 smooth transition to the individual's home and community. 192.10 (h) An individual under 65 years of age residing in a 192.11 nursing facility shall receive a face-to-face assessment at 192.12 least every 12 months to review the person's service choices and 192.13 available alternatives unless the individual indicates, in 192.14 writing, that annual visits are not desired. In this case, the 192.15 individual must receive a face-to-face assessment at least once 192.16 every 36 months for the same purposes. 192.17 (i) Notwithstanding the provisions of subdivision 6, the 192.18 commissioner may pay county agencies directly for face-to-face 192.19 assessments for individuals who are eligible for medical 192.20 assistance, under 65 years of age, and being considered for 192.21 placement or residing in a nursing facility. 192.22 Sec. 42. Minnesota Statutes 2000, section 256B.0916, 192.23 subdivision 1, is amended to read: 192.24 Subdivision 1. [REDUCTION OF WAITING LIST.] (a) The 192.25 legislature recognizes that as of January 1, 1999, 3,300 persons 192.26 with mental retardation or related conditions have been screened 192.27 and determined eligible for the home and community-based waiver 192.28 services program for persons with mental retardation or related 192.29 conditions. Many wait for several years before receiving 192.30 service. 192.31 (b) The waiting list for this program shall be reduced or 192.32 eliminated by June 30, 2003. In order to reduce the number of 192.33 eligible persons waiting for identified services provided 192.34 through the home and community-based waiver for persons with 192.35 mental retardation or related conditions, during the period from 192.36 July 1, 1999, to June 30, 2003, funding shall be increased to 193.1 add 100 additional eligible persons each year beyond the 193.2 February 1999 medical assistance forecast. 193.3 (c) The commissioner shall allocate resources in such a 193.4 manner as to use all resources budgeted during a biennium for 193.5 the home and community-based waiver for persons with mental 193.6 retardation or related conditions according to the priorities 193.7 listed in subdivision 2, paragraph (b), and then to serve other 193.8 persons on the waiting list. Resources allocated for a fiscal 193.9 year to serve persons affected by public and private sector 193.10 ICF/MR closures, but not expected to be expended for that 193.11 purpose, must be reallocated within that fiscal year to serve 193.12 other persons on the waiting list, and the number of waiver 193.13 diversion slots shall be adjusted accordingly. 193.14 (d) For fiscal year 2001, at least one-half of the increase 193.15 in funding over the previous year provided in the February 1999 193.16 medical assistance forecast for the home and community-based 193.17 waiver for persons with mental retardation and related 193.18 conditions, including changes made by the 1999 legislature, must 193.19 be used to serve persons who are not affected by public and 193.20 private sector ICF/MR closures. 193.21 (e) The commissioner of finance shall not reduce the 193.22 spending forecast for the coming biennium, if at the time of the 193.23 forecast there is a waiting list for waiver services for persons 193.24 with mental retardation or related conditions who need services 193.25 within the next 30 months. Funds that would have resulted from 193.26 a projected reduction in spending must be used by the 193.27 commissioner of human services to serve persons with 193.28 developmental disabilities through the home and community-based 193.29 waiver for persons with mental retardation or related conditions. 193.30 Sec. 43. Minnesota Statutes 2000, section 256B.0916, is 193.31 amended by adding a subdivision to read: 193.32 Subd. 6a. [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED 193.33 COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit 193.34 to the federal Health Care Financing Administration by August 1, 193.35 2001, an amendment to the home and community-based waiver for 193.36 persons with mental retardation or related conditions to make 194.1 consumer-directed community support services available in every 194.2 county of the state by January 1, 2002. 194.3 (b) If a county declines to meet the requirements for 194.4 provision of consumer-directed community supports, the 194.5 commissioner shall contract with another county, a group of 194.6 counties, or a private agency to plan for and administer 194.7 consumer-directed community supports in that county. 194.8 (c) The state of Minnesota, county agencies, tribal 194.9 governments, or administrative entities under contract to 194.10 participate in the implementation and administration of the home 194.11 and community-based waiver for persons with mental retardation 194.12 or a related condition, shall not be liable for damages, 194.13 injuries, or liabilities sustained through the purchase of 194.14 support by the individual, the individual's family, or the 194.15 authorized representative with funds received through the 194.16 consumer-directed community support service under this section. 194.17 Liabilities include but are not limited to: workers' 194.18 compensation liability, the Federal Insurance Contributions Act 194.19 (FICA), or the Federal Unemployment Tax Act (FUTA). 194.20 Sec. 44. Minnesota Statutes 2000, section 256B.0916, 194.21 subdivision 7, is amended to read: 194.22 Subd. 7. [ANNUAL REPORT BY COMMISSIONER.] Beginning 194.23October 1, 1999, and each October 1November 1, 2001, and each 194.24 November 1 thereafter, the commissioner shall issue an annual 194.25 report on county and state use of available resources for the 194.26 home and community-based waiver for persons with mental 194.27 retardation or related conditions. For each county or county 194.28 partnership, the report shall include: 194.29 (1) the amount of funds allocated but not used; 194.30 (2) the county specific allowed reserve amount approved and 194.31 used; 194.32 (3) the number, ages, and living situations of individuals 194.33 screened and waiting for services; 194.34 (4) the urgency of need for services to begin within one, 194.35 two, or more than two years for each individual; 194.36 (5) the services needed; 195.1 (6) the number of additional persons served by approval of 195.2 increased capacity within existing allocations; 195.3 (7) results of action by the commissioner to streamline 195.4 administrative requirements and improve county resource 195.5 management; and 195.6 (8) additional action that would decrease the number of 195.7 those eligible and waiting for waivered services. 195.8 The commissioner shall specify intended outcomes for the program 195.9 and the degree to which these specified outcomes are attained. 195.10 Sec. 45. Minnesota Statutes 2000, section 256B.0916, 195.11 subdivision 9, is amended to read: 195.12 Subd. 9. [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] 195.13 The commissioner, in cooperation with representatives of 195.14 counties, service providers, service recipients, family members, 195.15 legal representatives and advocates, shall develop criteria to 195.16 allow legal representatives to be reimbursed for providing 195.17 specific support services to meet the person's needs when a plan 195.18 which assures health and safety has been agreed upon and carried 195.19 out by the legal representative, the person, and the county. 195.20 Legal representatives providing support underconsumer-directed195.21community support services pursuant to section 256B.092,195.22subdivision 4,the home and community-based waiver for persons 195.23 with mental retardation or related conditions or the consumer 195.24 support grant program pursuant to section256B.092, subdivision195.257256.476, shall not be considered to have a direct or indirect 195.26 service provider interest under section 256B.092, subdivision 7, 195.27 if a health and safety plan which meets the criteria established 195.28 has been agreed upon and implemented. ByOctober 1, 1999August 195.29 1, 2001, the commissioner shall submit, for federal approval, 195.30 amendments to allow legal representatives to provide support and 195.31 receive reimbursement under theconsumer-directed community195.32support services section of thehome and community-based waiver 195.33 plan. 195.34 Sec. 46. Minnesota Statutes 2000, section 256B.092, 195.35 subdivision 2a, is amended to read: 195.36 Subd. 2a. [MEDICAL ASSISTANCE FOR CASE MANAGEMENT 196.1 ACTIVITIES UNDER THE STATE PLAN MEDICAID OPTION.] (a) Upon 196.2 receipt of federal approval, the commissioner shall make 196.3 payments toapproved vendorscounties, private individuals, and 196.4 agencies enrolled as providers of case management services 196.5 participating in the medical assistance program to reimburse 196.6 costs for providing case management service activities to 196.7 medical assistance eligible persons with mental retardation or a 196.8 related condition, in accordance with the state Medicaid plan, 196.9 the home and community-based waiver for persons with mental 196.10 retardation and related conditions plan, and federal 196.11 requirementsand limitations. 196.12 (b) The commissioner shall ensure that each eligible person 196.13 is given a choice of county and private agency case management 196.14 service providers. Case management service providers are 196.15 prohibited from providing any other service to the person 196.16 receiving case management services. 196.17 Sec. 47. Minnesota Statutes 2000, section 256B.092, 196.18 subdivision 5, is amended to read: 196.19 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 196.20 apply for any federal waivers necessary to secure, to the extent 196.21 allowed by law, federal financial participation under United 196.22 States Code, title 42, sections 1396 et seq., as amended, for 196.23 the provision of services to persons who, in the absence of the 196.24 services, would need the level of care provided in a regional 196.25 treatment center or a community intermediate care facility for 196.26 persons with mental retardation or related conditions. The 196.27 commissioner may seek amendments to the waivers or apply for 196.28 additional waivers under United States Code, title 42, sections 196.29 1396 et seq., as amended, to contain costs. The commissioner 196.30 shall ensure that payment for the cost of providing home and 196.31 community-based alternative services under the federal waiver 196.32 plan shall not exceed the cost of intermediate care services 196.33 including day training and habilitation services that would have 196.34 been provided without the waivered services. 196.35 (b) The commissioner, in administering home and 196.36 community-based waivers for persons with mental retardation and 197.1 related conditions, shall ensure that day services for eligible 197.2 persons are not provided by the person's residential service 197.3 provider, unless the person or the person's legal representative 197.4 is offered a choice of providers and agrees in writing to 197.5 provision of day services by the residential service provider. 197.6 The individual service plan for individuals who choose to have 197.7 their residential service provider provide their day services 197.8 must describe how health, safety, and protection needs will be 197.9 met by frequent and regular contact with persons other than the 197.10 residential service provider. 197.11 Sec. 48. Minnesota Statutes 2000, section 256B.093, 197.12 subdivision 3, is amended to read: 197.13 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 197.14 department shall fund administrative case management under this 197.15 subdivision using medical assistance administrative funds. The 197.16 traumatic brain injury program duties include: 197.17 (1) recommending to the commissioner in consultation with 197.18 the medical review agent according to Minnesota Rules, parts 197.19 9505.0500 to 9505.0540, the approval or denial of medical 197.20 assistance funds to pay for out-of-state placements for 197.21 traumatic brain injury services and in-state traumatic brain 197.22 injury services provided by designated Medicare long-term care 197.23 hospitals; 197.24 (2) coordinating the traumatic brain injury home and 197.25 community-based waiver; 197.26 (3)approving traumatic brain injury waiver eligibility or197.27care plans or both;197.28(4)providing ongoing technical assistance and consultation 197.29 to county and facility case managers to facilitate care plan 197.30 development for appropriate, accessible, and cost-effective 197.31 medical assistance services; 197.32(5)(4) providing technical assistance to promote statewide 197.33 development of appropriate, accessible, and cost-effective 197.34 medical assistance services and related policy; 197.35(6)(5) providing training and outreach to facilitate 197.36 access to appropriate home and community-based services to 198.1 prevent institutionalization; 198.2(7)(6) facilitating appropriate admissions, continued stay 198.3 review, discharges, and utilization review for neurobehavioral 198.4 hospitals and other specialized institutions; 198.5(8)(7) providing technical assistance on the use of prior 198.6 authorization of home care services and coordination of these 198.7 services with other medical assistance services; 198.8(9)(8) developing a system for identification of nursing 198.9 facility and hospital residents with traumatic brain injury to 198.10 assist in long-term planning for medical assistance services. 198.11 Factors will include, but are not limited to, number of 198.12 individuals served, length of stay, services received, and 198.13 barriers to community placement; and 198.14(10)(9) providing information, referral, and case 198.15 consultation to access medical assistance services for 198.16 recipients without a county or facility case manager. Direct 198.17 access to this assistance may be limited due to the structure of 198.18 the program. 198.19 Sec. 49. Minnesota Statutes 2000, section 256B.095, is 198.20 amended to read: 198.21 256B.095 [THREE-YEARQUALITY ASSURANCEPILOTPROJECT 198.22 ESTABLISHED.] 198.23 Effective July 1, 1998, an alternative quality assurance 198.24 licensing systempilotproject for programs for persons with 198.25 developmental disabilities is established in Dodge, Fillmore, 198.26 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 198.27 Wabasha, and Winona counties for the purpose of improving the 198.28 quality of services provided to persons with developmental 198.29 disabilities. A county, at its option, may choose to have all 198.30 programs for persons with developmental disabilities located 198.31 within the county licensed under chapter 245A using standards 198.32 determined under the alternative quality assurance licensing 198.33 systempilotproject or may continue regulation of these 198.34 programs under the licensing system operated by the 198.35 commissioner. Thepilotproject expires on June 30,20012005. 198.36 Sec. 50. Minnesota Statutes 2000, section 256B.0951, 199.1 subdivision 1, is amended to read: 199.2 Subdivision 1. [MEMBERSHIP.] The region 10 quality 199.3 assurance commission is established. The commission consists of 199.4 at least 14 but not more than 21 members as follows: at least 199.5 three but not more than five members representing advocacy 199.6 organizations; at least three but not more than five members 199.7 representing consumers, families, and their legal 199.8 representatives; at least three but not more than five members 199.9 representing service providers; at least three but not more than 199.10 five members representing counties; and the commissioner of 199.11 human services or the commissioner's designee. Initial 199.12 membership of the commission shall be recruited and approved by 199.13 the region 10 stakeholders group. Prior to approving the 199.14 commission's membership, the stakeholders group shall provide to 199.15 the commissioner a list of the membership in the stakeholders 199.16 group, as of February 1, 1997, a brief summary of meetings held 199.17 by the group since July 1, 1996, and copies of any materials 199.18 prepared by the group for public distribution. The first 199.19 commission shall establish membership guidelines for the 199.20 transition and recruitment of membership for the commission's 199.21 ongoing existence. Members of the commission who do not receive 199.22 a salary or wages from an employer for time spent on commission 199.23 duties may receive a per diem payment when performing commission 199.24 duties and functions. All members may be reimbursed for 199.25 expenses related to commission activities. Notwithstanding the 199.26 provisions of section 15.059, subdivision 5, the commission 199.27 expires on June 30,20012005. 199.28 Sec. 51. Minnesota Statutes 2000, section 256B.0951, 199.29 subdivision 3, is amended to read: 199.30 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the 199.31 commission, in cooperation with the commissioners of human 199.32 services and health, shall do the following: (1) approve an 199.33 alternative quality assurance licensing system based on the 199.34 evaluation of outcomes; (2) approve measurable outcomes in the 199.35 areas of health and safety, consumer evaluation, education and 199.36 training, providers, and systems that shall be evaluated during 200.1 the alternative licensing process; and (3) establish variable 200.2 licensure periods not to exceed three years based on outcomes 200.3 achieved. For purposes of this subdivision, "outcome" means the 200.4 behavior, action, or status of a person that can be observed or 200.5 measured and can be reliably and validly determined. 200.6 (b) By January 15, 1998, the commission shall approve, in 200.7 cooperation with the commissioner of human services, a training 200.8 program for members of the quality assurance teams established 200.9 under section 256B.0952, subdivision 4. 200.10 (c) The commission and the commissioner shall establish an 200.11 ongoing review process for the alternative quality assurance 200.12 licensing system. The review shall take into account the 200.13 comprehensive nature of the alternative system, which is 200.14 designed to evaluate the broad spectrum of licensed and 200.15 unlicensed entities that provide services to clients, as 200.16 compared to the current licensing system. 200.17 (d) The commission shall contract with an independent 200.18 entity to conduct a financial review of the alternative quality 200.19 assurancepilotproject. The review shall take into account the 200.20 comprehensive nature of the alternative system, which is 200.21 designed to evaluate the broad spectrum of licensed and 200.22 unlicensed entities that provide services to clients, as 200.23 compared to the current licensing system. The review shall 200.24 include an evaluation of possible budgetary savings within the 200.25 department of human services as a result of implementation of 200.26 the alternative quality assurancepilotproject. If a federal 200.27 waiver is approved under subdivision 7, the financial review 200.28 shall also evaluate possible savings within the department of 200.29 health. This review must be completed by December 15, 2000. 200.30 (e) The commission shall submit a report to the legislature 200.31 by January 15, 2001, on the results of the review process for 200.32 the alternative quality assurancepilotproject, a summary of 200.33 the results of the independent financial review, and a 200.34 recommendation on whether thepilotproject should be extended 200.35 beyond June 30, 2001. 200.36 (f) The commissioner, in consultation with the commission, 201.1 shall examine the feasibility of expanding the project to other 201.2 populations or geographic areas and identify barriers to 201.3 expansion. The commissioner shall report findings and 201.4 recommendations to the legislature by December 15, 2004. 201.5 Sec. 52. Minnesota Statutes 2000, section 256B.0951, 201.6 subdivision 4, is amended to read: 201.7 Subd. 4. [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF 201.8 LICENSING STANDARDS.] The commission may recommend to the 201.9 commissioners of human services and health variances from the 201.10 standards governing licensure of programs for persons with 201.11 developmental disabilities in order to improve the quality of 201.12 services by implementing an alternative developmental 201.13 disabilities licensing system if the commission determines that 201.14 the alternative licensing system does not adversely affect the 201.15 health or safety of persons being served by the licensed program 201.16 nor compromise the qualifications of staff to provide services. 201.17 Sec. 53. Minnesota Statutes 2000, section 256B.0951, 201.18 subdivision 5, is amended to read: 201.19 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 201.20 safety standards, rights, or procedural protections under 201.21 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 201.22 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 201.23 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 201.24 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 201.25 procedures for the monitoring of psychotropic medications shall 201.26 not be varied under the alternative licensing systempilot201.27 project. The commission may make recommendations to the 201.28 commissioners of human services and health or to the legislature 201.29 regarding alternatives to or modifications of the rules and 201.30 procedures referenced in this subdivision. 201.31 Sec. 54. Minnesota Statutes 2000, section 256B.0951, 201.32 subdivision 7, is amended to read: 201.33 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 201.34 exempt residents of intermediate care facilities for persons 201.35 with mental retardation (ICFs/MR) who participate in the 201.36 three-year quality assurance pilot project established in 202.1 section 256B.095 from the requirements of Minnesota Rules, 202.2 chapter 4665, upon approval by the federal government of a 202.3 waiver of federal certification requirements for ICFs/MR.The202.4commissioners of health and human services shall apply for any202.5necessary waivers as soon as practicable and shall submit the202.6concept paper to the federal government by June 1, 1998.202.7 Sec. 55. Minnesota Statutes 2000, section 256B.0951, is 202.8 amended by adding a subdivision to read: 202.9 Subd. 8. [FEDERAL WAIVER.] The commissioner of human 202.10 services shall seek federal authority to waive provisions of 202.11 intermediate care facilities for persons with mental retardation 202.12 (ICFs/MR) regulations to enable the demonstration and evaluation 202.13 of the alternative quality assurance system for ICFs/MR under 202.14 the project. The commissioner of human services shall apply for 202.15 any necessary waivers as soon as practicable. 202.16 Sec. 56. Minnesota Statutes 2000, section 256B.0951, is 202.17 amended by adding a subdivision to read: 202.18 Subd. 9. [EVALUATION.] The commission, in consultation 202.19 with the commissioner of human services, shall conduct an 202.20 evaluation of the alternative quality assurance system, and 202.21 present a report to the commissioner by June 30, 2004. 202.22 Sec. 57. Minnesota Statutes 2000, section 256B.0952, 202.23 subdivision 1, is amended to read: 202.24 Subdivision 1. [NOTIFICATION.]By January 15, 1998, each202.25affected county shall notify the commission and the202.26commissioners of human services and health as to whether it202.27chooses to implement on July 1, 1998, the alternative licensing202.28system for the pilot project. A county that does not implement202.29the alternative licensing system on July 1, 1998, may give202.30notice to the commission and the commissioners by January 15,202.311999, or January 15, 2000, that it will implement the202.32alternative licensing system on the following July 1. A county202.33that implements the alternative licensing system commits to202.34participate until June 30, 2001.For each year of the project, 202.35 region 10 counties shall give notice to the commission and 202.36 commissioners of human services and health by March 15 of intent 203.1 to join the quality assurance alternative licensing system, 203.2 effective July 1 of that year. A county choosing to participate 203.3 in the alternative licensing system commits to participate until 203.4 June 30, 2005. Counties participating in the quality assurance 203.5 alternative licensing system as of January 1, 2001, shall notify 203.6 the commission and the commissioners of human services and 203.7 health by March 15, 2001, of intent to continue participation. 203.8 Counties that elect to continue participation must participate 203.9 in the alternative licensing system until June 30, 2005. 203.10 Sec. 58. Minnesota Statutes 2000, section 256B.0952, 203.11 subdivision 4, is amended to read: 203.12 Subd. 4. [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A 203.13 county or group of counties that chooses to participate in the 203.14 alternative licensing system shall designate a quality assurance 203.15 manager and shall establish quality assurance teams in 203.16 accordance with subdivision 5. The manager shall recruit, 203.17 train, and assign duties to the quality assurance team members. 203.18 In assigning team members to conduct the quality assurance 203.19 process at a facility, program, or service, the manager shall 203.20 take into account the size of the service provider, the number 203.21 of services to be reviewed, the skills necessary for team 203.22 members to complete the process, and other relevant factors. 203.23 The manager shall ensure that no team member has a financial, 203.24 personal, or family relationship with the facility, program, or 203.25 service being reviewed or with any clients of the facility, 203.26 program, or service. 203.27 (b) Quality assurance teams shall report the findings of 203.28 their quality assurance reviews to the quality assurance manager. 203.29 The quality assurance manager shall provide the report from the 203.30 quality assurance team to the county and, upon request, to the 203.31 commissioners of human services and health, and shall provide a 203.32 summary of the report to the quality assurance review council. 203.33 Sec. 59. Minnesota Statutes 2000, section 256B.49, is 203.34 amended by adding a subdivision to read: 203.35 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized 203.36 to apply for home and community-based service waivers, as 204.1 authorized under section 1915(c) of the Social Security Act to 204.2 serve persons under the age of 65 who are determined to require 204.3 the level of care provided in a nursing home and persons who 204.4 require the level of care provided in a hospital. The 204.5 commissioner shall apply for the home and community-based 204.6 waivers in order to: (i) promote the support of persons with 204.7 disabilities in the most integrated settings; (ii) expand the 204.8 availability of services for persons who are eligible for 204.9 medical assistance; (iii) promote cost-effective options to 204.10 institutional care; and (iv) obtain federal financial 204.11 participation. 204.12 (b) The provision of waivered services to medical 204.13 assistance recipients with disabilities shall comply with the 204.14 requirements outlined in the federally approved applications for 204.15 home and community-based services and subsequent amendments, 204.16 including provision of services according to a service plan 204.17 designed to meet the needs of the individual. For purposes of 204.18 this section, the approved home and community-based application 204.19 is considered the necessary federal requirement. 204.20 (c) The commissioner shall provide interested persons 204.21 serving on agency advisory committees and task forces, and 204.22 others upon request, with notice of, and an opportunity to 204.23 comment on, any changes or amendments to the federally approved 204.24 applications for home and community-based waivers, prior to 204.25 their submission to the federal health care financing 204.26 administration. 204.27 (d) The commissioner shall seek approval, as authorized 204.28 under section 1915(c) of the Social Security Act, to allow 204.29 medical assistance eligibility under this section for children 204.30 under age 21 without deeming of parental income or assets. 204.31 (e) The commissioner shall seek approval, as authorized 204.32 under section 1915(c) of the Social Act, to allow medical 204.33 assistance eligibility under this section for individuals under 204.34 age 65 without deeming the spouse's income or assets. 204.35 Sec. 60. Minnesota Statutes 2000, section 256B.49, is 204.36 amended by adding a subdivision to read: 205.1 Subd. 12. [INFORMED CHOICE.] Persons who are determined 205.2 likely to require the level of care provided in a nursing 205.3 facility or hospital shall be informed of the home and 205.4 community-based support alternatives to the provision of 205.5 inpatient hospital services or nursing facility services. Each 205.6 person must be given the choice of either institutional or home 205.7 and community-based services, using the provisions described in 205.8 section 256B.77, subdivision 2, paragraph (p). 205.9 Sec. 61. Minnesota Statutes 2000, section 256B.49, is 205.10 amended by adding a subdivision to read: 205.11 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home 205.12 and community-based waiver shall be provided case management 205.13 services by qualified vendors as described in the federally 205.14 approved waiver application. The case management service 205.15 activities provided will include: 205.16 (1) assessing the needs of the individual within 20 working 205.17 days of a recipient's request; 205.18 (2) developing the written individual service plan within 205.19 ten working days after the assessment is completed; 205.20 (3) informing the recipient or the recipient's legal 205.21 guardian or conservator of service options; 205.22 (4) assisting the recipient in the identification of 205.23 potential service providers; 205.24 (5) assisting the recipient to access services; 205.25 (6) coordinating, evaluating, and monitoring of the 205.26 services identified in the service plan; 205.27 (7) completing the annual reviews of the service plan; and 205.28 (8) informing the recipient or legal representative of the 205.29 right to have assessments completed and service plans developed 205.30 within specified time periods, and to appeal county action or 205.31 inaction under section 256.045, subdivision 3. 205.32 (b) The case manager may delegate certain aspects of the 205.33 case management service activities to another individual 205.34 provided there is oversight by the case manager. The case 205.35 manager may not delegate those aspects which require 205.36 professional judgment including assessments, reassessments, and 206.1 care plan development. 206.2 Sec. 62. Minnesota Statutes 2000, section 256B.49, is 206.3 amended by adding a subdivision to read: 206.4 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments 206.5 of each recipient's strengths, informal support systems, and 206.6 need for services shall be completed within 20 working days of 206.7 the recipient's request. Reassessment of each recipient's 206.8 strengths, support systems, and need for services shall be 206.9 conducted at least every 12 months and at other times when there 206.10 has been a significant change in the recipient's functioning. 206.11 (b) Persons with mental retardation or a related condition 206.12 who apply for services under the nursing facility level waiver 206.13 programs shall be screened for the appropriate level of care 206.14 according to section 256B.092. 206.15 (c) Recipients who are found eligible for home and 206.16 community-based services under this section before their 65th 206.17 birthday may remain eligible for these services after their 65th 206.18 birthday if they continue to meet all other eligibility factors. 206.19 Sec. 63. Minnesota Statutes 2000, section 256B.49, is 206.20 amended by adding a subdivision to read: 206.21 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 206.22 home and community-based waivered services shall be provided a 206.23 copy of the written service plan which: 206.24 (1) is developed and signed by the recipient within ten 206.25 working days of the completion of the assessment; 206.26 (2) meets the assessed needs of the recipient; 206.27 (3) reasonably ensures the health and safety of the 206.28 recipient; 206.29 (4) promotes independence; 206.30 (5) allows for services to be provided in the most 206.31 integrated settings; and 206.32 (6) provides for an informed choice, as defined in section 206.33 256B.77, subdivision 2, paragraph (p), of service and support 206.34 providers. 206.35 Sec. 64. Minnesota Statutes 2000, section 256B.49, is 206.36 amended by adding a subdivision to read: 207.1 Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and 207.2 supports included in the home and community-based waivers for 207.3 persons with disabilities shall meet the requirements set out in 207.4 United States Code, title 42, section 1396n. The services and 207.5 supports, which are offered as alternatives to institutional 207.6 care, shall promote consumer choice, community inclusion, 207.7 self-sufficiency, and self-determination. 207.8 (b) Beginning January 1, 2003, the commissioner shall 207.9 simplify and improve access to home and community-based waivered 207.10 services, to the extent possible, through the establishment of a 207.11 common service menu that is available to eligible recipients 207.12 regardless of age, disability type, or waiver program. 207.13 (c) Consumer directed community support services shall be 207.14 offered as an option to all persons eligible for services under 207.15 section 256B.49, subdivision 11, by January 1, 2002. 207.16 (d) Services and supports shall be arranged and provided 207.17 consistent with individualized written plans of care for 207.18 eligible waiver recipients. 207.19 (e) The state of Minnesota and county agencies that 207.20 administer home and community-based waivered services for 207.21 persons with disabilities, shall not be liable for damages, 207.22 injuries, or liabilities sustained through the purchase of 207.23 supports by the individual, the individual's family, or the 207.24 authorized representative with funds received through the 207.25 consumer-directed community support service under this section. 207.26 Liabilities include but are not limited to: workers' 207.27 compensation liability, the Federal Insurance Contributions Act 207.28 (FICA), or the Federal Unemployment Tax Act (FUTA). 207.29 Sec. 65. Minnesota Statutes 2000, section 256B.49, is 207.30 amended by adding a subdivision to read: 207.31 Subd. 17. [COST OF SERVICES AND SUPPORTS.] (a) The 207.32 commissioner shall ensure that the average per capita 207.33 expenditures estimated in any fiscal year for home and 207.34 community-based waiver recipients does not exceed the average 207.35 per capita expenditures that would have been made to provide 207.36 institutional services for recipients in the absence of the 208.1 waiver. 208.2 (b) The commissioner shall implement on January 1, 2002, 208.3 one or more aggregate, need-based methods for allocating to 208.4 local agencies the home and community-based waivered service 208.5 resources available to support recipients with disabilities in 208.6 need of the level of care provided in a nursing facility or a 208.7 hospital. The commissioner shall allocate resources to single 208.8 counties and county partnerships in a manner that reflects 208.9 consideration of: 208.10 (1) an incentive-based payment process for achieving 208.11 outcomes; 208.12 (2) the need for a state-level risk pool; 208.13 (3) the need for retention of management responsibility at 208.14 the state agency level; and 208.15 (4) a phase-in strategy as appropriate. 208.16 (c) Until the allocation methods described in paragraph (b) 208.17 are implemented, the annual allowable reimbursement level of 208.18 home and community-based waiver services shall be the greater of: 208.19 (1) the statewide average payment amount which the 208.20 recipient is assigned under the waiver reimbursement system in 208.21 place on June 30, 2001, modified by the percentage of any 208.22 provider rate increase appropriated for home and community-based 208.23 services; or 208.24 (2) an amount approved by the commissioner based on the 208.25 recipient's extraordinary needs that cannot be met within the 208.26 current allowable reimbursement level. The increased 208.27 reimbursement level must be necessary to allow the recipient to 208.28 be discharged from an institution or to prevent imminent 208.29 placement in an institution. The additional reimbursement may 208.30 be used to secure environmental modifications; assistive 208.31 technology and equipment; and increased costs for supervision, 208.32 training, and support services necessary to address the 208.33 recipient's extraordinary needs. The commissioner may approve 208.34 an increased reimbursement level for up to one year of the 208.35 recipient's relocation from an institution or up to six months 208.36 of a determination that a current waiver recipient is at 209.1 imminent risk of being placed in an institution. 209.2 (d) Beginning July 1, 2001, medically necessary private 209.3 duty nursing services will be authorized under this section as 209.4 complex and regular care according to section 256B.0627. 209.5 Sec. 66. Minnesota Statutes 2000, section 256B.49, is 209.6 amended by adding a subdivision to read: 209.7 Subd. 18. [PAYMENTS.] The commissioner shall reimburse 209.8 approved vendors from the medical assistance account for the 209.9 costs of providing home and community-based services to eligible 209.10 recipients using the invoice processing procedures of the 209.11 Medicaid management information system (MMIS). Recipients will 209.12 be screened and authorized for services according to the 209.13 federally approved waiver application and its subsequent 209.14 amendments. 209.15 Sec. 67. Minnesota Statutes 2000, section 256B.49, is 209.16 amended by adding a subdivision to read: 209.17 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human 209.18 services shall take the necessary safeguards to protect the 209.19 health and welfare of individuals provided services under the 209.20 waiver. 209.21 Sec. 68. Minnesota Statutes 2000, section 256B.49, is 209.22 amended by adding a subdivision to read: 209.23 Subd. 20. [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.] 209.24 The commissioner shall seek to amend the traumatic brain injury 209.25 waiver to include, as eligible persons, individuals with an 209.26 acquired or degenerative disease diagnosis where cognitive 209.27 impairment is present, such as multiple sclerosis. 209.28 Sec. 69. Minnesota Statutes 2000, section 256B.69, 209.29 subdivision 23, is amended to read: 209.30 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 209.31 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 209.32 implement demonstration projects to create alternative 209.33 integrated delivery systems for acute and long-term care 209.34 services to elderly persons and persons with disabilities as 209.35 defined in section 256B.77, subdivision 7a, that provide 209.36 increased coordination, improve access to quality services, and 210.1 mitigate future cost increases. The commissioner may seek 210.2 federal authority to combine Medicare and Medicaid capitation 210.3 payments for the purpose of such demonstrations. Medicare funds 210.4 and services shall be administered according to the terms and 210.5 conditions of the federal waiver and demonstration provisions. 210.6 For the purpose of administering medical assistance funds, 210.7 demonstrations under this subdivision are subject to 210.8 subdivisions 1 to 22. The provisions of Minnesota Rules, parts 210.9 9500.1450 to 9500.1464, apply to these demonstrations, with the 210.10 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 210.11 subpart 1, items B and C, which do not apply to persons 210.12 enrolling in demonstrations under this section. An initial open 210.13 enrollment period may be provided. Persons who disenroll from 210.14 demonstrations under this subdivision remain subject to 210.15 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is 210.16 enrolled in a health plan under these demonstrations and the 210.17 health plan's participation is subsequently terminated for any 210.18 reason, the person shall be provided an opportunity to select a 210.19 new health plan and shall have the right to change health plans 210.20 within the first 60 days of enrollment in the second health 210.21 plan. Persons required to participate in health plans under 210.22 this section who fail to make a choice of health plan shall not 210.23 be randomly assigned to health plans under these demonstrations. 210.24 Notwithstanding section 256L.12, subdivision 5, and Minnesota 210.25 Rules, part 9505.5220, subpart 1, item A, if adopted, for the 210.26 purpose of demonstrations under this subdivision, the 210.27 commissioner may contract with managed care organizations, 210.28 including counties, to serve only elderly persons eligible for 210.29 medical assistance, elderly and disabled persons, or disabled 210.30 persons only. For persons with primary diagnoses of mental 210.31 retardation or a related condition, serious and persistent 210.32 mental illness, or serious emotional disturbance, the 210.33 commissioner must ensure that the county authority has approved 210.34 the demonstration and contracting design. Enrollment in these 210.35 projects for persons with disabilities shall be voluntaryuntil210.36July 1, 2001. The commissioner shall not implement any 211.1 demonstration project under this subdivision for persons with 211.2 primary diagnoses of mental retardation or a related condition, 211.3 serious and persistent mental illness, or serious emotional 211.4 disturbance, without approval of the county board of the county 211.5 in which the demonstration is being implemented. 211.6 Before implementation of a demonstration project for 211.7 disabled persons, the commissioner must provide information to 211.8 appropriate committees of the house of representatives and 211.9 senate and must involve representatives of affected disability 211.10 groups in the design of the demonstration projects. 211.11 (b) A nursing facility reimbursed under the alternative 211.12 reimbursement methodology in section 256B.434 may, in 211.13 collaboration with a hospital, clinic, or other health care 211.14 entity provide services under paragraph (a). The commissioner 211.15 shall amend the state plan and seek any federal waivers 211.16 necessary to implement this paragraph. 211.17 Sec. 70. Minnesota Statutes 2000, section 256D.35, is 211.18 amended by adding a subdivision to read: 211.19 Subd. 11a. [INSTITUTION.] "Institution" means: a 211.20 hospital, consistent with Code of Federal Regulations, title 42, 211.21 section 440.10; regional treatment center inpatient services; a 211.22 nursing facility; and an intermediate care facility for persons 211.23 with mental retardation. 211.24 Sec. 71. Minnesota Statutes 2000, section 256D.35, is 211.25 amended by adding a subdivision to read: 211.26 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means: rent, 211.27 manufactured home lot rentals; monthly principal, interest, 211.28 insurance premiums, and property taxes due for mortgages or 211.29 contract for deed costs; costs for utilities, including heating, 211.30 cooling, electricity, water, and sewerage; garbage collection 211.31 fees; and the basic service fee for one telephone. 211.32 Sec. 72. Minnesota Statutes 2000, section 256D.44, 211.33 subdivision 5, is amended to read: 211.34 Subd. 5. [SPECIAL NEEDS.] In addition to the state 211.35 standards of assistance established in subdivisions 1 to 4, 211.36 payments are allowed for the following special needs of 212.1 recipients of Minnesota supplemental aid who are not residents 212.2 of a nursing home, a regional treatment center, or a group 212.3 residential housing facility. 212.4 (a) The county agency shall pay a monthly allowance for 212.5 medically prescribed diets payable under the Minnesota family 212.6 investment program if the cost of those additional dietary needs 212.7 cannot be met through some other maintenance benefit. 212.8 (b) Payment for nonrecurring special needs must be allowed 212.9 for necessary home repairs or necessary repairs or replacement 212.10 of household furniture and appliances using the payment standard 212.11 of the AFDC program in effect on July 16, 1996, for these 212.12 expenses, as long as other funding sources are not available. 212.13 (c) A fee for guardian or conservator service is allowed at 212.14 a reasonable rate negotiated by the county or approved by the 212.15 court. This rate shall not exceed five percent of the 212.16 assistance unit's gross monthly income up to a maximum of $100 212.17 per month. If the guardian or conservator is a member of the 212.18 county agency staff, no fee is allowed. 212.19 (d) The county agency shall continue to pay a monthly 212.20 allowance of $68 for restaurant meals for a person who was 212.21 receiving a restaurant meal allowance on June 1, 1990, and who 212.22 eats two or more meals in a restaurant daily. The allowance 212.23 must continue until the person has not received Minnesota 212.24 supplemental aid for one full calendar month or until the 212.25 person's living arrangement changes and the person no longer 212.26 meets the criteria for the restaurant meal allowance, whichever 212.27 occurs first. 212.28 (e) A fee of ten percent of the recipient's gross income or 212.29 $25, whichever is less, is allowed for representative payee 212.30 services provided by an agency that meets the requirements under 212.31 SSI regulations to charge a fee for representative payee 212.32 services. This special need is available to all recipients of 212.33 Minnesota supplemental aid regardless of their living 212.34 arrangement. 212.35 (f) Notwithstanding the language in this subdivision, an 212.36 amount equal to the maximum allotment authorized by the federal 213.1 Food Stamp Program for a single individual which is in effect on 213.2 the first day of January of the previous year will be added to 213.3 the standards of assistance established in subdivisions 1 to 4 213.4 for individuals under the age of 65 who are relocating from an 213.5 institution and who are shelter needy. An eligible individual 213.6 who receives this benefit prior to age 65 may continue to 213.7 receive the benefit after the age of 65. 213.8 "Shelter needy" means that the assistance unit incurs 213.9 monthly shelter costs that exceed 40 percent of the assistance 213.10 unit's gross income before the application of this special needs 213.11 standard. "Gross income" for the purposes of this section is 213.12 the applicant's or recipient's income as defined in section 213.13 256D.35, subdivision 10, or the standard specified in 213.14 subdivision 3, whichever is greater. A recipient of a federal 213.15 or state housing subsidy, that limits shelter costs to a 213.16 percentage of gross income, shall not be considered shelter 213.17 needy for purposes of this paragraph. 213.18 Sec. 73. Minnesota Statutes 2000, section 256I.05, 213.19 subdivision 1e, is amended to read: 213.20 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 213.21 Notwithstanding the provisions of subdivisions 1a and 1c, 213.22 beginning July 1,19992001, a county agency shall negotiate a 213.23 supplementary rate in addition to the rate specified in 213.24 subdivision 1, equal to25125 percent of the amount specified 213.25 in subdivision 1a, including any legislatively authorized 213.26 inflationary adjustments, for a group residential housing 213.27 provider that: 213.28 (1) is located in Hennepin county and has had a group 213.29 residential housing contract with the county since June 1996; 213.30 (2) operates in three separate locations a56-bed71-bed 213.31 facility,aand two 40-bedfacility, and a 30-bed facility213.32 facilities; and 213.33 (3) serves a chemically dependent clientele, providing 24 213.34 hours per day supervision and limiting a resident's maximum 213.35 length of stay to 13 months out of a consecutive 24-month period. 213.36 Sec. 74. [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY 214.1 ADULT FOSTER CARE PROVIDERS.] 214.2 Subdivision 1. [PROGRAM ESTABLISHED.] The state recognizes 214.3 the importance of developing and maintaining quality family 214.4 foster care resources. In order to accomplish that goal, the 214.5 commissioner shall establish a two-year respite care pilot 214.6 project for family adult foster care providers in three 214.7 counties. This pilot project is intended to provide support to 214.8 caregivers of adult foster care residents. The commissioner 214.9 shall establish a pilot project to accomplish the provisions in 214.10 subdivisions 2 to 4. 214.11 Subd. 2. [ELIGIBILITY.] A family adult foster care home 214.12 provider as defined under section 144D.01, subdivision 7, who 214.13 has been licensed for six months is eligible for 30 days of 214.14 respite care per calendar year. In cases of emergency, a county 214.15 social services agency may waive the six-month licensing 214.16 requirement. In order to be eligible to receive respite payment 214.17 from group residential housing and alternative care, a provider 214.18 must take time off away from their foster care residents. 214.19 Subd. 3. [PAYMENT STRUCTURE.] (a) The payment for respite 214.20 care for an adult foster care resident eligible for only group 214.21 residential housing shall be based on the current monthly group 214.22 residential housing base room and board rate and the current 214.23 maximum monthly group residential housing difficulty of care 214.24 rate. 214.25 (b) The payment for respite care for an adult foster care 214.26 resident eligible for alternative care funds shall be based on 214.27 the resident's alternative care foster care rate. 214.28 (c) The payment for respite care for an adult foster care 214.29 resident eligible for Medicaid home and community-based services 214.30 waiver funds shall be based on the group residential housing 214.31 base room and board rate. 214.32 (d) The total amount available to pay for respite care for 214.33 a family adult foster care provider shall be based on the number 214.34 of residents currently served in the foster care home and the 214.35 source of funding used to pay for each resident's foster care. 214.36 Respite care must be paid for on a per diem basis and for a full 215.1 day. 215.2 Subd. 4. [PRIVATE PAY RESIDENTS.] Payment for respite care 215.3 for private pay foster care residents must be arranged between 215.4 the provider and the resident or the resident's family. 215.5 Sec. 75. Laws 1999, chapter 152, section 1, is amended to 215.6 read: 215.7 Section 1. [TASK FORCE.] 215.8 A day training and habilitation task force is established. 215.9 Task force membership shall consist of representatives of the 215.10 commissioner of human services, counties, service consumers, and 215.11 vendors of day training and habilitation as defined in Minnesota 215.12 Statutes, section 252.41, subdivision 9, including at least one 215.13 representative from each association representing day training 215.14 and habilitation vendors. Appointments to the task force shall 215.15 be made by the commissioner of human services and technical 215.16 assistance shall be provided by the department of human services. 215.17 Sec. 76. Laws 1999, chapter 152, section 4, is amended to 215.18 read: 215.19 Sec. 4. [REPORT.] 215.20 The task force shall present a report recommending a new 215.21 payment rate structure to the legislature by January 15, 2000, 215.22 and shall make recommendations to the commissioner of human 215.23 services regarding the implementation of the pilot project for 215.24 the individualized payment rate structure, so the pilot project 215.25 can be implemented by July 1, 2002, as required in section 3. 215.26 The task force expires onMarch 15, 2000December 30, 2003. 215.27 Sec. 77. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 215.28 PILOT PROJECT.] 215.29 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE 215.30 STRUCTURE.] Notwithstanding Minnesota Statutes, sections 215.31 252.451, subdivision 5; and 252.46; and Minnesota Rules, part 215.32 9525.1290, subpart 1, items A and B, the commissioner of human 215.33 services shall initiate a pilot project and phase-in for the 215.34 individualized payment rate structure described in this section 215.35 and section 74. The pilot project shall include actual 215.36 transfers of funds, not simulated transfers. The pilot project 216.1 may include all or some of the vendors in up to eight counties, 216.2 with no more than two counties from the seven-county 216.3 Minneapolis-St. Paul metropolitan area. Following initiation of 216.4 the pilot project, the commissioner shall phase in 216.5 implementation of the individualized payment rate structure to 216.6 the remaining counties and vendors according to the 216.7 implementation plan developed by the task force. The pilot and 216.8 phase-in shall not extend over more than 18 months and shall be 216.9 completed by December 31, 2003. 216.10 Subd. 2. [SUNSET.] The pilot project shall sunset upon 216.11 implementation of a new statewide rate structure according to 216.12 the implementation plan developed by the task force described in 216.13 subdivision 3, in its report to the legislature on December 1, 216.14 2001. The rates of vendors participating in the pilot project 216.15 must be modified to be consistent with the new statewide rate 216.16 structure, as implemented. 216.17 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training 216.18 and habilitation task force established under Laws 1999, chapter 216.19 152, section 4, shall evaluate the pilot project authorized 216.20 under subdivision 1, and by December 1, 2001, shall report to 216.21 the legislature with an implementation plan, which shall address 216.22 how and when the pilot project individualized payment rate 216.23 structure will be implemented statewide, shall ensure that 216.24 vendors that wish to maintain their current per diem rate may do 216.25 so within the new payment system, and shall identify criteria 216.26 that would halt statewide implementation if vendors or clients 216.27 were adversely affected by the new payment rate structure, and 216.28 with recommendations for any amendments that should be made 216.29 before statewide implementation. These recommendations shall be 216.30 made in a report to the chairs of the house health and human 216.31 services policy and finance committees and the senate health and 216.32 family security committee and finance division. 216.33 Subd. 4. [RATE SETTING.] (a) The rate structure under this 216.34 section is intended to allow a county to authorize an individual 216.35 rate for each client in the vendor's program based on the needs 216.36 and expected outcomes of the individual client. Rates shall be 217.1 based on an authorized package of services for each individual 217.2 over a typical time frame. Rates may be established across 217.3 multiple sites run by a single vendor. 217.4 (b) With county concurrence, a vendor shall establish up to 217.5 four levels of service, A through D, based on the intensity of 217.6 services provided to an individual client of day training and 217.7 habilitation services. Service level A shall be the highest 217.8 intensity of services, marked primarily, but not exclusively, by 217.9 a one-to-one client-to-staff ratio. Service level D shall be 217.10 the lowest intensity of services. The county shall document the 217.11 vendor's description of the type and amount of services 217.12 associated with each service level. 217.13 (c) For each vendor, a county board shall establish a 217.14 dollar value for one hour of service at each of the service 217.15 levels defined in paragraph (b). In establishing these values 217.16 for existing vendors transitioning from the payment rate 217.17 structure under Minnesota Statutes, section 252.46, subdivision 217.18 1, the county board shall follow the formula and guidelines 217.19 developed by the day training and habilitation task force under 217.20 paragraph (e). 217.21 (d) A vendor may elect to maintain a single transportation 217.22 rate or may elect to establish up to five types of 217.23 transportation services: public transportation, public special 217.24 transportation, nonambulatory transportation, out-of-service 217.25 area transportation, and ambulatory transportation. For vendors 217.26 that elect to establish multiple transportation services, the 217.27 county board shall establish a dollar value for a round trip on 217.28 each type of transportation service offered through the vendor. 217.29 With vendor concurrence, the county may also establish a uniform 217.30 one-way trip value for some or all of the transportation service 217.31 types. 217.32 (e) The county board shall ensure that the vendor 217.33 translates the vendor's existing program and transportation 217.34 rates to the rates and values in the pilot project by using the 217.35 conversion calculations for services and transportation approved 217.36 by the day training and habilitation task force established 218.1 under Laws 1999, chapter 152, and included in the task force's 218.2 recommendations to the legislature. The conversion calculation 218.3 may be amended by the task force with the approval of the 218.4 commissioner and any amendments shall become effective upon 218.5 notification to the pilot project counties from the 218.6 commissioner. The calculation shall take the total 218.7 reimbursement dollars available to the vendor and divide by the 218.8 units of service expected at each service level and of each 218.9 transportation type. In determining the total reimbursement 218.10 dollars available to a vendor, the vendor shall multiply the 218.11 vendor's current per diem rate for both services and 218.12 transportation, including any new rate increases, by the 218.13 vendor's actual utilization for the year prior to implementation 218.14 of the pilot project. Vendors shall be allowed to allocate 218.15 available reimbursement dollars between service and 218.16 transportation before the vendor's service level and 218.17 transportation values are calculated. After translating its 218.18 existing service and transportation rates to the service level 218.19 and transportation values under the pilot, the vendor shall 218.20 project its expected reimbursement income using the expected 218.21 service and transportation packages for its existing clients, 218.22 based on current service authorizations. If the projected 218.23 reimbursement income is less than the vendor would have received 218.24 under the payment structure of Minnesota Statutes, section 218.25 252.46, the vendor and the county, with the approval of the 218.26 commissioner, shall adjust the vendor's service level and 218.27 transportation values to eliminate the shortfall. The 218.28 commissioner shall report all adjustments to the day training 218.29 and habilitation task force for consideration of possible 218.30 modifications to the pilot project individualized payment rate 218.31 structure. 218.32 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 218.33 its annual authorization of services for each client under 218.34 Minnesota Statutes, section 252.44, paragraph (a), clause (1), 218.35 and Minnesota Rules, part 9525.0016, subpart 12, the county 218.36 shall authorize and document a service package and a 219.1 transportation package as follows: 219.2 (1) the service package shall include the amount and type 219.3 of services at each applicable service level to be provided to 219.4 the client over a package period. An individual client may 219.5 receive services at multiple service levels over the course of 219.6 the package period. The service package rate shall be the sum 219.7 of the amount of services at each level over the package period, 219.8 multiplied by the dollar value for each service level; 219.9 (2) the transportation package shall include the amount and 219.10 type of transportation services to be provided to the client 219.11 over the package period. The transportation package rate shall 219.12 be the sum of the amount of transportation services, multiplied 219.13 by the dollar value associated with the type of transportation 219.14 service authorized for the client; 219.15 (3) the package period shall be established by the county, 219.16 and may be one week, two weeks, or one month; and 219.17 (4) the individual rate authorization may be reviewed and 219.18 modified by the county at any time and must be reviewed and 219.19 reauthorized by the county at least annually. 219.20 (b) For vendors with rates established under this section, 219.21 a service day under Minnesota Statutes, sections 245B.06 and 219.22 252.44, includes any day in which a client receives any 219.23 reimbursable service from a vendor or attends employment 219.24 arranged by the vendor. 219.25 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill 219.26 for, and shall be reimbursed for, the service package rate and 219.27 transportation package rate for the package period as authorized 219.28 by the county for each client in the vendor's program. The 219.29 length of the package period shall not affect the timing or 219.30 frequency of vendors' submissions of claims for payment under 219.31 the Medicaid Management Information System II (MMIS) or its 219.32 successors. 219.33 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 219.34 vendor shall notify an individual client's case manager if the 219.35 vendor has knowledge of a material change in the client's needs 219.36 that may indicate a need for a change in service authorization. 220.1 Factors that would require such notice include, but are not 220.2 limited to, significant changes in medical status, residential 220.3 placement, attendance patterns, behavioral needs, or skill 220.4 functioning. The vendor shall notify the case manager as soon 220.5 as possible but no later than 30 calendar days after becoming 220.6 aware of the change in needs. The service authorization for the 220.7 client shall not change until the county authorizes a new 220.8 service and transportation package for the client in accordance 220.9 with the provisions in Minnesota Statutes, section 256B.092. 220.10 Sec. 78. [COUNTY BOARD RESPONSIBILITIES.] 220.11 For each vendor with rates established under section 73, 220.12 the county board shall document the vendor's description of the 220.13 type and amount of services associated with each service level, 220.14 the vendor's service level values, the vendor's transportation 220.15 values, and the package period that will be used to determine 220.16 the rate for each individual client. The county shall establish 220.17 a package period of one week, two weeks, or one month. 220.18 Sec. 79. [STUDY OF DAY TRAINING AND HABILITATION VENDOR 220.19 RATES.] 220.20 The commissioner shall identify the vendors with the lowest 220.21 rates or underfunded programs in the state and make 220.22 recommendations to reconcile the discrepancies prior to the 220.23 implementation of the individualized payment rate structure 220.24 described in sections 73 and 74. 220.25 Sec. 80. [FEDERAL APPROVAL.] 220.26 The commissioner shall seek any amendments to the state 220.27 Medicaid plan and any waivers necessary to permit implementation 220.28 of section 74 within the timelines specified. 220.29 Sec. 81. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 220.30 The commissioner of human services, in consultation with 220.31 county representatives and other interested persons, shall 220.32 develop recommendations revising the funding methodology for 220.33 SILS as defined in Minnesota Statutes, section 252.275, 220.34 subdivisions 3, 4, 4a, 4b, and 4c, and report by January 15, 220.35 2002, to the chair of the house of representatives health and 220.36 human services finance committee and the chairs of the senate 221.1 health, human services, and corrections budget division. 221.2 Sec. 82. [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 221.3 By September 1, 2001, the commissioner of human services 221.4 shall seek federal approval to allow recipients of home and 221.5 community-based waivers authorized under Minnesota Statutes, 221.6 section 256B.49, to choose either a waiver of deeming of spousal 221.7 income or the spousal impoverishment protections authorized 221.8 under United States Code, title 42, section 1396r-5, with the 221.9 addition of the group residential housing rate set according to 221.10 Minnesota Statutes, section 256I.03, subdivision 5, to the 221.11 personal needs allowance authorized by Minnesota Statutes, 221.12 section 256B.0575. 221.13 Sec. 83. [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH 221.14 DEVELOPMENTAL DISABILITIES.] 221.15 (a) The commissioner of human services shall ensure that 221.16 services continue to be available to persons with developmental 221.17 disabilities who were covered by social services supplemental 221.18 grants prior to July 1, 2001. Services shall be provided in 221.19 priority order as follows: 221.20 (1) to the extent possible, the commissioner shall 221.21 establish for these persons targeted slots under the home and 221.22 community-based waivered services program for persons with 221.23 mental retardation or related conditions; 221.24 (2) persons accommodated under clause (1) shall, if 221.25 eligible, receive room and board services through group 221.26 residential housing under Minnesota Statutes, chapter 256I; and 221.27 (3) any remaining persons shall continue to receive 221.28 services through community social services supplemental grants 221.29 to the affected counties. 221.30 (b) This section applies only to individuals receiving 221.31 services under social services supplemental grants as of June 221.32 30, 2001. 221.33 Sec. 84. [FEDERAL APPROVAL.] 221.34 The commissioner of human services, by September 1, 2001, 221.35 shall request any federal approval and plan amendments necessary 221.36 to implement the choice of case manager provision in section 222.1 256B.092, subdivision 2a, paragraph (b). 222.2 Sec. 85. [FEDERAL WAIVER REQUESTS.] 222.3 The commissioner of human services shall submit to the 222.4 federal Health Care Financing Administration by September 1, 222.5 2001, a request for a home and community-based services waiver 222.6 for day services, including: community inclusion, supported 222.7 employment, and day training and habilitation services defined 222.8 in Minnesota Statutes, section 252.41, subdivision 3, clause 222.9 (1), for persons eligible for the waiver under Minnesota 222.10 Statutes, section 256B.092. 222.11 Sec. 86. [REPEALER.] 222.12 (a) Minnesota Statutes 2000, sections 256B.0951, 222.13 subdivision 6; and 256E.06, subdivision 2b, are repealed. 222.14 (b) Minnesota Statutes 2000, sections 145.9245; 256.476, 222.15 subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 222.16 3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, 222.17 are repealed. 222.18 (c) Laws 1995, chapter 178, article 2, section 48, 222.19 subdivision 6, is repealed. 222.20 (d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 222.21 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 222.22 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 222.23 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 222.24 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 222.25 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 222.26 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 222.27 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 222.28 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 222.29 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 222.30 9505.3660; and 9505.3670, are repealed. 222.31 ARTICLE 4 222.32 CONSUMER INFORMATION AND ASSISTANCE 222.33 AND COMMUNITY-BASED CARE 222.34 Section 1. [144A.35] [EXPANSION OF BED DISTRIBUTION STUDY 222.35 AND CREATION OF CRITICAL ACCESS SITES.] 222.36 Subdivision 1. [OLDER ADULT SERVICES DISTRIBUTION 223.1 STUDY.] The commissioner of health, in coordination with the 223.2 commissioner of human services, shall monitor and analyze the 223.3 distribution of older adult services, including, but not limited 223.4 to, nursing home beds, senior housing, housing with services 223.5 units, and home and community-based services in the different 223.6 geographic areas of the state. The study shall include an 223.7 analysis of the impact of amendments to the nursing home 223.8 moratorium law which would allow for transfers of nursing home 223.9 beds within the state. The commissioner of health shall submit 223.10 to the legislature, beginning January 15, 2002, and each January 223.11 15 thereafter, an assessment of the distribution of long-term 223.12 health care services by geographic area, with particular 223.13 attention to service deficits or problems, the designation of 223.14 critical access service sites, and corrective action plans. 223.15 Subd. 2. [CRITICAL ACCESS SERVICE SITE.] "Critical access 223.16 service site" shall include nursing homes, senior housing, 223.17 housing with services, and home and community-based services 223.18 that are certified by the state as necessary providers of health 223.19 care services to a specific geographic area. For purposes of 223.20 this requirement, a "necessary provider of health care services" 223.21 is a provider that is: 223.22 (1) located more than 20 miles, defined as official mileage 223.23 as reported by the Minnesota department of transportation, from 223.24 the next nearest long-term health care provider; 223.25 (2) the sole long-term health care provider in the county; 223.26 or 223.27 (3) a long-term health care provider located in a medically 223.28 underserved area or health professional shortage area. 223.29 Subd. 3. [IDENTIFICATION OF CRITICAL ACCESS SERVICE 223.30 SITES.] Based on the results of the analysis completed in 223.31 subdivision 1, the commissioners of health and human services 223.32 shall identify and designate long-term health care providers as 223.33 critical access service sites. 223.34 Subd. 4. [CRITICAL ACCESS SERVICE SITES.] The commissioner 223.35 of health, in consultation with the commissioner of human 223.36 services, shall: 224.1 (1) develop and implement specific waivers to regulations 224.2 governing health care personnel scope of duties, physical plant 224.3 requirements, and location of community-based services, to 224.4 address critical access service site older adult service needs; 224.5 (2) identify payment barriers to the continued operation of 224.6 older adult services in critical access service sites, and 224.7 provide recommendations on changes to reimbursement rates to 224.8 facilitate the continued operation of these services. 224.9 Sec. 2. Minnesota Statutes 2000, section 256.973, is 224.10 amended by adding a subdivision to read: 224.11 Subd. 6. [GRANTS FOR HOME-SHARING PROGRAMS.] Grants 224.12 awarded for home-sharing programs under this section shall be 224.13 awarded through a request for proposals process every two years 224.14 according to criteria developed by the commissioner. In 224.15 awarding grants, the commissioner shall not give priority to an 224.16 applicant solely because the applicant has previously received a 224.17 grant under this section. Nothing under this subdivision shall 224.18 prohibit the commissioner from evaluating the performance of a 224.19 home-sharing program receiving a grant under this section and 224.20 allocating funds based on the evaluation. 224.21 Sec. 3. Minnesota Statutes 2000, section 256.975, is 224.22 amended by adding a subdivision to read: 224.23 Subd. 7. [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 224.24 LINKAGE.] (a) The Minnesota board on aging shall operate a 224.25 statewide information and assistance service to aid older 224.26 Minnesotans and their families in making informed choices about 224.27 long-term care options and health care benefits. Language 224.28 services to persons with limited English language skills may be 224.29 made available. The service, known as Senior LinkAge Line, must 224.30 be available during business hours through a statewide toll-free 224.31 number and must also be available through the Internet. 224.32 (b) The service must assist older adults, caregivers, and 224.33 providers in accessing information about choices in long-term 224.34 care services that are purchased through private providers or 224.35 available through public options. The service must: 224.36 (1) develop a comprehensive database that includes detailed 225.1 listings in both consumer- and provider-oriented formats; 225.2 (2) make the database accessible on the Internet and 225.3 through other telecommunication and media-related tools; 225.4 (3) link callers to interactive long-term care screening 225.5 tools and make these tools available through the Internet by 225.6 integrating the tools with the database; 225.7 (4) develop community education materials with a focus on 225.8 planning for long-term care and evaluating independent living, 225.9 housing, and service options; 225.10 (5) conduct an outreach campaign to assist older adults and 225.11 their caregivers in finding information on the Internet and 225.12 through other means of communication; 225.13 (6) implement a messaging system for overflow callers and 225.14 respond to these callers by the next business day; 225.15 (7) link callers with county human services and other 225.16 providers to receive more in-depth assistance and consultation 225.17 related to long-term care options; and 225.18 (8) link callers with quality profiles for nursing 225.19 facilities and other providers developed by the commissioner of 225.20 health. 225.21 (c) The Minnesota board on aging shall conduct an 225.22 evaluation of the effectiveness of the statewide information and 225.23 assistance, and submit this evaluation to the legislature by 225.24 December 1, 2002. The evaluation must include an analysis of 225.25 funding adequacy, gaps in service delivery, continuity in 225.26 information between the service and identified linkages, and 225.27 potential use of private funding to enhance the service. 225.28 Sec. 4. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 225.29 PROGRAM.] 225.30 Subdivision 1. [DEFINITIONS.] For purposes of this 225.31 section, the following terms have the meanings given. 225.32 (a) "Community" means a town, township, city, or targeted 225.33 neighborhood within a city, or a consortium of towns, townships, 225.34 cities, or targeted neighborhoods within cities. 225.35 (b) "Older adult services" means any services available 225.36 under the elderly waiver program or alternative care grant 226.1 programs; nursing facility services; transportation services; 226.2 respite services; and other community-based services identified 226.3 as necessary either to maintain lifestyle choices for older 226.4 Minnesotans, or to promote independence. 226.5 (c) "Older adult" refers to individuals 65 years of age and 226.6 older. 226.7 Subd. 2. [CREATION.] The community services development 226.8 grants program is created under the administration of the 226.9 commissioner of human services. 226.10 Subd. 3. [PROVISION OF GRANTS.] The commissioner shall 226.11 make grants available to communities, providers of older adult 226.12 services identified in subdivision 1, or to a consortium of 226.13 providers of older adult services, to establish older adult 226.14 services. Grants may be provided for capital and other costs 226.15 including, but not limited to, start-up and training costs, 226.16 equipment, and supplies related to older adult services or other 226.17 residential or service alternatives to nursing facility care. 226.18 Grants may also be made to renovate current buildings, provide 226.19 transportation services, fund programs that would allow older 226.20 adults or disabled individuals to stay in their own homes by 226.21 sharing a home, fund programs that coordinate and manage formal 226.22 and informal services to older adults in their homes to enable 226.23 them to live as independently as possible in their own homes as 226.24 an alternative to nursing home care, or expand state-funded 226.25 programs in the area. 226.26 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 226.27 communities and providers or to a consortium of providers that 226.28 have a local match of 50 percent of the costs for the project in 226.29 the form of donations, local tax dollars, in-kind donations, 226.30 fundraising, or other local matches. 226.31 Subd. 5. [GRANT PREFERENCE.] The commissioner of human 226.32 services may award grants to the extent grant funds are 226.33 available and to the extent applications are approved by the 226.34 commissioner. Denial of approval of an application in one year 226.35 does not preclude submission of an application in a subsequent 226.36 year. The maximum grant amount is limited to $750,000. 227.1 Sec. 5. Minnesota Statutes 2000, section 256B.0911, 227.2 subdivision 1, is amended to read: 227.3 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose ofthe227.4preadmission screening programlong-term care consultation 227.5 services is to assist persons with long-term or chronic care 227.6 needs in making long-term care decisions and selecting options 227.7 that meet their needs and reflect their preferences. The 227.8 availability of, and access to, information and other types of 227.9 assistance is also intended to prevent or delay certified 227.10 nursing facility placementsby assessing applicants and227.11residents and offering cost-effective alternatives appropriate227.12for the person's needsand to provide transition assistance 227.13 after admission. Further, the goal ofthe programthese 227.14 services is to contain costs associated with unnecessary 227.15 certified nursing facility admissions. The commissioners of 227.16 human services and health shall seek to maximize use of 227.17 available federal and state funds and establish the broadest 227.18 program possible within the funding available. 227.19 (b) These services must be coordinated with services 227.20 provided under sections 256.975, subdivision 7, and 256.9772, 227.21 and with services provided by other public and private agencies 227.22 in the community to offer a variety of cost-effective 227.23 alternatives to persons with disabilities and elderly persons. 227.24 The county agency providing long-term care consultation services 227.25 shall encourage the use of volunteers from families, religious 227.26 organizations, social clubs, and similar civic and service 227.27 organizations to provide community-based services. 227.28 Sec. 6. Minnesota Statutes 2000, section 256B.0911, is 227.29 amended by adding a subdivision to read: 227.30 Subd. 1a. [DEFINITIONS.] For purposes of this section, the 227.31 following definitions apply: 227.32 (a) "Long-term care consultation services" means: 227.33 (1) providing information and education to the general 227.34 public regarding availability of the services authorized under 227.35 this section; 227.36 (2) an intake process that provides access to the services 228.1 described in this section; 228.2 (3) assessment of the health, psychological, and social 228.3 needs of referred individuals; 228.4 (4) assistance in identifying services needed to maintain 228.5 an individual in the least restrictive environment; 228.6 (5) providing recommendations on cost-effective community 228.7 services that are available to the individual; 228.8 (6) development of an individual's community support plan; 228.9 (7) providing information regarding eligibility for 228.10 Minnesota health care programs; 228.11 (8) preadmission screening to determine the need for a 228.12 nursing facility level of care; 228.13 (9) preliminary determination of Minnesota health care 228.14 programs eligibility for individuals who need a nursing facility 228.15 level of care, with appropriate referrals for final 228.16 determination; 228.17 (10) providing recommendations for nursing facility 228.18 placement when there are no cost-effective community services 228.19 available; and 228.20 (11) assistance to transition people back to community 228.21 settings after facility admission. 228.22 (b) "Minnesota health care programs" means the medical 228.23 assistance program under chapter 256B, the alternative care 228.24 program under section 256B.0913, and the prescription drug 228.25 program under section 256.955. 228.26 Sec. 7. Minnesota Statutes 2000, section 256B.0911, 228.27 subdivision 3, is amended to read: 228.28 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE228.29PREADMISSION SCREENINGLONG-TERM CARE CONSULTATION TEAM.] (a) A 228.30local screeninglong-term care consultation team shall be 228.31 established by the county board of commissioners. Each local 228.32screeningconsultation team shall consist ofscreeners who are a228.33 at least one social worker andaat least one public health 228.34 nurse from their respective county agencies. The board may 228.35 designate public health or social services as the lead agency 228.36 for long-term care consultation services. If a county does not 229.1 have a public health nurse available, it may request approval 229.2 from the commissioner to assign a county registered nurse with 229.3 at least one year experience in home care to participate on the 229.4 team.The screening team members must confer regarding the most229.5appropriate care for each individual screened.Two or more 229.6 counties may collaborate to establish a joint localscreening229.7 consultation team or teams. 229.8 (b)In assessing a person's needs, screeners shall have a229.9physician available for consultation and shall consider the229.10assessment of the individual's attending physician, if any. The229.11individual's physician shall be included if the physician229.12chooses to participate. Other personnel may be included on the229.13team as deemed appropriate by the county agencies.The team is 229.14 responsible for providing long-term care consultation services 229.15 to all persons located in the county who request the services, 229.16 regardless of eligibility for Minnesota health care programs. 229.17 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is 229.18 amended by adding a subdivision to read: 229.19 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 229.20 requesting assessment, services planning, or other assistance 229.21 intended to support community-based living must be visited by a 229.22 long-term care consultation team within ten working days after 229.23 the date on which an assessment was requested or recommended. 229.24 Assessments must be conducted according to paragraphs (b) to (g). 229.25 (b) The county may utilize a team of either the social 229.26 worker or public health nurse, or both, to conduct the 229.27 assessment in a face-to-face interview. The consultation team 229.28 members must confer regarding the most appropriate care for each 229.29 individual screened or assessed. 229.30 (c) The long-term care consultation team must assess the 229.31 health and social needs of the person, using an assessment form 229.32 provided by the commissioner of human services. 229.33 (d) The team must conduct the assessment in a face-to-face 229.34 interview with the person being assessed and the person's legal 229.35 representative, if applicable. 229.36 (e) The team must provide the person, or the person's legal 230.1 representative, with written recommendations for facility- or 230.2 community-based services. The team must document that the most 230.3 cost-effective alternatives available were offered to the 230.4 individual. For purposes of this requirement, "cost-effective 230.5 alternatives" means community services and living arrangements 230.6 that cost the same as or less than nursing facility care. 230.7 (f) If the person chooses to use community-based services, 230.8 the team must provide the person or the person's legal 230.9 representative with a written community support plan, regardless 230.10 of whether the individual is eligible for Minnesota health care 230.11 programs. The person may request assistance in developing a 230.12 community support plan without participating in a complete 230.13 assessment. 230.14 (g) The team must give the person receiving assessment or 230.15 support planning, or the person's legal representative, 230.16 materials supplied by the commissioner of human services 230.17 containing the following information: 230.18 (1) the purpose of preadmission screening and assessment; 230.19 (2) information about Minnesota health care programs; 230.20 (3) the person's freedom to accept or reject the 230.21 recommendations of the team; 230.22 (4) the person's right to confidentiality under the 230.23 Minnesota Government Data Practices Act, chapter 13; and 230.24 (5) the person's right to appeal the decision regarding the 230.25 need for nursing facility level of care or the county's final 230.26 decisions regarding public programs eligibility according to 230.27 section 256.045, subdivision 3. 230.28 Sec. 9. Minnesota Statutes 2000, section 256B.0911, is 230.29 amended by adding a subdivision to read: 230.30 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care 230.31 consultation team shall provide assistance to persons residing 230.32 in a nursing facility, hospital, regional treatment center, or 230.33 intermediate care facility for persons with mental retardation 230.34 who request or are referred for such assistance. Transition 230.35 assistance must include assessment, community support plan 230.36 development, referrals to Minnesota health care programs, and 231.1 referrals to programs that provide assistance with housing. 231.2 (b) The county shall develop transition processes with 231.3 institutional social workers and discharge planners to ensure 231.4 that: 231.5 (1) persons admitted to facilities receive information 231.6 about transition assistance that is available; 231.7 (2) the assessment is completed for persons within ten 231.8 working days of the date of request or recommendation for 231.9 assessment; and 231.10 (3) there is a plan for transition and follow-up for the 231.11 individual's return to the community. The plan must require 231.12 notification of other local agencies when a person who may 231.13 require assistance is screened by one county for admission to a 231.14 facility located in another county. 231.15 (c) If a person who is eligible for a Minnesota health care 231.16 program is admitted to a nursing facility, the nursing facility 231.17 must include a consultation team member or the case manager in 231.18 the discharge planning process. 231.19 Sec. 10. Minnesota Statutes 2000, section 256B.0911, is 231.20 amended by adding a subdivision to read: 231.21 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 231.22 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 231.23 certified nursing facilities, including certified boarding care 231.24 facilities, must be screened prior to admission regardless of 231.25 income, assets, or funding sources for nursing facility care, 231.26 except as described in subdivision 4b. The purpose of the 231.27 screening is to determine the need for nursing facility level of 231.28 care as described in paragraph (d) and to complete activities 231.29 required under federal law related to mental illness and mental 231.30 retardation as outlined in paragraph (b). 231.31 (b) A person who has a diagnosis or possible diagnosis of 231.32 mental illness, mental retardation, or a related condition must 231.33 receive a preadmission screening before admission regardless of 231.34 the exemptions outlined in subdivision 4b, paragraph (b), to 231.35 identify the need for further evaluation and specialized 231.36 services, unless the admission prior to screening is authorized 232.1 by the local mental health authority or the local developmental 232.2 disabilities case manager, or unless authorized by the county 232.3 agency according to Public Law Number 100-508. 232.4 The following criteria apply to the preadmission screening: 232.5 (1) the county must use forms and criteria developed by the 232.6 commissioner of human services to identify persons who require 232.7 referral for further evaluation and determination of the need 232.8 for specialized services; and 232.9 (2) the evaluation and determination of the need for 232.10 specialized services must be done by: 232.11 (i) a qualified independent mental health professional, for 232.12 persons with a primary or secondary diagnosis of a serious 232.13 mental illness; or 232.14 (ii) a qualified mental retardation professional, for 232.15 persons with a primary or secondary diagnosis of mental 232.16 retardation or related conditions. For purposes of this 232.17 requirement, a qualified mental retardation professional must 232.18 meet the standards for a qualified mental retardation 232.19 professional under Code of Federal Regulations, title 42, 232.20 section 483.430. 232.21 (c) The local county mental health authority or the state 232.22 mental retardation authority under Public Laws Numbers 100-203 232.23 and 101-508 may prohibit admission to a nursing facility if the 232.24 individual does not meet the nursing facility level of care 232.25 criteria or needs specialized services as defined in Public Laws 232.26 Numbers 100-203 and 101-508. For purposes of this section, 232.27 "specialized services" for a person with mental retardation or a 232.28 related condition means active treatment as that term is defined 232.29 under Code of Federal Regulations, title 42, section 483.440, 232.30 paragraph (a), clause (1). 232.31 (d) The determination of the need for nursing facility 232.32 level of care must be made according to criteria developed by 232.33 the commissioner of human services. In assessing a person's 232.34 needs, consultation team members shall have a physician 232.35 available for consultation and shall consider the assessment of 232.36 the individual's attending physician, if any. The individual's 233.1 physician must be included if the physician chooses to 233.2 participate. Other personnel may be included on the team as 233.3 deemed appropriate by the county. 233.4 Sec. 11. Minnesota Statutes 2000, section 256B.0911, is 233.5 amended by adding a subdivision to read: 233.6 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 233.7 Exemptions from the federal screening requirements outlined in 233.8 subdivision 4a, paragraphs (b) and (c), are limited to: 233.9 (1) a person who, having entered an acute care facility 233.10 from a certified nursing facility, is returning to a certified 233.11 nursing facility; and 233.12 (2) a person transferring from one certified nursing 233.13 facility in Minnesota to another certified nursing facility in 233.14 Minnesota. 233.15 (b) Persons who are exempt from preadmission screening for 233.16 purposes of level of care determination include: 233.17 (1) persons described in paragraph (a); 233.18 (2) an individual who has a contractual right to have 233.19 nursing facility care paid for indefinitely by the veterans' 233.20 administration; 233.21 (3) an individual enrolled in a demonstration project under 233.22 section 256B.69, subdivision 8, at the time of application to a 233.23 nursing facility; 233.24 (4) an individual currently being served under the 233.25 alternative care program or under a home and community-based 233.26 services waiver authorized under section 1915(c) of the federal 233.27 Social Security Act; and 233.28 (5) individuals admitted to a certified nursing facility 233.29 for a short-term stay, which is expected to be 14 days or less 233.30 in duration based upon a physician's certification, and who have 233.31 been assessed and approved for nursing facility admission within 233.32 the previous six months. This exemption applies only if the 233.33 consultation team member determines at the time of the initial 233.34 assessment of the six-month period that it is appropriate to use 233.35 the nursing facility for short-term stays and that there is an 233.36 adequate plan of care for return to the home or community-based 234.1 setting. If a stay exceeds 14 days, the individual must be 234.2 referred no later than the first county working day following 234.3 the 14th resident day for a screening, which must be completed 234.4 within five working days of the referral. The payment 234.5 limitations in subdivision 7 apply to an individual found at 234.6 screening to not meet the level of care criteria for admission 234.7 to a certified nursing facility. 234.8 (c) Persons admitted to a Medicaid-certified nursing 234.9 facility from the community on an emergency basis as described 234.10 in paragraph (d) or from an acute care facility on a nonworking 234.11 day must be screened the first working day after admission. 234.12 (d) Emergency admission to a nursing facility prior to 234.13 screening is permitted when all of the following conditions are 234.14 met: 234.15 (1) a person is admitted from the community to a certified 234.16 nursing or certified boarding care facility during county 234.17 nonworking hours; 234.18 (2) a physician has determined that delaying admission 234.19 until preadmission screening is completed would adversely affect 234.20 the person's health and safety; 234.21 (3) there is a recent precipitating event that precludes 234.22 the client from living safely in the community, such as 234.23 sustaining an injury, sudden onset of acute illness, or a 234.24 caregiver's inability to continue to provide care; 234.25 (4) the attending physician has authorized the emergency 234.26 placement and has documented the reason that the emergency 234.27 placement is recommended; and 234.28 (5) the county is contacted on the first working day 234.29 following the emergency admission. 234.30 Transfer of a patient from an acute care hospital to a nursing 234.31 facility is not considered an emergency except for a person who 234.32 has received hospital services in the following situations: 234.33 hospital admission for observation, care in an emergency room 234.34 without hospital admission, or following hospital 24-hour bed 234.35 care. 234.36 Sec. 12. Minnesota Statutes 2000, section 256B.0911, is 235.1 amended by adding a subdivision to read: 235.2 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be 235.3 screened for nursing facility admission by telephone or in a 235.4 face-to-face screening interview. Consultation team members 235.5 shall identify each individual's needs using the following 235.6 categories: 235.7 (1) the person needs no face-to-face screening interview to 235.8 determine the need for nursing facility level of care based on 235.9 information obtained from other health care professionals; 235.10 (2) the person needs an immediate face-to-face screening 235.11 interview to determine the need for nursing facility level of 235.12 care and complete activities required under subdivision 4a; or 235.13 (3) the person may be exempt from screening requirements as 235.14 outlined in subdivision 4b, but will need transitional 235.15 assistance after admission or in-person follow-along after a 235.16 return home. 235.17 (b) Persons admitted on a nonemergency basis to a 235.18 Medicaid-certified nursing facility must be screened prior to 235.19 admission. 235.20 (c) The long-term care consultation team shall recommend a 235.21 case mix classification for persons admitted to a certified 235.22 nursing facility when sufficient information is received to make 235.23 that classification. The nursing facility is authorized to 235.24 conduct all case mix assessments for persons who have been 235.25 screened prior to admission for whom the county did not 235.26 recommend a case mix classification. The nursing facility is 235.27 authorized to conduct all case mix assessments for persons 235.28 admitted to the facility prior to a preadmission screening. The 235.29 county retains the responsibility of distributing appropriate 235.30 case mix forms to the nursing facility. 235.31 (d) The county screening or intake activity must include 235.32 processes to identify persons who may require transition 235.33 assistance as described in subdivision 3b. 235.34 Sec. 13. Minnesota Statutes 2000, section 256B.0911, 235.35 subdivision 5, is amended to read: 235.36 Subd. 5. [SIMPLIFICATION OF FORMSADMINISTRATIVE 236.1 ACTIVITY.] The commissioner shall minimize the number of forms 236.2 required in thepreadmission screening processprovision of 236.3 long-term care consultation services and shall limit the 236.4 screening document to items necessary forcarecommunity support 236.5 plan approval, reimbursement, program planning, evaluation, and 236.6 policy development. 236.7 Sec. 14. Minnesota Statutes 2000, section 256B.0911, 236.8 subdivision 6, is amended to read: 236.9 Subd. 6. [PAYMENT FORPREADMISSION SCREENINGLONG-TERM 236.10 CARE CONSULTATION SERVICES.] (a) The totalscreeningpayment for 236.11 each county must be paid monthly by certified nursing facilities 236.12 in the county. The monthly amount to be paid by each nursing 236.13 facility for each fiscal year must be determined by dividing the 236.14 county's annual allocation forscreeningslong-term care 236.15 consultation services by 12 to determine the monthly payment and 236.16 allocating the monthly payment to each nursing facility based on 236.17 the number of licensed beds in the nursing facility. Payments 236.18 to counties in which there is no certified nursing facility must 236.19 be made by increasing the payment rate of the two facilities 236.20 located nearest to the county seat. 236.21 (b) The commissioner shall include the total annual payment 236.22for screeningdetermined under paragraph (a) for each nursing 236.23 facility according to section 256B.431, subdivision 2b, 236.24 paragraph (g), 256B.434, or 256B.435. 236.25 (c) Payments forscreening activitieslong-term care 236.26 consultation services are available to the county or counties to 236.27 cover staff salaries and expenses to provide thescreening236.28functionservices described in subdivision 1a. Thelead agency236.29 county shall employ, or contract with other agencies to employ, 236.30 within the limits of available funding, sufficient personnel 236.31 toconduct the preadmission screening activityprovide long-term 236.32 care consultation services while meeting the state's long-term 236.33 care outcomes and objectives as defined in section 256B.0917, 236.34 subdivision 1. Thelocal agencycounty shall be accountable for 236.35 meeting local objectives as approved by the commissioner in the 236.36 CSSA biennial plan. 237.1 (d) Notwithstanding section 256B.0641, overpayments 237.2 attributable to payment of the screening costs under the medical 237.3 assistance program may not be recovered from a facility. 237.4 (e) The commissioner of human services shall amend the 237.5 Minnesota medical assistance plan to include reimbursement for 237.6 the localscreeningconsultation teams. 237.7 (f) The county may bill, as case management services, 237.8 assessments, support planning, and follow-along provided to 237.9 persons determined to be eligible for case management under 237.10 Minnesota health care programs. No individual or family member 237.11 shall be charged for an initial assessment or initial support 237.12 plan development provided under subdivision 3a or 3b. 237.13 Sec. 15. Minnesota Statutes 2000, section 256B.0911, 237.14 subdivision 7, is amended to read: 237.15 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 237.16 (a) Medical assistance reimbursement for nursing facilities 237.17 shall be authorized for a medical assistance recipient only if a 237.18 preadmission screening has been conducted prior to admission or 237.19 thelocalcountyagencyhas authorized an exemption. Medical 237.20 assistance reimbursement for nursing facilities shall not be 237.21 provided for any recipient who the local screener has determined 237.22 does not meet the level of care criteria for nursing facility 237.23 placement or, if indicated, has not had a level IIPASARROBRA 237.24 evaluation as required under the federal Omnibus Reconciliation 237.25 Act of 1987 completed unless an admission for a recipient with 237.26 mental illness is approved by the local mental health authority 237.27 or an admission for a recipient with mental retardation or 237.28 related condition is approved by the state mental retardation 237.29 authority. 237.30 (b) The nursing facility must not bill a person who is not 237.31 a medical assistance recipient for resident days that preceded 237.32 the date of completion of screening activities as required under 237.33 subdivisions 4a, 4b, and 4c. The nursing facility must include 237.34 unreimbursed resident days in the nursing facility resident day 237.35 totals reported to the commissioner. 237.36 (c) The commissioner shall make a request to the health 238.1 care financing administration for a waiver allowing screening 238.2 team approval of Medicaid payments for certified nursing 238.3 facility care. An individual has a choice and makes the final 238.4 decision between nursing facility placement and community 238.5 placement after the screening team's recommendation, except as 238.6 provided inparagraphs (b) and (c)subdivision 4a, paragraph (c). 238.7(c) The local county mental health authority or the state238.8mental retardation authority under Public Law Numbers 100-203238.9and 101-508 may prohibit admission to a nursing facility, if the238.10individual does not meet the nursing facility level of care238.11criteria or needs specialized services as defined in Public Law238.12Numbers 100-203 and 101-508. For purposes of this section,238.13"specialized services" for a person with mental retardation or a238.14related condition means "active treatment" as that term is238.15defined in Code of Federal Regulations, title 42, section238.16483.440(a)(1).238.17(e) Appeals from the screening team's recommendation or the238.18county agency's final decision shall be made according to238.19section 256.045, subdivision 3.238.20 Sec. 16. Minnesota Statutes 2000, section 256B.0913, 238.21 subdivision 1, is amended to read: 238.22 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the 238.23 alternative care program is to provide funding foror access to238.24 home and community-based services forfrailelderly persons, in 238.25 order to limit nursing facility placements. The program is 238.26 designed to supportfrailelderly persons in their desire to 238.27 remain in the community as independently and as long as possible 238.28 and to support informal caregivers in their efforts to provide 238.29 care forfrailelderly people. Further, the goals of the 238.30 program are: 238.31 (1) to contain medical assistance expenditures byproviding238.32 funding care in the communityat a cost the same or less than238.33nursing facility costs; and 238.34 (2) to maintain the moratorium on new construction of 238.35 nursing home beds. 238.36 Sec. 17. Minnesota Statutes 2000, section 256B.0913, 239.1 subdivision 2, is amended to read: 239.2 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 239.3 services are available toall frail olderMinnesotans. This239.4includes:239.5(1) persons who are receiving medical assistance and served239.6under the medical assistance program or the Medicaid waiver239.7program;239.8(2) personsage 65 or older who are not eligible for 239.9 medical assistance without a spenddown or waiver obligation but 239.10 who would be eligible for medical assistance within 180 days of 239.11 admission to a nursing facility andserved undersubject to 239.12 subdivisions 4 to 13; and239.13(3) persons who are paying for their services out-of-pocket. 239.14 Sec. 18. Minnesota Statutes 2000, section 256B.0913, 239.15 subdivision 4, is amended to read: 239.16 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 239.17 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 239.18 under the alternative care program is available to persons who 239.19 meet the following criteria: 239.20 (1) the person has beenscreened by the county screening239.21team or, if previously screened and served under the alternative239.22care program, assessed by the local county social worker or239.23public health nursedetermined by a community assessment under 239.24 section 256B.0911, to be a person who would require the level of 239.25 care provided in a nursing facility, but for the provision of 239.26 services under the alternative care program; 239.27 (2) the person is age 65 or older; 239.28 (3) the person would befinanciallyeligible for medical 239.29 assistance within 180 days of admission to a nursing facility; 239.30 (4) the personmeets the asset transfer requirements ofis 239.31 not ineligible for the medical assistance program due to an 239.32 asset transfer penalty; 239.33 (5)the screening team would recommend nursing facility239.34admission or continued stay for the person if alternative care239.35services were not available;239.36(6)the person needs services that are notavailable at240.1that time in the countyfunded through othercounty,state,or 240.2 federal fundingsources; and 240.3(7)(6) the monthly cost of the alternative care services 240.4 funded by the program for this person does not exceed 75 percent 240.5 of the statewideaverage monthly medical assistance payment for240.6nursing facility care at the individual's case mix240.7classificationweighted average monthly nursing facility rate of 240.8 the case mix resident class to which the individual alternative 240.9 care client would be assigned under Minnesota Rules, parts 240.10 9549.0050 to 9549.0059, less the recipient's maintenance needs 240.11 allowance as described in section 256B.0915, subdivision 1d, 240.12 paragraph (a), until the first day of the state fiscal year in 240.13 which the resident assessment system, under section 256B.437, 240.14 for nursing home rate determination is implemented. Effective 240.15 on the first day of the state fiscal year in which a resident 240.16 assessment system, under section 256B.437, for nursing home rate 240.17 determination is implemented and the first day of each 240.18 subsequent state fiscal year, the monthly cost of alternative 240.19 care services for this person shall not exceed the alternative 240.20 care monthly cap for the case mix resident class to which the 240.21 alternative care client would be assigned under Minnesota Rules, 240.22 parts 9549.0050 to 9549.0059, which was in effect on the last 240.23 day of the previous state fiscal year, and adjusted by the 240.24 greater of any legislatively adopted home and community-based 240.25 services cost-of-living percentage increase or any legislatively 240.26 adopted statewide percent rate increase for nursing facilities. 240.27 This monthly limit does not prohibit the alternative care client 240.28 from payment for additional services, but in no case may the 240.29 cost of additional services purchased under this section exceed 240.30 the difference between the client's monthly service limit 240.31 defined under section 256B.0915, subdivision 3, and the 240.32 alternative care program monthly service limit defined in this 240.33 paragraph. If medical supplies and equipment oradaptations240.34 environmental modifications are or will be purchased for an 240.35 alternative care services recipient, the costs may be prorated 240.36 on a monthly basisthroughout the year in which they are241.1purchasedfor up to 12 consecutive months beginning with the 241.2 month of purchase. If the monthly cost of a recipient's other 241.3 alternative care services exceeds the monthly limit established 241.4 in this paragraph, the annual cost of the alternative care 241.5 services shall be determined. In this event, the annual cost of 241.6 alternative care services shall not exceed 12 times the monthly 241.7 limitcalculateddescribed in this paragraph. 241.8 (b)Individuals who meet the criteria in paragraph (a) and241.9who have been approved for alternative care funding are called241.10180-day eligible clients.241.11(c) The statewide average payment for nursing facility care241.12is the statewide average monthly nursing facility rate in effect241.13on July 1 of the fiscal year in which the cost is incurred, less241.14the statewide average monthly income of nursing facility241.15residents who are age 65 or older and who are medical assistance241.16recipients in the month of March of the previous fiscal year.241.17This monthly limit does not prohibit the 180-day eligible client241.18from paying for additional services needed or desired.241.19(d) In determining the total costs of alternative care241.20services for one month, the costs of all services funded by the241.21alternative care program, including supplies and equipment, must241.22be included.241.23(e)Alternative care funding under this subdivision is not 241.24 available for a person who is a medical assistance recipient or 241.25 who would be eligible for medical assistance without a 241.26 spenddown, unless authorized by the commissioneror waiver 241.27 obligation. A person whose initial application for medical 241.28 assistance is being processed may be served under the 241.29 alternative care program for a period up to 60 days. If the 241.30 individual is found to be eligible for medical assistance,the241.31county must billmedical assistance must be billed for services 241.32 payable under the federally approved elderly waiver plan and 241.33 delivered from the date the individual was found eligible 241.34 forservices reimbursable underthe federally approved elderly 241.35 waiverprogramplan. Notwithstanding this provision, upon 241.36 federal approval, alternative care funds may not be used to pay 242.1 for any service the cost of which is payable by medical 242.2 assistance or which is used by a recipient to meet a medical 242.3 assistance income spenddown or waiver obligation. 242.4(f)(c) Alternative care funding is not available for a 242.5 person who resides in a licensed nursing homeor, certified 242.6 boarding care home, hospital, or intermediate care facility, 242.7 except for case management services which arebeingprovided in 242.8 support of the discharge planning process to a nursing home 242.9 resident or certified boarding care home resident who is 242.10 ineligible for case management funded by medical assistance. 242.11 Sec. 19. Minnesota Statutes 2000, section 256B.0913, 242.12 subdivision 5, is amended to read: 242.13 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 242.14 Alternative care funding may be used for payment of costs of: 242.15 (1) adult foster care; 242.16 (2) adult day care; 242.17 (3) home health aide; 242.18 (4) homemaker services; 242.19 (5) personal care; 242.20 (6) case management; 242.21 (7) respite care; 242.22 (8) assisted living; 242.23 (9) residential care services; 242.24 (10) care-related supplies and equipment; 242.25 (11) meals delivered to the home; 242.26 (12) transportation; 242.27 (13) skilled nursing; 242.28 (14) chore services; 242.29 (15) companion services; 242.30 (16) nutrition services; 242.31 (17) training for direct informal caregivers; 242.32 (18) telemedicine devices to monitor recipients in their 242.33 own homes as an alternative to hospital care, nursing home care, 242.34 or home visits;and242.35 (19) other servicesincludingwhich includes discretionary 242.36 funds and direct cash payments to clients,approved by the243.1county agencyfollowing approval by the commissioner, subject to 243.2 the provisions of paragraph(m)(j). Total annual payments for " 243.3 other services" for all clients within a county may not exceed 243.4 either ten percent of that county's annual alternative care 243.5 program base allocation or $5,000, whichever is greater. In no 243.6 case shall this amount exceed the county's total annual 243.7 alternative care program base allocation; and 243.8 (20) environmental modifications. 243.9 (b) The county agency must ensure that the funds are not 243.10 usedonly to supplement and notto supplant services available 243.11 through other public assistance or services programs. 243.12 (c) Unless specified in statute, the service definitions 243.13 and standards for alternative care services shall be the same as 243.14 the service definitions and standardsdefinedspecified in the 243.15 federally approved elderly waiver plan. Except for the county 243.16 agencies' approval of direct cash payments to clients as 243.17 described in paragraph (j) or for a provider of supplies and 243.18 equipment when the monthly cost of the supplies and equipment is 243.19 less than $250, persons or agencies must be employed by or under 243.20 a contract with the county agency or the public health nursing 243.21 agency of the local board of health in order to receive funding 243.22 under the alternative care program. Supplies and equipment may 243.23 be purchased from a non-Medicaid certified vendor if the cost 243.24 for the item is less than that of a Medicaid vendor. 243.25 (d) The adult foster care rate shall be considered a 243.26 difficulty of care payment and shall not include room and 243.27 board. The adult foster caredailyrate shall be negotiated 243.28 between the county agency and the foster care provider.The243.29rate established under this section shall not exceed 75 percent243.30of the state average monthly nursing home payment for the case243.31mix classification to which the individual receiving foster care243.32is assigned, and it must allow for other alternative care243.33services to be authorized by the case manager.The alternative 243.34 care payment for the foster care service in combination with the 243.35 payment for other alternative care services, including case 243.36 management, must not exceed the limit specified in subdivision 244.1 4, paragraph (a), clause (6). 244.2 (e) Personal care servicesmay be provided by a personal244.3care provider organization.must meet the service standards 244.4 defined in the federally approved elderly waiver plan, except 244.5 that a county agency may contract with a client's relativeof244.6the clientwho meets the relative hardship waiver requirement as 244.7 defined in section 256B.0627, subdivision 4, paragraph (b), 244.8 clause (10), to provide personal care services, but must ensure244.9nursingif the county agency ensures supervision of this service 244.10 by a registered nurse or mental health practitioner.Covered244.11personal care services defined in section 256B.0627, subdivision244.124, must meet applicable standards in Minnesota Rules, part244.139505.0335.244.14 (f)A county may use alternative care funds to purchase244.15medical supplies and equipment without prior approval from the244.16commissioner when: (1) there is no other funding source; (2)244.17the supplies and equipment are specified in the individual's244.18care plan as medically necessary to enable the individual to244.19remain in the community according to the criteria in Minnesota244.20Rules, part 9505.0210, item A; and (3) the supplies and244.21equipment represent an effective and appropriate use of244.22alternative care funds. A county may use alternative care funds244.23to purchase supplies and equipment from a non-Medicaid certified244.24vendor if the cost for the items is less than that of a Medicaid244.25vendor. A county is not required to contract with a provider of244.26supplies and equipment if the monthly cost of the supplies and244.27equipment is less than $250.244.28(g)For purposes of this section, residential care services 244.29 are services which are provided to individuals living in 244.30 residential care homes. Residential care homes are currently 244.31 licensed as board and lodging establishments and are registered 244.32 with the department of health as providing special 244.33 services under section 157.17 and are not subject to 244.34 registration under chapter 144D. Residential care services are 244.35 defined as "supportive services" and "health-related services." 244.36 "Supportive services" means the provision of up to 24-hour 245.1 supervision and oversight. Supportive services includes: (1) 245.2 transportation, when provided by the residential carecenter245.3 home only; (2) socialization, when socialization is part of the 245.4 plan of care, has specific goals and outcomes established, and 245.5 is not diversional or recreational in nature; (3) assisting 245.6 clients in setting up meetings and appointments; (4) assisting 245.7 clients in setting up medical and social services; (5) providing 245.8 assistance with personal laundry, such as carrying the client's 245.9 laundry to the laundry room. Assistance with personal laundry 245.10 does not include any laundry, such as bed linen, that is 245.11 included in the room and board rate. "Health-related services" 245.12 are limited to minimal assistance with dressing, grooming, and 245.13 bathing and providing reminders to residents to take medications 245.14 that are self-administered or providing storage for medications, 245.15 if requested. Individuals receiving residential care services 245.16 cannot receive homemaking services funded under this section. 245.17(h)(g) For the purposes of this section, "assisted living" 245.18 refers to supportive services provided by a single vendor to 245.19 clients who reside in the same apartment building of three or 245.20 more units which are not subject to registration under chapter 245.21 144D and are licensed by the department of health as a class A 245.22 home care provider or a class E home care provider. Assisted 245.23 living services are defined as up to 24-hour supervision, and 245.24 oversight, supportive services as defined in clause (1), 245.25 individualized home care aide tasks as defined in clause (2), 245.26 and individualized home management tasks as defined in clause 245.27 (3) provided to residents of a residential center living in 245.28 their units or apartments with a full kitchen and bathroom. A 245.29 full kitchen includes a stove, oven, refrigerator, food 245.30 preparation counter space, and a kitchen utensil storage 245.31 compartment. Assisted living services must be provided by the 245.32 management of the residential center or by providers under 245.33 contract with the management or with the county. 245.34 (1) Supportive services include: 245.35 (i) socialization, when socialization is part of the plan 245.36 of care, has specific goals and outcomes established, and is not 246.1 diversional or recreational in nature; 246.2 (ii) assisting clients in setting up meetings and 246.3 appointments; and 246.4 (iii) providing transportation, when provided by the 246.5 residential center only. 246.6Individuals receiving assisted living services will not246.7receive both assisted living services and homemaking services.246.8Individualized means services are chosen and designed246.9specifically for each resident's needs, rather than provided or246.10offered to all residents regardless of their illnesses,246.11disabilities, or physical conditions.246.12 (2) Home care aide tasks means: 246.13 (i) preparing modified diets, such as diabetic or low 246.14 sodium diets; 246.15 (ii) reminding residents to take regularly scheduled 246.16 medications or to perform exercises; 246.17 (iii) household chores in the presence of technically 246.18 sophisticated medical equipment or episodes of acute illness or 246.19 infectious disease; 246.20 (iv) household chores when the resident's care requires the 246.21 prevention of exposure to infectious disease or containment of 246.22 infectious disease; and 246.23 (v) assisting with dressing, oral hygiene, hair care, 246.24 grooming, and bathing, if the resident is ambulatory, and if the 246.25 resident has no serious acute illness or infectious disease. 246.26 Oral hygiene means care of teeth, gums, and oral prosthetic 246.27 devices. 246.28 (3) Home management tasks means: 246.29 (i) housekeeping; 246.30 (ii) laundry; 246.31 (iii) preparation of regular snacks and meals; and 246.32 (iv) shopping. 246.33 Individuals receiving assisted living services shall not 246.34 receive both assisted living services and homemaking services. 246.35 Individualized means services are chosen and designed 246.36 specifically for each resident's needs, rather than provided or 247.1 offered to all residents regardless of their illnesses, 247.2 disabilities, or physical conditions. Assisted living services 247.3 as defined in this section shall not be authorized in boarding 247.4 and lodging establishments licensed according to sections 247.5 157.011 and 157.15 to 157.22. 247.6(i)(h) For establishments registered under chapter 144D, 247.7 assisted living services under this section means either the 247.8 services describedand licensedin paragraph (g) and delivered 247.9 by a class E home care provider licensed by the department of 247.10 health or the services described under section 144A.4605 and 247.11 delivered by an assisted living home care provider or a class A 247.12 home care provider licensed by the commissioner of health. 247.13(j) For the purposes of this section, reimbursement(i) 247.14 Payment for assisted living services and residential care 247.15 services shall be a monthly rate negotiated and authorized by 247.16 the county agency based on an individualized service plan for 247.17 each resident and may not cover direct rent or food costs.The247.18rate247.19 (1) The individualized monthly negotiated payment for 247.20 assisted living services as described in paragraph (g) or (h), 247.21 and residential care services as described in paragraph (f), 247.22 shall not exceed the nonfederal share in effect on July 1 of the 247.23 state fiscal year for which the rate limit is being calculated 247.24 of the greater of either the statewide or any of the geographic 247.25 groups' weighted average monthlymedical assistancenursing 247.26 facility payment rate of the case mix resident class to which 247.27 the180-dayalternative care eligible client would be assigned 247.28 under Minnesota Rules, parts 9549.0050 to 9549.0059,unless the247.29 less the maintenance needs allowance as described in subdivision 247.30 1d, paragraph (a), until the first day of the state fiscal year 247.31 in which a resident assessment system, under section 256B.437, 247.32 of nursing home rate determination is implemented. Effective on 247.33 the first day of the state fiscal year in which a resident 247.34 assessment system, under section 256B.437, of nursing home rate 247.35 determination is implemented and the first day of each 247.36 subsequent state fiscal year, the individualized monthly 248.1 negotiated payment for the services described in this clause 248.2 shall not exceed the limit described in this clause which was in 248.3 effect on the last day of the previous state fiscal year and 248.4 which has been adjusted by the greater of any legislatively 248.5 adopted home and community-based services cost-of-living 248.6 percentage increase or any legislatively adopted statewide 248.7 percent rate increase for nursing facilities. 248.8 (2) The individualized monthly negotiated payment for 248.9 assisted living servicesare provided by a home caredescribed 248.10 under section 144A.4605 and delivered by a provider licensed by 248.11 the department of health as a class A home care provider or an 248.12 assisted living home care provider andareprovided in a 248.13 building that is registered as a housing with services 248.14 establishment under chapter 144D and that provides 24-hour 248.15 supervision in combination with the payment for other 248.16 alternative care services, including case management, must not 248.17 exceed the limit specified in subdivision 4, paragraph (a), 248.18 clause (6). 248.19(k) For purposes of this section, companion services are248.20defined as nonmedical care, supervision and oversight, provided248.21to a functionally impaired adult. Companions may assist the248.22individual with such tasks as meal preparation, laundry and248.23shopping, but do not perform these activities as discrete248.24services. The provision of companion services does not entail248.25hands-on medical care. Providers may also perform light248.26housekeeping tasks which are incidental to the care and248.27supervision of the recipient. This service must be approved by248.28the case manager as part of the care plan. Companion services248.29must be provided by individuals or organizations who are under248.30contract with the local agency to provide the service. Any248.31person related to the waiver recipient by blood, marriage or248.32adoption cannot be reimbursed under this service. Persons248.33providing companion services will be monitored by the case248.34manager.248.35(l) For purposes of this section, training for direct248.36informal caregivers is defined as a classroom or home course of249.1instruction which may include: transfer and lifting skills,249.2nutrition, personal and physical cares, home safety in a home249.3environment, stress reduction and management, behavioral249.4management, long-term care decision making, care coordination249.5and family dynamics. The training is provided to an informal249.6unpaid caregiver of a 180-day eligible client which enables the249.7caregiver to deliver care in a home setting with high levels of249.8quality. The training must be approved by the case manager as249.9part of the individual care plan. Individuals, agencies, and249.10educational facilities which provide caregiver training and249.11education will be monitored by the case manager.249.12(m)(j) A county agency may make payment from their 249.13 alternative care program allocation for "other services" 249.14provided to an alternative care program recipient if those249.15services prevent, shorten, or delay institutionalization. These249.16services maywhich include use of "discretionary funds" for 249.17 services that are not otherwise defined in this section and 249.18 direct cash payments to therecipientclient for the purpose of 249.19 purchasing therecipient'sservices. The following provisions 249.20 apply to payments under this paragraph: 249.21 (1) a cash payment to a client under this provision cannot 249.22 exceed 80 percent of the monthly payment limit for that client 249.23 as specified in subdivision 4, paragraph (a), clause(7)(6); 249.24 (2) a county may not approve any cash payment for a client 249.25 who meets either of the following: 249.26 (i) has been assessed as having a dependency in 249.27 orientation, unless the client has an authorized 249.28 representativeunder section 256.476, subdivision 2, paragraph249.29(g), or for a client who. An "authorized representative" means 249.30 an individual who is at least 18 years of age and is designated 249.31 by the person or the person's legal representative to act on the 249.32 person's behalf. This individual may be a family member, 249.33 guardian, representative payee, or other individual designated 249.34 by the person or the person's legal representative, if any, to 249.35 assist in purchasing and arranging for supports; or 249.36 (ii) is concurrently receiving adult foster care, 250.1 residential care, or assisted living services; 250.2 (3)any service approved under this section must be a250.3service which meets the purpose and goals of the program as250.4listed in subdivision 1;250.5(4) cash payments must also meet the criteria of and are250.6governed by the procedures and liability protection established250.7in section 256.476, subdivision 4, paragraphs (b) through (h),250.8and recipients of cash grants must meet the requirements in250.9section 256.476, subdivision 10; andcash payments to a person 250.10 or a person's family will be provided through a monthly payment 250.11 and be in the form of cash, voucher, or direct county payment to 250.12 vendor. Fees or premiums assessed to the person for eligibility 250.13 for health and human services are not reimbursable through this 250.14 service option. Services and goods purchased through cash 250.15 payments must be identified in the person's individualized care 250.16 plan and must meet all of the following criteria: 250.17 (i) they must be over and above the normal cost of caring 250.18 for the person if the person did not have functional 250.19 limitations; 250.20 (ii) they must be directly attributable to the person's 250.21 functional limitations; 250.22 (iii) they must have the potential to be effective at 250.23 meeting the goals of the program; 250.24 (iv) they must be consistent with the needs identified in 250.25 the individualized service plan. The service plan shall specify 250.26 the needs of the person and family, the form and amount of 250.27 payment, the items and services to be reimbursed, and the 250.28 arrangements for management of the individual grant; and 250.29 (v) the person, the person's family, or the legal 250.30 representative shall be provided sufficient information to 250.31 ensure an informed choice of alternatives. The local agency 250.32 shall document this information in the person's care plan, 250.33 including the type and level of expenditures to be reimbursed; 250.34 (4) the county, lead agency under contract, or tribal 250.35 government under contract to administer the alternative care 250.36 program shall not be liable for damages, injuries, or 251.1 liabilities sustained through the purchase of direct supports or 251.2 goods by the person, the person's family, or the authorized 251.3 representative with funds received through the cash payments 251.4 under this section. Liabilities include, but are not limited 251.5 to, workers' compensation, the Federal Insurance Contributions 251.6 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 251.7 (5) persons receiving grants under this section shall have 251.8 the following responsibilities: 251.9 (i) spend the grant money in a manner consistent with their 251.10 individualized service plan with the local agency; 251.11 (ii) notify the local agency of any necessary changes in 251.12 the grant-expenditures; 251.13 (iii) arrange and pay for supports; and 251.14 (iv) inform the local agency of areas where they have 251.15 experienced difficulty securing or maintaining supports; and 251.16(5)(6) the county shall report client outcomes, services, 251.17 and costs under this paragraph in a manner prescribed by the 251.18 commissioner. 251.19 (k) Upon implementation of direct cash payments to clients 251.20 under this section, any person determined eligible for the 251.21 alternative care program who chooses a cash payment approved by 251.22 the county agency shall receive the cash payment under this 251.23 section and not under section 256.476 unless the person was 251.24 receiving a consumer support grant under section 256.476 before 251.25 implementation of direct cash payments under this section. 251.26 Sec. 20. Minnesota Statutes 2000, section 256B.0913, 251.27 subdivision 6, is amended to read: 251.28 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 251.29 alternative care program is administered by the county agency. 251.30 This agency is the lead agency responsible for the local 251.31 administration of the alternative care program as described in 251.32 this section. However, it may contract with the public health 251.33 nursing service to be the lead agency. The commissioner may 251.34 contract with federally recognized Indian tribes with a 251.35 reservation in Minnesota to serve as the lead agency responsible 251.36 for the local administration of the alternative care program as 252.1 described in the contract. 252.2 Sec. 21. Minnesota Statutes 2000, section 256B.0913, 252.3 subdivision 7, is amended to read: 252.4 Subd. 7. [CASE MANAGEMENT.] Providers of case management 252.5 services for persons receiving services funded by the 252.6 alternative care program must meet the qualification 252.7 requirements and standards specified in section 256B.0915, 252.8 subdivision 1b. The case manager mustensure the health and252.9safety of the individual client andnot approve alternative care 252.10 funding for a client in any setting in which the case manager 252.11 cannot reasonably ensure the client's health and safety. The 252.12 case manager is responsible for the cost-effectiveness of the 252.13 alternative care individual care plan and must not approve any 252.14 care plan in which the cost of services funded by alternative 252.15 care and client contributions exceeds the limit specified in 252.16 section 256B.0915, subdivision 3, paragraph (b). The county may 252.17 allow a case manager employed by the county to delegate certain 252.18 aspects of the case management activity to another individual 252.19 employed by the county provided there is oversight of the 252.20 individual by the case manager. The case manager may not 252.21 delegate those aspects which require professional judgment 252.22 including assessments, reassessments, and care plan development. 252.23 Sec. 22. Minnesota Statutes 2000, section 256B.0913, 252.24 subdivision 8, is amended to read: 252.25 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 252.26 case manager shall implement the plan of care for each180-day252.27eligiblealternative care client and ensure that a client's 252.28 service needs and eligibility are reassessed at least every 12 252.29 months. The plan shall include any services prescribed by the 252.30 individual's attending physician as necessary to allow the 252.31 individual to remain in a community setting. In developing the 252.32 individual's care plan, the case manager should include the use 252.33 of volunteers from families and neighbors, religious 252.34 organizations, social clubs, and civic and service organizations 252.35 to support the formal home care services. The county shall be 252.36 held harmless for damages or injuries sustained through the use 253.1 of volunteers under this subdivision including workers' 253.2 compensation liability.The lead agency shall provide253.3documentation to the commissioner verifying that the253.4individual's alternative care is not available at that time253.5through any other public assistance or service program.The 253.6 lead agency shall provide documentation in each individual's 253.7 plan of care and, if requested, to the commissioner that the 253.8 most cost-effective alternatives available have been offered to 253.9 the individual and that the individual was free to choose among 253.10 available qualified providers, both public and private. The 253.11 case manager must give the individual a ten-day written notice 253.12 of any decrease in or termination of alternative care services. 253.13 (b) If the county administering alternative care services 253.14 is different than the county of financial responsibility, the 253.15 care plan may be implemented without the approval of the county 253.16 of financial responsibility. 253.17 Sec. 23. Minnesota Statutes 2000, section 256B.0913, 253.18 subdivision 9, is amended to read: 253.19 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.]The lead253.20agency shall document to the commissioner that the agency made253.21reasonable efforts to inform potential providers of the253.22anticipated need for services under the alternative care program253.23or waiver programs under sections 256B.0915 and 256B.49,253.24including a minimum of 14 days' written advance notice of the253.25opportunity to be selected as a service provider and an annual253.26public meeting with providers to explain and review the criteria253.27for selection. The lead agency shall also document to the253.28commissioner that the agency allowed potential providers an253.29opportunity to be selected to contract with the county agency.253.30Funds reimbursed to counties under this subdivisionAlternative 253.31 care funds paid to service providers are subject to audit by the 253.32 commissioner for fiscal and utilization control. 253.33 The lead agency must select providers for contracts or 253.34 agreements using the following criteria and other criteria 253.35 established by the county: 253.36 (1) the need for the particular services offered by the 254.1 provider; 254.2 (2) the population to be served, including the number of 254.3 clients, the length of time services will be provided, and the 254.4 medical condition of clients; 254.5 (3) the geographic area to be served; 254.6 (4) quality assurance methods, including appropriate 254.7 licensure, certification, or standards, and supervision of 254.8 employees when needed; 254.9 (5) rates for each service and unit of service exclusive of 254.10 county administrative costs; 254.11 (6) evaluation of services previously delivered by the 254.12 provider; and 254.13 (7) contract or agreement conditions, including billing 254.14 requirements, cancellation, and indemnification. 254.15 The county must evaluate its own agency services under the 254.16 criteria established for other providers.The county shall254.17provide a written statement of the reasons for not selecting254.18providers.254.19 Sec. 24. Minnesota Statutes 2000, section 256B.0913, 254.20 subdivision 10, is amended to read: 254.21 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 254.22 appropriation for fiscal years 1992 and beyond shall cover 254.23 only180-dayalternative care eligible clients. Prior to July 1 254.24 of each year, the commissioner shall allocate to county agencies 254.25 the state funds available for alternative care for persons 254.26 eligible under subdivision 2. 254.27 (b)Prior to July 1 of each year, the commissioner shall254.28allocate to county agencies the state funds available for254.29alternative care for persons eligible under subdivision 2. The254.30allocation for fiscal year 1992 shall be calculated using a base254.31that is adjusted to exclude the medical assistance share of254.32alternative care expenditures. The adjusted base is calculated254.33by multiplying each county's allocation for fiscal year 1991 by254.34the percentage of county alternative care expenditures for254.35180-day eligible clients. The percentage is determined based on254.36expenditures for services rendered in fiscal year 1989 or255.1calendar year 1989, whichever is greater.The adjusted base for 255.2 each county is the county's current fiscal year base allocation 255.3 plus any targeted funds approved during the current fiscal 255.4 year. Calculations for paragraphs (c) and (d) are to be made as 255.5 follows: for each county, the determination of alternative care 255.6 program expenditures shall be based on payments for services 255.7 rendered from April 1 through March 31 in the base year, to the 255.8 extent that claims have been submitted and paid by June 1 of 255.9 that year. 255.10 (c) If thecountyalternative care program expendituresfor255.11180-day eligible clientsas defined in paragraph (b) are 95 255.12 percent or more ofitsthe county's adjusted base allocation, 255.13 the allocation for the next fiscal year is 100 percent of the 255.14 adjusted base, plus inflation to the extent that inflation is 255.15 included in the state budget. 255.16 (d) If thecountyalternative care program expendituresfor255.17180-day eligible clientsas defined in paragraph (b) are less 255.18 than 95 percent ofitsthe county's adjusted base allocation, 255.19 the allocation for the next fiscal year is the adjusted base 255.20 allocation less the amount of unspent funds below the 95 percent 255.21 level. 255.22 (e)For fiscal year 1992 only, a county may receive an255.23increased allocation if annualized service costs for the month255.24of May 1991 for 180-day eligible clients are greater than the255.25allocation otherwise determined. A county may apply for this255.26increase by reporting projected expenditures for May to the255.27commissioner by June 1, 1991. The amount of the allocation may255.28exceed the amount calculated in paragraph (b). The projected255.29expenditures for May must be based on actual 180-day eligible255.30client caseload and the individual cost of clients' care plans.255.31If a county does not report its expenditures for May, the amount255.32in paragraph (c) or (d) shall be used.255.33(f) Calculations for paragraphs (c) and (d) are to be made255.34as follows: for each county, the determination of expenditures255.35shall be based on payments for services rendered from April 1255.36through March 31 in the base year, to the extent that claims256.1have been submitted by June 1 of that year. Calculations for256.2paragraphs (c) and (d) must also include the funds transferred256.3to the consumer support grant program for clients who have256.4transferred to that program from April 1 through March 31 in the256.5base year.256.6(g) For the biennium ending June 30, 2001, the allocation256.7of state funds to county agencies shall be calculated as256.8described in paragraphs (c) and (d).If the annual legislative 256.9 appropriation for the alternative care program is inadequate to 256.10 fund the combined county allocations forfiscal year 2000 or256.112001a biennium, the commissioner shall distribute to each 256.12 county the entire annual appropriation as that county's 256.13 percentage of the computed base as calculated inparagraph256.14(f)paragraphs (c) and (d). 256.15 Sec. 25. Minnesota Statutes 2000, section 256B.0913, 256.16 subdivision 11, is amended to read: 256.17 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted 256.18 funding is to make additional money available to counties with 256.19 the greatest need. Targeted funds are not intended to be 256.20 distributed equitably among all counties, but rather, allocated 256.21 to those with long-term care strategies that meet state goals. 256.22 (b) The funds available for targeted funding shall be the 256.23 total appropriation for each fiscal year minus county 256.24 allocations determined under subdivision 10 as adjusted for any 256.25 inflation increases provided in appropriations for the biennium. 256.26 (c) The commissioner shall allocate targeted funds to 256.27 counties that demonstrate to the satisfaction of the 256.28 commissioner that they have developed feasible plans to increase 256.29 alternative care spending. In making targeted funding 256.30 allocations, the commissioner shall use the following priorities: 256.31 (1) counties that received a lower allocation in fiscal 256.32 year 1991 than in fiscal year 1990. Counties remain in this 256.33 priority until they have been restored to their fiscal year 1990 256.34 level plus inflation; 256.35 (2) counties that sustain a base allocation reduction for 256.36 failure to spend 95 percent of the allocation if they 257.1 demonstrate that the base reduction should be restored; 257.2 (3) counties that propose projects to divert community 257.3 residents from nursing home placement or convert nursing home 257.4 residents to community living; and 257.5 (4) counties that can otherwise justify program growth by 257.6 demonstrating the existence of waiting lists, demographically 257.7 justified needs, or other unmet needs. 257.8 (d) Counties that would receive targeted funds according to 257.9 paragraph (c) must demonstrate to the commissioner's 257.10 satisfaction that the funds would be appropriately spent by 257.11 showing how the funds would be used to further the state's 257.12 alternative care goals as described in subdivision 1, and that 257.13 the county has the administrative and service delivery 257.14 capability to use them. 257.15 (e) The commissioner shall request applicationsby June 1257.16each year, for county agencies to applyfor targeted funds by 257.17 November 1 of each year. The counties selected for targeted 257.18 funds shall be notified of the amount of their additional 257.19 fundingby August 1 of each year. Targeted funds allocated to a 257.20 county agency in one year shall be treated as part of the 257.21 county's base allocation for that year in determining 257.22 allocations for subsequent years. No reallocations between 257.23 counties shall be made. 257.24(f) The allocation for each year after fiscal year 1992257.25shall be determined using the previous fiscal year's allocation,257.26including any targeted funds, as the base and then applying the257.27criteria under subdivision 10, paragraphs (c), (d), and (f), to257.28the current year's expenditures.257.29 Sec. 26. Minnesota Statutes 2000, section 256B.0913, 257.30 subdivision 12, is amended to read: 257.31 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 257.32 all180-dayalternative care eligible clients to help pay for 257.33 the cost of participating in the program. The amount of the 257.34 premium for the alternative care client shall be determined as 257.35 follows: 257.36 (1) when the alternative care client's income less 258.1 recurring and predictable medical expenses is greater than the 258.2medical assistance income standardrecipient's maintenance needs 258.3 allowance as defined in section 256B.0915, subdivision 1d, 258.4 paragraph (a), but less than 150 percent of the federal poverty 258.5 guideline effective on July 1 of the state fiscal year in which 258.6 the premium is being computed, and total assets are less than 258.7 $10,000, the fee is zero; 258.8 (2) when the alternative care client's income less 258.9 recurring and predictable medical expenses is greater than 150 258.10 percent of the federal poverty guideline effective on July 1 of 258.11 the state fiscal year in which the premium is being computed, 258.12 and total assets are less than $10,000, the fee is 25 percent of 258.13 the cost of alternative care services or the difference between 258.14 150 percent of the federal poverty guideline effective on July 1 258.15 of the state fiscal year in which the premium is being computed 258.16 and the client's income less recurring and predictable medical 258.17 expenses, whichever is less; and 258.18 (3) when the alternative care client's total assets are 258.19 greater than $10,000, the fee is 25 percent of the cost of 258.20 alternative care services. 258.21 For married persons, total assets are defined as the total 258.22 marital assets less the estimated community spouse asset 258.23 allowance, under section 256B.059, if applicable. For married 258.24 persons, total income is defined as the client's income less the 258.25 monthly spousal allotment, under section 256B.058. 258.26 All alternative care services except case management shall 258.27 be included in the estimated costs for the purpose of 258.28 determining 25 percent of the costs. 258.29 The monthly premium shall be calculated based on the cost 258.30 of the first full month of alternative care services and shall 258.31 continue unaltered until the next reassessment is completed or 258.32 at the end of 12 months, whichever comes first. Premiums are 258.33 due and payable each month alternative care services are 258.34 received unless the actual cost of the services is less than the 258.35 premium. 258.36 (b) The fee shall be waived by the commissioner when: 259.1 (1) a person who is residing in a nursing facility is 259.2 receiving case management only; 259.3 (2) a person is applying for medical assistance; 259.4 (3) a married couple is requesting an asset assessment 259.5 under the spousal impoverishment provisions; 259.6 (4)a person is a medical assistance recipient, but has259.7been approved for alternative care-funded assisted living259.8services;259.9(5)a person is found eligible for alternative care, but is 259.10 not yet receiving alternative care services; or 259.11(6)(5) a person's fee under paragraph (a) is less than $25. 259.12 (c) The county agency must record in the state's receivable 259.13 system the client's assessed premium amount or the reason the 259.14 premium has been waived. The commissioner will bill and collect 259.15 the premium from the clientand forward the amounts collected to259.16the commissioner in the manner and at the times prescribed by259.17the commissioner. Money collected must be deposited in the 259.18 general fund and is appropriated to the commissioner for the 259.19 alternative care program. The client must supply the county 259.20 with the client's social security number at the time of 259.21 application.If a client fails or refuses to pay the premium259.22due,The county shall supply the commissioner with the client's 259.23 social security number and other information the commissioner 259.24 requires to collect the premium from the client. The 259.25 commissioner shall collect unpaid premiums using the Revenue 259.26 Recapture Act in chapter 270A and other methods available to the 259.27 commissioner. The commissioner may require counties to inform 259.28 clients of the collection procedures that may be used by the 259.29 state if a premium is not paid. 259.30 (d) The commissioner shall begin to adopt emergency or 259.31 permanent rules governing client premiums within 30 days after 259.32 July 1, 1991, including criteria for determining when services 259.33 to a client must be terminated due to failure to pay a premium. 259.34 Sec. 27. Minnesota Statutes 2000, section 256B.0913, 259.35 subdivision 13, is amended to read: 259.36 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan 260.1 forthe preadmission screening programlong-term care 260.2 consultation under section 256B.0911, the alternative care 260.3 program under this section, and waivers for the elderly under 260.4 section 256B.0915,and waivers for the disabled under section260.5256B.49,shall be incorporated into the biennial Community 260.6 Social Services Act plan and shall meet the regulations and 260.7 timelines of that plan.This county biennial plan shall include:260.8(1) information on the administration of the preadmission260.9screening program;260.10(2) information on the administration of the home and260.11community-based services waivers for the elderly under section260.12256B.0915, and for the disabled under section 256B.49; and260.13(3) information on the administration of the alternative260.14care program.260.15 Sec. 28. Minnesota Statutes 2000, section 256B.0913, 260.16 subdivision 14, is amended to read: 260.17 Subd. 14. [REIMBURSEMENTPAYMENT AND RATE ADJUSTMENTS.] (a) 260.18ReimbursementPayment forexpenditures for theprovided 260.19 alternative care services as approved by the client's case 260.20 manager shall be through the invoice processing procedures of 260.21 the department's Medicaid Management Information System (MMIS). 260.22 To receivereimbursementpayment, the county or vendor must 260.23 submit invoices within 12 months following the date of service. 260.24 The county agency and its vendors under contract shall not be 260.25 reimbursed for services which exceed the county allocation. 260.26 (b)If a county collects less than 50 percent of the client260.27premiums due under subdivision 12, the commissioner may withhold260.28up to three percent of the county's final alternative care260.29program allocation determined under subdivisions 10 and 11.260.30(c)The county shall negotiate individual rates with 260.31 vendors and maybe reimbursedauthorize service payment for 260.32 actual costs up tothe greater ofthe county's current approved 260.33 rateor 60 percent of the maximum rate in fiscal year 1994 and260.3465 percent of the maximum rate in fiscal year 1995 for each260.35alternative care service. Notwithstanding any other rule or 260.36 statutory provision to the contrary, the commissioner shall not 261.1 be authorized to increase rates by an annual inflation factor, 261.2 unless so authorized by the legislature. 261.3(d)(c)On July 1, 1993, the commissioner shall increase261.4the maximum rate for home delivered meals to $4.50 per meal.To 261.5 improve access to community services and eliminate payment 261.6 disparities between the alternative care program and the elderly 261.7 waiver program, the commissioner shall establish statewide 261.8 maximum service rate limits and eliminate county-specific 261.9 service rate limits. 261.10 (1) Effective July 1, 2001, for service rate limits, except 261.11 those in subdivision 5, paragraphs (d) and (j), the rate limit 261.12 for each service shall be the greater of the alternative care 261.13 statewide maximum rate or the elderly waiver statewide maximum 261.14 rate. 261.15 (2) Counties may negotiate individual service rates with 261.16 vendors for actual costs up to the statewide maximum service 261.17 rate limit. 261.18 Sec. 29. Minnesota Statutes 2000, section 256B.0915, 261.19 subdivision 1d, is amended to read: 261.20 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 261.21 RESOURCES FOR ELDERLY WAIVER.](a)Notwithstanding the 261.22 provisions of section 256B.056, the commissioner shall make the 261.23 following amendment to the medical assistance elderly waiver 261.24 program effective July 1, 1999, or upon federal approval, 261.25 whichever is later. 261.26 A recipient's maintenance needs will be an amount equal to 261.27 the Minnesota supplemental aid equivalent rate as defined in 261.28 section 256I.03, subdivision 5, plus the medical assistance 261.29 personal needs allowance as defined in section 256B.35, 261.30 subdivision 1, paragraph (a), when applying posteligibility 261.31 treatment of income rules to the gross income of elderly waiver 261.32 recipients, except for individuals whose income is in excess of 261.33 the special income standard according to Code of Federal 261.34 Regulations, title 42, section 435.236. Recipient maintenance 261.35 needs shall be adjusted under this provision each July 1. 261.36(b) The commissioner of human services shall secure262.1approval of additional elderly waiver slots sufficient to serve262.2persons who will qualify under the revised income standard262.3described in paragraph (a) before implementing section262.4256B.0913, subdivision 16.262.5(c) In implementing this subdivision, the commissioner262.6shall consider allowing persons who would otherwise be eligible262.7for the alternative care program but would qualify for the262.8elderly waiver with a spenddown to remain on the alternative262.9care program.262.10 Sec. 30. Minnesota Statutes 2000, section 256B.0915, 262.11 subdivision 3, is amended to read: 262.12 Subd. 3. [LIMITS OF CASES, RATES,REIMBURSEMENTPAYMENTS, 262.13 AND FORECASTING.] (a) The number of medical assistance waiver 262.14 recipients that a county may serve must be allocated according 262.15 to the number of medical assistance waiver cases open on July 1 262.16 of each fiscal year. Additional recipients may be served with 262.17 the approval of the commissioner. 262.18 (b) The monthly limit for the cost of waivered services to 262.19 an individual elderly waiver client shall be thestatewide262.20average paymentweighted average monthly nursing facility rate 262.21 of the case mix resident class to which the elderly waiver 262.22 client would be assigned underthe medical assistance case mix262.23reimbursement system.Minnesota Rules, parts 9549.0050 to 262.24 9549.0059, less the recipient's maintenance needs allowance as 262.25 described in subdivision 1d, paragraph (a), until the first day 262.26 of the state fiscal year in which the resident assessment system 262.27 as described in section 256B.437 for nursing home rate 262.28 determination is implemented. Effective on the first day of the 262.29 state fiscal year in which the resident assessment system as 262.30 described in section 256B.437 for nursing home rate 262.31 determination is implemented and the first day of each 262.32 subsequent state fiscal year, the monthly limit for the cost of 262.33 waivered services to an individual elderly waiver client shall 262.34 be the rate of the case mix resident class to which the waiver 262.35 client would be assigned under Minnesota Rules, parts 9549.0050 262.36 to 9549.0059, in effect on the last day of the previous state 263.1 fiscal year, adjusted by the greater of any legislatively 263.2 adopted home and community-based services cost-of-living 263.3 percentage increase or any legislatively adopted statewide 263.4 percent rate increase for nursing facilities. 263.5 (c) If extended medical supplies and equipment or 263.6adaptationsenvironmental modifications are or will be purchased 263.7 for an elderly waiverservices recipientclient, the costs may 263.8 be proratedon a monthly basis throughout the year in which they263.9are purchasedfor up to 12 consecutive months beginning with the 263.10 month of purchase. If the monthly cost of a recipient'sother263.11 waivered services exceeds the monthly limit established inthis263.12 paragraph (b), the annual cost oftheall waivered services 263.13 shall be determined. In this event, the annual cost of all 263.14 waivered services shall not exceed 12 times the monthly 263.15 limitcalculated in this paragraph. The statewide average263.16payment rate is calculated by determining the statewide average263.17monthly nursing home rate, effective July 1 of the fiscal year263.18in which the cost is incurred, less the statewide average263.19monthly income of nursing home residents who are age 65 or263.20older, and who are medical assistance recipients in the month of263.21March of the previous state fiscal year. The annual cost263.22divided by 12 of elderly or disabled waivered servicesof 263.23 waivered services as described in paragraph (b). 263.24 (d) For a person who is a nursing facility resident at the 263.25 time of requesting a determination of eligibility for elderlyor263.26disabledwaivered servicesshall be the greater of the monthly263.27payment for: (i), a monthly conversion limit for the cost of 263.28 elderly waivered services may be requested. The monthly 263.29 conversion limit for the cost of elderly waiver services shall 263.30 be the resident class assigned under Minnesota Rules, parts 263.31 9549.0050 to 9549.0059, for that resident in the nursing 263.32 facility where the resident currently resides; or (ii) the263.33statewide average payment of the case mix resident class to263.34which the resident would be assigned under the medical263.35assistance case mix reimbursement system, provided thatuntil 263.36 July 1 of the state fiscal year in which the resident assessment 264.1 system as described in section 256B.437 for nursing home rate 264.2 determination is implemented. Effective on July 1 of the state 264.3 fiscal year in which the resident assessment system as described 264.4 in section 256B.437 for nursing home rate determination is 264.5 implemented, the monthly conversion limit for the cost of 264.6 elderly waiver services shall be the per diem nursing facility 264.7 rate as determined by the resident assessment system as 264.8 described in section 256B.437 for that resident in the nursing 264.9 facility where the resident currently resides multiplied by 365 264.10 and divided by 12, less the recipient's maintenance needs 264.11 allowance as described in subdivision 1d. The limit under this 264.12 clause only applies to persons discharged from a nursing 264.13 facility after a minimum 30-day stay and found eligible for 264.14 waivered services on or after July 1, 1997. The following costs 264.15 must be included in determining the total monthly costs for the 264.16 waiver client: 264.17 (1) cost of all waivered services, including extended 264.18 medical supplies and equipment and environmental modifications; 264.19 and 264.20 (2) cost of skilled nursing, home health aide, and personal 264.21 care services reimbursable by medical assistance. 264.22(c)(e) Medical assistance funding for skilled nursing 264.23 services, private duty nursing, home health aide, and personal 264.24 care services for waiver recipients must be approved by the case 264.25 manager and included in the individual care plan. 264.26(d) For both the elderly waiver and the nursing facility264.27disabled waiver, a county may purchase extended supplies and264.28equipment without prior approval from the commissioner when264.29there is no other funding source and the supplies and equipment264.30are specified in the individual's care plan as medically264.31necessary to enable the individual to remain in the community264.32according to the criteria in Minnesota Rules, part 9505.0210,264.33items A and B.(f) A county is not required to contract with a 264.34 provider of supplies and equipment if the monthly cost of the 264.35 supplies and equipment is less than $250. 264.36(e)(g) The adult foster caredailyratefor the elderly265.1and disabled waiversshall be considered a difficulty of care 265.2 payment and shall not include room and board. The adult foster 265.3 care service rate shall be negotiated between the county agency 265.4 and the foster care provider.The rate established under this265.5section shall not exceed the state average monthly nursing home265.6payment for the case mix classification to which the individual265.7receiving foster care is assigned; the rate must allow for other265.8waiver and medical assistance home care services to be265.9authorized by the case manager.The elderly waiver payment for 265.10 the foster care service in combination with the payment for all 265.11 other elderly waiver services, including case management, must 265.12 not exceed the limit specified in paragraph (b). 265.13(f) The assisted living and residential care service rates265.14for elderly and community alternatives for disabled individuals265.15(CADI) waivers shall be made to the vendor as a monthly rate265.16negotiated with the county agency based on an individualized265.17service plan for each resident. The rate shall not exceed the265.18nonfederal share of the greater of either the statewide or any265.19of the geographic groups' weighted average monthly medical265.20assistance nursing facility payment rate of the case mix265.21resident class to which the elderly or disabled client would be265.22assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,265.23unless the services are provided by a home care provider265.24licensed by the department of health and are provided in a265.25building that is registered as a housing with services265.26establishment under chapter 144D and that provides 24-hour265.27supervision. For alternative care assisted living projects265.28established under Laws 1988, chapter 689, article 2, section265.29256, monthly rates may not exceed 65 percent of the greater of265.30either the statewide or any of the geographic groups' weighted265.31average monthly medical assistance nursing facility payment rate265.32for the case mix resident class to which the elderly or disabled265.33client would be assigned under Minnesota Rules, parts 9549.0050265.34to 9549.0059. The rate may not cover direct rent or food costs.265.35 (h) Payment for assisted living service shall be a monthly 265.36 rate negotiated and authorized by the county agency based on an 266.1 individualized service plan for each resident and may not cover 266.2 direct rent or food costs. 266.3 (1) The individualized monthly negotiated payment for 266.4 assisted living services as described in section 256B.0913, 266.5 subdivision 5, paragraph (g) or (h), and residential care 266.6 services as described in section 256B.0913, subdivision 5, 266.7 paragraph (f), shall not exceed the nonfederal share, in effect 266.8 on July 1 of the state fiscal year for which the rate limit is 266.9 being calculated, of the greater of either the statewide or any 266.10 of the geographic groups' weighted average monthly nursing 266.11 facility rate of the case mix resident class to which the 266.12 elderly waiver eligible client would be assigned under Minnesota 266.13 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 266.14 allowance as described in subdivision 1d, paragraph (a), until 266.15 the July 1 of the state fiscal year in which the resident 266.16 assessment system as described in section 256B.437 for nursing 266.17 home rate determination is implemented. Effective on July 1 of 266.18 the state fiscal year in which the resident assessment system as 266.19 described in section 256B.437 for nursing home rate 266.20 determination is implemented and July 1 of each subsequent state 266.21 fiscal year, the individualized monthly negotiated payment for 266.22 the services described in this clause shall not exceed the limit 266.23 described in this clause which was in effect on June 30 of the 266.24 previous state fiscal year and which has been adjusted by the 266.25 greater of any legislatively adopted home and community-based 266.26 services cost-of-living percentage increase or any legislatively 266.27 adopted statewide percent rate increase for nursing facilities. 266.28 (2) The individualized monthly negotiated payment for 266.29 assisted living services described in section 144A.4605 and 266.30 delivered by a provider licensed by the department of health as 266.31 a class A home care provider or an assisted living home care 266.32 provider and provided in a building that is registered as a 266.33 housing with services establishment under chapter 144D and that 266.34 provides 24-hour supervision in combination with the payment for 266.35 other elderly waiver services, including case management, must 266.36 not exceed the limit specified in paragraph (b). 267.1(g)(i) The county shall negotiate individual service rates 267.2 with vendors and maybe reimbursedauthorize payment for actual 267.3 costs up to thegreater of thecounty's current approved rateor267.460 percent of the maximum rate in fiscal year 1994 and 65267.5percent of the maximum rate in fiscal year 1995 for each service267.6within each program. Persons or agencies must be employed by or 267.7 under a contract with the county agency or the public health 267.8 nursing agency of the local board of health in order to receive 267.9 funding under the elderly waiver program, except as a provider 267.10 of supplies and equipment when the monthly cost of the supplies 267.11 and equipment is less than $250. 267.12(h) On July 1, 1993, the commissioner shall increase the267.13maximum rate for home-delivered meals to $4.50 per meal.267.14(i)(j) Reimbursement for the medical assistance recipients 267.15 under the approved waiver shall be made from the medical 267.16 assistance account through the invoice processing procedures of 267.17 the department's Medicaid Management Information System (MMIS), 267.18 only with the approval of the client's case manager. The budget 267.19 for the state share of the Medicaid expenditures shall be 267.20 forecasted with the medical assistance budget, and shall be 267.21 consistent with the approved waiver. 267.22 (k) To improve access to community services and eliminate 267.23 payment disparities between the alternative care program and the 267.24 elderly waiver, the commissioner shall establish statewide 267.25 maximum service rate limits and eliminate county-specific 267.26 service rate limits. 267.27 (1) Effective July 1, 2001, for service rate limits, except 267.28 those described or defined in paragraphs (g) and (h), the rate 267.29 limit for each service shall be the greater of the alternative 267.30 care statewide maximum rate or the elderly waiver statewide 267.31 maximum rate. 267.32 (2) Counties may negotiate individual service rates with 267.33 vendors for actual costs up to the statewide maximum service 267.34 rate limit. 267.35(j)(l) Beginning July 1, 1991, the state shall reimburse 267.36 counties according to the payment schedule in section 256.025 268.1 for the county share of costs incurred under this subdivision on 268.2 or after January 1, 1991, for individuals who are receiving 268.3 medical assistance. 268.4(k) For the community alternatives for disabled individuals268.5waiver, and nursing facility disabled waivers, county may use268.6waiver funds for the cost of minor adaptations to a client's268.7residence or vehicle without prior approval from the268.8commissioner if there is no other source of funding and the268.9adaptation:268.10(1) is necessary to avoid institutionalization;268.11(2) has no utility apart from the needs of the client; and268.12(3) meets the criteria in Minnesota Rules, part 9505.0210,268.13items A and B.268.14For purposes of this subdivision, "residence" means the client's268.15own home, the client's family residence, or a family foster268.16home. For purposes of this subdivision, "vehicle" means the268.17client's vehicle, the client's family vehicle, or the client's268.18family foster home vehicle.268.19(l) The commissioner shall establish a maximum rate unit268.20for baths provided by an adult day care provider that are not268.21included in the provider's contractual daily or hourly rate.268.22This maximum rate must equal the home health aide extended rate268.23and shall be paid for baths provided to clients served under the268.24elderly and disabled waivers.268.25 Sec. 31. Minnesota Statutes 2000, section 256B.0915, 268.26 subdivision 5, is amended to read: 268.27 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A 268.28 reassessment of a client served under the elderlyor disabled268.29 waiver must be conducted at least every 12 months and at other 268.30 times when the case manager determines that there has been 268.31 significant change in the client's functioning. This may 268.32 include instances where the client is discharged from the 268.33 hospital. 268.34 Sec. 32. Minnesota Statutes 2000, section 256B.0917, 268.35 subdivision 7, is amended to read: 268.36 Subd. 7. [CONTRACT.] (a) The commissioner of human 269.1 services shall execute a contract with Living at Home/Block 269.2 Nurse Program, Inc. (LAH/BN, Inc.). The contract shall require 269.3 LAH/BN, Inc. to: 269.4 (1) develop criteria for and award grants to establish 269.5 community-based organizations that will implement 269.6 living-at-home/block nurse programs throughout the state; 269.7 (2) award grants to enablecurrentliving-at-home/block 269.8 nurse programs to continue to implement the combined 269.9 living-at-home/block nurse program model; 269.10 (3) serve as a state technical assistance center to assist 269.11 and coordinate the living-at-home/block nurse programs 269.12 established; and 269.13 (4) manage contracts with individual living-at-home/block 269.14 nurse programs. 269.15 (b) The contract shall be effective July 1, 1997, and 269.16 section 16B.17 shall not apply. 269.17 Sec. 33. [256B.0918] [DEVELOPMENT AND PURPOSE OF MEDICAL 269.18 ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.] 269.19 Subdivision 1. [DEVELOPMENT AND PURPOSE.] The commissioner 269.20 of human services shall develop a medical assistance pilot 269.21 project on senior services to determine how converting the 269.22 delivery of housing, supportive services, and health care for 269.23 seniors into a flexible voucher program will impact public 269.24 expenditures for older adult service care and provide an 269.25 alternative way to purchase services based on consumer choice. 269.26 Subd. 2. [FEDERAL WAIVER AUTHORITY.] The commissioner 269.27 shall apply for any necessary federal waivers or approvals to 269.28 implement this pilot project. The commissioner shall submit the 269.29 waiver request no later than April 15, 2002. 269.30 Subd. 3. [REPORT.] The commissioner shall report to the 269.31 legislature by January 15, 2003, on approval of waivers 269.32 requested. Upon federal approval, the commissioner shall seek 269.33 legislative authorization to implement the pilot project. Once 269.34 the pilot project is implemented, participating communities and 269.35 the commissioner of human services shall collaborate to prepare 269.36 and issue an annual report each December 1 to the appropriate 270.1 committee chairs in the senate and house on: (1) the use of 270.2 state resources, including other funds leveraged for this 270.3 initiative; (2) the status of individuals being served in the 270.4 pilot project; and (3) the cost-effectiveness of the pilot 270.5 project. The commissioner shall provide data that may be needed 270.6 to evaluate the pilot project to communities that request the 270.7 data. 270.8 Subd. 4. [SUNSET.] This section sunsets June 30, 2008. 270.9 Sec. 34. [SERVICE ACCESS STUDY.] 270.10 By February 15, 2002, the commissioner of human services 270.11 shall submit to the legislature recommendations for creating 270.12 coordinated service access at the county agency level for both 270.13 publicly subsidized and nonsubsidized long-term care services 270.14 and housing options. The report must: 270.15 (1) include a plan to coordinate public funding streams to 270.16 allow low-income, privately paying consumers to purchase 270.17 services through a sliding fee scale; and 270.18 (2) evaluate the feasibility of statewide implementation, 270.19 based upon an evaluation of public cost, consumer preferences 270.20 and satisfaction, and other relevant factors. 270.21 Sec. 35. [RESPITE CARE.] 270.22 The Minnesota board on aging shall report to the 270.23 legislature by February 1, 2002, on the provision of in-home and 270.24 out-of-home respite care services on a sliding scale basis under 270.25 the federal Older Americans Act. 270.26 Sec. 36. [REPEALER.] 270.27 Minnesota Statutes 2000, sections 256B.0911, subdivisions 270.28 2, 2a, 4, 8, and 9; and 256B.0913, subdivisions 3, 15a, 15b, 270.29 15c, and 16; Minnesota Rules, parts 9505.2390; 9505.2395; 270.30 9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413; 270.31 9505.2415; 9505.2420; 9505.2425; 9505,2426; 9505.2430; 270.32 9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455; 270.33 9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 270.34 9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 270.35 9505.2495; 9505.2496; and 9505.2500, are repealed. 270.36 ARTICLE 5 271.1 LONG-TERM CARE REFORM AND REIMBURSEMENT 271.2 Section 1. [144.0724] [RESIDENT REIMBURSEMENT 271.3 CLASSIFICATION.] 271.4 Subdivision 1. [RESIDENT REIMBURSEMENT 271.5 CLASSIFICATIONS.] The commissioner of health shall establish 271.6 resident reimbursement classifications based upon the 271.7 assessments of residents of nursing homes and boarding care 271.8 homes conducted under this section and according to section 271.9 256B.437. The reimbursement classifications established under 271.10 this section shall be implemented after June 30, 2002, but no 271.11 later than January 1, 2003. 271.12 Subd. 2. [DEFINITIONS.] For purposes of this section, the 271.13 following terms have the meanings given. 271.14 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 271.15 date" means the last day of the minimum data set observation 271.16 period. The date sets the designated endpoint of the common 271.17 observation period, and all minimum data set items refer back in 271.18 time from that point. 271.19 (b) [CASE MIX INDEX.] "Case mix index" means the weighting 271.20 factors assigned to the RUG-III classifications. 271.21 (c) [INDEX MAXIMIZATION.] "Index maximization" means 271.22 classifying a resident who could be assigned to more than one 271.23 category, to the category with the highest case mix index. 271.24 (d) [MINIMUM DATA SET.] "Minimum data set" means the 271.25 assessment instrument specified by the Health Care Financing 271.26 Administration and designated by the Minnesota department of 271.27 health. 271.28 (e) [REPRESENTATIVE.] "Representative" means a person who 271.29 is the resident's guardian or conservator, the person authorized 271.30 to pay the nursing home expenses of the resident, a 271.31 representative of the nursing home ombudsman's office whose 271.32 assistance has been requested, or any other individual 271.33 designated by the resident. 271.34 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 271.35 utilization groups" or "RUG" means the system for grouping a 271.36 nursing facility's residents according to their clinical and 272.1 functional status identified in data supplied by the facility's 272.2 minimum data set. 272.3 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 272.4 Resident reimbursement classifications shall be based on the 272.5 minimum data set, version 2.0 assessment instrument, or its 272.6 successor version mandated by the Health Care Financing 272.7 Administration that nursing facilities are required to complete 272.8 for all residents. The commissioner of health shall establish 272.9 resident classes according to the 34 group, resource utilization 272.10 groups, version III or RUG-III model. Resident classes must be 272.11 established based on the individual items on the minimum data 272.12 set and must be completed according to the facility manual for 272.13 case mix classification issued by the Minnesota department of 272.14 health. The facility manual for case mix classification shall 272.15 be drafted by the Minnesota department of health and presented 272.16 to the chairs of health and human services legislative 272.17 committees by December 31, 2001. 272.18 (b) Each resident must be classified based on the 272.19 information from the minimum data set according to general 272.20 domains in clauses (1) to (7): 272.21 (1) extensive services where a resident requires 272.22 intravenous feeding or medications, suctioning, tracheostomy 272.23 care, or is on a ventilator or respirator; 272.24 (2) rehabilitation where a resident requires physical, 272.25 occupational, or speech therapy; 272.26 (3) special care where a resident has cerebral palsy; 272.27 quadriplegia; multiple sclerosis; pressure ulcers; fever with 272.28 vomiting, weight loss, or dehydration; tube feeding and aphasia; 272.29 or is receiving radiation therapy; 272.30 (4) clinically complex status where a resident has burns, 272.31 coma, septicemia, pneumonia, internal bleeding, chemotherapy, 272.32 wounds, kidney failure, urinary tract infections, oxygen, or 272.33 transfusions; 272.34 (5) impaired cognition where a resident has poor cognitive 272.35 performance; 272.36 (6) behavior problems where a resident exhibits wandering, 273.1 has hallucinations, or is physically or verbally abusive toward 273.2 others, unless the resident's other condition would place the 273.3 resident in other categories; and 273.4 (7) reduced physical functioning where a resident has no 273.5 special clinical conditions. 273.6 (c) The commissioner of health shall establish resident 273.7 classification according to a 34 group model based on the 273.8 information on the minimum data set and within the general 273.9 domains listed in paragraph (b), clauses (1) to (7). Detailed 273.10 descriptions of each resource utilization group shall be defined 273.11 in the facility manual for case mix classification issued by the 273.12 Minnesota department of health. The 34 groups are described as 273.13 follows: 273.14 (1) SE3: requires four or five extensive services; 273.15 (2) SE2: requires two or three extensive services; 273.16 (3) SE1: requires one extensive service; 273.17 (4) RAD: requires rehabilitation services and is dependent 273.18 in activity of daily living (ADL) at a count of 17 or 18; 273.19 (5) RAC: requires rehabilitation services and ADL count is 273.20 14 to 16; 273.21 (6) RAB: requires rehabilitation services and ADL count is 273.22 ten to 13; 273.23 (7) RAA: requires rehabilitation services and ADL count is 273.24 four to nine; 273.25 (8) SSC: requires special care and ADL count is 17 or 18; 273.26 (9) SSB: requires special care and ADL count is 15 or 16; 273.27 (10) SSA: requires special care and ADL count is seven to 273.28 14; 273.29 (11) CC2: clinically complex with depression and ADL count 273.30 is 17 or 18; 273.31 (12) CC1: clinically complex with no depression and ADL 273.32 count is 17 or 18; 273.33 (13) CB2: clinically complex with depression and ADL count 273.34 is 12 to 16; 273.35 (14) CB1: clinically complex with no depression and ADL 273.36 count is 12 to 16; 274.1 (15) CA2: clinically complex with depression and ADL count 274.2 is four to 11; 274.3 (16) CA1: clinically complex with no depression and ADL 274.4 count is four to 11; 274.5 (17) IB2: impaired cognition with nursing rehabilitation 274.6 and ADL count is six to ten; 274.7 (18) IB1: impaired cognition with no nursing 274.8 rehabilitation and ADL count is six to ten; 274.9 (19) IA2: impaired cognition with nursing rehabilitation 274.10 and ADL count is four or five; 274.11 (20) IA1: impaired cognition with no nursing 274.12 rehabilitation and ADL count is four or five; 274.13 (21) BB2: behavior problems with nursing rehabilitation 274.14 and ADL count is six to ten; 274.15 (22) BB1: behavior problems with no nursing rehabilitation 274.16 and ADL count is six to ten; 274.17 (23) BA2: behavior problems with nursing rehabilitation 274.18 and ADL count is four to five; 274.19 (24) BA1: behavior problems with no nursing rehabilitation 274.20 and ADL count is four to five; 274.21 (25) PE2: reduced physical functioning with nursing 274.22 rehabilitation and ADL count is 16 to 18; 274.23 (26) PE1: reduced physical functioning with no nursing 274.24 rehabilitation and ADL count is 16 to 18; 274.25 (27) PD2: reduced physical functioning with nursing 274.26 rehabilitation and ADL count is 11 to 15; 274.27 (28) PD1: reduced physical functioning with no nursing 274.28 rehabilitation and ADL count is 11 to 15; 274.29 (29) PC2: reduced physical functioning with nursing 274.30 rehabilitation and ADL count is nine or ten; 274.31 (30) PC1: reduced physical functioning with no nursing 274.32 rehabilitation and ADL count is nine or ten; 274.33 (31) PB2: reduced physical functioning with nursing 274.34 rehabilitation and ADL count is six to eight; 274.35 (32) PB1: reduced physical functioning with no nursing 274.36 rehabilitation and ADL count is six to eight; 275.1 (33) PA2: reduced physical functioning with nursing 275.2 rehabilitation and ADL count is four or five; and 275.3 (34) PA1: reduced physical functioning with no nursing 275.4 rehabilitation and ADL count is four or five. 275.5 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 275.6 must conduct and electronically submit to the commissioner of 275.7 health case mix assessments that conform with the assessment 275.8 schedule defined by the Code of Federal Regulations, title 42, 275.9 section 483.20, and published by the United States Department of 275.10 Health and Human Services, Health Care Financing Administration, 275.11 in the Long Term Care Assessment Instrument User's Manual, 275.12 version 2.0, October 1995, and subsequent clarifications made in 275.13 the Long-Term Care Assessment Instrument Questions and Answers, 275.14 version 2.0, August 1996. The commissioner of health may 275.15 substitute successor manuals or question and answer documents 275.16 published by the United States Department of Health and Human 275.17 Services, Health Care Financing Administration, to replace or 275.18 supplement the current version of the manual or document. 275.19 (b) The assessments used to determine a case mix 275.20 classification for reimbursement include the following: 275.21 (1) a new admission assessment must be completed by day 14 275.22 following admission; 275.23 (2) an annual assessment must be completed within 366 days 275.24 of the last comprehensive assessment; 275.25 (3) a significant change assessment must be completed 275.26 within 14 days of the identification of a significant change; 275.27 and 275.28 (4) the second quarterly assessment following either a new 275.29 admission assessment, an annual assessment, or a significant 275.30 change assessment. Each quarterly assessment must be completed 275.31 within 92 days of the previous assessment. 275.32 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the 275.33 commissioner of health an initial admission assessment for all 275.34 residents who stay in the facility less than 14 days. 275.35 (b) Notwithstanding the admission assessment requirements 275.36 of paragraph (a), a facility may elect to accept a default rate 276.1 with a case mix index of 1.0 for all facility residents who stay 276.2 less than 14 days in lieu of submitting an initial assessment. 276.3 Facilities may make this election to be effective on the day of 276.4 implementation of the revised case mix system. 276.5 (c) After implementation of the revised case mix system, 276.6 nursing facilities must elect one of the options described in 276.7 paragraphs (a) and (b) on the annual report to the commissioner 276.8 of human services filed for each report year ending September 276.9 30. The election shall be effective on the following July 1. 276.10 (d) For residents who are admitted or readmitted and leave 276.11 the facility on a frequent basis and for whom readmission is 276.12 expected, the resident may be discharged on an extended leave 276.13 status. This status does not require reassessment each time the 276.14 resident returns to the facility unless a significant change in 276.15 the resident's status has occurred since the last assessment. 276.16 The case mix classification for these residents is determined by 276.17 the facility election made in paragraphs (a) and (b). 276.18 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 276.19 that fails to complete or submit an assessment for a RUG-III 276.20 classification within seven days of the time requirements in 276.21 subdivisions 4 and 5 is subject to a reduced rate for that 276.22 resident. The reduced rate shall be the lowest rate for that 276.23 facility. The reduced rate is effective on the day of admission 276.24 for new admission assessments or on the day that the assessment 276.25 was due for all other assessments and continues in effect until 276.26 the first day of the month following the date of submission of 276.27 the resident's assessment. 276.28 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT 276.29 CLASSIFICATION.] (a) A facility must elect between the options 276.30 in clauses (1) and (2) to provide notice to a resident of the 276.31 resident's case mix classification. 276.32 (1) The commissioner of health shall provide to a nursing 276.33 facility a notice for each resident of the reimbursement 276.34 classification established under subdivision 1. The notice must 276.35 inform the resident of the classification that was assigned, the 276.36 opportunity to review the documentation supporting the 277.1 classification, the opportunity to obtain clarification from the 277.2 commissioner, and the opportunity to request a reconsideration 277.3 of the classification. The commissioner must send notice of 277.4 resident classification by first class mail. A nursing facility 277.5 is responsible for the distribution of the notice to each 277.6 resident, to the person responsible for the payment of the 277.7 resident's nursing home expenses, or to another person 277.8 designated by the resident. This notice must be distributed 277.9 within three working days after the facility's receipt of the 277.10 notice from the commissioner of health. 277.11 (2) A facility may choose to provide a classification 277.12 notice, as prescribed by the commissioner of health, to a 277.13 resident upon receipt of the confirmation of the case mix 277.14 classification calculated by a facility or a corrected case mix 277.15 classification as indicated on the final validation report from 277.16 the commissioner. A nursing facility is responsible for the 277.17 distribution of the notice to each resident, to the person 277.18 responsible for the payment of the resident's nursing home 277.19 expenses, or to another person designated by the resident. This 277.20 notice must be distributed within three working days after the 277.21 facility's receipt of the validation report from the 277.22 commissioner. If a facility elects this option, the 277.23 commissioner of health shall provide the facility with a list of 277.24 residents and their case mix classifications as determined by 277.25 the commissioner. A nursing facility may make this election to 277.26 be effective on the day of implementation of the revised case 277.27 mix system. 277.28 (3) After implementation of the revised case mix system, a 277.29 nursing facility shall elect a notice of resident reimbursement 277.30 classification procedure as described in clause (1) or (2) on 277.31 the annual report to the commissioner of human services filed 277.32 for each report year ending September 30. The election will be 277.33 effective the following July 1. 277.34 (b) If a facility submits a correction to an assessment 277.35 conducted under subdivision 3 that results in a change in case 277.36 mix classification, the facility shall give written notice to 278.1 the resident or the resident's representative about the item 278.2 that was corrected and the reason for the correction. The 278.3 notice of corrected assessment may be provided at the same time 278.4 that the resident or resident's representative is provided the 278.5 resident's corrected notice of classification. 278.6 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT 278.7 CLASSIFICATIONS.] (a) The resident, or resident's 278.8 representative, or the nursing facility or boarding care home 278.9 may request that the commissioner of health reconsider the 278.10 assigned reimbursement classification. The request for 278.11 reconsideration must be submitted in writing to the commissioner 278.12 within 30 days of the day the resident or the resident's 278.13 representative receives the resident classification notice. The 278.14 request for reconsideration must include the name of the 278.15 resident, the name and address of the facility in which the 278.16 resident resides, the reasons for the reconsideration, the 278.17 requested classification changes, and documentation supporting 278.18 the requested classification. The documentation accompanying 278.19 the reconsideration request is limited to documentation which 278.20 establishes that the needs of the resident at the time of the 278.21 assessment justify a classification which is different than the 278.22 classification established by the commissioner of health. 278.23 (b) Upon request, the nursing facility must give the 278.24 resident or the resident's representative a copy of the 278.25 assessment form and the other documentation that was given to 278.26 the commissioner of health to support the assessment findings. 278.27 The nursing facility shall also provide access to and a copy of 278.28 other information from the resident's record that has been 278.29 requested by or on behalf of the resident to support a 278.30 resident's reconsideration request. A copy of any requested 278.31 material must be provided within three working days of receipt 278.32 of a written request for the information. If a facility fails 278.33 to provide the material within this time, it is subject to the 278.34 issuance of a correction order and penalty assessment under 278.35 sections 144.653 and 144A.10. Notwithstanding those sections, 278.36 any correction order issued under this subdivision must require 279.1 that the nursing facility immediately comply with the request 279.2 for information and that as of the date of the issuance of the 279.3 correction order, the facility shall forfeit to the state a $100 279.4 fine for the first day of noncompliance, and an increase in the 279.5 $100 fine by $50 increments for each day the noncompliance 279.6 continues. 279.7 (c) In addition to the information required under 279.8 paragraphs (a) and (b), a reconsideration request from a nursing 279.9 facility must contain the following information: (i) the date 279.10 the reimbursement classification notices were received by the 279.11 facility; (ii) the date the classification notices were 279.12 distributed to the resident or the resident's representative; 279.13 and (iii) a copy of a notice sent to the resident or to the 279.14 resident's representative. This notice must inform the resident 279.15 or the resident's representative that a reconsideration of the 279.16 resident's classification is being requested, the reason for the 279.17 request, that the resident's rate will change if the request is 279.18 approved by the commissioner, the extent of the change, that 279.19 copies of the facility's request and supporting documentation 279.20 are available for review, and that the resident also has the 279.21 right to request a reconsideration. If the facility fails to 279.22 provide the required information with the reconsideration 279.23 request, the request must be denied, and the facility may not 279.24 make further reconsideration requests on that specific 279.25 reimbursement classification. 279.26 (d) Reconsideration by the commissioner must be made by 279.27 individuals not involved in reviewing the assessment, audit, or 279.28 reconsideration that established the disputed classification. 279.29 The reconsideration must be based upon the initial assessment 279.30 and upon the information provided to the commissioner under 279.31 paragraphs (a) and (b). If necessary for evaluating the 279.32 reconsideration request, the commissioner may conduct on-site 279.33 reviews. Within 15 working days of receiving the request for 279.34 reconsideration, the commissioner shall affirm or modify the 279.35 original resident classification. The original classification 279.36 must be modified if the commissioner determines that the 280.1 assessment resulting in the classification did not accurately 280.2 reflect the needs or assessment characteristics of the resident 280.3 at the time of the assessment. The resident and the nursing 280.4 facility or boarding care home shall be notified within five 280.5 working days after the decision is made. A decision by the 280.6 commissioner under this subdivision is the final administrative 280.7 decision of the agency for the party requesting reconsideration. 280.8 (e) The resident classification established by the 280.9 commissioner shall be the classification that applies to the 280.10 resident while the request for reconsideration is pending. 280.11 (f) The commissioner may request additional documentation 280.12 regarding a reconsideration necessary to make an accurate 280.13 reconsideration determination. 280.14 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall 280.15 audit the accuracy of resident assessments performed under 280.16 section 256B.437 through desk audits, on-site review of 280.17 residents and their records, and interviews with staff and 280.18 families. The commissioner shall reclassify a resident if the 280.19 commissioner determines that the resident was incorrectly 280.20 classified. 280.21 (b) The commissioner is authorized to conduct on-site 280.22 audits on an unannounced basis. 280.23 (c) A facility must grant the commissioner access to 280.24 examine the medical records relating to the resident assessments 280.25 selected for audit under this subdivision. The commissioner may 280.26 also observe and speak to facility staff and residents. 280.27 (d) The commissioner shall consider documentation under the 280.28 time frames for coding items on the minimum data set as set out 280.29 in the Resident Assessment Instrument Manual published by the 280.30 Health Care Financing Administration. 280.31 (e) The commissioner shall develop an audit selection 280.32 procedure that includes the following factors: 280.33 (1) The commissioner may target facilities that demonstrate 280.34 an atypical pattern of scoring minimum data set items, 280.35 nonsubmission of assessments, late submission of assessments, or 280.36 a previous history of audit changes of greater than 35 percent. 281.1 The commissioner shall select at least 20 percent of the most 281.2 current assessments submitted to the state for audit. Audits of 281.3 assessments selected in the targeted facilities must focus on 281.4 the factors leading to the audit. If the number of targeted 281.5 assessments selected does not meet the threshold of 20 percent 281.6 of the facility residents, then a stratified sample of the 281.7 remainder of assessments shall be drawn to meet the quota. If 281.8 the total change exceeds 35 percent, the commissioner may 281.9 conduct an expanded audit up to 100 percent of the remaining 281.10 current assessments. 281.11 (2) Facilities that are not a part of the targeted group 281.12 shall be placed in a general pool from which facilities will be 281.13 selected on a random basis for audit. Every facility shall be 281.14 audited annually. If a facility has two successive audits in 281.15 which the percentage of change is five percent or less and the 281.16 facility has not been the subject of a targeted audit in the 281.17 past 36 months, the facility may be audited biannually. A 281.18 stratified sample of 15 percent of the most current assessments 281.19 shall be selected for audit. If more than 20 percent of the 281.20 RUGS-III classifications after the audit are changed, the audit 281.21 shall be expanded to a second 15 percent sample. If the total 281.22 change between the first and second samples exceed 35 percent, 281.23 the commissioner may expand the audit to all of the remaining 281.24 assessments. 281.25 (3) If a facility qualifies for an expanded audit, the 281.26 commissioner may audit the facility again within six months. If 281.27 a facility has two expanded audits within a 24-month period, 281.28 that facility will be audited at least every six months for the 281.29 next 18 months. 281.30 (4) The commissioner may conduct special audits if the 281.31 commissioner determines that circumstances exist that could 281.32 alter or affect the validity of case mix classifications of 281.33 residents. These circumstances include, but are not limited to, 281.34 the following: 281.35 (i) frequent changes in the administration or management of 281.36 the facility; 282.1 (ii) an unusually high percentage of residents in a 282.2 specific case mix classification; 282.3 (iii) a high frequency in the number of reconsideration 282.4 requests received from a facility; 282.5 (iv) frequent adjustments of case mix classifications as 282.6 the result of reconsiderations or audits; 282.7 (v) a criminal indictment alleging provider fraud; or 282.8 (vi) other similar factors that relate to a facility's 282.9 ability to conduct accurate assessments. 282.10 (f) Within 15 working days of completing the audit process, 282.11 the commissioner shall mail the written results of the audit to 282.12 the facility, along with a written notice for each resident 282.13 affected to be forwarded by the facility. The notice must 282.14 contain the resident's classification and a statement informing 282.15 the resident, the resident's authorized representative, and the 282.16 facility of their right to review the commissioner's documents 282.17 supporting the classification and to request a reconsideration 282.18 of the classification. This notice must also include the 282.19 address and telephone number of the area nursing home ombudsman. 282.20 Subd. 10. [TRANSITION.] After implementation of this 282.21 section, reconsiderations requested for classifications made 282.22 under section 144.0722, subdivision 1, shall be determined under 282.23 section 144.0722, subdivision 3. 282.24 Sec. 2. Minnesota Statutes 2000, section 144A.071, 282.25 subdivision 1, is amended to read: 282.26 Subdivision 1. [FINDINGS.] The legislature declares that a 282.27 moratorium on the licensure and medical assistance certification 282.28 of new nursing home beds and construction projects that 282.29 exceed$750,000$1,000,000 is necessary to control nursing home 282.30 expenditure growth and enable the state to meet the needs of its 282.31 elderly by providing high quality services in the most 282.32 appropriate manner along a continuum of care. 282.33 Sec. 3. Minnesota Statutes 2000, section 144A.071, 282.34 subdivision 1a, is amended to read: 282.35 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 282.36 to 144A.073, the following terms have the meanings given them: 283.1 (a) "attached fixtures" has the meaning given in Minnesota 283.2 Rules, part 9549.0020, subpart 6. 283.3 (b) "buildings" has the meaning given in Minnesota Rules, 283.4 part 9549.0020, subpart 7. 283.5 (c) "capital assets" has the meaning given in section 283.6 256B.421, subdivision 16. 283.7 (d) "commenced construction" means that all of the 283.8 following conditions were met: the final working drawings and 283.9 specifications were approved by the commissioner of health; the 283.10 construction contracts were let; a timely construction schedule 283.11 was developed, stipulating dates for beginning, achieving 283.12 various stages, and completing construction; and all zoning and 283.13 building permits were applied for. 283.14 (e) "completion date" means the date on which a certificate 283.15 of occupancy is issued for a construction project, or if a 283.16 certificate of occupancy is not required, the date on which the 283.17 construction project is available for facility use. 283.18 (f) "construction" means any erection, building, 283.19 alteration, reconstruction, modernization, or improvement 283.20 necessary to comply with the nursing home licensure rules. 283.21 (g) "construction project" means: 283.22 (1) a capital asset addition to, or replacement of a 283.23 nursing home or certified boarding care home that results in new 283.24 space or the remodeling of or renovations to existing facility 283.25 space; 283.26 (2) the remodeling or renovation of existing facility space 283.27 the use of which is modified as a result of the project 283.28 described in clause (1). This existing space and the project 283.29 described in clause (1) must be used for the functions as 283.30 designated on the construction plans on completion of the 283.31 project described in clause (1) for a period of not less than 24 283.32 months; or 283.33 (3) capital asset additions or replacements that are 283.34 completed within 12 months before or after the completion date 283.35 of the project described in clause (1). 283.36 (h) "new licensed" or "new certified beds" means: 284.1 (1) newly constructed beds in a facility or the 284.2 construction of a new facility that would increase the total 284.3 number of licensed nursing home beds or certified boarding care 284.4 or nursing home beds in the state; or 284.5 (2) newly licensed nursing home beds or newly certified 284.6 boarding care or nursing home beds that result from remodeling 284.7 of the facility that involves relocation of beds but does not 284.8 result in an increase in the total number of beds, except when 284.9 the project involves the upgrade of boarding care beds to 284.10 nursing home beds, as defined in section 144A.073, subdivision 284.11 1. "Remodeling" includes any of the type of conversion, 284.12 renovation, replacement, or upgrading projects as defined in 284.13 section 144A.073, subdivision 1. 284.14 (i) "project construction costs" means the cost of the 284.15 facility capital asset additions, replacements, renovations, or 284.16 remodeling projects, construction site preparation costs, and 284.17 related soft costs. Project construction costsalsoinclude the 284.18 cost of any remodeling or renovation of existing facility space 284.19 which is modified as a result of the construction 284.20 project. Project construction costs also includes the cost of 284.21 new technology implemented as part of the construction project. 284.22 (j) "technology" means information systems or devices that 284.23 make documentation, charting, and staff time more efficient or 284.24 encourage and allow for care through alternative settings 284.25 including, but not limited to, touch screens, monitors, 284.26 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 284.27 medication dispensers, and equipment to monitor vital signs and 284.28 self-injections, and to observe skin and other conditions. 284.29 Sec. 4. Minnesota Statutes 2000, section 144A.071, 284.30 subdivision 2, is amended to read: 284.31 Subd. 2. [MORATORIUM.] The commissioner of health, in 284.32 coordination with the commissioner of human services, shall deny 284.33 each request for new licensed or certified nursing home or 284.34 certified boarding care beds except as provided in subdivision 3 284.35 or 4a, or section 144A.073. "Certified bed" means a nursing 284.36 home bed or a boarding care bed certified by the commissioner of 285.1 health for the purposes of the medical assistance program, under 285.2 United States Code, title 42, sections 1396 et seq. 285.3 The commissioner of human services, in coordination with 285.4 the commissioner of health, shall deny any request to issue a 285.5 license under section 252.28 and chapter 245A to a nursing home 285.6 or boarding care home, if that license would result in an 285.7 increase in the medical assistance reimbursement amount. 285.8 In addition, the commissioner of health must not approve 285.9 any construction project whose cost exceeds$750,000$1,000,000 285.10 unless: 285.11 (a) any construction costs exceeding$750,000$1,000,000 285.12 are not added to the facility's appraised value and are not 285.13 included in the facility's payment rate for reimbursement under 285.14 the medical assistance program; or 285.15 (b) the project: 285.16 (1) has been approved through the process described in 285.17 section 144A.073; 285.18 (2) meets an exception in subdivision 3 or 4a; 285.19 (3) is necessary to correct violations of state or federal 285.20 law issued by the commissioner of health; 285.21 (4) is necessary to repair or replace a portion of the 285.22 facility that was damaged by fire, lightning, groundshifts, or 285.23 other such hazards, including environmental hazards, provided 285.24 that the provisions of subdivision 4a, clause (a), are met; 285.25 (5) as of May 1, 1992, the facility has submitted to the 285.26 commissioner of health written documentation evidencing that the 285.27 facility meets the "commenced construction" definition as 285.28 specified in subdivision 1a, clause (d), or that substantial 285.29 steps have been taken prior to April 1, 1992, relating to the 285.30 construction project. "Substantial steps" require that the 285.31 facility has made arrangements with outside parties relating to 285.32 the construction project and include the hiring of an architect 285.33 or construction firm, submission of preliminary plans to the 285.34 department of health or documentation from a financial 285.35 institution that financing arrangements for the construction 285.36 project have been made; or 286.1 (6) is being proposed by a licensed nursing facility that 286.2 is not certified to participate in the medical assistance 286.3 program and will not result in new licensed or certified beds. 286.4 Prior to the final plan approval of any construction 286.5 project, the commissioner of health shall be provided with an 286.6 itemized cost estimate for the project construction costs. If a 286.7 construction project is anticipated to be completed in phases, 286.8 the total estimated cost of all phases of the project shall be 286.9 submitted to the commissioner and shall be considered as one 286.10 construction project. Once the construction project is 286.11 completed and prior to the final clearance by the commissioner, 286.12 the total project construction costs for the construction 286.13 project shall be submitted to the commissioner. If the final 286.14 project construction cost exceeds the dollar threshold in this 286.15 subdivision, the commissioner of human services shall not 286.16 recognize any of the project construction costs or the related 286.17 financing costs in excess of this threshold in establishing the 286.18 facility's property-related payment rate. 286.19 The dollar thresholds for construction projects are as 286.20 follows: for construction projects other than those authorized 286.21 in clauses (1) to (6), the dollar threshold 286.22 is$750,000$1,000,000. For projects authorized after July 1, 286.23 1993, under clause (1), the dollar threshold is the cost 286.24 estimate submitted with a proposal for an exception under 286.25 section 144A.073, plus inflation as calculated according to 286.26 section 256B.431, subdivision 3f, paragraph (a). For projects 286.27 authorized under clauses (2) to (4), the dollar threshold is the 286.28 itemized estimate project construction costs submitted to the 286.29 commissioner of health at the time of final plan approval, plus 286.30 inflation as calculated according to section 256B.431, 286.31 subdivision 3f, paragraph (a). 286.32 The commissioner of health shall adopt rules to implement 286.33 this section or to amend the emergency rules for granting 286.34 exceptions to the moratorium on nursing homes under section 286.35 144A.073. 286.36 Sec. 5. Minnesota Statutes 2000, section 144A.071, 287.1 subdivision 4a, is amended to read: 287.2 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 287.3 best interest of the state to ensure that nursing homes and 287.4 boarding care homes continue to meet the physical plant 287.5 licensing and certification requirements by permitting certain 287.6 construction projects. Facilities should be maintained in 287.7 condition to satisfy the physical and emotional needs of 287.8 residents while allowing the state to maintain control over 287.9 nursing home expenditure growth. 287.10 The commissioner of health in coordination with the 287.11 commissioner of human services, may approve the renovation, 287.12 replacement, upgrading, or relocation of a nursing home or 287.13 boarding care home, under the following conditions: 287.14 (a) to license or certify beds in a new facility 287.15 constructed to replace a facility or to make repairs in an 287.16 existing facility that was destroyed or damaged after June 30, 287.17 1987, by fire, lightning, or other hazard provided: 287.18 (i) destruction was not caused by the intentional act of or 287.19 at the direction of a controlling person of the facility; 287.20 (ii) at the time the facility was destroyed or damaged the 287.21 controlling persons of the facility maintained insurance 287.22 coverage for the type of hazard that occurred in an amount that 287.23 a reasonable person would conclude was adequate; 287.24 (iii) the net proceeds from an insurance settlement for the 287.25 damages caused by the hazard are applied to the cost of the new 287.26 facility or repairs; 287.27 (iv) the new facility is constructed on the same site as 287.28 the destroyed facility or on another site subject to the 287.29 restrictions in section 144A.073, subdivision 5; 287.30 (v) the number of licensed and certified beds in the new 287.31 facility does not exceed the number of licensed and certified 287.32 beds in the destroyed facility; and 287.33 (vi) the commissioner determines that the replacement beds 287.34 are needed to prevent an inadequate supply of beds. 287.35 Project construction costs incurred for repairs authorized under 287.36 this clause shall not be considered in the dollar threshold 288.1 amount defined in subdivision 2; 288.2 (b) to license or certify beds that are moved from one 288.3 location to another within a nursing home facility, provided the 288.4 total costs of remodeling performed in conjunction with the 288.5 relocation of beds does not exceed$750,000$1,000,000; 288.6 (c) to license or certify beds in a project recommended for 288.7 approval under section 144A.073; 288.8 (d) to license or certify beds that are moved from an 288.9 existing state nursing home to a different state facility, 288.10 provided there is no net increase in the number of state nursing 288.11 home beds; 288.12 (e) to certify and license as nursing home beds boarding 288.13 care beds in a certified boarding care facility if the beds meet 288.14 the standards for nursing home licensure, or in a facility that 288.15 was granted an exception to the moratorium under section 288.16 144A.073, and if the cost of any remodeling of the facility does 288.17 not exceed$750,000$1,000,000. If boarding care beds are 288.18 licensed as nursing home beds, the number of boarding care beds 288.19 in the facility must not increase beyond the number remaining at 288.20 the time of the upgrade in licensure. The provisions contained 288.21 in section 144A.073 regarding the upgrading of the facilities do 288.22 not apply to facilities that satisfy these requirements; 288.23 (f) to license and certify up to 40 beds transferred from 288.24 an existing facility owned and operated by the Amherst H. Wilder 288.25 Foundation in the city of St. Paul to a new unit at the same 288.26 location as the existing facility that will serve persons with 288.27 Alzheimer's disease and other related disorders. The transfer 288.28 of beds may occur gradually or in stages, provided the total 288.29 number of beds transferred does not exceed 40. At the time of 288.30 licensure and certification of a bed or beds in the new unit, 288.31 the commissioner of health shall delicense and decertify the 288.32 same number of beds in the existing facility. As a condition of 288.33 receiving a license or certification under this clause, the 288.34 facility must make a written commitment to the commissioner of 288.35 human services that it will not seek to receive an increase in 288.36 its property-related payment rate as a result of the transfers 289.1 allowed under this paragraph; 289.2 (g) to license and certify nursing home beds to replace 289.3 currently licensed and certified boarding care beds which may be 289.4 located either in a remodeled or renovated boarding care or 289.5 nursing home facility or in a remodeled, renovated, newly 289.6 constructed, or replacement nursing home facility within the 289.7 identifiable complex of health care facilities in which the 289.8 currently licensed boarding care beds are presently located, 289.9 provided that the number of boarding care beds in the facility 289.10 or complex are decreased by the number to be licensed as nursing 289.11 home beds and further provided that, if the total costs of new 289.12 construction, replacement, remodeling, or renovation exceed ten 289.13 percent of the appraised value of the facility or $200,000, 289.14 whichever is less, the facility makes a written commitment to 289.15 the commissioner of human services that it will not seek to 289.16 receive an increase in its property-related payment rate by 289.17 reason of the new construction, replacement, remodeling, or 289.18 renovation. The provisions contained in section 144A.073 289.19 regarding the upgrading of facilities do not apply to facilities 289.20 that satisfy these requirements; 289.21 (h) to license as a nursing home and certify as a nursing 289.22 facility a facility that is licensed as a boarding care facility 289.23 but not certified under the medical assistance program, but only 289.24 if the commissioner of human services certifies to the 289.25 commissioner of health that licensing the facility as a nursing 289.26 home and certifying the facility as a nursing facility will 289.27 result in a net annual savings to the state general fund of 289.28 $200,000 or more; 289.29 (i) to certify, after September 30, 1992, and prior to July 289.30 1, 1993, existing nursing home beds in a facility that was 289.31 licensed and in operation prior to January 1, 1992; 289.32 (j) to license and certify new nursing home beds to replace 289.33 beds in a facility acquired by the Minneapolis community 289.34 development agency as part of redevelopment activities in a city 289.35 of the first class, provided the new facility is located within 289.36 three miles of the site of the old facility. Operating and 290.1 property costs for the new facility must be determined and 290.2 allowed under section 256B.431 or 256B.434; 290.3 (k) to license and certify up to 20 new nursing home beds 290.4 in a community-operated hospital and attached convalescent and 290.5 nursing care facility with 40 beds on April 21, 1991, that 290.6 suspended operation of the hospital in April 1986. The 290.7 commissioner of human services shall provide the facility with 290.8 the same per diem property-related payment rate for each 290.9 additional licensed and certified bed as it will receive for its 290.10 existing 40 beds; 290.11 (l) to license or certify beds in renovation, replacement, 290.12 or upgrading projects as defined in section 144A.073, 290.13 subdivision 1, so long as the cumulative total costs of the 290.14 facility's remodeling projects do not 290.15 exceed$750,000$1,000,000; 290.16 (m) to license and certify beds that are moved from one 290.17 location to another for the purposes of converting up to five 290.18 four-bed wards to single or double occupancy rooms in a nursing 290.19 home that, as of January 1, 1993, was county-owned and had a 290.20 licensed capacity of 115 beds; 290.21 (n) to allow a facility that on April 16, 1993, was a 290.22 106-bed licensed and certified nursing facility located in 290.23 Minneapolis to layaway all of its licensed and certified nursing 290.24 home beds. These beds may be relicensed and recertified in a 290.25 newly-constructed teaching nursing home facility affiliated with 290.26 a teaching hospital upon approval by the legislature. The 290.27 proposal must be developed in consultation with the interagency 290.28 committee on long-term care planning. The beds on layaway 290.29 status shall have the same status as voluntarily delicensed and 290.30 decertified beds, except that beds on layaway status remain 290.31 subject to the surcharge in section 256.9657. This layaway 290.32 provision expires July 1, 1998; 290.33 (o) to allow a project which will be completed in 290.34 conjunction with an approved moratorium exception project for a 290.35 nursing home in southern Cass county and which is directly 290.36 related to that portion of the facility that must be repaired, 291.1 renovated, or replaced, to correct an emergency plumbing problem 291.2 for which a state correction order has been issued and which 291.3 must be corrected by August 31, 1993; 291.4 (p) to allow a facility that on April 16, 1993, was a 291.5 368-bed licensed and certified nursing facility located in 291.6 Minneapolis to layaway, upon 30 days prior written notice to the 291.7 commissioner, up to 30 of the facility's licensed and certified 291.8 beds by converting three-bed wards to single or double 291.9 occupancy. Beds on layaway status shall have the same status as 291.10 voluntarily delicensed and decertified beds except that beds on 291.11 layaway status remain subject to the surcharge in section 291.12 256.9657, remain subject to the license application and renewal 291.13 fees under section 144A.07 and shall be subject to a $100 per 291.14 bed reactivation fee. In addition, at any time within three 291.15 years of the effective date of the layaway, the beds on layaway 291.16 status may be: 291.17 (1) relicensed and recertified upon relocation and 291.18 reactivation of some or all of the beds to an existing licensed 291.19 and certified facility or facilities located in Pine River, 291.20 Brainerd, or International Falls; provided that the total 291.21 project construction costs related to the relocation of beds 291.22 from layaway status for any facility receiving relocated beds 291.23 may not exceed the dollar threshold provided in subdivision 2 291.24 unless the construction project has been approved through the 291.25 moratorium exception process under section 144A.073; 291.26 (2) relicensed and recertified, upon reactivation of some 291.27 or all of the beds within the facility which placed the beds in 291.28 layaway status, if the commissioner has determined a need for 291.29 the reactivation of the beds on layaway status. 291.30 The property-related payment rate of a facility placing 291.31 beds on layaway status must be adjusted by the incremental 291.32 change in its rental per diem after recalculating the rental per 291.33 diem as provided in section 256B.431, subdivision 3a, paragraph 291.34 (c). The property-related payment rate for a facility 291.35 relicensing and recertifying beds from layaway status must be 291.36 adjusted by the incremental change in its rental per diem after 292.1 recalculating its rental per diem using the number of beds after 292.2 the relicensing to establish the facility's capacity day 292.3 divisor, which shall be effective the first day of the month 292.4 following the month in which the relicensing and recertification 292.5 became effective. Any beds remaining on layaway status more 292.6 than three years after the date the layaway status became 292.7 effective must be removed from layaway status and immediately 292.8 delicensed and decertified; 292.9 (q) to license and certify beds in a renovation and 292.10 remodeling project to convert 12 four-bed wards into 24 two-bed 292.11 rooms, expand space, and add improvements in a nursing home 292.12 that, as of January 1, 1994, met the following conditions: the 292.13 nursing home was located in Ramsey county; had a licensed 292.14 capacity of 154 beds; and had been ranked among the top 15 292.15 applicants by the 1993 moratorium exceptions advisory review 292.16 panel. The total project construction cost estimate for this 292.17 project must not exceed the cost estimate submitted in 292.18 connection with the 1993 moratorium exception process; 292.19 (r) to license and certify up to 117 beds that are 292.20 relocated from a licensed and certified 138-bed nursing facility 292.21 located in St. Paul to a hospital with 130 licensed hospital 292.22 beds located in South St. Paul, provided that the nursing 292.23 facility and hospital are owned by the same or a related 292.24 organization and that prior to the date the relocation is 292.25 completed the hospital ceases operation of its inpatient 292.26 hospital services at that hospital. After relocation, the 292.27 nursing facility's status under section 256B.431, subdivision 292.28 2j, shall be the same as it was prior to relocation. The 292.29 nursing facility's property-related payment rate resulting from 292.30 the project authorized in this paragraph shall become effective 292.31 no earlier than April 1, 1996. For purposes of calculating the 292.32 incremental change in the facility's rental per diem resulting 292.33 from this project, the allowable appraised value of the nursing 292.34 facility portion of the existing health care facility physical 292.35 plant prior to the renovation and relocation may not exceed 292.36 $2,490,000; 293.1 (s) to license and certify two beds in a facility to 293.2 replace beds that were voluntarily delicensed and decertified on 293.3 June 28, 1991; 293.4 (t) to allow 16 licensed and certified beds located on July 293.5 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 293.6 facility in Minneapolis, notwithstanding the licensure and 293.7 certification after July 1, 1995, of the Minneapolis facility as 293.8 a 147-bed nursing home facility after completion of a 293.9 construction project approved in 1993 under section 144A.073, to 293.10 be laid away upon 30 days' prior written notice to the 293.11 commissioner. Beds on layaway status shall have the same status 293.12 as voluntarily delicensed or decertified beds except that they 293.13 shall remain subject to the surcharge in section 256.9657. The 293.14 16 beds on layaway status may be relicensed as nursing home beds 293.15 and recertified at any time within five years of the effective 293.16 date of the layaway upon relocation of some or all of the beds 293.17 to a licensed and certified facility located in Watertown, 293.18 provided that the total project construction costs related to 293.19 the relocation of beds from layaway status for the Watertown 293.20 facility may not exceed the dollar threshold provided in 293.21 subdivision 2 unless the construction project has been approved 293.22 through the moratorium exception process under section 144A.073. 293.23 The property-related payment rate of the facility placing 293.24 beds on layaway status must be adjusted by the incremental 293.25 change in its rental per diem after recalculating the rental per 293.26 diem as provided in section 256B.431, subdivision 3a, paragraph 293.27 (c). The property-related payment rate for the facility 293.28 relicensing and recertifying beds from layaway status must be 293.29 adjusted by the incremental change in its rental per diem after 293.30 recalculating its rental per diem using the number of beds after 293.31 the relicensing to establish the facility's capacity day 293.32 divisor, which shall be effective the first day of the month 293.33 following the month in which the relicensing and recertification 293.34 became effective. Any beds remaining on layaway status more 293.35 than five years after the date the layaway status became 293.36 effective must be removed from layaway status and immediately 294.1 delicensed and decertified; 294.2 (u) to license and certify beds that are moved within an 294.3 existing area of a facility or to a newly constructed addition 294.4 which is built for the purpose of eliminating three- and 294.5 four-bed rooms and adding space for dining, lounge areas, 294.6 bathing rooms, and ancillary service areas in a nursing home 294.7 that, as of January 1, 1995, was located in Fridley and had a 294.8 licensed capacity of 129 beds; 294.9 (v) to relocate 36 beds in Crow Wing county and four beds 294.10 from Hennepin county to a 160-bed facility in Crow Wing county, 294.11 provided all the affected beds are under common ownership; 294.12 (w) to license and certify a total replacement project of 294.13 up to 49 beds located in Norman county that are relocated from a 294.14 nursing home destroyed by flood and whose residents were 294.15 relocated to other nursing homes. The operating cost payment 294.16 rates for the new nursing facility shall be determined based on 294.17 the interim and settle-up payment provisions of Minnesota Rules, 294.18 part 9549.0057, and the reimbursement provisions of section 294.19 256B.431, except that subdivision 26, paragraphs (a) and (b), 294.20 shall not apply until the second rate year after the settle-up 294.21 cost report is filed. Property-related reimbursement rates 294.22 shall be determined under section 256B.431, taking into account 294.23 any federal or state flood-related loans or grants provided to 294.24 the facility; 294.25 (x) to license and certify a total replacement project of 294.26 up to 129 beds located in Polk county that are relocated from a 294.27 nursing home destroyed by flood and whose residents were 294.28 relocated to other nursing homes. The operating cost payment 294.29 rates for the new nursing facility shall be determined based on 294.30 the interim and settle-up payment provisions of Minnesota Rules, 294.31 part 9549.0057, and the reimbursement provisions of section 294.32 256B.431, except that subdivision 26, paragraphs (a) and (b), 294.33 shall not apply until the second rate year after the settle-up 294.34 cost report is filed. Property-related reimbursement rates 294.35 shall be determined under section 256B.431, taking into account 294.36 any federal or state flood-related loans or grants provided to 295.1 the facility; 295.2 (y) to license and certify beds in a renovation and 295.3 remodeling project to convert 13 three-bed wards into 13 two-bed 295.4 rooms and 13 single-bed rooms, expand space, and add 295.5 improvements in a nursing home that, as of January 1, 1994, met 295.6 the following conditions: the nursing home was located in 295.7 Ramsey county, was not owned by a hospital corporation, had a 295.8 licensed capacity of 64 beds, and had been ranked among the top 295.9 15 applicants by the 1993 moratorium exceptions advisory review 295.10 panel. The total project construction cost estimate for this 295.11 project must not exceed the cost estimate submitted in 295.12 connection with the 1993 moratorium exception process; 295.13 (z) to license and certify up to 150 nursing home beds to 295.14 replace an existing 285 bed nursing facility located in St. 295.15 Paul. The replacement project shall include both the renovation 295.16 of existing buildings and the construction of new facilities at 295.17 the existing site. The reduction in the licensed capacity of 295.18 the existing facility shall occur during the construction 295.19 project as beds are taken out of service due to the construction 295.20 process. Prior to the start of the construction process, the 295.21 facility shall provide written information to the commissioner 295.22 of health describing the process for bed reduction, plans for 295.23 the relocation of residents, and the estimated construction 295.24 schedule. The relocation of residents shall be in accordance 295.25 with the provisions of law and rule; 295.26 (aa) to allow the commissioner of human services to license 295.27 an additional 36 beds to provide residential services for the 295.28 physically handicapped under Minnesota Rules, parts 9570.2000 to 295.29 9570.3400, in a 198-bed nursing home located in Red Wing, 295.30 provided that the total number of licensed and certified beds at 295.31 the facility does not increase; 295.32 (bb) to license and certify a new facility in St. Louis 295.33 county with 44 beds constructed to replace an existing facility 295.34 in St. Louis county with 31 beds, which has resident rooms on 295.35 two separate floors and an antiquated elevator that creates 295.36 safety concerns for residents and prevents nonambulatory 296.1 residents from residing on the second floor. The project shall 296.2 include the elimination of three- and four-bed rooms; 296.3 (cc) to license and certify four beds in a 16-bed certified 296.4 boarding care home in Minneapolis to replace beds that were 296.5 voluntarily delicensed and decertified on or before March 31, 296.6 1992. The licensure and certification is conditional upon the 296.7 facility periodically assessing and adjusting its resident mix 296.8 and other factors which may contribute to a potential 296.9 institution for mental disease declaration. The commissioner of 296.10 human services shall retain the authority to audit the facility 296.11 at any time and shall require the facility to comply with any 296.12 requirements necessary to prevent an institution for mental 296.13 disease declaration, including delicensure and decertification 296.14 of beds, if necessary;or296.15 (dd) to license and certify 72 beds in an existing facility 296.16 in Mille Lacs county with 80 beds as part of a renovation 296.17 project. The renovation must include construction of an 296.18 addition to accommodate ten residents with beginning and 296.19 midstage dementia in a self-contained living unit; creation of 296.20 three resident households where dining, activities, and support 296.21 spaces are located near resident living quarters; designation of 296.22 four beds for rehabilitation in a self-contained area; 296.23 designation of 30 private rooms; and other improvements.; 296.24 (ee) to license and certify beds in a facility that has 296.25 undergone replacement or remodeling as part of a planned closure 296.26 under section 256B.437; 296.27 (ff) to license and certify a total replacement project of 296.28 up to 124 beds located in Wilkin county that are in need of 296.29 relocation from a nursing home substantially destroyed by 296.30 flood. The operating cost payment rates for the new nursing 296.31 facility shall be determined based on the interim and settle-up 296.32 payment provisions of Minnesota Rules, part 9549.0057, and the 296.33 reimbursement provisions of section 256B.431, except that 296.34 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 296.35 not apply until the second rate year after the settle-up cost 296.36 report is filed. Property-related reimbursement rates shall be 297.1 determined under section 256B.431, taking into account any 297.2 federal or state flood-related loans or grants provided to the 297.3 facility; 297.4 (gg) to allow the commissioner of human services to license 297.5 an additional nine beds to provide residential services for the 297.6 physically handicapped under Minnesota Rules, parts 9570.2000 to 297.7 9570.3400, in a 215-bed nursing home located in Duluth, provided 297.8 that the total number of licensed and certified beds at the 297.9 facility does not increase; 297.10 (hh) to license and certify up to 120 new nursing facility 297.11 beds to replace beds in a facility in Anoka county, which was 297.12 licensed for 98 beds as of July 1, 2000, provided the new 297.13 facility is located within four miles of the existing facility 297.14 and is in Anoka county. Operating and property rates shall be 297.15 determined and allowed under section 256B.431 and Minnesota 297.16 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 297.17 256B.435. The provisions of section 256B.431, subdivision 26, 297.18 paragraphs (a) and (b), do not apply until the second rate year 297.19 following settle-up; or 297.20 (ii) to transfer up to 98 beds of a 129-licensed bed 297.21 facility located in Anoka county that, as of March 25, 2001, is 297.22 in the active process of closing, to a 122-licensed bed 297.23 nonprofit nursing facility located in the city of Columbia 297.24 Heights or its affiliate. The transfer is effective when the 297.25 receiving facility notifies the commissioner in writing of the 297.26 number of beds accepted. The commissioner shall place all 297.27 transferred beds on layaway status held in the name of the 297.28 receiving facility. The layaway adjustment provisions of 297.29 section 256B.431, subdivision 30, do not apply to this layaway. 297.30 The receiving facility may only remove the beds from layaway for 297.31 recertification and relicensure at the receiving facility's 297.32 current site, or at a newly constructed facility located in 297.33 Anoka county. The receiving facility must receive statutory 297.34 authorization before removing these beds from layaway. 297.35 Sec. 6. Minnesota Statutes 2000, section 144A.073, 297.36 subdivision 2, is amended to read: 298.1 Subd. 2. [REQUEST FOR PROPOSALS.] At the authorization by 298.2 the legislature of additional medical assistance expenditures 298.3 for exceptions to the moratorium on nursing homes, the 298.4 interagency committee shall publish in the State Register a 298.5 request for proposals for nursing home projects to be licensed 298.6 or certified under section 144A.071, subdivision 4a, clause 298.7 (c). The public notice of this funding and the request for 298.8 proposals must specify how the approval criteria will be 298.9 prioritized by the advisory review panel, the interagency 298.10 long-term care planning committee, and the commissioner. The 298.11 notice must describe the information that must accompany a 298.12 request and state that proposals must be submitted to the 298.13 interagency committee within 90 days of the date of 298.14 publication. The notice must include the amount of the 298.15 legislative appropriation available for the additional costs to 298.16 the medical assistance program of projects approved under this 298.17 section. If no money is appropriated for a year, the 298.18 interagency committee shall publish a notice to that effect, and 298.19 no proposals shall be requested. If money is appropriated, the 298.20 interagency committee shall initiate the application and review 298.21 process described in this section at least twice each biennium 298.22 and up to four times each biennium, according to dates 298.23 established by rule. Authorized funds shall be allocated 298.24 proportionally to the number of processes. Funds not encumbered 298.25 by an earlier process within a biennium shall carry forward to 298.26 subsequent iterations of the process. Authorization for 298.27 expenditures does not carry forward into the following 298.28 biennium. To be considered for approval, a proposal must 298.29 include the following information: 298.30 (1) whether the request is for renovation, replacement, 298.31 upgrading, conversion, or relocation; 298.32 (2) a description of the problem the project is designed to 298.33 address; 298.34 (3) a description of the proposed project; 298.35 (4) an analysis of projected costs of the nursing facility 298.36 proposal, which are not required to exceed the cost threshold 299.1 referred to in section 144A.071, subdivision 1, to be considered 299.2 under this section, including initial construction and 299.3 remodeling costs; site preparation costs; technology costs; 299.4 financing costs, including the current estimated long-term 299.5 financing costs of the proposal, which consists of estimates of 299.6 the amount and sources of money, reserves if required under the 299.7 proposed funding mechanism, annual payments schedule, interest 299.8 rates, length of term, closing costs and fees, insurance costs, 299.9 and any completed marketing study or underwriting review; and 299.10 estimated operating costs during the first two years after 299.11 completion of the project; 299.12 (5) for proposals involving replacement of all or part of a 299.13 facility, the proposed location of the replacement facility and 299.14 an estimate of the cost of addressing the problem through 299.15 renovation; 299.16 (6) for proposals involving renovation, an estimate of the 299.17 cost of addressing the problem through replacement; 299.18 (7) the proposed timetable for commencing construction and 299.19 completing the project; 299.20 (8) a statement of any licensure or certification issues, 299.21 such as certification survey deficiencies; 299.22 (9) the proposed relocation plan for current residents if 299.23 beds are to be closed so that the department of human services 299.24 can estimate the total costs of a proposal; and 299.25 (10) other information required by permanent rule of the 299.26 commissioner of health in accordance with subdivisions 4 and 8. 299.27 Sec. 7. Minnesota Statutes 2000, section 144A.073, 299.28 subdivision 4, is amended to read: 299.29 Subd. 4. [CRITERIA FOR REVIEW.] The following criteria 299.30 shall be used in a consistent manner to compare, evaluate, and 299.31 rank all proposals submitted. Except for the criteria specified 299.32 in clause (3), the application of criteria listed under this 299.33 subdivision shall not reflect any distinction based on the 299.34 geographic location of the proposed project: 299.35 (1) the extent to which the proposal furthers state 299.36 long-term care goals,including the goals stated in section300.1144A.31, andincluding the goal of enhancing the availability 300.2 and use of alternative care services and the goal of reducing 300.3 the number of long-term care resident rooms with more than two 300.4 beds; 300.5 (2) the proposal's long-term effects on state costs 300.6 including the cost estimate of the project according to section 300.7 144A.071, subdivision 5a; 300.8 (3) the extent to which the proposal promotes equitable 300.9 access to long-term care services in nursing homes through 300.10 redistribution of the nursing home bed supply, as measured by 300.11 the number of beds relative to the population 85 or older, 300.12 projected to the year 2000 by the state demographer, and 300.13 according to items (i) to (iv): 300.14 (i) reduce beds in counties where the supply is high, 300.15 relative to the statewide mean, and increase beds in counties 300.16 where the supply is low, relative to the statewide mean; 300.17 (ii) adjust the bed supply so as to create the greatest 300.18 benefits in improving the distribution of beds; 300.19 (iii) adjust the existing bed supply in counties so that 300.20 the bed supply in a county moves toward the statewide mean; and 300.21 (iv) adjust the existing bed supply so that the 300.22 distribution of beds as projected for the year 2020 would be 300.23 consistent with projected need, based on the methodology 300.24 outlined in the interagency long-term care committee's1993300.25 nursing home bed distribution study; 300.26 (4) the extent to which the project improves conditions 300.27 that affect the health or safety of residents, such as narrow 300.28 corridors, narrow door frames, unenclosed fire exits, and wood 300.29 frame construction, and similar provisions contained in fire and 300.30 life safety codes and licensure and certification rules; 300.31 (5) the extent to which the project improves conditions 300.32 that affect the comfort or quality of life of residents in a 300.33 facility or the ability of the facility to provide efficient 300.34 care, such as a relatively high number of residents in a room; 300.35 inadequate lighting or ventilation; poor access to bathing or 300.36 toilet facilities; a lack of available ancillary space for 301.1 dining rooms, day rooms, or rooms used for other activities; 301.2 problems relating to heating, cooling, or energy efficiency; 301.3 inefficient location of nursing stations; narrow corridors; or 301.4 other provisions contained in the licensure and certification 301.5 rules; 301.6 (6) the extent to which the applicant demonstrates the 301.7 delivery of quality care, as defined in state and federal 301.8 statutes and rules, to residents as evidenced by the two most 301.9 recent state agency certification surveys and the applicants' 301.10 response to those surveys; 301.11 (7) the extent to which the project removes the need for 301.12 waivers or variances previously granted by either the licensing 301.13 agency, certifying agency, fire marshal, or local government 301.14 entity;and301.15 (8) the extent to which the project increases the number of 301.16 private or single bed rooms; and 301.17 (9) other factors that may be developed in permanent rule 301.18 by the commissioner of health that evaluate and assess how the 301.19 proposed project will further promote or protect the health, 301.20 safety, comfort, treatment, or well-being of the facility's 301.21 residents. 301.22 Sec. 8. [144A.185] [DEFINITIONS.] 301.23 Subdivision 1. [APPLICABILITY.] For purposes of sections 301.24 144A.185 to 144A.1887, the terms defined in this section have 301.25 the meanings given them. 301.26 Subd. 2. [CLOSURE.] "Closure" means the cessation of 301.27 operations of a nursing home and the delicensure or 301.28 decertification of all beds within the facility. 301.29 Subd. 3. [CURTAILMENT, REDUCTION, OR CHANGE IN 301.30 OPERATIONS.] "Curtailment, reduction, or change in operations" 301.31 means any change in operations or services that would result in 301.32 or encourage the relocation of residents. 301.33 Subd. 4. [FACILITY.] "Facility" means a licensed nursing 301.34 home or a certified boarding care home licensed according to 301.35 sections 144.50 to 144.56. 301.36 Subd. 5. [LICENSEE.] "Licensee" means the owner of the 302.1 facility or the owner's designee or the commissioner of health 302.2 for a facility in receivership. 302.3 Subd. 6. [LOCAL AGENCY.] "Local agency" means a county or 302.4 a multicounty social service agency authorized under section 302.5 393.01 as the agency responsible for providing social services 302.6 for the county in which the facility is located. 302.7 Subd. 7. [PLAN.] "Plan" means a process developed under 302.8 section 144A.186 for the closure or curtailment, reduction, or 302.9 change in operations of a facility and for the subsequent 302.10 relocation of residents. 302.11 Subd. 8. [RELOCATION.] "Relocation" means the discharge of 302.12 a resident and movement of the resident to another facility or 302.13 living arrangement as a result of a closure or curtailment, 302.14 reduction, or change in operations of a facility. 302.15 Sec. 9. [144A.1855] [INITIAL NOTICE.] 302.16 Subdivision 1. [NOTIFICATION; PARTIES.] A licensee shall 302.17 notify the following parties in writing when there is an intent 302.18 to close or curtail, reduce, or change operations which would 302.19 result in or encourage the relocation of residents: 302.20 (1) the commissioner of health; 302.21 (2) the commissioner of human services; 302.22 (3) the local agency; 302.23 (4) the office of the ombudsman for older Minnesotans; and 302.24 (5) the office of the ombudsman for mental health and 302.25 mental retardation. 302.26 Subd. 2. [NOTICE REQUIREMENTS.] The written notice shall 302.27 include the names, telephone numbers, fax numbers, and e-mail 302.28 addresses of the persons in the facility who are responsible for 302.29 coordinating the facility's efforts in the planning process and 302.30 the number of residents potentially affected by the closure or 302.31 curtailment, reduction, or change in operations. 302.32 Sec. 10. [144A.186] [PLANNING PROCESS.] 302.33 Subdivision 1. [LOCAL AGENCY REQUIREMENTS.] (a) A local 302.34 agency, within five working days of receiving an initial notice 302.35 from a licensee according to section 144A.1855, shall provide 302.36 all parties identified in section 144A.1855, subdivision 1, with 303.1 the names, telephone numbers, fax numbers, and e-mail addresses 303.2 of those persons who are responsible for coordinating local 303.3 agency efforts in the planning process. 303.4 (b) Within ten working days of receipt of the notice under 303.5 paragraph (a), the local agency and licensee shall meet to 303.6 develop the relocation plan under subdivision 2. The local 303.7 agency shall inform the departments of health and human 303.8 services, the office of the ombudsman for older Minnesotans, and 303.9 the office of the ombudsman for mental health and mental 303.10 retardation of the date, time, and location of the meeting so 303.11 that their representatives may attend. The relocation plan must 303.12 be completed within 45 days, but may be completed earlier 303.13 according to a schedule agreed to by all parties. 303.14 Subd. 2. [RELOCATION PLAN.] (a) The plan shall: 303.15 (1) identify the expected date of closure or curtailment, 303.16 reduction, or change in operations; 303.17 (2) outline the process for public notification of the 303.18 closure or curtailment, reduction, or change in operations; 303.19 (3) outline the process to ensure 60-day advance written 303.20 notice to residents, family members, and designated 303.21 representatives of residents; 303.22 (4) present an aggregate description of the resident 303.23 population remaining to be relocated and the population's needs; 303.24 (5) outline the individual resident assessment process to 303.25 be used; 303.26 (6) identify an inventory of available relocation options, 303.27 including home and community-based services; 303.28 (7) identify a timeline for submission of the list required 303.29 under section 144A.1865, subdivision 3; and 303.30 (8) identify a schedule for each element of the plan. 303.31 (b) All parties to the plan shall refrain from any public 303.32 notification of the intent to close or curtail, reduce, or 303.33 change operations until a relocation plan has been established. 303.34 Sec. 11. [144A.1865] [REQUIREMENTS OF LICENSEE.] 303.35 Subdivision 1. [RELOCATION.] The licensee shall provide 303.36 for the safe, orderly, and appropriate relocation of residents. 304.1 The licensee and facility staff shall cooperate with 304.2 representatives from the local agency, the departments of health 304.3 and human services, the office of the ombudsman for older 304.4 Minnesotans, and the office of the ombudsman for mental health 304.5 and mental retardation in planning for and implementing the 304.6 relocation of residents. 304.7 Subd. 2. [INTERDISCIPLINARY TEAM.] The licensee shall 304.8 establish an interdisciplinary team responsible for coordinating 304.9 and implementing the plan under section 144A.186, subdivision 304.10 2. The interdisciplinary team shall include representatives 304.11 from the local agency, the office of the ombudsman for older 304.12 Minnesotans, facility staff who provide direct care services to 304.13 the residents, and the facility administration. 304.14 Subd. 3. [RESIDENT LISTS.] The licensee shall provide a 304.15 list to the local agency that includes the following information 304.16 on each resident to be relocated: 304.17 (1) name; 304.18 (2) date of birth; 304.19 (3) social security number; 304.20 (4) medical assistance ID number; 304.21 (5) all diagnoses; and 304.22 (6) name of and contact information for the resident's 304.23 family or other designated representative. 304.24 Subd. 4. [CONSULTATION WITH LOCAL AGENCY.] The licensee 304.25 shall consult with the local agency on the availability and 304.26 development of resources and in the resident relocation process. 304.27 [EFFECTIVE DATE.] This section is effective the day 304.28 following final enactment. 304.29 Sec. 12. [144A.187] [RESIDENT AND PHYSICIAN NOTICE.] 304.30 Subdivision 1. [RESIDENT NOTICE REQUIRED.] (a) At least 60 304.31 days before the proposed date of closure or curtailment, 304.32 reduction, or change in operations as agreed to in the plan 304.33 under section 144A.186, the licensee shall send a written notice 304.34 of closure or curtailment, reduction, or change in operations to 304.35 each resident being relocated, the resident's family member or 304.36 designated representative, and the resident's attending 305.1 physician. 305.2 (b) The notice must include: 305.3 (1) the date of the proposed closure or curtailment, 305.4 reduction, or change in operations; 305.5 (2) the name, address, telephone number, fax number, and 305.6 e-mail address of the individuals in the facility responsible 305.7 for providing assistance and information; 305.8 (3) a notice of upcoming meetings for residents, families 305.9 and designated representatives, and resident and family councils 305.10 to discuss the relocation of residents; 305.11 (4) the name, address, and telephone number of the local 305.12 agency contact person; 305.13 (5) the name, address, and telephone number of the office 305.14 of the ombudsman for older Minnesotans and the office of the 305.15 ombudsman for mental health and mental retardation; and 305.16 (6) a notice of resident rights during discharge and 305.17 relocation. 305.18 (c) The notice to residents must comply with all applicable 305.19 state and federal requirements for notice of transfer or 305.20 discharge of nursing home residents. 305.21 Subd. 2. [MEDICAL INFORMATION REQUEST.] The licensee shall 305.22 request the attending physician to furnish the licensee with, or 305.23 arrange for the release of, any medical information needed to 305.24 update a resident's medical records and to prepare transfer 305.25 forms and discharge summaries. 305.26 Sec. 13. [144A.1875] [RELOCATION OF RESIDENTS.] 305.27 Subdivision 1. [PREPARATION; PLACEMENT INFORMATION.] A 305.28 licensee shall provide sufficient preparation to residents to 305.29 ensure safe, orderly, and appropriate discharge and relocation. 305.30 The facility is responsible for assisting residents in finding 305.31 placement within the resident's desired geographic location 305.32 using the Senior LinkAge database of the department of human 305.33 services. By January 1, 2002, Senior LinkAge line shall make 305.34 available via a Web site the name, address, and telephone and 305.35 fax numbers of each facility with available beds, the 305.36 certification level of the available beds, the types of services 306.1 available, and the number of beds that are available as updated 306.2 daily by the licensee. The Web site shall include the 306.3 information required by section 256.975, subdivision 7, 306.4 paragraph (b), clause (1), and home and community-based services 306.5 and other options for individuals with special needs. The 306.6 licensee must provide residents, their families or designated 306.7 representatives, the office of the ombudsman for older 306.8 Minnesotans, the office of the ombudsman for mental health and 306.9 mental retardation, and the local agency with the toll-free 306.10 number and Web site address for the Senior LinkAge line. 306.11 Subd. 2. [RESIDENT AND FAMILY MEETINGS.] After preparing 306.12 the plan according to section 144A.186, the licensee shall 306.13 conduct meetings with residents, families and designated 306.14 representatives, and resident and family councils to notify them 306.15 of the process for resident relocation. Representatives from 306.16 the local agency, the office of the ombudsman for older 306.17 Minnesotans, the office of the ombudsman for mental health and 306.18 mental retardation, the departments of health and human services 306.19 shall receive advance notice of these meetings. 306.20 Subd. 3. [PERSONAL PROPERTY.] (a) The licensee shall 306.21 update the inventory of residents' personal possessions and 306.22 provide a copy of the final inventory to each resident and the 306.23 resident's family or designated representative prior to the 306.24 relocation of the resident. The licensee is responsible for the 306.25 timely transfer of a resident's possessions for all relocations 306.26 within the state and within a 50-mile radius of the facility for 306.27 relocations outside the state. 306.28 (b) The licensee shall complete a final accounting of 306.29 personal funds held in trust by the licensee and provide a copy 306.30 of the accounting to each resident and the resident's family or 306.31 designated representative. The licensee is responsible for the 306.32 timely transfer of all personal funds held in trust by the 306.33 licensee. 306.34 Subd. 4. [SITE VISITS.] The licensee is responsible for 306.35 assisting residents desiring to make site visits to facilities 306.36 or other placements to which the resident may be relocated, 307.1 unless it is medically inadvisable, as documented by the 307.2 attending physician in the resident's care record. The licensee 307.3 shall provide, or make arrangements for, transportation for site 307.4 visits to facilities or other placements within a 50-mile radius. 307.5 Subd. 5. [FINAL NOTICE OF RELOCATION.] (a) Before 307.6 relocating a resident, the licensee shall provide a final 307.7 written notice to the resident, the resident's family or 307.8 designated representative, and the resident's attending 307.9 physician. 307.10 (b) The final written notice shall: 307.11 (1) be provided seven days before the relocation of a 307.12 resident, unless the resident agrees to waive the resident's 307.13 right to advance notice; and 307.14 (2) identify the date of the anticipated relocation and the 307.15 location to which the resident is being relocated. 307.16 Subd. 6. [ADMINISTRATIVE DUTIES.] (a) All administrative 307.17 duties of the licensee under subdivisions 1, 2, 4, and 5 must be 307.18 completed before relocation of a resident. 307.19 (b) The licensee is responsible for providing the receiving 307.20 facility or other health, housing, or care entity with a 307.21 complete and accurate resident record, including information on 307.22 family members, designated representatives, guardians, social 307.23 service caseworkers, and other contact information. The record 307.24 must also include all information necessary to provide 307.25 appropriate medical care and social services, including, but not 307.26 limited to, information on preadmission screening, Level I and 307.27 Level II screening, minimum data set and all other assessments, 307.28 resident diagnosis, behavior, and medication. 307.29 (c) For residents with special care needs, the licensee 307.30 shall consult with the receiving facility or other placement 307.31 entity and provide staff training or other preparation as needed 307.32 to assist in providing for the special needs. 307.33 (d) The licensee shall assist residents with the transfer 307.34 or reconnection of telephone service. The licensee shall bear 307.35 all costs associated with reestablishing telephone service. 307.36 Subd. 7. [TRANSPORTATION; CONTINUITY OF CARE.] The 308.1 licensee shall make arrangements or provide for the 308.2 transportation of residents to the new facility or placement 308.3 within the state or within a 50-mile radius for relocations 308.4 outside the state. The licensee shall provide a staff person to 308.5 accompany the resident during transportation, upon request of 308.6 the resident, the resident's family, or designated 308.7 representative. The discharge and relocation of residents must 308.8 comply with all applicable state and federal requirements and 308.9 must be conducted in a safe, orderly, and appropriate manner. 308.10 The licensee must ensure that there is no disruption in 308.11 providing meals, medications, or treatments of a resident during 308.12 the relocation process. 308.13 Sec. 14. [144A.1885] [RELOCATION REPORTS.] 308.14 (a) Beginning the week following development of the initial 308.15 relocation plan under section 144A.186, the licensee shall 308.16 submit weekly status reports to the commissioners of health and 308.17 human services, or their designees, and to the local agency. 308.18 (b) The first status report must identify the relocation 308.19 plan developed under section 144A.186, the interdisciplinary 308.20 team members, and the number of residents to be relocated. 308.21 (c) Subsequent status reports must note any modifications 308.22 to the relocation plan, any change of interdisciplinary team 308.23 members or number of residents relocated, the placement 308.24 destination to which residents have been relocated, and the 308.25 number of residents remaining to be relocated. Subsequent 308.26 status reports must also identify issues or problems encountered 308.27 during the relocation process and the resolution of these issues. 308.28 Sec. 15. [144A.1886] [REQUIREMENTS OF LOCAL AGENCY.] 308.29 Subdivision 1. [MEETING; REPRESENTATION.] (a) The local 308.30 agency with the licensee shall convene a meeting to develop a 308.31 plan according to section 144A.186, subdivision 1, paragraph (b). 308.32 (b) The local agency shall designate a representative to 308.33 the interdisciplinary team established by the licensee 308.34 responsible for coordinating the relocation efforts. 308.35 Subd. 2. [RESOURCE.] (a) The local agency shall serve as a 308.36 resource in the relocation process. 309.1 (b) Concurrent with the notice sent to residents from the 309.2 licensee according to section 144A.187, subdivision 1, the local 309.3 agency shall provide written notice to residents, family 309.4 members, and designated representatives describing: 309.5 (1) the local agency's role in the relocation process and 309.6 in the follow-up to relocation; 309.7 (2) a local agency contact name, address, and telephone 309.8 number; and 309.9 (3) the name, address, and telephone number of the office 309.10 of the ombudsman for older Minnesotans and the office of the 309.11 ombudsman for mental health and mental retardation. 309.12 (c) The local agency is responsible for the safe and 309.13 orderly relocation of residents in cases where an emergent need 309.14 arises or when the licensee has abrogated the licensee's 309.15 responsibilities under the relocation plan. 309.16 Subd. 3. [COORDINATION; OVERSIGHT.] (a) The local agency 309.17 shall meet with appropriate facility staff to coordinate any 309.18 assistance. Coordination shall include participating in group 309.19 meetings with residents, family members, and designated 309.20 representatives to explain the transfer or relocation process. 309.21 (b) The local agency shall monitor compliance with all 309.22 components of the relocation plan. When the licensee is not in 309.23 compliance, the local agency shall notify the commissioners of 309.24 health and human services. 309.25 (c) Except as requested by the resident, family member, or 309.26 designated representative and within the parameters of the 309.27 Vulnerable Adults Act, the local agency may halt a relocation 309.28 that it deems inappropriate or dangerous to the health or safety 309.29 of a resident. 309.30 Subd. 4. [FOLLOW-UP REVIEW.] (a) A member of the local 309.31 agency staff shall visit residents relocated within 100 miles of 309.32 the county within 30 days after a relocation. Local agency 309.33 staff shall interview the resident and family member or 309.34 designated representative or shall observe the resident on-site, 309.35 or both, and review and discuss pertinent medical or social 309.36 records with appropriate facility staff to assess the adjustment 310.1 of the resident to the new placement, recommend services or 310.2 methods to meet any special needs of the resident, and identify 310.3 residents at risk. 310.4 (b) The local agency may conduct subsequent follow-up 310.5 visits in cases where the adjustment of the resident to the new 310.6 placement is in question. 310.7 (c) Within 60 days of the completion of the follow-up 310.8 visits, the local agency shall submit a written summary of the 310.9 follow-up work to the commissioners of health and human 310.10 services, in a manner approved by the commissioners. 310.11 (d) The local agency shall submit a report of any issues 310.12 that may require further review or monitoring to the 310.13 commissioner of health. 310.14 Sec. 16. [144A.1887] [FUNDING.] 310.15 (a) Within 60 days of a nursing home ceasing operations, 310.16 the commissioner of human services shall reimburse nursing homes 310.17 that are reimbursed under sections 256B.431, 256B.434, and 310.18 256B.435 for operating costs incurred by the nursing home during 310.19 the closure process. The amount to be reimbursed to the nursing 310.20 home shall be determined by applying paragraphs (b) to (f). 310.21 (b) The facility shall provide the commissioner of human 310.22 services with the nursing home's operating costs for the time 310.23 period of 30 days prior to the notice specified under section 310.24 144A.16, to 30 days after the nursing home's closure. 310.25 (c) The nursing home shall provide the commissioner of 310.26 human services with the number of medical assistance, Medicare, 310.27 private pay, and other resident days for the period referenced 310.28 in paragraph (b) by the 11 case mix categories. 310.29 (d) The commissioner of human services shall calculate a 310.30 nursing home closure rate by dividing the facility operating 310.31 costs in paragraph (b) by the total resident days in paragraph 310.32 (c). 310.33 (e) The total closure costs attributable to medical 310.34 assistance shall be determined by multiplying the nursing home 310.35 closure rate in paragraph (d) by the medical assistance days 310.36 provided by the nursing facility in paragraph (c). 311.1 (f) The amount to be reimbursed to the nursing home is 311.2 equal to the total closure costs in paragraph (e) minus the sum 311.3 of the nursing facility's 11 operating rates times their 311.4 respective number of medical assistance days by case mix as 311.5 referenced in paragraph (c). 311.6 Sec. 17. [144A.36] [TRANSITION PLANNING GRANTS.] 311.7 Subdivision 1. [DEFINITIONS.] "Eligible nursing home" 311.8 means any nursing home licensed under sections 144A.01 to 311.9 144A.16 and certified by the appropriate authority under United 311.10 States Code, title 42, sections 1396-1396p, to participate as a 311.11 vendor in the medical assistance program established under 311.12 chapter 256B. 311.13 Subd. 2. [GRANTS AUTHORIZED.] (a) The commissioner shall 311.14 establish a program of transition planning grants to assist 311.15 eligible nursing homes in implementing the provisions in 311.16 paragraphs (b) and (c). 311.17 (b) Transition planning grants may be used by nursing homes 311.18 to develop strategic plans which identify the appropriate 311.19 institutional and noninstitutional settings necessary to meet 311.20 the older adult service needs of the community. 311.21 (c) At a minimum, a strategic plan must consist of: 311.22 (1) a needs assessment to determine what older adult 311.23 services are needed and desired by the community; 311.24 (2) an assessment of the appropriate settings in which to 311.25 provide needed older adult services; 311.26 (3) an assessment identifying currently available services 311.27 and their settings in the community; and 311.28 (4) a transition plan to achieve the needed outcome 311.29 identified by the assessment. 311.30 Subd. 3. [ALLOCATION OF GRANTS.] (a) Eligible nursing 311.31 homes must apply to the commissioner no later than September 1 311.32 of each fiscal year for grants awarded in that fiscal year. A 311.33 grant shall be awarded upon signing of a grant contract. 311.34 (b) The commissioner must make a final decision on the 311.35 funding of each application within 60 days of the deadline for 311.36 receiving applications. 312.1 Subd. 4. [EVALUATION.] The commissioner shall evaluate the 312.2 overall effectiveness of the grant program. The commissioner 312.3 may collect, from the nursing homes receiving grants, the 312.4 information necessary to evaluate the grant program. 312.5 Information related to the financial condition of individual 312.6 nursing homes shall be classified as nonpublic data. 312.7 Sec. 18. [144A.37] [ALTERNATIVE NURSING HOME SURVEY 312.8 PROCESS.] 312.9 Subdivision 1. [ALTERNATIVE NURSING HOME SURVEY 312.10 SCHEDULES.] (a) The commissioner of health shall implement 312.11 alternative procedures for the nursing home survey process as 312.12 authorized under this section. 312.13 (b) These alternative survey process procedures seek to: 312.14 (1) use department resources more effectively and efficiently to 312.15 target problem areas; (2) use other existing or new mechanisms 312.16 to provide objective assessments of quality and to measure 312.17 quality improvement; (3) provide for frequent collaborative 312.18 interaction of facility staff and surveyors rather than a 312.19 punitive approach; and (4) reward a nursing home that has 312.20 performed very well by extending intervals between full surveys. 312.21 (c) The commissioner shall pursue changes in federal law 312.22 necessary to accomplish this process and shall apply for any 312.23 necessary federal waivers or approval. If a federal waiver is 312.24 approved, the commissioner shall promptly submit, to the house 312.25 and senate committees with jurisdiction over health and human 312.26 services policy and finance, fiscal estimates for implementing 312.27 the alternative survey process waiver. The commissioner shall 312.28 also pursue any necessary federal law changes during the 107th 312.29 Congress. 312.30 (d) The alternative nursing home survey schedule and 312.31 related educational activities shall not be implemented until 312.32 funding is appropriated by the legislature. 312.33 Subd. 2. [SURVEY INTERVALS.] The commissioner of health 312.34 must extend the time period between standard surveys up to 30 312.35 months based on the criteria established in subdivision 4. In 312.36 using the alternative survey schedule, the requirement for the 313.1 statewide average to not exceed 12 months does not apply. 313.2 Subd. 3. [COMPLIANCE HISTORY.] The commissioner shall 313.3 develop a process for identifying the survey cycles for skilled 313.4 nursing facilities based upon the compliance history of the 313.5 facility. This process can use a range of months for survey 313.6 intervals. At a minimum, the process must be based on 313.7 information from the last two survey cycles and shall take into 313.8 consideration any deficiencies issued as the result of a survey 313.9 or a complaint investigation during the interval. A skilled 313.10 nursing facility with a finding of substandard quality of care 313.11 or a finding of immediate jeopardy is not entitled to a survey 313.12 interval greater than 12 months. The commissioner shall alter 313.13 the survey cycle for a specific skilled nursing facility based 313.14 on findings identified through the completion of a survey, a 313.15 monitoring visit, or a complaint investigation. The 313.16 commissioner must also take into consideration information other 313.17 than the facility's compliance history. 313.18 Subd. 4. [CRITERIA FOR SURVEY INTERVAL 313.19 CLASSIFICATION.] (a) The commissioner shall provide public 313.20 notice of the classification process and shall identify the 313.21 selected survey cycles for each skilled nursing facility. The 313.22 classification system must be based on an analysis of the 313.23 findings made during the past two standard survey intervals, but 313.24 it only takes one survey or complaint finding to modify the 313.25 interval. 313.26 (b) The commissioner shall also take into consideration 313.27 information obtained from residents and family members in each 313.28 skilled nursing facility and from other sources such as 313.29 employees and ombudsmen in determining the appropriate survey 313.30 intervals for facilities. 313.31 Subd. 5. [REQUIRED MONITORING.] (a) The commissioner shall 313.32 conduct at least one monitoring visit on an annual basis for 313.33 every skilled nursing facility which has been selected for a 313.34 survey cycle greater than 12 months. The commissioner shall 313.35 develop protocols for the monitoring visits which shall be less 313.36 extensive than the requirements for a standard survey. The 314.1 commissioner shall use the criteria in paragraph (b) to 314.2 determine whether additional monitoring visits to a facility 314.3 will be required. 314.4 (b) The criteria shall include, but not be limited to, the 314.5 following: 314.6 (1) changes in ownership, administration of the facility, 314.7 or direction of the facility's nursing service; 314.8 (2) changes in the facility's quality indicators which 314.9 might evidence a decline in the facility's quality of care; 314.10 (3) reductions in staffing or an increase in the 314.11 utilization of temporary nursing personnel; and 314.12 (4) complaint information or other information that 314.13 identifies potential concerns for the quality of the care and 314.14 services provided in the skilled nursing facility. 314.15 Subd. 6. [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED 314.16 FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish 314.17 a process for surveying and monitoring of facilities which 314.18 require a survey interval of less than 15 months. This 314.19 information shall identify the steps that the commissioner must 314.20 take to monitor the facility in addition to the standard survey. 314.21 Subd. 7. [IMPACT ON SURVEY AGENCY'S BUDGET.] The 314.22 implementation of an alternative survey process for the state 314.23 must not result in any reduction of funding that would have been 314.24 provided to the state survey agency for survey and enforcement 314.25 activity based upon the completion of full standard surveys for 314.26 each skilled nursing facility in the state. 314.27 Subd. 8. [EDUCATIONAL ACTIVITIES.] The commissioner shall 314.28 expand the state survey agency's ability to conduct training and 314.29 educational efforts for skilled nursing facilities, residents 314.30 and family members, residents and family councils, long-term 314.31 care ombudsman programs, and the general public. 314.32 Subd. 9. [EVALUATION.] The commissioner shall develop a 314.33 process for the evaluation of the effectiveness of an 314.34 alternative survey process conducted under this section. 314.35 [EFFECTIVE DATE.] This section is effective the day 314.36 following final enactment. 315.1 Sec. 19. [144A.38] [INNOVATIONS IN QUALITY DEMONSTRATION 315.2 GRANTS.] 315.3 Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of 315.4 health and the commissioner of human services shall establish a 315.5 long-term care grant program that demonstrates best practices 315.6 and innovation for long-term care service delivery and housing. 315.7 The grants must fund demonstrations that create new means and 315.8 models for serving the elderly or demonstrate creativity in 315.9 service provision through the scope of their program or service. 315.10 Subd. 2. [ELIGIBILITY.] Grants may only be made to those 315.11 who provide direct service or housing to the elderly within the 315.12 state. Grants may only be made for projects that show 315.13 innovations and measurable improvement in resident care, quality 315.14 of life, use of technology, or customer satisfaction. 315.15 Subd. 3. [AWARDING OF GRANTS.] (a) Applications for grants 315.16 must be made to the commissioners on forms prescribed by the 315.17 commissioners. 315.18 (b) The commissioners shall review applications and award 315.19 grants based on the following criteria: 315.20 (1) improvement in direct care to residents; 315.21 (2) increase in efficiency through the use of technology; 315.22 (3) increase in quality of care through the use of 315.23 technology; 315.24 (4) increase in the access and delivery of service; 315.25 (5) enhancement of nursing staff training; 315.26 (6) the effectiveness of the project as a demonstration; 315.27 and 315.28 (7) the immediate transferability of the project to scale. 315.29 (c) In reviewing applications and awarding grants, the 315.30 commissioners shall consult with long-term care providers, 315.31 consumers of long-term care, long-term care researchers, and 315.32 staff of other state agencies. 315.33 (d) Grants for eligible projects may not exceed $100,000. 315.34 Sec. 20. [144A.39] [LONG-TERM CARE QUALITY PROFILES.] 315.35 Subdivision l. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 315.36 PROFILES.] (a) The commissioner of health and the commissioner 316.1 of human services shall develop and implement a quality profile 316.2 system for nursing facilities and, beginning not later than July 316.3 1, 2003, other providers of long-term care services, except when 316.4 the quality profile system would duplicate requirements under 316.5 sections 256B.5011 and 256B.5013. The system must be developed 316.6 and implemented to the extent possible without the collection of 316.7 new data. To the extent possible, the system must incorporate 316.8 or be coordinated with information on quality maintained by area 316.9 agencies on aging, long-term care trade associations, and other 316.10 entities. The system must be designed to provide information on 316.11 quality: 316.12 (1) to consumers and their families to facilitate informed 316.13 choices of service providers; 316.14 (2) to providers to enable them to measure the results of 316.15 their quality improvement efforts and compare quality 316.16 achievements with other service providers; and 316.17 (3) to public and private purchasers of long-term care 316.18 services to enable them to purchase high-quality care. 316.19 (b) The system must be developed in consultation with the 316.20 long-term care task force, area agencies on aging, and 316.21 representatives of consumers, providers, and labor unions. 316.22 Within the limits of available appropriations, the commissioners 316.23 may employ consultants to assist with this project. 316.24 Subd. 2. [QUALITY MEASUREMENT TOOLS.] The commissioners 316.25 shall identify and apply existing quality measurement tools to: 316.26 (1) emphasize quality of care and its relationship to 316.27 quality of life; and 316.28 (2) address the needs of various users of long-term care 316.29 services, including, but not limited to, short-stay residents, 316.30 persons with behavioral problems, persons with dementia, and 316.31 persons who are members of minority groups. 316.32 The tools must be identified and applied, to the extent 316.33 possible, without requiring providers to supply information 316.34 beyond current state and federal requirements. 316.35 Subd. 3. [CONSUMER SURVEYS.] Following identification of 316.36 the quality measurement tool, the commissioners shall conduct 317.1 surveys of long-term care service consumers to develop quality 317.2 profiles of providers. To the extent possible, surveys must be 317.3 conducted face-to-face by state employees or contractors. At 317.4 the discretion of the commissioners, surveys may be conducted by 317.5 telephone or by provider staff. Surveys must be conducted 317.6 periodically to update quality profiles of individual service 317.7 providers. 317.8 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 1, 317.9 2002, the commissioners shall implement a system to disseminate 317.10 the quality profiles developed from consumer surveys using the 317.11 quality measurement tool. Profiles must be disseminated to the 317.12 Senior LinkAge line and to consumers, providers, and purchasers 317.13 of long-term care services through all feasible printed and 317.14 electronic outlets. The commissioners shall conduct a public 317.15 awareness campaign to inform potential users regarding profile 317.16 contents and potential uses. 317.17 Sec. 21. Minnesota Statutes 2000, section 256B.431, 317.18 subdivision 17, is amended to read: 317.19 Subd. 17. [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 317.20 (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 317.21 for rate periods beginning on October 1, 1992, and for rate 317.22 years beginning after June 30, 1993, a nursing facility that (1) 317.23 has completed a construction project approved under section 317.24 144A.071, subdivision 4a, clause (m); (2) has completed a 317.25 construction project approved under section 144A.071, 317.26 subdivision 4a, and effective after June 30, 1995; or (3) has 317.27 completed a renovation, replacement, or upgrading project 317.28 approved under the moratorium exception process in section 317.29 144A.073 shall be reimbursed for costs directly identified to 317.30 that project as provided in subdivision 16 and this subdivision. 317.31 (b) Notwithstanding Minnesota Rules, part 9549.0060, 317.32 subparts 5, item A, subitems (1) and (3), and 7, item D, 317.33 allowable interest expense on debt shall include: 317.34 (1) interest expense on debt related to the cost of 317.35 purchasing or replacing depreciable equipment, excluding 317.36 vehicles, not to exceed six percent of the total historical cost 318.1 of the project; and 318.2 (2) interest expense on debt related to financing or 318.3 refinancing costs, including costs related to points, loan 318.4 origination fees, financing charges, legal fees, and title 318.5 searches; and issuance costs including bond discounts, bond 318.6 counsel, underwriter's counsel, corporate counsel, printing, and 318.7 financial forecasts. Allowable debt related to items in this 318.8 clause shall not exceed seven percent of the total historical 318.9 cost of the project. To the extent these costs are financed, 318.10 the straight-line amortization of the costs in this clause is 318.11 not an allowable cost; and 318.12 (3) interest on debt incurred for the establishment of a 318.13 debt reserve fund, net of the interest earned on the debt 318.14 reserve fund. 318.15 (c) Debt incurred for costs under paragraph (b) is not 318.16 subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 318.17 subitem (5) or (6). 318.18 (d) The incremental increase in a nursing facility's rental 318.19 rate, determined under Minnesota Rules, parts 9549.0010 to 318.20 9549.0080, and this section, resulting from the acquisition of 318.21 allowable capital assets, and allowable debt and interest 318.22 expense under this subdivision shall be added to its 318.23 property-related payment rate and shall be effective on the 318.24 first day of the month following the month in which the 318.25 moratorium project was completed. 318.26 (e) Notwithstanding subdivision 3f, paragraph (a), for rate 318.27 periods beginning on October 1, 1992, and for rate years 318.28 beginning after June 30, 1993, the replacement-costs-new per bed 318.29 limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 318.30 item B, for a nursing facility that has completed a renovation, 318.31 replacement, or upgrading project that has been approved under 318.32 the moratorium exception process in section 144A.073, or that 318.33 has completed an addition to or replacement of buildings, 318.34 attached fixtures, or land improvements for which the total 318.35 historical cost exceeds the lesser of $150,000 or ten percent of 318.36 the most recent appraised value, must be $47,500 per licensed 319.1 bed in multiple-bed rooms and $71,250 per licensed bed in a 319.2 single-bed room. These amounts must be adjusted annually as 319.3 specified in subdivision 3f, paragraph (a), beginning January 1, 319.4 1993. 319.5 (f) For purposes of this paragraph, a total replacement 319.6 means the complete replacement of the nursing facility's 319.7 physical plant through the construction of a new physical plant, 319.8 the transfer of the nursing facility's license from one physical 319.9 plant location to another, or a new building addition to 319.10 relocate beds from three- and four-bed wards. For total 319.11 replacement projects completed on or after July 1, 1992, the 319.12 commissioner shall compute the incremental change in the nursing 319.13 facility's rental per diem, for rate years beginning on or after 319.14 July 1, 1995, by replacing its appraised value, including the 319.15 historical capital asset costs, and the capital debt and 319.16 interest costs with the new nursing facility's allowable capital 319.17 asset costs and the related allowable capital debt and interest 319.18 costs. If the new nursing facility has decreased its licensed 319.19 capacity, the aggregate investment per bed limit in subdivision 319.20 3a, paragraph (c), shall apply. If the new nursing facility has 319.21 retained a portion of the original physical plant for nursing 319.22 facility usage, then a portion of the appraised value prior to 319.23 the replacement must be retained and included in the calculation 319.24 of the incremental change in the nursing facility's rental per 319.25 diem. For purposes of this part, the original nursing facility 319.26 means the nursing facility prior to the total replacement 319.27 project. The portion of the appraised value to be retained 319.28 shall be calculated according to clauses (1) to (3): 319.29 (1) The numerator of the allocation ratio shall be the 319.30 square footage of the area in the original physical plant which 319.31 is being retained for nursing facility usage. 319.32 (2) The denominator of the allocation ratio shall be the 319.33 total square footage of the original nursing facility physical 319.34 plant. 319.35 (3) Each component of the nursing facility's allowable 319.36 appraised value prior to the total replacement project shall be 320.1 multiplied by the allocation ratio developed by dividing clause 320.2 (1) by clause (2). 320.3 In the case of either type of total replacement as 320.4 authorized under section 144A.071 or 144A.073, the provisions of 320.5 this subdivision shall also apply. For purposes of the 320.6 moratorium exception authorized under section 144A.071, 320.7 subdivision 4a, paragraph (s), if the total replacement involves 320.8 the renovation and use of an existing health care facility 320.9 physical plant, the new allowable capital asset costs and 320.10 related debt and interest costs shall include first the 320.11 allowable capital asset costs and related debt and interest 320.12 costs of the renovation, to which shall be added the allowable 320.13 capital asset costs of the existing physical plant prior to the 320.14 renovation, and if reported by the facility, the related 320.15 allowable capital debt and interest costs. 320.16 (g) Notwithstanding Minnesota Rules, part 9549.0060, 320.17 subpart 11, item C, subitem (2), for a total replacement, as 320.18 defined in paragraph (f), authorized under section 144A.071 or 320.19 144A.073 after July 1, 1999, or any building project that is a 320.20 relocation, renovation, upgrading, or conversionauthorized320.21under section 144A.073,completed on or after July 1, 2001, the 320.22 replacement-costs-new per bed limit shall be $74,280 per 320.23 licensed bed in multiple-bed rooms, $92,850 per licensed bed in 320.24 semiprivate rooms with a fixed partition separating the resident 320.25 beds, and $111,420 per licensed bed in single rooms. Minnesota 320.26 Rules, part 9549.0060, subpart 11, item C, subitem (2), does not 320.27 apply. These amounts must be adjusted annually as specified in 320.28 subdivision 3f, paragraph (a), beginning January 1, 2000. 320.29 (h) For a total replacement, as defined in paragraph (f), 320.30 authorized under section 144A.073 for a 96-bed nursing home in 320.31 Carlton county, the replacement-costs-new per bed limit shall be 320.32 $74,280 per licensed bed in multiple-bed rooms, $92,850 per 320.33 licensed bed in semiprivate rooms with a fixed partition 320.34 separating the resident's beds, and $111,420 per licensed bed in 320.35 a single room. Minnesota Rules, part 9549.0060, subpart 11, 320.36 item C, subitem (2), does not apply. The resulting maximum 321.1 allowable replacement-costs-new multiplied by 1.25 shall 321.2 constitute the project's dollar threshold for purposes of 321.3 application of the limit set forth in section 144A.071, 321.4 subdivision 2. The commissioner of health may waive the 321.5 requirements of section 144A.073, subdivision 3b, paragraph (b), 321.6 clause (2), on the condition that the other requirements of that 321.7 paragraph are met. 321.8 (i) For a renovation authorized under section 144A.073 for 321.9 a 65-bed nursing home in St. Louis county, the incremental 321.10 increase in rental rate for purposes of paragraph (d) shall be 321.11 $8.16, and the total replacement cost, allowable appraised 321.12 value, allowable debt, and allowable interest shall be increased 321.13 according to the incremental increase. 321.14 (j) For a total replacement, as defined in paragraph (f), 321.15 authorized under section 144A.073 involving a new building 321.16 addition that relocates beds from three-bed wards for an 80-bed 321.17 nursing home in Redwood county, the replacement-costs-new per 321.18 bed limit shall be $74,280 per licensed bed for multiple-bed 321.19 rooms; $92,850 per licensed bed for semiprivate rooms with a 321.20 fixed partition separating the beds; and $111,420 per licensed 321.21 bed for single rooms. These amounts shall be adjusted annually, 321.22 beginning January 1, 2001. Minnesota Rules, part 9549.0060, 321.23 subpart 11, item C, subitem (2), does not apply. The resulting 321.24 maximum allowable replacement-costs-new multiplied by 1.25 shall 321.25 constitute the project's dollar threshold for purposes of 321.26 application of the limit set forth in section 144A.071, 321.27 subdivision 2. The commissioner of health may waive the 321.28 requirements of section 144A.073, subdivision 3b, paragraph (b), 321.29 clause (2), on the condition that the other requirements of that 321.30 paragraph are met. 321.31 Sec. 22. Minnesota Statutes 2000, section 256B.431, is 321.32 amended by adding a subdivision to read: 321.33 Subd. 31. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 321.34 years beginning on or after July 1, 2001, the total payment rate 321.35 for a facility reimbursed under this section, section 256B.434, 321.36 or any other section for the first 90 days after admission shall 322.1 be: 322.2 (1) for the first 30 paid days, the rate shall be 120 322.3 percent of the facility's medical assistance rate for each case 322.4 mix class; and 322.5 (2) for the next 60 days after the first 30 paid days, the 322.6 rate shall be 110 percent of the facility's medical assistance 322.7 rate for each case mix class. 322.8 (b) Beginning with the 91st paid day after admission, the 322.9 payment rate shall be the rate otherwise determined under this 322.10 section, section 256B.434, or any other section. 322.11 (c) This subdivision applies to admissions occurring on or 322.12 after July 1, 2001. 322.13 Sec. 23. Minnesota Statutes 2000, section 256B.431, is 322.14 amended by adding a subdivision to read: 322.15 Subd. 32. [NURSING FACILITY RATE INCREASES BEGINNING JULY 322.16 1, 2001, AND JULY 1, 2002.] For the rate years beginning July 1, 322.17 2001, and July 1, 2002, the commissioner shall make available to 322.18 each nursing facility reimbursed under this section or section 322.19 256B.434 an adjustment equal to 3.0 percent of the total 322.20 operating payment rate. The operating payment rates in effect 322.21 on June 30, 2001, and June 30, 2002, respectively, shall include 322.22 the adjustment in subdivision 2i, paragraph (c). 322.23 Sec. 24. Minnesota Statutes 2000, section 256B.431, is 322.24 amended by adding a subdivision to read: 322.25 Subd. 33. [ADDITIONAL INCREASES FOR LOW RATE METROPOLITAN 322.26 AREA FACILITIES.] After the calculation of the increase for the 322.27 rate year beginning July 1, 2001, in subdivision 31, the 322.28 commissioner must provide for special increases to facilities 322.29 determined to be the lowest rate facilities in state development 322.30 region 11, as defined in section 462.385. Within this region, 322.31 the commissioner shall identify the median nursing facility rate 322.32 by case mix category for all nursing facilities under section 322.33 256B.431 or 256B.434. Nursing home rates that are below the 322.34 median must be adjusted to the greater of their current rates or 322.35 98 percent of the region median. Certified boarding care home 322.36 rates that are below the median must be adjusted to the greater 323.1 of their current rates or 90 percent of the region median. 323.2 Sec. 25. Minnesota Statutes 2000, section 256B.431, is 323.3 amended by adding a subdivision to read: 323.4 Subd. 34. [RATE FLOOR FOR FACILITIES LOCATED OUTSIDE THE 323.5 METROPOLITAN AREA.] (a) For the rate year beginning July 1, 323.6 2001, the commissioner shall adjust operating costs per diem for 323.7 nursing facilities located outside of state development region 323.8 11, as defined in section 462.385, reimbursed under this section 323.9 and sections 256B.434 and 256B.435, as provided in this 323.10 subdivision. 323.11 (b) For each nursing facility, the commissioner shall 323.12 compare the operating costs per diem listed in this paragraph to 323.13 the operating costs per diem the facility would otherwise 323.14 receive for the July 1, 2001, rate year after provision of any 323.15 other rate increases required by this chapter. 323.16 Case mix classification Operating costs per diem 323.17 A $ 67.02 323.18 B $ 73.00 323.19 C $ 79.77 323.20 D $ 85.94 323.21 E $ 92.32 323.22 F $ 92.72 323.23 G $ 98.13 323.24 H $108.40 323.25 I $112.03 323.26 J $117.67 323.27 K $129.55 323.28 (c) If a facility's total reimbursement for operating 323.29 costs, using the case mix classification operating costs per 323.30 diem listed in paragraph (b), is greater than the total 323.31 reimbursement for operating costs the facility would otherwise 323.32 receive, the commissioner shall calculate operating costs per 323.33 diem for that facility for the rate year beginning July 1, 2001, 323.34 using the case mix classification operating costs per diem 323.35 listed in paragraph (b). 323.36 (d) If a facility's total reimbursement for operating 324.1 costs, using the case mix classification costs per diem listed 324.2 in paragraph (b), is less than the total reimbursement for 324.3 operating costs the facility would otherwise receive, the 324.4 commissioner shall reimburse that facility for the rate year 324.5 beginning July 1, 2001, as provided in this section, section 324.6 256B.434, or 256B.435, whichever is applicable, and shall not 324.7 calculate operating costs per diem for that facility using the 324.8 case mix classification operating costs per diem listed in 324.9 paragraph (b). 324.10 Sec. 26. Minnesota Statutes 2000, section 256B.431, is 324.11 amended by adding a subdivision to read: 324.12 Subd. 35. [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For 324.13 rate years beginning on or after July 1, 2001, in calculating a 324.14 nursing facility's operating cost per diem for the purposes of 324.15 constructing an array of nursing facility payment rates to be 324.16 used to determine future rate increases under this section, 324.17 section 256B.434, or any other section, the commissioner shall 324.18 exclude adjustments for raw food costs under subdivision 2b, 324.19 paragraph (h), that are related to providing special diets based 324.20 on religious beliefs. 324.21 Sec. 27. Minnesota Statutes 2000, section 256B.434, 324.22 subdivision 4, is amended to read: 324.23 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 324.24 nursing facilities which have their payment rates determined 324.25 under this section rather than section 256B.431, the 324.26 commissioner shall establish a rate under this subdivision. The 324.27 nursing facility must enter into a written contract with the 324.28 commissioner. 324.29 (b) A nursing facility's case mix payment rate for the 324.30 first rate year of a facility's contract under this section is 324.31 the payment rate the facility would have received under section 324.32 256B.431. 324.33 (c) A nursing facility's case mix payment rates for the 324.34 second and subsequent years of a facility's contract under this 324.35 section are the previous rate year's contract payment rates plus 324.36 an inflation adjustment and an adjustment to include the cost of 325.1 any increase in health department licensing fees for the 325.2 facility taking effect on or after July 1, 2001. The index for 325.3 the inflation adjustment must be based on the change in the 325.4 Consumer Price Index-All Items (United States City average) 325.5 (CPI-U) forecasted by Data Resources, Inc., as forecasted in the 325.6 fourth quarter of the calendar year preceding the rate year. 325.7 The inflation adjustment must be based on the 12-month period 325.8 from the midpoint of the previous rate year to the midpoint of 325.9 the rate year for which the rate is being determined. For the 325.10 rate years beginning on July 1, 1999,andJuly 1, 2000, July 1, 325.11 2001, and July 1, 2002, this paragraph shall apply only to the 325.12 property-related payment rate, except that adjustments to 325.13 include the cost of any increase in health department licensing 325.14 fees taking effect on or after July 1, 2001, shall be provided. 325.15 In determining the amount of the property-related payment rate 325.16 adjustment under this paragraph, the commissioner shall 325.17 determine the proportion of the facility's rates that are 325.18 property-related based on the facility's most recent cost report. 325.19 (d) The commissioner shall develop additional 325.20 incentive-based payments of up to five percent above the 325.21 standard contract rate for achieving outcomes specified in each 325.22 contract. The specified facility-specific outcomes must be 325.23 measurable and approved by the commissioner. The commissioner 325.24 may establish, for each contract, various levels of achievement 325.25 within an outcome. After the outcomes have been specified the 325.26 commissioner shall assign various levels of payment associated 325.27 with achieving the outcome. Any incentive-based payment cancels 325.28 if there is a termination of the contract. In establishing the 325.29 specified outcomes and related criteria the commissioner shall 325.30 consider the following state policy objectives: 325.31 (1) improved cost effectiveness and quality of life as 325.32 measured by improved clinical outcomes; 325.33 (2) successful diversion or discharge to community 325.34 alternatives; 325.35 (3) decreased acute care costs; 325.36 (4) improved consumer satisfaction; 326.1 (5) the achievement of quality; or 326.2 (6) any additional outcomes proposed by a nursing facility 326.3 that the commissioner finds desirable. 326.4 Sec. 28. Minnesota Statutes 2000, section 256B.434, is 326.5 amended by adding a subdivision to read: 326.6 Subd. 4c. [FACILITY RATE INCREASES EFFECTIVE JANUARY 1, 326.7 2002.] For the rate period beginning January 1, 2002, and for 326.8 the rate year beginning July 1, 2002, a nursing facility in 326.9 Morrison county licensed for 83 beds shall receive an increase 326.10 of $2.54 in each case mix payment rate to offset property tax 326.11 payments due as a result of the facility's conversion from 326.12 nonprofit to for-profit status. The increases under this 326.13 subdivision shall be added following the determination under 326.14 this chapter of the payment rate for the rate year beginning 326.15 July 1, 2001, and shall be included in the facility's total 326.16 payment rates for the purposes of determining future rates under 326.17 this section or any other section. 326.18 Sec. 29. Minnesota Statutes 2000, section 256B.434, is 326.19 amended by adding a subdivision to read: 326.20 Subd. 4d. [FACILITY RATE INCREASES EFFECTIVE JULY 1, 326.21 2001.] For the rate year beginning July 1, 2001, a nursing 326.22 facility in Hennepin county licensed for 302 beds shall receive 326.23 an increase of 29 cents in each case mix payment rate to correct 326.24 an error in the cost-reporting system that occurred prior to the 326.25 date that the facility entered the alternative payment 326.26 demonstration project. The increases under this subdivision 326.27 shall be added following the determination under this chapter of 326.28 the payment rate for the rate year beginning July 1, 2001, and 326.29 shall be included in the facility's total payment rates for the 326.30 purposes of determining future rates under this section or any 326.31 other section. 326.32 Sec. 30. Minnesota Statutes 2000, section 256B.434, is 326.33 amended by adding a subdivision to read: 326.34 Subd. 4e. [RATE INCREASE EFFECTIVE JULY 1, 2001.] A 326.35 nursing facility in Anoka county licensed for 98 beds as of July 326.36 1, 2000, shall receive an increase of $10 in each case mix rate 327.1 for the rate year beginning July 1, 2001. This increase shall 327.2 be included in the facility's total payment rate for purposes of 327.3 determining future rates under this section or any other section 327.4 through June 30, 2004. 327.5 Sec. 31. Minnesota Statutes 2000, section 256B.434, 327.6 subdivision 10, is amended to read: 327.7 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 327.8 federal law, (1) a facility that has entered into a contract 327.9 under this section is not required to file a cost report, as 327.10 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 327.11 year after the base year that is the basis for the calculation 327.12 of the contract payment rate for the first rate year of the 327.13 alternative payment demonstration project contract; and (2) a 327.14 facility under contract is not subject to audits of historical 327.15 costs or revenues, or paybacks or retroactive adjustments based 327.16 on these costs or revenues, except audits, paybacks, or 327.17 adjustments relating to the cost report that is the basis for 327.18 calculation of the first rate year under the contract. 327.19 (b)A facility that is under contract with the commissioner327.20under this section is not subject to the moratorium on licensure327.21or certification of new nursing home beds in section 144A.071,327.22unless the project results in a net increase in bed capacity or327.23involves relocation of beds from one site to another. Contract327.24payment rates must not be adjusted to reflect any additional327.25costs that a nursing facility incurs as a result of a327.26construction project undertaken under this paragraph. In327.27addition, as a condition of entering into a contract under this327.28section, a nursing facility must agree that any future medical327.29assistance payments for nursing facility services will not327.30reflect any additional costs attributable to the sale of a327.31nursing facility under this section and to construction327.32undertaken under this paragraph that otherwise would not be327.33authorized under the moratorium in section 144A.073. Nothing in327.34this section prevents a nursing facility participating in the327.35alternative payment demonstration project under this section327.36from seeking approval of an exception to the moratorium through328.1the process established in section 144A.073, and if approved the328.2facility's rates shall be adjusted to reflect the cost of the328.3project. Nothing in this section prevents a nursing facility328.4participating in the alternative payment demonstration project328.5from seeking legislative approval of an exception to the328.6moratorium under section 144A.071, and, if enacted, the328.7facility's rates shall be adjusted to reflect the cost of the328.8project.328.9(c)Notwithstanding section 256B.48, subdivision 6, 328.10 paragraphs (c), (d), and (e), and pursuant to any terms and 328.11 conditions contained in the facility's contract, a nursing 328.12 facility that is under contract with the commissioner under this 328.13 section is in compliance with section 256B.48, subdivision 6, 328.14 paragraph (b), if the facility is Medicare certified. 328.15(d)(c) Notwithstanding paragraph (a), if by April 1, 1996, 328.16 the health care financing administration has not approved a 328.17 required waiver, or the health care financing administration 328.18 otherwise requires cost reports to be filed prior to the 328.19 waiver's approval, the commissioner shall require a cost report 328.20 for the rate year. 328.21(e)(d) A facility that is under contract with the 328.22 commissioner under this section shall be allowed to change 328.23 therapy arrangements from an unrelated vendor to a related 328.24 vendor during the term of the contract. The commissioner may 328.25 develop reasonable requirements designed to prevent an increase 328.26 in therapy utilization for residents enrolled in the medical 328.27 assistance program. 328.28 Sec. 32. [256B.437] [IMPLEMENTATION OF A CASE MIX SYSTEM 328.29 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 328.30 Subdivision 1. [SCOPE.] This section establishes the 328.31 method and criteria used to determine resident reimbursement 328.32 classifications based upon the assessments of residents of 328.33 nursing homes and boarding care homes whose payment rates are 328.34 established under section 256B.431, 256B.434, or 256B.435. 328.35 Resident reimbursement classifications shall be established 328.36 according to the 34 group, resource utilization groups, version 329.1 III or RUG-III model as described in section 144.0724. 329.2 Reimbursement classifications established under this section 329.3 shall be implemented after June 30, 2002, but no later than 329.4 January 1, 2003. 329.5 Subd. 2. [DEFINITIONS.] For purposes of this section, the 329.6 following terms have the meanings given. 329.7 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 329.8 date" has the meaning given in section 144.0724, subdivision 2, 329.9 paragraph (a). 329.10 (b) [CASE MIX INDEX.] "Case mix index" has the meaning 329.11 given in section 144.0724, subdivision 2, paragraph (b). 329.12 (c) [INDEX MAXIMIZATION.] "Index maximization" has the 329.13 meaning given in section 144.0724, subdivision 2, paragraph (c). 329.14 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 329.15 given in section 144.0724, subdivision 2, paragraph (d). 329.16 (e) [REPRESENTATIVE.] "Representative" has the meaning 329.17 given in section 144.0724, subdivision 2, paragraph (e). 329.18 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 329.19 utilization groups" or "RUG" has the meaning given in section 329.20 144.0724, subdivision 2, paragraph (f). 329.21 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human 329.22 services shall assign a case mix index to each resident class 329.23 based on the Health Care Financing Administration's staff time 329.24 measurement study and adjusted for Minnesota-specific wage 329.25 indices. The case mix indices assigned to each resident class 329.26 shall be published in the Minnesota State Register at least 120 329.27 days prior to the implementation of the 34 group, RUG-III 329.28 resident classification system. 329.29 (b) An index maximization approach shall be used to 329.30 classify residents. 329.31 (c) After implementation of the revised case mix system, 329.32 the commissioner of human services may annually rebase case mix 329.33 indices and base rates using more current data on average wage 329.34 rates and staff time measurement studies. This rebasing shall 329.35 be calculated under subdivision 7, paragraph (b). The 329.36 commissioner shall publish in the Minnesota State Register 330.1 adjusted case mix indices at least 45 days prior to the 330.2 effective date of the adjusted case mix indices. 330.3 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 330.4 facilities shall conduct and submit case mix assessments 330.5 according to the schedule established by the commissioner of 330.6 health under section 144.0724, subdivisions 4 and 5. 330.7 (b) The resident reimbursement classifications established 330.8 under section 144.0724, subdivision 3, shall be effective the 330.9 day of admission for new admission assessments. The effective 330.10 date for significant change assessments shall be the assessment 330.11 reference date. The effective date for annual and second 330.12 quarterly assessments shall be the first day of the month 330.13 following assessment reference date. 330.14 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT 330.15 CLASSIFICATION.] Nursing facilities shall provide notice to a 330.16 resident of the resident's case mix classification according to 330.17 procedures established by the commissioner of health under 330.18 section 144.0724, subdivision 7. 330.19 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 330.20 request for reconsideration of a resident classification must be 330.21 made under section 144.0724, subdivision 8. 330.22 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III 330.23 PAYMENT RATES.] (a) The commissioner of human services shall 330.24 determine payment rates at the time of transition to the RUG 330.25 based payment model in a facility-specific, budget-neutral 330.26 manner. The case mix indices as defined in subdivision 3 shall 330.27 be used to allocate the case mix adjusted component of total 330.28 payment across all case mix groups. To transition from the 330.29 current calculation methodology to the RUG based methodology, 330.30 the commissioner of health shall report to the commissioner of 330.31 human services the resident days classified according to the 330.32 categories defined in subdivision 3 for the 12-month reporting 330.33 period ending September 30, 2001, for each nursing facility. 330.34 The commissioner of human services shall use this data to 330.35 compute the standardized days for the reporting period under the 330.36 RUG system. 331.1 (b) The commissioner of human services shall determine the 331.2 case mix adjusted component of the rate as follows: 331.3 (1) determine the case mix portion of the 11 case mix rates 331.4 in effect on June 30, 2002, or the 34 case mix rates in effect 331.5 on or after June 30, 2003; 331.6 (2) multiply each amount in clause (1) by the number of 331.7 resident days assigned to each group for the reporting period 331.8 ending September 30, 2001, or the most recent year for which 331.9 data is available; 331.10 (3) compute the sum of the amounts in clause (2); 331.11 (4) determine the total RUG standardized days for the 331.12 reporting period ending September 30, 2001, or the most recent 331.13 year for which data is available using new indices calculated 331.14 under subdivision 3, paragraph (c); 331.15 (5) divide the amount in clause (3) by the amount in clause 331.16 (4) which shall be the average case mix adjusted component of 331.17 the rate under the RUG method; and 331.18 (6) multiply this average rate by the case mix weight in 331.19 subdivision 3 for each RUG group. 331.20 (c) The noncase mix component will be allocated to each RUG 331.21 group as a constant amount to determine the transition payment 331.22 rate. Any other rate adjustments that are effective on or after 331.23 July 1, 2002, shall be applied to the transition rates 331.24 determined under this section. 331.25 Sec. 33. [256B.4371] [NURSING FACILITY VOLUNTARY CLOSURES 331.26 AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 331.27 Subdivision 1. [DEFINITIONS.] (a) The definitions in this 331.28 subdivision apply to subdivisions 2 to 9. 331.29 (b) "Closure" means the cessation of operations of a 331.30 nursing facility and delicensure and decertification of all beds 331.31 within the facility. 331.32 (c) "Commencement of closure" means the date on which 331.33 residents and designated representatives are notified of a 331.34 planned closure according to sections 144A.185 to 144A.1887 as 331.35 part of an approved closure plan. 331.36 (d) "Completion of closure" means the date on which the 332.1 final resident of the nursing facility or nursing facilities 332.2 designated for closure in an approved closure plan is discharged 332.3 from the facility or facilities. 332.4 (e) "Closure plan" means a plan to close a nursing facility 332.5 and reallocate the resulting savings to provide planned closure 332.6 rate adjustments at other facilities. 332.7 (f) "Partial closure" means the delicensure and 332.8 decertification of a portion of the beds within the facility. 332.9 (g) "Planned closure rate adjustment" means an increase in 332.10 a nursing facility's operating rates resulting from a partial 332.11 planned closure of a facility or a planned closure of another 332.12 facility. 332.13 Subd. 2. [PLANNING AND DEVELOPMENT OF COMMUNITY BASED 332.14 SERVICES.] 332.15 (a) The commissioner of human services shall establish a 332.16 process to adjust the capacity and distribution of long-term 332.17 care services to equalize the supply and demand for different 332.18 types of services. This process must include community 332.19 planning, expansion or establishment of needed services, and 332.20 analysis of voluntary nursing facility closures. 332.21 (b) The purpose of this process is to support the planning 332.22 and development of community-based services. This process must 332.23 support early intervention, advocacy, and consumer protection 332.24 while providing resources and incentives for expanded county 332.25 planning and for nursing facilities to transition to meet 332.26 community needs. 332.27 (c) The process shall support and facilitate expansion of 332.28 community-based services under the county-administered 332.29 alternative care program under section 256B.0913 and waivers for 332.30 elderly under section 256B.0915, including the development of 332.31 supportive services such as housing and transportation. The 332.32 process shall utilize community assessments and planning 332.33 developed for the community health services plan and plan update 332.34 and for the community social services act plan. 332.35 (d) The addendum to the biennial plan shall be submitted 332.36 annually, beginning in 2001, and shall include recommendations 333.1 for development of community-based services. Both planning and 333.2 implementation shall be implemented within the amount of funding 333.3 made available to the county board for these purposes. 333.4 (e) The commissioner of health and the commissioner of 333.5 human services, as appropriate, shall provide available data 333.6 necessary for the county, including but not limited to data on 333.7 nursing facility bed distribution, housing with services 333.8 options, the closure of nursing facilities that occur outside of 333.9 the planned closure process, and approval of planned closures in 333.10 the county and contiguous counties. 333.11 (f) The plan, within the funding allocated, shall: 333.12 (1) identify the need for services based on demographic 333.13 data, service availability, caseload information, and provider 333.14 information; 333.15 (2) involve providers, consumers, cities, townships, 333.16 businesses, and area agencies on aging in the planning process; 333.17 (3) address the availability of alternative care and 333.18 elderly waiver services for eligible recipients; 333.19 (4) address the development of other supportive services, 333.20 such as transit, housing, and workforce and economic 333.21 development; and 333.22 (5) estimate the cost and timelines for development. 333.23 (g) The biennial plan addendum shall be coordinated with 333.24 the county mental health plan for inclusion in the community 333.25 health services plan and included as an addendum to the 333.26 community social services plan. 333.27 (h) The county board having financial responsibility for 333.28 persons present in another county shall cooperate with that 333.29 county for planning and development of services. 333.30 (i) The county board shall cooperate in planning and 333.31 development of community based services with other counties, as 333.32 necessary, and coordinate planning for long-term care services 333.33 that involve more than one county, within the funding allocated 333.34 for these purposes. 333.35 (j) The commissioners of health and human services, in 333.36 cooperation with county boards, shall report to the legislature 334.1 by February 1 of each year, beginning February 1, 2002, 334.2 regarding the development of community based services, 334.3 transition or closure of nursing facilities, and consumer 334.4 outcomes achieved, as documented by each county and reported to 334.5 the commissioner by December 31 of each year. 334.6 (k) The process established by the commissioner of human 334.7 services shall ensure: 334.8 (1) that counties consider multicounty service areas in 334.9 developing services that may impact delivery efficiencies; and 334.10 (2) review and comment by the area agencies on aging, 334.11 regional development commissions, where they exist, and other 334.12 planning agencies of the biennial plan addendum. 334.13 Subd. 3. [REQUEST FOR APPLICATIONS FOR PLANNED CLOSURE OF 334.14 NURSING FACILITIES.] (a) By July 15, 2001, the commissioner of 334.15 human services shall implement and announce a program for 334.16 closure or partial closure of nursing facilities. Names and 334.17 identifying information provided in response to the announcement 334.18 shall remain private unless approved, according to the timelines 334.19 established in the plan. The announcement must specify: 334.20 (1) the criteria that will be used by the interagency 334.21 long-term care planning committee established under section 334.22 144A.31 and the commissioner to approve or reject applications; 334.23 (2) a requirement for the submission of a letter of intent 334.24 before the submission of an application; 334.25 (3) the information that must accompany an application; 334.26 (4) a schedule for letters of intent, applications, and 334.27 consideration of applications for a minimum of four review 334.28 processes to be conducted before June 30, 2003; and 334.29 (5) that applications may combine planned closure rate 334.30 adjustments with moratorium exception funding, in which case a 334.31 single application may serve both purposes. 334.32 Between October 1, 2001, and June 30, 2003, the commissioner 334.33 shall approve planned closures of at least 5,140 nursing 334.34 facility beds, with no more than 2,070 approved for closure 334.35 prior to July 1, 2002, less the number of licensed beds in 334.36 facilities that close during the same time period without 335.1 approved closure plans or have notified the commissioner of 335.2 health of their intent to close without an approved closure plan. 335.3 (b) A facility or facilities reimbursed under section 335.4 256B.431, 256B.434, or 256B.435 with a closure plan approved by 335.5 the commissioner under subdivision 6 may assign a planned 335.6 closure rate adjustment to another facility that is not closing 335.7 or facilities that are not closing, or in the case of a partial 335.8 closure, to the facility undertaking the partial closure. A 335.9 facility may also elect to have a planned closure rate 335.10 adjustment shared equally by the five nursing facilities with 335.11 the lowest total operating payment rates in the state 335.12 development region, designated under section 462.385, in which 335.13 the facility receiving the planned closure rate adjustment is 335.14 located. The planned closure rate adjustment must be calculated 335.15 under subdivision 7. A planned closure rate adjustment under 335.16 this section is effective on the first day of the month 335.17 following completion of closure of all facilities designated for 335.18 closure in the application and becomes part of the nursing 335.19 facility's total operating payment rate. 335.20 Applicants may use the planned closure rate adjustment to 335.21 allow for a property payment for a new nursing facility or an 335.22 addition to an existing nursing facility. Applications approved 335.23 under this paragraph are exempt from other requirements for 335.24 moratorium exceptions under section 144A.073, subdivisions 2 and 335.25 3. 335.26 Facilities without a closure plan, or whose closure plan is 335.27 not approved by the commissioner, are not eligible for a planned 335.28 closure rate adjustment under subdivision 7. However, the 335.29 commissioner shall calculate the amount the facility would have 335.30 received under subdivision 7 and shall use this amount to 335.31 provide equal rate adjustments to the five nursing facilities 335.32 with the lowest total operating payment rates in the state 335.33 development region, designated under section 462.385, in which 335.34 the facility is located. 335.35 (c) To be considered for approval, an application must 335.36 include: 336.1 (1) a description of the proposed closure plan, which must 336.2 include identification of the facility or facilities to receive 336.3 a planned closure rate adjustment and the amount and timing of a 336.4 planned closure rate adjustment proposed for each facility; 336.5 (2) the proposed timetable for any proposed closure, 336.6 including the proposed dates for announcement to residents, 336.7 commencement of closure, and completion of closure; 336.8 (3) the proposed relocation plan for current residents of 336.9 any facility designated for closure. The proposed relocation 336.10 plan must be designed to comply with all applicable state and 336.11 federal statutes and regulations, including, but not limited to, 336.12 section 144A.16 and Minnesota Rules, parts 4655.6810 to 336.13 4655.6830, 4658.1600 to 4658.1690, and 9546.0010 to 9546.0060; 336.14 (4) a description of the relationship between the nursing 336.15 facility that is proposed for closure and the nursing facility 336.16 or facilities proposed to receive the planned closure rate 336.17 adjustment. If these facilities are not under common ownership, 336.18 copies of any contracts, purchase agreements, or other documents 336.19 establishing a relationship or proposed relationship must be 336.20 provided; 336.21 (5) documentation, in a format approved by the 336.22 commissioner, that all the nursing facilities receiving a 336.23 planned closure rate adjustment under the plan have accepted 336.24 joint and several liability for recovery of overpayments under 336.25 section 256B.0641, subdivision 2, for the facilities designated 336.26 for closure under the plan; and 336.27 (6) an explanation of how the application coordinates with 336.28 planning efforts under subdivision 2. 336.29 (d) The application must address the criteria listed in 336.30 subdivision 4. 336.31 Subd. 4. [CRITERIA FOR REVIEW OF APPLICATION.] In 336.32 reviewing and approving closure proposals, the commissioner 336.33 shall consider, but not be limited to, the following criteria: 336.34 (1) improved quality of care and quality of life for 336.35 consumers; 336.36 (2) closure of a nursing facility that has a poor physical 337.1 plant; 337.2 (3) the existence of excess nursing facility beds, measured 337.3 in terms of beds per thousand persons aged 85 or older. The 337.4 excess must be measured in reference to: 337.5 (i) the county in which the facility is located; 337.6 (ii) the county and all contiguous counties; 337.7 (iii) the region in which the facility is located; or 337.8 (iv) the facility's service area. 337.9 The facility shall indicate in its proposal the area it believes 337.10 is appropriate for this measurement. A facility in a county 337.11 that is in the lowest quartile of counties with reference to 337.12 beds per thousand persons aged 85 or older is not in an area of 337.13 excess capacity; 337.14 (4) low-occupancy rates, provided that the unoccupied beds 337.15 are not the result of a personnel shortage. In analyzing 337.16 occupancy rates, the commissioner shall examine waiting lists in 337.17 the applicant facility and at facilities in the surrounding 337.18 area, as determined under clause (3); 337.19 (5) evidence of a community planning process to determine 337.20 what services are needed and ensure that needed services are 337.21 established; 337.22 (6) innovative use of reinvestment funds; 337.23 (7) innovative use planned for the closed facility's 337.24 physical plant; 337.25 (8) evidence that the proposal serves the interests of the 337.26 state; and 337.27 (9) evidence of other factors that affect the viability of 337.28 the facility, including excessive nursing pool costs. 337.29 Subd. 5. [REVIEW AND APPROVAL OF PROPOSALS.] (a) The 337.30 interagency long-term care planning committee may recommend that 337.31 the commissioner of human services grant approval, within the 337.32 limits established in subdivision 3, paragraph (a), to 337.33 applications that satisfy the requirements of this section. The 337.34 interagency committee may appoint an advisory review panel 337.35 composed of representatives of counties, SAIL projects, 337.36 consumers, and providers to review proposals and provide 338.1 comments and recommendations to the committee. The 338.2 commissioners of human services and health shall provide staff 338.3 and technical assistance to the committee for the review and 338.4 analysis of proposals. The commissioners of human services and 338.5 health shall jointly approve or disapprove an application within 338.6 30 days after receiving the committee's recommendations. 338.7 (b) Approval of a planned closure expires 18 months after 338.8 approval by the commissioner of human services, unless 338.9 commencement of closure has begun. 338.10 (c) The commissioner of human services may change any 338.11 provision of the application to which all parties agree. 338.12 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] The 338.13 commissioner of human services shall calculate the amount of the 338.14 planned closure rate adjustment available under subdivision 3, 338.15 paragraph (b), according to clauses (1) to (4): 338.16 (1) the amount available is the net reduction of nursing 338.17 facility beds multiplied by $2,080; 338.18 (2) the total number of beds in the nursing facility 338.19 receiving the planned closure rate adjustment must be 338.20 identified; 338.21 (3) capacity days are determined by multiplying the number 338.22 determined under clause (2) by 365; and 338.23 (4) the planned closure rate adjustment is the amount 338.24 available in clause (1), divided by capacity days determined 338.25 under clause (3). 338.26 Subd. 7. [OTHER RATE ADJUSTMENTS.] Facilities receiving 338.27 planned closure rate adjustments remain eligible for any 338.28 applicable rate adjustments provided under section 256B.431, 338.29 256B.434, or any other section. 338.30 Subd. 8. [COUNTY COSTS.] The commissioner of human 338.31 services shall allocate up to $500 per nursing facility bed that 338.32 is closing, within the limits of the appropriation specified for 338.33 this purpose, to be used for relocation costs incurred by 338.34 counties for planned closures under this section or resident 338.35 relocation under sections 144A.185 to 144A.1887. To be eligible 338.36 for this allocation, a county in which a nursing facility closes 339.1 must provide to the commissioner a detailed statement in a form 339.2 provided by the commissioner of additional costs, not to exceed 339.3 $500 per bed closed, that are directly incurred related to the 339.4 county's required role in the relocation process. 339.5 Sec. 34. Minnesota Statutes 2000, section 256B.501, is 339.6 amended by adding a subdivision to read: 339.7 Subd. 14. [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 339.8 AND JULY 1, 2002.] (a) For the rate periods beginning July 1, 339.9 2001, and July 1, 2002, the commissioner shall make available to 339.10 each facility reimbursed under this section, section 256B.5011, 339.11 and Laws 1993, First Special Session chapter 1, article 4, 339.12 section 11, an adjustment to the total operating payment rate of 339.13 3.0 percent. 339.14 (b) For each facility, the commissioner shall determine the 339.15 payment rate adjustment using the percentage specified in 339.16 paragraph (a) multiplied by the total operating payment rate in 339.17 effect on the last day of the prior rate year, and dividing the 339.18 resulting amount by the facility's actual resident days. The 339.19 total operating payment rate shall include the adjustment 339.20 provided in subdivision 12. 339.21 (c) Any facility whose payment rates are governed by 339.22 closure agreements, receivership agreements, or Minnesota Rules, 339.23 part 9553.0075, is not eligible for an adjustment otherwise 339.24 granted under this subdivision. 339.25 Sec. 35. Minnesota Statutes 2000, section 256B.76, is 339.26 amended to read: 339.27 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 339.28 (a) Effective for services rendered on or after October 1, 339.29 1992, the commissioner shall make payments for physician 339.30 services as follows: 339.31 (1) payment for level one Health Care Finance 339.32 Administration's common procedural coding system (HCPCS) codes 339.33 titled "office and other outpatient services," "preventive 339.34 medicine new and established patient," "delivery, antepartum, 339.35 and postpartum care," "critical care,"Caesareancesarean 339.36 delivery and pharmacologic management provided to psychiatric 340.1 patients, and HCPCS level three codes for enhanced services for 340.2 prenatal high risk, shall be paid at the lower of (i) submitted 340.3 charges, or (ii) 25 percent above the rate in effect on June 30, 340.4 1992. If the rate on any procedure code within these categories 340.5 is different than the rate that would have been paid under the 340.6 methodology in section 256B.74, subdivision 2, then the larger 340.7 rate shall be paid; 340.8 (2) payments for all other services shall be paid at the 340.9 lower of (i) submitted charges, or (ii) 15.4 percent above the 340.10 rate in effect on June 30, 1992; 340.11 (3) all physician rates shall be converted from the 50th 340.12 percentile of 1982 to the 50th percentile of 1989, less the 340.13 percent in aggregate necessary to equal the above increases 340.14 except that payment rates for home health agency services shall 340.15 be the rates in effect on September 30, 1992; 340.16 (4) effective for services rendered on or after January 1, 340.17 2000, payment rates for physician and professional services 340.18 shall be increased by three percent over the rates in effect on 340.19 December 31, 1999, except for home health agency and family 340.20 planning agency services; and 340.21 (5) the increases in clause (4) shall be implemented 340.22 January 1, 2000, for managed care. 340.23 (b) Effective for services rendered on or after October 1, 340.24 1992, the commissioner shall make payments for dental services 340.25 as follows: 340.26 (1) dental services shall be paid at the lower of (i) 340.27 submitted charges, or (ii) 25 percent above the rate in effect 340.28 on June 30, 1992; 340.29 (2) dental rates shall be converted from the 50th 340.30 percentile of 1982 to the 50th percentile of 1989, less the 340.31 percent in aggregate necessary to equal the above increases; 340.32 (3) effective for services rendered on or after January 1, 340.33 2000, payment rates for dental services shall be increased by 340.34 three percent over the rates in effect on December 31, 1999; 340.35 (4) the commissioner shall award grants to community 340.36 clinics or other nonprofit community organizations, political 341.1 subdivisions, professional associations, or other organizations 341.2 that demonstrate the ability to provide dental services 341.3 effectively to public program recipients. Grants may be used to 341.4 fund the costs related to coordinating access for recipients, 341.5 developing and implementing patient care criteria, upgrading or 341.6 establishing new facilities, acquiring furnishings or equipment, 341.7 recruiting new providers, or other development costs that will 341.8 improve access to dental care in a region. In awarding grants, 341.9 the commissioner shall give priority to applicants that plan to 341.10 serve areas of the state in which the number of dental providers 341.11 is not currently sufficient to meet the needs of recipients of 341.12 public programs or uninsured individuals. The commissioner 341.13 shall consider the following in awarding the grants: (i) 341.14 potential to successfully increase access to an underserved 341.15 population; (ii) the ability to raise matching funds; (iii) the 341.16 long-term viability of the project to improve access beyond the 341.17 period of initial funding; (iv) the efficiency in the use of the 341.18 funding; and (v) the experience of the proposers in providing 341.19 services to the target population. 341.20 The commissioner shall monitor the grants and may terminate 341.21 a grant if the grantee does not increase dental access for 341.22 public program recipients. The commissioner shall consider 341.23 grants for the following: 341.24 (i) implementation of new programs or continued expansion 341.25 of current access programs that have demonstrated success in 341.26 providing dental services in underserved areas; 341.27 (ii) a pilot program for utilizing hygienists outside of a 341.28 traditional dental office to provide dental hygiene services; 341.29 and 341.30 (iii) a program that organizes a network of volunteer 341.31 dentists, establishes a system to refer eligible individuals to 341.32 volunteer dentists, and through that network provides donated 341.33 dental care services to public program recipients or uninsured 341.34 individuals. 341.35 (5) beginning October 1, 1999, the payment for tooth 341.36 sealants and fluoride treatments shall be the lower of (i) 342.1 submitted charge, or (ii) 80 percent of median 1997 charges; and 342.2 (6) the increases listed in clauses (3) and (5) shall be 342.3 implemented January 1, 2000, for managed care. 342.4 (c) An entity that operates both a Medicare certified 342.5 comprehensive outpatient rehabilitation facility and a facility 342.6 which was certified prior to January 1, 1993, that is licensed 342.7 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 342.8 whom at least 33 percent of the clients receiving rehabilitation 342.9 services and mental health services in the most recent calendar 342.10 year are medical assistance recipients, shall be reimbursed by 342.11 the commissioner for rehabilitation services and mental health 342.12 services at rates that are 38 percent greater than the maximum 342.13 reimbursement rate allowed under paragraph (a), clause (2), when 342.14 those services are (1) provided within the comprehensive 342.15 outpatient rehabilitation facility and (2) provided to residents 342.16 of nursing facilities owned by the entity. 342.17 Sec. 36. Laws 1995, chapter 207, article 3, section 21, as 342.18 amended by Laws 1999, chapter 245, article 3, section 43, is 342.19 amended to read: 342.20 Sec. 21. [FACILITY CERTIFICATION.] 342.21 (a) Notwithstanding Minnesota Statutes, section 252.291, 342.22 subdivisions 1 and 2, the commissioner of health shall inspect 342.23 to certify a large community-based facility currently licensed 342.24 under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 342.25 than 16 beds and located in Northfield. The facility may be 342.26 certified for up to 44 beds. The commissioner of health must 342.27 inspect to certify the facility as soon as possible after the 342.28 effective date of this section. The commissioner of human 342.29 services shall work with the facility and affected counties to 342.30 relocate any current residents of the facility who do not meet 342.31 the admission criteria for an ICF/MR. Until January 1, 1999, in 342.32 order to fund the ICF/MR services and relocations of current 342.33 residents authorized, the commissioner of human services may 342.34 transfer on a quarterly basis to the medical assistance account 342.35 from each affected county's community social service allocation, 342.36 an amount equal to the state share of medical assistance 343.1 reimbursement for the residential and day habilitation services 343.2 funded by medical assistance and provided to clients for whom 343.3 the county is financially responsible. 343.4 (b) After January 1, 1999, the commissioner of human 343.5 services shall fund the services under the state medical 343.6 assistance program and may transfer on a quarterly basis to the 343.7 medical assistance account from each affected county's community 343.8 social service allocation, an amount equal to one-half of the 343.9 state share of medical assistance reimbursement for the 343.10 residential and day habilitation services funded by medical 343.11 assistance and provided to clients for whom the county is 343.12 financially responsible. 343.13 (c) Effective July 1, 2001, the commissioner of human 343.14 services shall fund the entire state share of medical assistance 343.15 reimbursement for the residential and day habilitation services 343.16 funded by medical assistance and provided to clients for whom 343.17 counties are financially responsible from the medical assistance 343.18 account, and shall not make any transfer from the community 343.19 social service allocations of affected counties. 343.20 (d) For nonresidents of Minnesota seeking admission to the 343.21 facility, Rice county shall be notified in order to assure that 343.22 appropriate funding is guaranteed from their state or country of 343.23 residence. 343.24 Sec. 37. Laws 1999, chapter 245, article 3, section 45, as 343.25 amended by Laws 2000, chapter 312, section 3, is amended to read: 343.26 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 343.27 REGULATIONS.] 343.28 (a) Notwithstanding the provisions of Minnesota Rules, part 343.29 4658.0520, an incontinent resident must be checked according to 343.30 a specific time interval written in the resident's care plan. 343.31 The resident's attending physician must authorize in writing any 343.32 interval longer than two hours unless the resident, if 343.33 competent, or a family member or legally appointed conservator, 343.34 guardian, or health care agent of a resident who is not 343.35 competent, agrees in writing to waive physician involvement in 343.36 determining this interval. 344.1 (b) This section expires July 1,20012003. 344.2 Sec. 38. [DEVELOPMENT OF NEW NURSING FACILITY 344.3 REIMBURSEMENT SYSTEM.] 344.4 (a) The commissioner of human services shall develop and 344.5 report to the legislature by January 15, 2003, a system to 344.6 replace the current nursing facility reimbursement system 344.7 established under Minnesota Statutes, sections 256B.431, 344.8 256B.434, and 256B.435. 344.9 (b) The system must be developed in consultation with the 344.10 long-term care task force and with representatives of consumers, 344.11 providers, and labor unions. Within the limits of available 344.12 appropriations, the commissioner may employ consultants to 344.13 assist with this project. 344.14 (c) The new reimbursement system must: 344.15 (1) provide incentives to enhance quality of life and 344.16 quality of care; 344.17 (2) recognize cost differences in the care of different 344.18 types of populations, including subacute care and dementia care; 344.19 (3) establish rates that are sufficient without being 344.20 excessive; 344.21 (4) be affordable for the state and for private-pay 344.22 residents; 344.23 (5) be sensitive to changing conditions in the long-term 344.24 care environment; 344.25 (6) avoid creating access problems related to insufficient 344.26 funding; 344.27 (7) allow providers maximum flexibility in their business 344.28 operations; 344.29 (8) recognize the need for capital investment to improve 344.30 physical plants; and 344.31 (9) provide incentives for the development and use of 344.32 private rooms. 344.33 (d) Notwithstanding Minnesota Statutes, section 256B.435, 344.34 the commissioner must not implement a performance-based 344.35 contracting system for nursing facilities prior to July 1, 2003. 344.36 The commissioner shall continue to reimburse nursing facilities 345.1 under Minnesota Statutes, section 256B.431 or 256B.434, until 345.2 otherwise directed by law. 345.3 (e) The commissioner of human services, in consultation 345.4 with the commissioner of health, shall conduct or contract for a 345.5 time study to determine staff time being spent on various case 345.6 mix categories; recommend adjustments to the case mix weights 345.7 based on the time study data; and determine whether current 345.8 staffing standards are adequate for providing quality care based 345.9 on professional best practice and consumer experience. If the 345.10 commissioner determines the current standards are inadequate, 345.11 the commissioner shall determine an appropriate staffing 345.12 standard for the various case mix categories and the financial 345.13 implications of phasing into this standard over the next four 345.14 years. 345.15 Sec. 39. [REPORT ON STANDARDS FOR SUBACUTE CARE FACILITY 345.16 LICENSURE.] 345.17 By January 15, 2003, the commissioner of health shall 345.18 submit a report to the legislature on implementation of a 345.19 licensure program for subacute care. This report must include: 345.20 (1) definitions of subacute care and applicability of the 345.21 proposed licensure program to various types of licensed 345.22 facilities; 345.23 (2) an analysis of whether specific standards for subacute 345.24 levels of care need to be developed and the potential for 345.25 increased costs for existing providers of subacute care; 345.26 (3) recommendations on the applicability of the nursing 345.27 home moratorium law to the licensure of subacute care facilities 345.28 or programs; 345.29 (4) identification of federal regulations guiding the 345.30 provision of subacute care and whether further state standards 345.31 are needed; and 345.32 (5) identification of current and potential reimbursement 345.33 for subacute care under Medicare, Medicaid, or managed care 345.34 programs. 345.35 Sec. 40. [REGULATORY FLEXIBILITY.] 345.36 (a) By July 1, 2001, the commissioners of health and human 346.1 services shall: 346.2 (1) develop a summary of federal nursing facility and 346.3 community long-term care regulations that hamper state 346.4 flexibility and place burdens on the goal of achieving 346.5 high-quality care and optimum outcomes for consumers of 346.6 services; and 346.7 (2) share this summary with the legislature, other states, 346.8 national groups that advocate for state interests with Congress, 346.9 and the Minnesota congressional delegation. 346.10 (b) The commissioners shall conduct ongoing follow-up with 346.11 the entities to which this summary is provided and with the 346.12 health care financing administration to achieve maximum 346.13 regulatory flexibility, including the possibility of pilot 346.14 projects to demonstrate regulatory flexibility on less than a 346.15 statewide basis. 346.16 Sec. 41. [REPORT.] 346.17 By January 15, 2003, the commissioner of health and the 346.18 commissioner of human services shall report to the senate health 346.19 and family security committee and the house health and human 346.20 services policy committee on the number of closures that have 346.21 taken place under Minnesota Statutes, section 256B.437, and any 346.22 other nursing facility closures that may have taken place, 346.23 alternatives to nursing facility care that have been developed, 346.24 any problems with access to long-term care services that have 346.25 resulted, and any recommendations for continuation of the 346.26 regional long-term care planning process and the closure process 346.27 after June 30, 2003. 346.28 Sec. 42. [NURSING ASSISTANT; HOME HEALTH AIDE CURRICULUM.] 346.29 By January 1, 2003, the commissioner of health, in 346.30 consultation with long-term care consumers, advocates, unions, 346.31 and trade associations, shall present to the chairs of the 346.32 legislative committees dealing with health care policy 346.33 recommendations for updating the nursing assistant and home 346.34 health aide curriculum (1998 edition) to help students learn 346.35 front-line survival skills that support job motivation and 346.36 satisfaction. These skills include, but are not limited to, 347.1 working with challenging behaviors, communication skills, stress 347.2 management including the impact of personal life stress in the 347.3 work setting, building relationships with families, cultural 347.4 competencies, and working with death and dying. 347.5 Sec. 43. [EVALUATION OF REPORTING REQUIREMENTS.] 347.6 The commissioners of human services and health, in 347.7 consultation with interested parties, shall evaluate long-term 347.8 care provider reporting requirements, balancing the need for 347.9 public accountability with the need to reduce unnecessary 347.10 paperwork, and shall eliminate unnecessary reporting 347.11 requirements, seeking any necessary changes in federal and state 347.12 law. The commissioners shall present a progress report by 347.13 February 1, 2002, to the chairs of the house and senate 347.14 committees with jurisdiction over health and human services 347.15 policy and finance. 347.16 Sec. 44. [NURSING FACILITY MULTIPLE SCLEROSIS PILOT 347.17 PROJECT.] 347.18 (a) For the period from July 1, 2001, to June 30, 2003, the 347.19 commissioner of human services shall establish and implement a 347.20 pilot project to contract with nursing facilities eligible to 347.21 receive medical assistance payments that, at the time of 347.22 enrollment in the pilot project, serve ten or more persons with 347.23 a diagnosis of multiple sclerosis. The commissioner shall 347.24 negotiate a payment rate with eligible facilities to provide 347.25 services to persons with multiple sclerosis that must not exceed 347.26 150 percent of the person's case mix classification payment rate 347.27 for that facility. The commissioner may contract with up to six 347.28 nursing facilities. 347.29 (b) Facilities may enroll in the pilot project between July 347.30 1, 2001, and December 31, 2001. 347.31 (c) The commissioner shall evaluate the additional payments 347.32 made under the pilot project to determine if the adjustment 347.33 enables participating facilities to adequately meet the needs 347.34 for individual care and specialized programming, including 347.35 programs to meet psychosocial, physiological, and case 347.36 management needs, without incurring financial losses. The 348.1 commissioner of human services, in consultation with the 348.2 commissioner of health, shall report to the legislature by 348.3 January 15, 2003, on the results of the project and with a 348.4 recommendation on whether the project should be made permanent. 348.5 (d) The negotiated adjustment shall not affect the payment 348.6 rate charged to private paying residents under the provisions of 348.7 Minnesota Statutes, section 256B.48, subdivision 1. 348.8 Sec. 45. [MINIMUM STAFFING STANDARDS REPORT.] 348.9 By January 15, 2002, the commissioner of health and the 348.10 commissioner of human services shall report to the legislature 348.11 on whether they should translate the minimum nurse staffing 348.12 requirement in Minnesota Statutes, section 144A.04, subdivision 348.13 7, paragraph (a), upon the transition to the RUG-III 348.14 classification system, or whether they should establish 348.15 different time-based standards, and how to accomplish either. 348.16 Sec. 46. [REPEALER.] 348.17 Minnesota Statutes 2000, sections 144.0721, subdivision 1, 348.18 and 256B.434, subdivision 5, are repealed. 348.19 ARTICLE 6 348.20 WORK FORCE 348.21 Section 1. Minnesota Statutes 2000, section 144.1464, is 348.22 amended to read: 348.23 144.1464 [SUMMER HEALTH CARE INTERNS.] 348.24 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of 348.25 health, through a contract with a nonprofit organization as 348.26 required by subdivision 4, shall award grants to hospitalsand, 348.27 clinics, nursing facilities, and home care providers to 348.28 establish a secondary and post-secondary summer health care 348.29 intern program. The purpose of the program is to expose 348.30 interested secondary and post-secondary pupils to various 348.31 careers within the health care profession. 348.32 Subd. 2. [CRITERIA.] (a) The commissioner, through the 348.33 organization under contract, shall award grants to 348.34 hospitalsand, clinics, nursing facilities, and home care 348.35 providers that agree to: 348.36 (1) provide secondary and post-secondary summer health care 349.1 interns with formal exposure to the health care profession; 349.2 (2) provide an orientation for the secondary and 349.3 post-secondary summer health care interns; 349.4 (3) pay one-half the costs of employing the secondary and 349.5 post-secondary summer health care intern, based on an overall349.6hourly wage that is at least the minimum wage but does not349.7exceed $6 an hour; 349.8 (4) interview and hire secondary and post-secondary pupils 349.9 for a minimum of six weeks and a maximum of 12 weeks; and 349.10 (5) employ at least one secondary student for each 349.11 post-secondary student employed, to the extent that there are 349.12 sufficient qualifying secondary student applicants. 349.13 (b) In order to be eligible to be hired as a secondary 349.14 summer health intern by a hospitalor, clinic, nursing facility, 349.15 or home care provider, a pupil must: 349.16 (1) intend to complete high school graduation requirements 349.17 and be between the junior and senior year of high school; and 349.18 (2) be from a school district in proximity to the facility;349.19and349.20(3) provide the facility with a letter of recommendation349.21from a health occupations or science educator. 349.22 (c) In order to be eligible to be hired as a post-secondary 349.23 summer health care intern by a hospital or clinic, a pupil must: 349.24 (1) intend to complete a health care training program or a 349.25 two-year or four-year degree program and be planning on 349.26 enrolling in or be enrolled in that training program or degree 349.27 program; and 349.28 (2) be enrolled in a Minnesota educational institution or 349.29 be a resident of the state of Minnesota; priority must be given 349.30 to applicants from a school district or an educational 349.31 institution in proximity to the facility; and349.32(3) provide the facility with a letter of recommendation349.33from a health occupations or science educator. 349.34 (d) Hospitalsand, clinics, nursing facilities, and home 349.35 care providers awarded grants may employ pupils as secondary and 349.36 post-secondary summer health care interns beginning on or after 350.1 June 15, 1993, if they agree to pay the intern, during the 350.2 period before disbursement of state grant money, with money 350.3 designated as the facility's 50 percent contribution towards 350.4 internship costs. 350.5 Subd. 3. [GRANTS.] The commissioner, through the 350.6 organization under contract, shall award separate grants to 350.7 hospitalsand, clinics, nursing facilities, and home care 350.8 providers meeting the requirements of subdivision 2. The grants 350.9 must be used to pay one-half of the costs of employing secondary 350.10 and post-secondary pupils in a hospitalor, clinic, nursing 350.11 facility, or home care setting during the course of the 350.12 program. No more than 50 percent of the participants may be 350.13 post-secondary students, unless the program does not receive 350.14 enough qualified secondary applicants per fiscal year. No more 350.15 than five pupils may be selected from any secondary or 350.16 post-secondary institution to participate in the program and no 350.17 more than one-half of the number of pupils selected may be from 350.18 the seven-county metropolitan area. 350.19 Subd. 4. [CONTRACT.] The commissioner shall contract with 350.20 a statewide, nonprofit organization representing facilities at 350.21 which secondary and post-secondary summer health care interns 350.22 will serve, to administer the grant program established by this 350.23 section. Grant funds that are not used in one fiscal year may 350.24 be carried over to the next fiscal year. The organization 350.25 awarded the grant shall provide the commissioner with any 350.26 information needed by the commissioner to evaluate the program, 350.27 in the form and at the times specified by the commissioner. 350.28 Sec. 2. [144.1499] [PROMOTION OF HEALTH CARE AND LONG-TERM 350.29 CARE CAREERS.] 350.30 The commissioner of health, in consultation with an 350.31 organization representing health care employers, long-term care 350.32 employers, and educational institutions, may make grants to 350.33 qualifying consortia as defined in section 116L.11, subdivision 350.34 4, for intergenerational programs to encourage middle and high 350.35 school students to work and volunteer in health care and 350.36 long-term care settings. To qualify for a grant under this 351.1 section, a consortium shall: 351.2 (1) develop a health and long-term care careers curriculum 351.3 that provides career exploration and training in national skill 351.4 standards for health care and long-term care and that is 351.5 consistent with Minnesota graduation standards and other related 351.6 requirements; 351.7 (2) offer programs for high school students that provide 351.8 training in health and long-term care careers with credits that 351.9 articulate into post-secondary programs; and 351.10 (3) provide technical support to the participating health 351.11 care and long-term care employer to enable the use of the 351.12 employer's facilities and programs for K-12 health and long-term 351.13 care careers education. 351.14 Sec. 3. Minnesota Statutes 2000, section 144A.62, 351.15 subdivision 1, is amended to read: 351.16 Subdivision 1. [ASSISTANCE WITH EATING AND DRINKING.] (a) 351.17 Upon federal approval, a nursing home may employ resident 351.18 attendants to assist with the activities authorized under 351.19 subdivision 2. The resident attendantwill notshall be counted 351.20 in the minimum staffing requirements under section 144A.04, 351.21 subdivision 7. 351.22 (b) The commissioner shall submit byMayJuly 15,2000351.23 2001, a new request for a federal waiver necessary to implement 351.24 this section. 351.25 Sec. 4. Minnesota Statutes 2000, section 144A.62, 351.26 subdivision 2, is amended to read: 351.27 Subd. 2. [DEFINITION.] (a) "Resident attendant" means an 351.28 individual who assists residentsin a nursing homewiththeone 351.29 or more of the following activitiesof eating and drinking: 351.30 (1) eating and drinking; and 351.31 (2) transporting. 351.32 (b) A resident attendant does not include an individual who: 351.33 (1) is a licensed health professional or a registered 351.34 dietitian; 351.35 (2) volunteers without monetary compensation; or 351.36 (3) is a registered nursing assistant. 352.1 Sec. 5. Minnesota Statutes 2000, section 144A.62, 352.2 subdivision 3, is amended to read: 352.3 Subd. 3. [REQUIREMENTS.] (a) A nursing home may not use on 352.4 a full-time or other paid basis any individual as a resident 352.5 attendant in the nursing home unless the individual: 352.6 (1) has completed a training and competency evaluation 352.7 program encompassing thetasksactivities in subdivision 2 that 352.8 the individual provides; 352.9 (2) is competent to providefeeding and hydration services352.10 those activities; and 352.11 (3) is under the supervision of the director of nursing. 352.12 (b) A nursing home may not use a current employee as a 352.13 resident attendant unless the employee satisfies the 352.14 requirements of paragraph (a) and volunteers to be used in that 352.15 capacity. 352.16 Sec. 6. Minnesota Statutes 2000, section 144A.62, 352.17 subdivision 4, is amended to read: 352.18 Subd. 4. [EVALUATION.] The training and competency 352.19 evaluation program may be facility based. It must include, at a 352.20 minimum, the training and competency standards foreating and352.21drinking assistancethe specific activities the attendant will 352.22 be conducting contained in the nursing assistant training 352.23 curriculum. 352.24 Sec. 7. Minnesota Statutes 2000, section 148.212, is 352.25 amended to read: 352.26 148.212 [TEMPORARY PERMIT.] 352.27 Upon receipt of the applicable licensure or reregistration 352.28 fee and permit fee, and in accordance with rules of the board, 352.29 the board may issue a nonrenewable temporary permit to practice 352.30 professional or practical nursing to an applicant for licensure 352.31 or reregistration who is not the subject of a pending 352.32 investigation or disciplinary action, nor disqualified for any 352.33 other reason, under the following circumstances: 352.34 (a) The applicant for licensure by examination under 352.35 section 148.211, subdivision 1, has graduated from an approved 352.36 nursing program within the 60 days preceding board receipt of an 353.1 affidavit of graduation or transcript and has been authorized by 353.2 the board to write the licensure examination for the first time 353.3 in the United States. The permit holder must practice 353.4 professional or practical nursing under the direct supervision 353.5 of a registered nurse. The permit is valid from the date of 353.6 issue until the date the board takes action on the application 353.7 or for 60 days whichever occurs first. 353.8 (b) The applicant for licensure by endorsement under 353.9 section 148.211, subdivision 2, is currently licensed to 353.10 practice professional or practical nursing in another state, 353.11 territory, or Canadian province. The permit is valid from 353.12 submission of a proper request until the date of board action on 353.13 the application. 353.14 (c) The applicant for licensure by endorsement under 353.15 section 148.211, subdivision 2, or for reregistration under 353.16 section 148.231, subdivision 5, is currently registered in a 353.17 formal, structured refresher course or its equivalent for nurses 353.18 that includes clinical practice. 353.19 (d) The applicant for licensure by examination under 353.20 section 148.211, subdivision 1, as a registered nurse has been 353.21 issued a commission on graduates of foreign nurse schools 353.22 certificate, has completed all requirements for licensure except 353.23 the licensing examination, and has been authorized by the board 353.24 to write the licensure examination for the first time in the 353.25 United States. The permit holder must practice professional 353.26 nursing under the direct supervision of a registered nurse. The 353.27 permit is valid from the date of issue until the date the board 353.28 takes action on the application or for 60 days, whichever occurs 353.29 first. 353.30 ARTICLE 7 353.31 REGULATION OF SUPPLEMENTAL 353.32 NURSING SERVICES AGENCIES 353.33 Section 1. Minnesota Statutes 2000, section 144.057, is 353.34 amended to read: 353.35 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 353.36 NURSING SERVICES AGENCY PERSONNEL.] 354.1 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 354.2 commissioner of health shall contract with the commissioner of 354.3 human services to conduct background studies of: 354.4 (1) individuals providing services which have direct 354.5 contact, as defined under section 245A.04, subdivision 3, with 354.6 patients and residents in hospitals, boarding care homes, 354.7 outpatient surgical centers licensed under sections 144.50 to 354.8 144.58; nursing homes and home care agencies licensed under 354.9 chapter 144A; residential care homes licensed under chapter 354.10 144B, and board and lodging establishments that are registered 354.11 to provide supportive or health supervision services under 354.12 section 157.17;and354.13 (2) beginning July 1, 1999, all other employees in nursing 354.14 homes licensed under chapter 144A, and boarding care homes 354.15 licensed under sections 144.50 to 144.58. A disqualification of 354.16 an individual in this section shall disqualify the individual 354.17 from positions allowing direct contact or access to patients or 354.18 residents receiving services; 354.19 (3) individuals employed by a supplemental nursing services 354.20 agency, as defined under section 144A.70, who are providing 354.21 services in health care facilities; and 354.22 (4) controlling persons of a supplemental nursing services 354.23 agency, as defined under section 144A.70. 354.24 If a facility or program is licensed by the department of 354.25 human services and subject to the background study provisions of 354.26 chapter 245A and is also licensed by the department of health, 354.27 the department of human services is solely responsible for the 354.28 background studies of individuals in the jointly licensed 354.29 programs. 354.30 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 354.31 SERVICES.] The department of human services shall conduct the 354.32 background studies required by subdivision 1 in compliance with 354.33 the provisions of chapter 245A and Minnesota Rules, parts 354.34 9543.3000 to 9543.3090. For the purpose of this section, the 354.35 term "residential program" shall include all facilities 354.36 described in subdivision 1. The department of human services 355.1 shall provide necessary forms and instructions, shall conduct 355.2 the necessary background studies of individuals, and shall 355.3 provide notification of the results of the studies to the 355.4 facilities, supplemental nursing services agencies, individuals, 355.5 and the commissioner of health. Individuals shall be 355.6 disqualified under the provisions of chapter 245A and Minnesota 355.7 Rules, parts 9543.3000 to 9543.3090. If an individual is 355.8 disqualified, the department of human services shall notify the 355.9 facility, the supplemental nursing services agency, and the 355.10 individual and shall inform the individual of the right to 355.11 request a reconsideration of the disqualification by submitting 355.12 the request to the department of health. 355.13 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 355.14 shall review and decide reconsideration requests, including the 355.15 granting of variances, in accordance with the procedures and 355.16 criteria contained in chapter 245A and Minnesota Rules, parts 355.17 9543.3000 to 9543.3090. The commissioner's decision shall be 355.18 provided to the individual and to the department of human 355.19 services. The commissioner's decision to grant or deny a 355.20 reconsideration of disqualification is the final administrative 355.21 agency action. 355.22 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 355.23 Facilities and agencies described in subdivision 1 shall be 355.24 responsible for cooperating with the departments in implementing 355.25 the provisions of this section. The responsibilities imposed on 355.26 applicants and licensees under chapter 245A and Minnesota Rules, 355.27 parts 9543.3000 to 9543.3090, shall apply to these 355.28 facilities and supplemental nursing services agencies. The 355.29 provision of section 245A.04, subdivision 3, paragraph (e), 355.30 shall apply to applicants, licensees, registrants, or an 355.31 individual's refusal to cooperate with the completion of the 355.32 background studies. Supplemental nursing services agencies 355.33 subject to the registration requirements in section 144A.71 must 355.34 maintain records verifying compliance with the background study 355.35 requirements under this section. 355.36 Sec. 2. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 356.1 SERVICES AGENCIES; DEFINITIONS.] 356.2 Subdivision 1. [SCOPE.] As used in sections 144A.70 to 356.3 144A.74, the terms defined in this section have the meanings 356.4 given them. 356.5 Subd. 2. [COMMISSIONER.] "Commissioner" means the 356.6 commissioner of health. 356.7 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means 356.8 a business entity, officer, program administrator, or director 356.9 whose responsibilities include the direction of the management 356.10 or policies of a supplemental nursing services agency. 356.11 Controlling person also means an individual who, directly or 356.12 indirectly, beneficially owns an interest in a corporation, 356.13 partnership, or other business association that is a controlling 356.14 person. 356.15 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility" 356.16 means a hospital, boarding care home, or outpatient surgical 356.17 center licensed under sections 144.50 to 144.58, a nursing home 356.18 or home care agency licensed under this chapter, a residential 356.19 care home, or a board and lodging establishment that is 356.20 registered to provide supportive or health supervision services 356.21 under section 157.17. 356.22 Subd. 5. [PERSON.] "Person" includes an individual, firm, 356.23 corporation, partnership, or association. 356.24 Subd. 6. [SUPPLEMENTAL NURSING SERVICES 356.25 AGENCY.] "Supplemental nursing services agency" means a person, 356.26 firm, corporation, partnership, or association engaged for hire 356.27 in the business of providing or procuring temporary employment 356.28 in health care facilities for nurses, nursing assistants, nurse 356.29 aides, and orderlies. Supplemental nursing services agency does 356.30 not include an individual who only engages in providing the 356.31 individual's services on a temporary basis to health care 356.32 facilities. Supplemental nursing services agency also does not 356.33 include any nursing services agency that is limited to providing 356.34 temporary nursing personnel solely to one or more health care 356.35 facilities owned or operated by the same person, firm, 356.36 corporation, or partnership. 357.1 Sec. 3. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 357.2 REGISTRATION.] 357.3 Subdivision 1. [DUTY TO REGISTER.] A person who operates a 357.4 supplemental nursing services agency shall register the agency 357.5 with the commissioner. Each separate location of the business 357.6 of a supplemental nursing services agency shall register the 357.7 agency with the commissioner. Each separate location of the 357.8 business of a supplemental nursing services agency shall have a 357.9 separate registration. 357.10 Subd. 2. [APPLICATION INFORMATION AND FEE.] The 357.11 commissioner shall establish forms and procedures for processing 357.12 each supplemental nursing services agency registration 357.13 application. An application for a supplemental nursing services 357.14 agency registration must include at least the following: 357.15 (1) the names and addresses of the owner or owners of the 357.16 supplemental nursing services agency; 357.17 (2) if the owner is a corporation, copies of its articles 357.18 of incorporation and current bylaws, together with the names and 357.19 addresses of its officers and directors; 357.20 (3) any other relevant information that the commissioner 357.21 determines is necessary to properly evaluate an application for 357.22 registration; and 357.23 (4) the annual registration fee for a supplemental nursing 357.24 services agency, which is $891. 357.25 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration 357.26 issued by the commissioner according to this section is 357.27 effective for a period of one year from the date of its issuance 357.28 unless the registration is revoked or suspended under section 357.29 144A.72, subdivision 2, or unless the supplemental nursing 357.30 services agency is sold or ownership or management is 357.31 transferred. When a supplemental nursing services agency is 357.32 sold or ownership or management is transferred, the registration 357.33 of the agency must be voided and the new owner or operator may 357.34 apply for a new registration. 357.35 Sec. 4. [144A.72] [REGISTRATION REQUIREMENTS.] 357.36 The commissioner shall require that, as a condition of 358.1 registration: 358.2 (1) the supplemental nursing services agency shall document 358.3 that each temporary employee provided to health care facilities 358.4 currently meets the minimum licensing, training, and continuing 358.5 education standards for the position in which the employee will 358.6 be working; 358.7 (2) the supplemental nursing services agency shall comply 358.8 with all pertinent requirements relating to the health and other 358.9 qualifications of personnel employed in health care facilities; 358.10 (3) the supplemental nursing services agency must not 358.11 restrict in any manner the employment opportunities of its 358.12 employees; 358.13 (4) the supplemental nursing services agency, when 358.14 supplying temporary employees to a health care facility, and 358.15 when requested by the facility to do so, shall agree that at 358.16 least 30 percent of the total personnel hours supplied are 358.17 during night, holiday, or weekend shifts; 358.18 (5) the supplemental nursing services agency shall carry 358.19 medical malpractice insurance to insure against the loss, 358.20 damage, or expense incident to a claim arising out of the death 358.21 or injury of any person as the result of negligence or 358.22 malpractice in the provision of health care services by the 358.23 supplemental nursing services agency or by any employee of the 358.24 agency; and 358.25 (6) the supplemental nursing services agency must not, in 358.26 any contract with any employee or health care facility, require 358.27 the payment of liquidated damages, employment fees, or other 358.28 compensation should the employee be hired as a permanent 358.29 employee of a health care facility. 358.30 Sec. 5. [144A.73] [COMPLAINT SYSTEM.] 358.31 The commissioner shall establish a system for reporting 358.32 complaints against a supplemental nursing services agency or its 358.33 employees. Complaints may be made by any member of the public. 358.34 Written complaints must be forwarded to the employer of each 358.35 person against whom a complaint is made. The employer shall 358.36 promptly report to the commissioner any corrective action taken. 359.1 Sec. 6. [144A.74] [MAXIMUM CHARGES.] 359.2 A supplemental nursing services agency must not bill or 359.3 receive payments from a nursing home licensed under this chapter 359.4 at a rate higher than 150 percent of the weighted average wage 359.5 rate for the applicable employee classification for the 359.6 geographic group to which the nursing home is assigned under 359.7 chapter 256B. The weighted average wage rates must be 359.8 determined by the commissioner of human services and reported to 359.9 the commissioner of health on an annual basis. Facilities shall 359.10 provide information necessary to determine weighted average wage 359.11 rates to the commissioner of human services in a format 359.12 requested by the commissioner. The maximum rate must include 359.13 all charges for administrative fees, contract fees, or other 359.14 special charges in addition to the hourly rates for the 359.15 temporary nursing pool personnel supplied to a nursing home. 359.16 Sec. 7. Minnesota Statutes 2000, section 245A.04, 359.17 subdivision 3, is amended to read: 359.18 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 359.19 (a) Before the commissioner issues a license, the commissioner 359.20 shall conduct a study of the individuals specified in paragraph 359.21(c)(d), clauses (1) to (5), according to rules of the 359.22 commissioner. 359.23 Beginning January 1, 1997, the commissioner shall also 359.24 conduct a study of employees providing direct contact services 359.25 for nonlicensed personal care provider organizations described 359.26 in paragraph(c)(d), clause (5). 359.27 The commissioner shall recover the cost of these background 359.28 studies through a fee of no more than $12 per study charged to 359.29 the personal care provider organization. The fees collected 359.30 under this paragraph are appropriated to the commissioner for 359.31 the purpose of conducting background studies. 359.32 Beginning August 1, 1997, the commissioner shall conduct 359.33 all background studies required under this chapter for adult 359.34 foster care providers who are licensed by the commissioner of 359.35 human services and registered under chapter 144D. The 359.36 commissioner shall conduct these background studies in 360.1 accordance with this chapter. The commissioner shall initiate a 360.2 pilot project to conduct up to 5,000 background studies under 360.3 this chapter in programs with joint licensure as home and 360.4 community-based services and adult foster care for people with 360.5 developmental disabilities when the license holder does not 360.6 reside in the foster care residence. 360.7 (b) Beginning July 1, 1998, the commissioner shall conduct 360.8 a background study on individuals specified in 360.9 paragraph(c)(d), clauses (1) to (5), who perform direct 360.10 contact services in a nursing home or a home care agency 360.11 licensed under chapter 144A or a boarding care home licensed 360.12 under sections 144.50 to 144.58, when the subject of the study 360.13 resides outside Minnesota; the study must be at least as 360.14 comprehensive as that of a Minnesota resident and include a 360.15 search of information from the criminal justice data 360.16 communications network in the state where the subject of the 360.17 study resides. 360.18 (c) Beginning August 1, 2001, the commissioner shall 360.19 conduct all background studies required under this chapter and 360.20 initiated by supplemental nursing services agencies registered 360.21 under chapter 144A. Studies for the agencies must be initiated 360.22 annually by each agency. The commissioner shall conduct the 360.23 background studies according to this chapter. The commissioner 360.24 shall recover the cost of the background studies through a fee 360.25 of no more than $8 per study, charged to the supplemental 360.26 nursing services agency. The fees collected under this 360.27 paragraph are appropriated to the commissioner for the purpose 360.28 of conducting background studies. 360.29 (d) The applicant, license holder,theregistrant, bureau 360.30 of criminal apprehension,thecommissioner of health, and county 360.31 agencies, after written notice to the individual who is the 360.32 subject of the study, shall help with the study by giving the 360.33 commissioner criminal conviction data and reports about the 360.34 maltreatment of adults substantiated under section 626.557 and 360.35 the maltreatment of minors in licensed programs substantiated 360.36 under section 626.556. The individuals to be studied shall 361.1 include: 361.2 (1) the applicant; 361.3 (2) persons over the age of 13 living in the household 361.4 where the licensed program will be provided; 361.5 (3) current employees or contractors of the applicant who 361.6 will have direct contact with persons served by the facility, 361.7 agency, or program; 361.8 (4) volunteers or student volunteers who have direct 361.9 contact with persons served by the program to provide program 361.10 services, if the contact is not directly supervised by the 361.11 individuals listed in clause (1) or (3); and 361.12 (5) any person who, as an individual or as a member of an 361.13 organization, exclusively offers, provides, or arranges for 361.14 personal care assistant services under the medical assistance 361.15 program as authorized under sections 256B.04, subdivision 16, 361.16 and 256B.0625, subdivision 19a. 361.17 The juvenile courts shall also help with the study by 361.18 giving the commissioner existing juvenile court records on 361.19 individuals described in clause (2) relating to delinquency 361.20 proceedings held within either the five years immediately 361.21 preceding the application or the five years immediately 361.22 preceding the individual's 18th birthday, whichever time period 361.23 is longer. The commissioner shall destroy juvenile records 361.24 obtained pursuant to this subdivision when the subject of the 361.25 records reaches age 23. 361.26 For purposes of this section and Minnesota Rules, part 361.27 9543.3070, a finding that a delinquency petition is proven in 361.28 juvenile court shall be considered a conviction in state 361.29 district court. 361.30 For purposes of this subdivision, "direct contact" means 361.31 providing face-to-face care, training, supervision, counseling, 361.32 consultation, or medication assistance to persons served by a 361.33 program. For purposes of this subdivision, "directly supervised" 361.34 means an individual listed in clause (1), (3), or (5) is within 361.35 sight or hearing of a volunteer to the extent that the 361.36 individual listed in clause (1), (3), or (5) is capable at all 362.1 times of intervening to protect the health and safety of the 362.2 persons served by the program who have direct contact with the 362.3 volunteer. 362.4 A study of an individual in clauses (1) to (5) shall be 362.5 conducted at least upon application for initial license or 362.6 registration and reapplication for a license or registration. 362.7 The commissioner is not required to conduct a study of an 362.8 individual at the time of reapplication for a license or if the 362.9 individual has been continuously affiliated with a foster care 362.10 provider licensed by the commissioner of human services and 362.11 registered under chapter 144D, other than a family day care or 362.12 foster care license, if: (i) a study of the individual was 362.13 conducted either at the time of initial licensure or when the 362.14 individual became affiliated with the license holder; (ii) the 362.15 individual has been continuously affiliated with the license 362.16 holder since the last study was conducted; and (iii) the 362.17 procedure described in paragraph(d)(e) has been implemented 362.18 and was in effect continuously since the last study was 362.19 conducted. For the purposes of this section, a physician 362.20 licensed under chapter 147 is considered to be continuously 362.21 affiliated upon the license holder's receipt from the 362.22 commissioner of health or human services of the physician's 362.23 background study results. For individuals who are required to 362.24 have background studies under clauses (1) to (5) and who have 362.25 been continuously affiliated with a foster care provider that is 362.26 licensed in more than one county, criminal conviction data may 362.27 be shared among those counties in which the foster care programs 362.28 are licensed. A county agency's receipt of criminal conviction 362.29 data from another county agency shall meet the criminal data 362.30 background study requirements of this section. 362.31 The commissioner may also conduct studies on individuals 362.32 specified in clauses (3) and (4) when the studies are initiated 362.33 by: 362.34 (i) personnel pool agencies; 362.35 (ii) temporary personnel agencies; 362.36 (iii) educational programs that train persons by providing 363.1 direct contact services in licensed programs; and 363.2 (iv) professional services agencies that are not licensed 363.3 and which contract with licensed programs to provide direct 363.4 contact services or individuals who provide direct contact 363.5 services. 363.6 Studies on individuals in items (i) to (iv) must be 363.7 initiated annually by these agencies, programs, and 363.8 individuals. Except for personal care provider 363.9 organizations and supplemental nursing services agencies, no 363.10 applicant, license holder, or individual who is the subject of 363.11 the study shall pay any fees required to conduct the study. 363.12 (1) At the option of the licensed facility, rather than 363.13 initiating another background study on an individual required to 363.14 be studied who has indicated to the licensed facility that a 363.15 background study by the commissioner was previously completed, 363.16 the facility may make a request to the commissioner for 363.17 documentation of the individual's background study status, 363.18 provided that: 363.19 (i) the facility makes this request using a form provided 363.20 by the commissioner; 363.21 (ii) in making the request the facility informs the 363.22 commissioner that either: 363.23 (A) the individual has been continuously affiliated with a 363.24 licensed facility since the individual's previous background 363.25 study was completed, or since October 1, 1995, whichever is 363.26 shorter; or 363.27 (B) the individual is affiliated only with a personnel pool 363.28 agency, a temporary personnel agency, an educational program 363.29 that trains persons by providing direct contact services in 363.30 licensed programs, or a professional services agency that is not 363.31 licensed and which contracts with licensed programs to provide 363.32 direct contact services or individuals who provide direct 363.33 contact services; and 363.34 (iii) the facility provides notices to the individual as 363.35 required in paragraphs (a) to(d)(e), and that the facility is 363.36 requesting written notification of the individual's background 364.1 study status from the commissioner. 364.2 (2) The commissioner shall respond to each request under 364.3 paragraph (1) with a written or electronic notice to the 364.4 facility and the study subject. If the commissioner determines 364.5 that a background study is necessary, the study shall be 364.6 completed without further request from a licensed agency or 364.7 notifications to the study subject. 364.8 (3) When a background study is being initiated by a 364.9 licensed facility or a foster care provider that is also 364.10 registered under chapter 144D, a study subject affiliated with 364.11 multiple licensed facilities may attach to the background study 364.12 form a cover letter indicating the additional facilities' names, 364.13 addresses, and background study identification numbers. When 364.14 the commissioner receives such notices, each facility identified 364.15 by the background study subject shall be notified of the study 364.16 results. The background study notice sent to the subsequent 364.17 agencies shall satisfy those facilities' responsibilities for 364.18 initiating a background study on that individual. 364.19(d)(e) If an individual who is affiliated with a program 364.20 or facility regulated by the department of human services or 364.21 department of health or who is affiliated with a nonlicensed 364.22 personal care provider organization, is convicted of a crime 364.23 constituting a disqualification under subdivision 3d, the 364.24 probation officer or corrections agent shall notify the 364.25 commissioner of the conviction. The commissioner, in 364.26 consultation with the commissioner of corrections, shall develop 364.27 forms and information necessary to implement this paragraph and 364.28 shall provide the forms and information to the commissioner of 364.29 corrections for distribution to local probation officers and 364.30 corrections agents. The commissioner shall inform individuals 364.31 subject to a background study that criminal convictions for 364.32 disqualifying crimes will be reported to the commissioner by the 364.33 corrections system. A probation officer, corrections agent, or 364.34 corrections agency is not civilly or criminally liable for 364.35 disclosing or failing to disclose the information required by 364.36 this paragraph. Upon receipt of disqualifying information, the 365.1 commissioner shall provide the notifications required in 365.2 subdivision 3a, as appropriate to agencies on record as having 365.3 initiated a background study or making a request for 365.4 documentation of the background study status of the individual. 365.5 This paragraph does not apply to family day care and child 365.6 foster care programs. 365.7(e)(f) The individual who is the subject of the study must 365.8 provide the applicant or license holder with sufficient 365.9 information to ensure an accurate study including the 365.10 individual's first, middle, and last name; home address, city, 365.11 county, and state of residence for the past five years; zip 365.12 code; sex; date of birth; and driver's license number. The 365.13 applicant or license holder shall provide this information about 365.14 an individual in paragraph(c)(d), clauses (1) to (5), on forms 365.15 prescribed by the commissioner. By January 1, 2000, for 365.16 background studies conducted by the department of human 365.17 services, the commissioner shall implement a system for the 365.18 electronic transmission of: (1) background study information to 365.19 the commissioner; and (2) background study results to the 365.20 license holder. The commissioner may request additional 365.21 information of the individual, which shall be optional for the 365.22 individual to provide, such as the individual's social security 365.23 number or race. 365.24(f)(g) Except for child foster care, adult foster care, 365.25 and family day care homes, a study must include information 365.26 related to names of substantiated perpetrators of maltreatment 365.27 of vulnerable adults that has been received by the commissioner 365.28 as required under section 626.557, subdivision 9c, paragraph 365.29 (i), and the commissioner's records relating to the maltreatment 365.30 of minors in licensed programs, information from juvenile courts 365.31 as required in paragraph(c)(d) for persons listed in paragraph 365.32(c)(d), clause (2), and information from the bureau of criminal 365.33 apprehension. For child foster care, adult foster care, and 365.34 family day care homes, the study must include information from 365.35 the county agency's record of substantiated maltreatment of 365.36 adults, and the maltreatment of minors, information from 366.1 juvenile courts as required in paragraph(c)(d) for persons 366.2 listed in paragraph(c)(d), clause (2), and information from 366.3 the bureau of criminal apprehension. The commissioner may also 366.4 review arrest and investigative information from the bureau of 366.5 criminal apprehension, the commissioner of health, a county 366.6 attorney, county sheriff, county agency, local chief of police, 366.7 other states, the courts, or the Federal Bureau of Investigation 366.8 if the commissioner has reasonable cause to believe the 366.9 information is pertinent to the disqualification of an 366.10 individual listed in paragraph(c)(d), clauses (1) to (5). The 366.11 commissioner is not required to conduct more than one review of 366.12 a subject's records from the Federal Bureau of Investigation if 366.13 a review of the subject's criminal history with the Federal 366.14 Bureau of Investigation has already been completed by the 366.15 commissioner and there has been no break in the subject's 366.16 affiliation with the license holder who initiated the background 366.17 studies. 366.18 When the commissioner has reasonable cause to believe that 366.19 further pertinent information may exist on the subject, the 366.20 subject shall provide a set of classifiable fingerprints 366.21 obtained from an authorized law enforcement agency. For 366.22 purposes of requiring fingerprints, the commissioner shall be 366.23 considered to have reasonable cause under, but not limited to, 366.24 the following circumstances: 366.25 (1) information from the bureau of criminal apprehension 366.26 indicates that the subject is a multistate offender; 366.27 (2) information from the bureau of criminal apprehension 366.28 indicates that multistate offender status is undetermined; or 366.29 (3) the commissioner has received a report from the subject 366.30 or a third party indicating that the subject has a criminal 366.31 history in a jurisdiction other than Minnesota. 366.32(g)(h) An applicant'sor, license holder's, or 366.33 registrant's failure or refusal to cooperate with the 366.34 commissioner is reasonable cause to disqualify a subject, deny a 366.35 license application or immediately suspend, suspend, or revoke a 366.36 license or registration. Failure or refusal of an individual to 367.1 cooperate with the study is just cause for denying or 367.2 terminating employment of the individual if the individual's 367.3 failure or refusal to cooperate could cause the applicant's 367.4 application to be denied or the license holder's license to be 367.5 immediately suspended, suspended, or revoked. 367.6(h)(i) The commissioner shall not consider an application 367.7 to be complete until all of the information required to be 367.8 provided under this subdivision has been received. 367.9(i)(j) No person in paragraph(c)(d), clause (1), (2), 367.10 (3), (4), or (5), who is disqualified as a result of this 367.11 section may be retained by the agency in a position involving 367.12 direct contact with persons served by the program. 367.13(j)(k) Termination of persons in paragraph(c)(d), clause 367.14 (1), (2), (3), (4), or (5), made in good faith reliance on a 367.15 notice of disqualification provided by the commissioner shall 367.16 not subject the applicant or license holder to civil liability. 367.17(k)(l) The commissioner may establish records to fulfill 367.18 the requirements of this section. 367.19(l)(m) The commissioner may not disqualify an individual 367.20 subject to a study under this section because that person has, 367.21 or has had, a mental illness as defined in section 245.462, 367.22 subdivision 20. 367.23(m)(n) An individual subject to disqualification under 367.24 this subdivision has the applicable rights in subdivision 3a, 367.25 3b, or 3c. 367.26(n)(o) For the purposes of background studies completed by 367.27 tribal organizations performing licensing activities otherwise 367.28 required of the commissioner under this chapter, after obtaining 367.29 consent from the background study subject, tribal licensing 367.30 agencies shall have access to criminal history data in the same 367.31 manner as county licensing agencies and private licensing 367.32 agencies under this chapter. 367.33 Sec. 8. Minnesota Statutes 2000, section 245A.04, 367.34 subdivision 3a, is amended to read: 367.35 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 367.36 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 368.1 commissioner shall notify the applicantor, license holder, or 368.2 registrant and the individual who is the subject of the study, 368.3 in writing or by electronic transmission, of the results of the 368.4 study. When the study is completed, a notice that the study was 368.5 undertaken and completed shall be maintained in the personnel 368.6 files of the program. For studies on individuals pertaining to 368.7 a license to provide family day care or group family day care, 368.8 foster care for children in the provider's own home, or foster 368.9 care or day care services for adults in the provider's own home, 368.10 the commissioner is not required to provide a separate notice of 368.11 the background study results to the individual who is the 368.12 subject of the study unless the study results in a 368.13 disqualification of the individual. 368.14 The commissioner shall notify the individual studied if the 368.15 information in the study indicates the individual is 368.16 disqualified from direct contact with persons served by the 368.17 program. The commissioner shall disclose the information 368.18 causing disqualification and instructions on how to request a 368.19 reconsideration of the disqualification to the individual 368.20 studied. An applicant or license holder who is not the subject 368.21 of the study shall be informed that the commissioner has found 368.22 information that disqualifies the subject from direct contact 368.23 with persons served by the program. However, only the 368.24 individual studied must be informed of the information contained 368.25 in the subject's background study unless the only basis for the 368.26 disqualification is failure to cooperate, the Data Practices Act 368.27 provides for release of the information, or the individual 368.28 studied authorizes the release of the information. 368.29 (b) If the commissioner determines that the individual 368.30 studied has a disqualifying characteristic, the commissioner 368.31 shall review the information immediately available and make a 368.32 determination as to the subject's immediate risk of harm to 368.33 persons served by the program where the individual studied will 368.34 have direct contact. The commissioner shall consider all 368.35 relevant information available, including the following factors 368.36 in determining the immediate risk of harm: the recency of the 369.1 disqualifying characteristic; the recency of discharge from 369.2 probation for the crimes; the number of disqualifying 369.3 characteristics; the intrusiveness or violence of the 369.4 disqualifying characteristic; the vulnerability of the victim 369.5 involved in the disqualifying characteristic; and the similarity 369.6 of the victim to the persons served by the program where the 369.7 individual studied will have direct contact. The commissioner 369.8 may determine that the evaluation of the information immediately 369.9 available gives the commissioner reason to believe one of the 369.10 following: 369.11 (1) The individual poses an imminent risk of harm to 369.12 persons served by the program where the individual studied will 369.13 have direct contact. If the commissioner determines that an 369.14 individual studied poses an imminent risk of harm to persons 369.15 served by the program where the individual studied will have 369.16 direct contact, the individual and the license holder must be 369.17 sent a notice of disqualification. The commissioner shall order 369.18 the license holder to immediately remove the individual studied 369.19 from direct contact. The notice to the individual studied must 369.20 include an explanation of the basis of this determination. 369.21 (2) The individual poses a risk of harm requiring 369.22 continuous supervision while providing direct contact services 369.23 during the period in which the subject may request a 369.24 reconsideration. If the commissioner determines that an 369.25 individual studied poses a risk of harm that requires continuous 369.26 supervision, the individual and the license holder must be sent 369.27 a notice of disqualification. The commissioner shall order the 369.28 license holder to immediately remove the individual studied from 369.29 direct contact services or assure that the individual studied is 369.30 within sight or hearing of another staff person when providing 369.31 direct contact services during the period in which the 369.32 individual may request a reconsideration of the 369.33 disqualification. If the individual studied does not submit a 369.34 timely request for reconsideration, or the individual submits a 369.35 timely request for reconsideration, but the disqualification is 369.36 not set aside for that license holder, the license holder will 370.1 be notified of the disqualification and ordered to immediately 370.2 remove the individual from any position allowing direct contact 370.3 with persons receiving services from the license holder. 370.4 (3) The individual does not pose an imminent risk of harm 370.5 or a risk of harm requiring continuous supervision while 370.6 providing direct contact services during the period in which the 370.7 subject may request a reconsideration. If the commissioner 370.8 determines that an individual studied does not pose a risk of 370.9 harm that requires continuous supervision, only the individual 370.10 must be sent a notice of disqualification. The license holder 370.11 must be sent a notice that more time is needed to complete the 370.12 individual's background study. If the individual studied 370.13 submits a timely request for reconsideration, and if the 370.14 disqualification is set aside for that license holder, the 370.15 license holder will receive the same notification received by 370.16 license holders in cases where the individual studied has no 370.17 disqualifying characteristic. If the individual studied does 370.18 not submit a timely request for reconsideration, or the 370.19 individual submits a timely request for reconsideration, but the 370.20 disqualification is not set aside for that license holder, the 370.21 license holder will be notified of the disqualification and 370.22 ordered to immediately remove the individual from any position 370.23 allowing direct contact with persons receiving services from the 370.24 license holder. 370.25 (c) County licensing agencies performing duties under this 370.26 subdivision may develop an alternative system for determining 370.27 the subject's immediate risk of harm to persons served by the 370.28 program, providing the notices under paragraph (b), and 370.29 documenting the action taken by the county licensing agency. 370.30 Each county licensing agency's implementation of the alternative 370.31 system is subject to approval by the commissioner. 370.32 Notwithstanding this alternative system, county licensing 370.33 agencies shall complete the requirements of paragraph (a). 370.34 Sec. 9. Minnesota Statutes 2000, section 245A.04, 370.35 subdivision 3b, is amended to read: 370.36 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 371.1 individual who is the subject of the disqualification may 371.2 request a reconsideration of the disqualification. 371.3 The individual must submit the request for reconsideration 371.4 to the commissioner in writing. A request for reconsideration 371.5 for an individual who has been sent a notice of disqualification 371.6 under subdivision 3a, paragraph (b), clause (1) or (2), must be 371.7 submitted within 30 calendar days of the disqualified 371.8 individual's receipt of the notice of disqualification. A 371.9 request for reconsideration for an individual who has been sent 371.10 a notice of disqualification under subdivision 3a, paragraph 371.11 (b), clause (3), must be submitted within 15 calendar days of 371.12 the disqualified individual's receipt of the notice of 371.13 disqualification. Removal of a disqualified individual from 371.14 direct contact shall be ordered if the individual does not 371.15 request reconsideration within the prescribed time, and for an 371.16 individual who submits a timely request for reconsideration, if 371.17 the disqualification is not set aside. The individual must 371.18 present information showing that: 371.19 (1) the information the commissioner relied upon is 371.20 incorrect or inaccurate. If the basis of a reconsideration 371.21 request is that a maltreatment determination or disposition 371.22 under section 626.556 or 626.557 is incorrect, and the 371.23 commissioner has issued a final order in an appeal of that 371.24 determination or disposition under section 256.045, the 371.25 commissioner's order is conclusive on the issue of maltreatment; 371.26 or 371.27 (2) the subject of the study does not pose a risk of harm 371.28 to any person served by the applicantor, license holder, or 371.29 registrant. 371.30 (b) The commissioner may set aside the disqualification 371.31 under this section if the commissioner finds that the 371.32 information the commissioner relied upon is incorrect or the 371.33 individual does not pose a risk of harm to any person served by 371.34 the applicantor, license holder, or registrant. In determining 371.35 that an individual does not pose a risk of harm, the 371.36 commissioner shall consider the consequences of the event or 372.1 events that lead to disqualification, whether there is more than 372.2 one disqualifying event, the vulnerability of the victim at the 372.3 time of the event, the time elapsed without a repeat of the same 372.4 or similar event, documentation of successful completion by the 372.5 individual studied of training or rehabilitation pertinent to 372.6 the event, and any other information relevant to 372.7 reconsideration. In reviewing a disqualification under this 372.8 section, the commissioner shall give preeminent weight to the 372.9 safety of each person to be served by the license holderor, 372.10 applicant, or registrant over the interests of the license 372.11 holderor, applicant, or registrant. 372.12 (c) Unless the information the commissioner relied on in 372.13 disqualifying an individual is incorrect, the commissioner may 372.14 not set aside the disqualification of an individual in 372.15 connection with a license to provide family day care for 372.16 children, foster care for children in the provider's own home, 372.17 or foster care or day care services for adults in the provider's 372.18 own home if: 372.19 (1) less than ten years have passed since the discharge of 372.20 the sentence imposed for the offense; and the individual has 372.21 been convicted of a violation of any offense listed in sections 372.22 609.20 (manslaughter in the first degree), 609.205 (manslaughter 372.23 in the second degree), criminal vehicular homicide under 609.21 372.24 (criminal vehicular homicide and injury), 609.215 (aiding 372.25 suicide or aiding attempted suicide), felony violations under 372.26 609.221 to 609.2231 (assault in the first, second, third, or 372.27 fourth degree), 609.713 (terroristic threats), 609.235 (use of 372.28 drugs to injure or to facilitate crime), 609.24 (simple 372.29 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 372.30 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 372.31 first or second degree), 609.71 (riot), burglary in the first or 372.32 second degree under 609.582 (burglary), 609.66 (dangerous 372.33 weapon), 609.665 (spring guns), 609.67 (machine guns and 372.34 short-barreled shotguns), 609.749 (harassment; stalking), 372.35 152.021 or 152.022 (controlled substance crime in the first or 372.36 second degree), 152.023, subdivision 1, clause (3) or (4), or 373.1 subdivision 2, clause (4) (controlled substance crime in the 373.2 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 373.3 (controlled substance crime in the fourth degree), 609.224, 373.4 subdivision 2, paragraph (c) (fifth-degree assault by a 373.5 caregiver against a vulnerable adult), 609.228 (great bodily 373.6 harm caused by distribution of drugs), 609.23 (mistreatment of 373.7 persons confined), 609.231 (mistreatment of residents or 373.8 patients), 609.2325 (criminal abuse of a vulnerable adult), 373.9 609.233 (criminal neglect of a vulnerable adult), 609.2335 373.10 (financial exploitation of a vulnerable adult), 609.234 (failure 373.11 to report), 609.265 (abduction), 609.2664 to 609.2665 373.12 (manslaughter of an unborn child in the first or second degree), 373.13 609.267 to 609.2672 (assault of an unborn child in the first, 373.14 second, or third degree), 609.268 (injury or death of an unborn 373.15 child in the commission of a crime), 617.293 (disseminating or 373.16 displaying harmful material to minors), a gross misdemeanor 373.17 offense under 609.324, subdivision 1 (other prohibited acts), a 373.18 gross misdemeanor offense under 609.378 (neglect or endangerment 373.19 of a child), a gross misdemeanor offense under 609.377 373.20 (malicious punishment of a child), 609.72, subdivision 3 373.21 (disorderly conduct against a vulnerable adult); or an attempt 373.22 or conspiracy to commit any of these offenses, as each of these 373.23 offenses is defined in Minnesota Statutes; or an offense in any 373.24 other state, the elements of which are substantially similar to 373.25 the elements of any of the foregoing offenses; 373.26 (2) regardless of how much time has passed since the 373.27 discharge of the sentence imposed for the offense, the 373.28 individual was convicted of a violation of any offense listed in 373.29 sections 609.185 to 609.195 (murder in the first, second, or 373.30 third degree), 609.2661 to 609.2663 (murder of an unborn child 373.31 in the first, second, or third degree), a felony offense under 373.32 609.377 (malicious punishment of a child), a felony offense 373.33 under 609.324, subdivision 1 (other prohibited acts), a felony 373.34 offense under 609.378 (neglect or endangerment of a child), 373.35 609.322 (solicitation, inducement, and promotion of 373.36 prostitution), 609.342 to 609.345 (criminal sexual conduct in 374.1 the first, second, third, or fourth degree), 609.352 374.2 (solicitation of children to engage in sexual conduct), 617.246 374.3 (use of minors in a sexual performance), 617.247 (possession of 374.4 pictorial representations of a minor), 609.365 (incest), a 374.5 felony offense under sections 609.2242 and 609.2243 (domestic 374.6 assault), a felony offense of spousal abuse, a felony offense of 374.7 child abuse or neglect, a felony offense of a crime against 374.8 children, or an attempt or conspiracy to commit any of these 374.9 offenses as defined in Minnesota Statutes, or an offense in any 374.10 other state, the elements of which are substantially similar to 374.11 any of the foregoing offenses; 374.12 (3) within the seven years preceding the study, the 374.13 individual committed an act that constitutes maltreatment of a 374.14 child under section 626.556, subdivision 10e, and that resulted 374.15 in substantial bodily harm as defined in section 609.02, 374.16 subdivision 7a, or substantial mental or emotional harm as 374.17 supported by competent psychological or psychiatric evidence; or 374.18 (4) within the seven years preceding the study, the 374.19 individual was determined under section 626.557 to be the 374.20 perpetrator of a substantiated incident of maltreatment of a 374.21 vulnerable adult that resulted in substantial bodily harm as 374.22 defined in section 609.02, subdivision 7a, or substantial mental 374.23 or emotional harm as supported by competent psychological or 374.24 psychiatric evidence. 374.25 In the case of any ground for disqualification under 374.26 clauses (1) to (4), if the act was committed by an individual 374.27 other than the applicantor, license holder, or registrant 374.28 residing in the applicant'sor, license holder's, or 374.29 registrant's home, the applicantor, license holder, or 374.30 registrant may seek reconsideration when the individual who 374.31 committed the act no longer resides in the home. 374.32 The disqualification periods provided under clauses (1), 374.33 (3), and (4) are the minimum applicable disqualification 374.34 periods. The commissioner may determine that an individual 374.35 should continue to be disqualified from licensure or 374.36 registration because the license holderor, registrant, or 375.1 applicant poses a risk of harm to a person served by that 375.2 individual after the minimum disqualification period has passed. 375.3 (d) The commissioner shall respond in writing or by 375.4 electronic transmission to all reconsideration requests for 375.5 which the basis for the request is that the information relied 375.6 upon by the commissioner to disqualify is incorrect or 375.7 inaccurate within 30 working days of receipt of a request and 375.8 all relevant information. If the basis for the request is that 375.9 the individual does not pose a risk of harm, the commissioner 375.10 shall respond to the request within 15 working days after 375.11 receiving the request for reconsideration and all relevant 375.12 information. If the disqualification is set aside, the 375.13 commissioner shall notify the applicant or license holder in 375.14 writing or by electronic transmission of the decision. 375.15 (e) Except as provided in subdivision 3c, the 375.16 commissioner's decision to disqualify an individual, including 375.17 the decision to grant or deny a rescission or set aside a 375.18 disqualification under this section, is the final administrative 375.19 agency action and shall not be subject to further review in a 375.20 contested case under chapter 14 involving a negative licensing 375.21 appeal taken in response to the disqualification or involving an 375.22 accuracy and completeness appeal under section 13.04. 375.23 Sec. 10. Minnesota Statutes 2000, section 245A.04, 375.24 subdivision 3d, is amended to read: 375.25 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in 375.26 paragraph (b), when a background study completed under 375.27 subdivision 3 shows any of the following: a conviction of one 375.28 or more crimes listed in clauses (1) to (4); the individual has 375.29 admitted to or a preponderance of the evidence indicates the 375.30 individual has committed an act or acts that meet the definition 375.31 of any of the crimes listed in clauses (1) to (4); or an 375.32 administrative determination listed under clause (4), the 375.33 individual shall be disqualified from any position allowing 375.34 direct contact with persons receiving services from the license 375.35 holder or registrant: 375.36 (1) regardless of how much time has passed since the 376.1 discharge of the sentence imposed for the offense, and unless 376.2 otherwise specified, regardless of the level of the conviction, 376.3 the individual was convicted of any of the following offenses: 376.4 sections 609.185 (murder in the first degree); 609.19 (murder in 376.5 the second degree); 609.195 (murder in the third degree); 376.6 609.2661 (murder of an unborn child in the first degree); 376.7 609.2662 (murder of an unborn child in the second degree); 376.8 609.2663 (murder of an unborn child in the third degree); 376.9 609.322 (solicitation, inducement, and promotion of 376.10 prostitution); 609.342 (criminal sexual conduct in the first 376.11 degree); 609.343 (criminal sexual conduct in the second degree); 376.12 609.344 (criminal sexual conduct in the third degree); 609.345 376.13 (criminal sexual conduct in the fourth degree); 609.352 376.14 (solicitation of children to engage in sexual conduct); 609.365 376.15 (incest); felony offense under 609.377 (malicious punishment of 376.16 a child); a felony offense under 609.378 (neglect or 376.17 endangerment of a child); a felony offense under 609.324, 376.18 subdivision 1 (other prohibited acts); 617.246 (use of minors in 376.19 sexual performance prohibited); 617.247 (possession of pictorial 376.20 representations of minors); a felony offense under sections 376.21 609.2242 and 609.2243 (domestic assault), a felony offense of 376.22 spousal abuse, a felony offense of child abuse or neglect, a 376.23 felony offense of a crime against children; or attempt or 376.24 conspiracy to commit any of these offenses as defined in 376.25 Minnesota Statutes, or an offense in any other state or country, 376.26 where the elements are substantially similar to any of the 376.27 offenses listed in this clause; 376.28 (2) if less than 15 years have passed since the discharge 376.29 of the sentence imposed for the offense; and the individual has 376.30 received a felony conviction for a violation of any of these 376.31 offenses: sections 609.20 (manslaughter in the first degree); 376.32 609.205 (manslaughter in the second degree); 609.21 (criminal 376.33 vehicular homicide and injury); 609.215 (suicide); 609.221 to 376.34 609.2231 (assault in the first, second, third, or fourth 376.35 degree); repeat offenses under 609.224 (assault in the fifth 376.36 degree); repeat offenses under 609.3451 (criminal sexual conduct 377.1 in the fifth degree); 609.713 (terroristic threats); 609.235 377.2 (use of drugs to injure or facilitate crime); 609.24 (simple 377.3 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 377.4 609.255 (false imprisonment); 609.561 (arson in the first 377.5 degree); 609.562 (arson in the second degree); 609.563 (arson in 377.6 the third degree); repeat offenses under 617.23 (indecent 377.7 exposure; penalties); repeat offenses under 617.241 (obscene 377.8 materials and performances; distribution and exhibition 377.9 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 377.10 609.67 (machine guns and short-barreled shotguns); 609.749 377.11 (harassment; stalking; penalties); 609.228 (great bodily harm 377.12 caused by distribution of drugs); 609.2325 (criminal abuse of a 377.13 vulnerable adult); 609.2664 (manslaughter of an unborn child in 377.14 the first degree); 609.2665 (manslaughter of an unborn child in 377.15 the second degree); 609.267 (assault of an unborn child in the 377.16 first degree); 609.2671 (assault of an unborn child in the 377.17 second degree); 609.268 (injury or death of an unborn child in 377.18 the commission of a crime); 609.52 (theft); 609.2335 (financial 377.19 exploitation of a vulnerable adult); 609.521 (possession of 377.20 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 377.21 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 377.22 forged check); 609.635 (obtaining signature by false pretense); 377.23 609.27 (coercion); 609.275 (attempt to coerce); 609.687 377.24 (adulteration); 260C.301 (grounds for termination of parental 377.25 rights); and chapter 152 (drugs; controlled substance). An 377.26 attempt or conspiracy to commit any of these offenses, as each 377.27 of these offenses is defined in Minnesota Statutes; or an 377.28 offense in any other state or country, the elements of which are 377.29 substantially similar to the elements of the offenses in this 377.30 clause. If the individual studied is convicted of one of the 377.31 felonies listed in this clause, but the sentence is a gross 377.32 misdemeanor or misdemeanor disposition, the lookback period for 377.33 the conviction is the period applicable to the disposition, that 377.34 is the period for gross misdemeanors or misdemeanors; 377.35 (3) if less than ten years have passed since the discharge 377.36 of the sentence imposed for the offense; and the individual has 378.1 received a gross misdemeanor conviction for a violation of any 378.2 of the following offenses: sections 609.224 (assault in the 378.3 fifth degree); 609.2242 and 609.2243 (domestic assault); 378.4 violation of an order for protection under 518B.01, subdivision 378.5 14; 609.3451 (criminal sexual conduct in the fifth degree); 378.6 repeat offenses under 609.746 (interference with privacy); 378.7 repeat offenses under 617.23 (indecent exposure); 617.241 378.8 (obscene materials and performances); 617.243 (indecent 378.9 literature, distribution); 617.293 (harmful materials; 378.10 dissemination and display to minors prohibited); 609.71 (riot); 378.11 609.66 (dangerous weapons); 609.749 (harassment; stalking; 378.12 penalties); 609.224, subdivision 2, paragraph (c) (assault in 378.13 the fifth degree by a caregiver against a vulnerable adult); 378.14 609.23 (mistreatment of persons confined); 609.231 (mistreatment 378.15 of residents or patients); 609.2325 (criminal abuse of a 378.16 vulnerable adult); 609.233 (criminal neglect of a vulnerable 378.17 adult); 609.2335 (financial exploitation of a vulnerable adult); 378.18 609.234 (failure to report maltreatment of a vulnerable adult); 378.19 609.72, subdivision 3 (disorderly conduct against a vulnerable 378.20 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 378.21 a child); 609.377 (malicious punishment of a child); 609.324, 378.22 subdivision 1a (other prohibited acts; minor engaged in 378.23 prostitution); 609.33 (disorderly house); 609.52 (theft); 378.24 609.582 (burglary); 609.631 (check forgery; offering a forged 378.25 check); 609.275 (attempt to coerce); or an attempt or conspiracy 378.26 to commit any of these offenses, as each of these offenses is 378.27 defined in Minnesota Statutes; or an offense in any other state 378.28 or country, the elements of which are substantially similar to 378.29 the elements of any of the offenses listed in this clause. If 378.30 the defendant is convicted of one of the gross misdemeanors 378.31 listed in this clause, but the sentence is a misdemeanor 378.32 disposition, the lookback period for the conviction is the 378.33 period applicable to misdemeanors; or 378.34 (4) if less than seven years have passed since the 378.35 discharge of the sentence imposed for the offense; and the 378.36 individual has received a misdemeanor conviction for a violation 379.1 of any of the following offenses: sections 609.224 (assault in 379.2 the fifth degree); 609.2242 (domestic assault); violation of an 379.3 order for protection under 518B.01 (Domestic Abuse Act); 379.4 violation of an order for protection under 609.3232 (protective 379.5 order authorized; procedures; penalties); 609.746 (interference 379.6 with privacy); 609.79 (obscene or harassing phone calls); 379.7 609.795 (letter, telegram, or package; opening; harassment); 379.8 617.23 (indecent exposure; penalties); 609.2672 (assault of an 379.9 unborn child in the third degree); 617.293 (harmful materials; 379.10 dissemination and display to minors prohibited); 609.66 379.11 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 379.12 exploitation of a vulnerable adult); 609.234 (failure to report 379.13 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 379.14 (coercion); or an attempt or conspiracy to commit any of these 379.15 offenses, as each of these offenses is defined in Minnesota 379.16 Statutes; or an offense in any other state or country, the 379.17 elements of which are substantially similar to the elements of 379.18 any of the offenses listed in this clause; failure to make 379.19 required reports under section 626.556, subdivision 3, or 379.20 626.557, subdivision 3, for incidents in which: (i) the final 379.21 disposition under section 626.556 or 626.557 was substantiated 379.22 maltreatment, and (ii) the maltreatment was recurring or 379.23 serious; or substantiated serious or recurring maltreatment of a 379.24 minor under section 626.556 or of a vulnerable adult under 379.25 section 626.557 for which there is a preponderance of evidence 379.26 that the maltreatment occurred, and that the subject was 379.27 responsible for the maltreatment. 379.28 For the purposes of this section, "serious maltreatment" 379.29 means sexual abuse; maltreatment resulting in death; or 379.30 maltreatment resulting in serious injury which reasonably 379.31 requires the care of a physician whether or not the care of a 379.32 physician was sought; or abuse resulting in serious injury. For 379.33 purposes of this section, "abuse resulting in serious injury" 379.34 means: bruises, bites, skin laceration or tissue damage; 379.35 fractures; dislocations; evidence of internal injuries; head 379.36 injuries with loss of consciousness; extensive second-degree or 380.1 third-degree burns and other burns for which complications are 380.2 present; extensive second-degree or third-degree frostbite, and 380.3 others for which complications are present; irreversible 380.4 mobility or avulsion of teeth; injuries to the eyeball; 380.5 ingestion of foreign substances and objects that are harmful; 380.6 near drowning; and heat exhaustion or sunstroke. For purposes 380.7 of this section, "care of a physician" is treatment received or 380.8 ordered by a physician, but does not include diagnostic testing, 380.9 assessment, or observation. For the purposes of this section, 380.10 "recurring maltreatment" means more than one incident of 380.11 maltreatment for which there is a preponderance of evidence that 380.12 the maltreatment occurred, and that the subject was responsible 380.13 for the maltreatment. 380.14 (b) If the subject of a background study is licensed by a 380.15 health-related licensing board, the board shall make the 380.16 determination regarding a disqualification under this 380.17 subdivision based on a finding of substantiated maltreatment 380.18 under section 626.556 or 626.557. The commissioner shall notify 380.19 the health-related licensing board if a background study shows 380.20 that a licensee would be disqualified because of substantiated 380.21 maltreatment and the board shall make a determination under 380.22 section 214.104. 380.23 Sec. 11. [REPORT ON SUPPLEMENTAL NURSING SERVICES AGENCY 380.24 USE.] 380.25 Beginning July 1, 2001, through June 30, 2003, the 380.26 commissioner of human services shall require nursing facilities 380.27 and other providers of long-term care services to report 380.28 semiannually on the use of supplemental nursing services, in the 380.29 form and manner specified by the commissioner. The information 380.30 reported must include, but is not limited to: 380.31 (1) number of hours worked by supplemental nursing services 380.32 personnel, by job classification, for each month; 380.33 (2) payments to supplemental nursing services agencies, on 380.34 a per hour worked basis, by job classification, for each month; 380.35 and 380.36 (3) percentage of total monthly work hours provided by 381.1 supplemental nursing services agency personnel, by job 381.2 classification, for each shift and for weekdays and weekends. 381.3 ARTICLE 8 381.4 LONG-TERM CARE INSURANCE 381.5 Section 1. Minnesota Statutes 2000, section 62A.48, 381.6 subdivision 4, is amended to read: 381.7 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for 381.8 long-term care policies must not be less than 65 percent for 381.9 policies issued on a group basis or 60 percent for policies 381.10 issued on an individual or mass-market basis. This subdivision 381.11 does not apply to policies issued on or after January 1, 2002, 381.12 that comply with sections 62S.021 and 62S.081. 381.13 [EFFECTIVE DATE.] This section is effective the day 381.14 following final enactment. 381.15 Sec. 2. Minnesota Statutes 2000, section 62A.48, is 381.16 amended by adding a subdivision to read: 381.17 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM 381.18 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 381.19 or after January 1, 2002, must comply with sections 62S.021, 381.20 62S.081, 62S.265, and 62S.266 to the same extent as policies 381.21 issued under chapter 62S. 381.22 [EFFECTIVE DATE.] This section is effective the day 381.23 following final enactment. 381.24 Sec. 3. Minnesota Statutes 2000, section 62A.48, is 381.25 amended by adding a subdivision to read: 381.26 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under 381.27 sections 62A.46 to 62A.56 on or after January 1, 2002, must 381.28 comply with section 62S.02, subdivision 2, to the same extent as 381.29 policies issued under chapter 62S. 381.30 [EFFECTIVE DATE.] This section is effective the day 381.31 following final enactment. 381.32 Sec. 4. Minnesota Statutes 2000, section 62S.01, is 381.33 amended by adding a subdivision to read: 381.34 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional 381.35 increase" means only those premium rate increases filed by an 381.36 insurer as exceptional for which the commissioner determines 382.1 that the need for the premium rate increase is justified due to 382.2 changes in laws or rules applicable to long-term care coverage 382.3 in this state, or due to increased and unexpected utilization 382.4 that affects the majority of insurers of similar products. 382.5 (b) Except as provided in section 62S.265, exceptional 382.6 increases are subject to the same requirements as other premium 382.7 rate schedule increases. The commissioner may request a review 382.8 by an independent actuary or a professional actuarial body of 382.9 the basis for a request that an increase be considered an 382.10 exceptional increase. The commissioner, in determining that the 382.11 necessary basis for an exceptional increase exists, shall also 382.12 determine any potential offsets to higher claims costs. 382.13 [EFFECTIVE DATE.] This section is effective the day 382.14 following final enactment. 382.15 Sec. 5. Minnesota Statutes 2000, section 62S.01, is 382.16 amended by adding a subdivision to read: 382.17 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section 382.18 62S.265, subdivision 10, means that the value of the long-term 382.19 care benefits provided is less than ten percent of the total 382.20 value of the benefits provided over the life of the policy. 382.21 These values must be measured as of the date of issue. 382.22 [EFFECTIVE DATE.] This section is effective the day 382.23 following final enactment. 382.24 Sec. 6. Minnesota Statutes 2000, section 62S.01, is 382.25 amended by adding a subdivision to read: 382.26 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means 382.27 a member in good standing of the American Academy of Actuaries. 382.28 [EFFECTIVE DATE.] This section is effective the day 382.29 following final enactment. 382.30 Sec. 7. Minnesota Statutes 2000, section 62S.01, is 382.31 amended by adding a subdivision to read: 382.32 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms" 382.33 means all of the long-term care insurance policies and 382.34 certificates issued by an insurer in the same long-term care 382.35 benefit classification as the policy form being considered. 382.36 Certificates of groups that meet the definition in section 383.1 62S.01, subdivision 15, clause (1), are not considered similar 383.2 to certificates or policies otherwise issued as long-term care 383.3 insurance, but are similar to other comparable certificates with 383.4 the same long-term care benefit classifications. For purposes 383.5 of determining similar policy forms, long-term care benefit 383.6 classifications are defined as follows: institutional long-term 383.7 care benefits only, noninstitutional long-term care benefits 383.8 only, or comprehensive long-term care benefits. 383.9 [EFFECTIVE DATE.] This section is effective the day 383.10 following final enactment. 383.11 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 383.12 FILING.] 383.13 Subdivision 1. [APPLICABILITY.] This section applies to 383.14 any long-term care policy issued in this state on or after 383.15 January 1, 2002, under this chapter or sections 62A.46 to 62A.56. 383.16 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 383.17 shall provide the following information to the commissioner 30 383.18 days prior to making a long-term care insurance form available 383.19 for sale: 383.20 (1) a copy of the disclosure documents required in section 383.21 62S.081; and 383.22 (2) an actuarial certification consisting of at least the 383.23 following: 383.24 (i) a statement that the initial premium rate schedule is 383.25 sufficient to cover anticipated costs under moderately adverse 383.26 experience and that the premium rate schedule is reasonably 383.27 expected to be sustainable over the life of the form with no 383.28 future premium increases anticipated; 383.29 (ii) a statement that the policy design and coverage 383.30 provided have been reviewed and taken into consideration; 383.31 (iii) a statement that the underwriting and claims 383.32 adjudication processes have been reviewed and taken into 383.33 consideration; and 383.34 (iv) a complete description of the basis for contract 383.35 reserves that are anticipated to be held under the form, to 383.36 include: 384.1 (A) sufficient detail or sample calculations provided so as 384.2 to have a complete depiction of the reserve amounts to be held; 384.3 (B) a statement that the assumptions used for reserves 384.4 contain reasonable margins for adverse experience; 384.5 (C) a statement that the net valuation premium for renewal 384.6 years does not increase, except for attained-age rating where 384.7 permitted; 384.8 (D) a statement that the difference between the gross 384.9 premium and the net valuation premium for renewal years is 384.10 sufficient to cover expected renewal expenses, or if such a 384.11 statement cannot be made, a complete description of the 384.12 situations in which this does not occur. An aggregate 384.13 distribution of anticipated issues may be used as long as the 384.14 underlying gross premiums maintain a reasonably consistent 384.15 relationship. If the gross premiums for certain age groups 384.16 appear to be inconsistent with this requirement, the 384.17 commissioner may request a demonstration under item (i) based on 384.18 a standard age distribution; and 384.19 (E) either a statement that the premium rate schedule is 384.20 not less than the premium rate schedule for existing similar 384.21 policy forms also available from the insurer except for 384.22 reasonable differences attributable to benefits, or a comparison 384.23 of the premium schedules for similar policy forms that are 384.24 currently available from the insurer with an explanation of the 384.25 differences. 384.26 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may 384.27 request an actuarial demonstration that benefits are reasonable 384.28 in relation to premiums. The actuarial demonstration must 384.29 include either premium and claim experience on similar policy 384.30 forms, adjusted for any premium or benefit differences, relevant 384.31 and credible data from other studies, or both. If the 384.32 commissioner asks for additional information under this 384.33 subdivision, the 30-day time limit in subdivision 2 does not 384.34 include the time during which the insurer is preparing the 384.35 requested information. 384.36 [EFFECTIVE DATE.] This section is effective the day 385.1 following final enactment. 385.2 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 385.3 TO CONSUMERS.] 385.4 Subdivision 1. [APPLICATION.] This section applies as 385.5 follows: 385.6 (a) Except as provided in paragraph (b), this section 385.7 applies to any long-term care policy or certificate issued in 385.8 this state on or after January 1, 2002. 385.9 (b) For certificates issued on or after the effective date 385.10 of this section under a policy of group long-term care insurance 385.11 as defined in section 62S.01, subdivision 15, that was in force 385.12 on the effective date of this section, this section applies on 385.13 the policy anniversary following June 30, 2002. 385.14 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for 385.15 which no applicable premium rate or rate schedule increases can 385.16 be made, insurers shall provide all of the information listed in 385.17 this subdivision to the applicant at the time of application or 385.18 enrollment, unless the method of application does not allow for 385.19 delivery at that time; in this case, an insurer shall provide 385.20 all of the information listed in this subdivision to the 385.21 applicant no later than at the time of delivery of the policy or 385.22 certificate: 385.23 (1) a statement that the policy may be subject to rate 385.24 increases in the future; 385.25 (2) an explanation of potential future premium rate 385.26 revisions and the policyholder's or certificate holder's option 385.27 in the event of a premium rate revision; 385.28 (3) the premium rate or rate schedules applicable to the 385.29 applicant that will be in effect until a request is made for an 385.30 increase; 385.31 (4) a general explanation of applying premium rate or rate 385.32 schedule adjustments that must include: 385.33 (i) a description of when premium rate or rate schedule 385.34 adjustments will be effective, for example the next anniversary 385.35 date or the next billing date; and 385.36 (ii) the right to a revised premium rate or rate schedule 386.1 as provided in clause (3) if the premium rate or rate schedule 386.2 is changed; and 386.3 (5)(i) information regarding each premium rate increase on 386.4 this policy form or similar policy forms over the past ten years 386.5 for this state or any other state that, at a minimum, identifies: 386.6 (A) the policy forms for which premium rates have been 386.7 increased; 386.8 (B) the calendar years when the form was available for 386.9 purchase; and 386.10 (C) the amount or percent of each increase. The percentage 386.11 may be expressed as a percentage of the premium rate prior to 386.12 the increase and may also be expressed as minimum and maximum 386.13 percentages if the rate increase is variable by rating 386.14 characteristics; 386.15 (ii) the insurer may, in a fair manner, provide additional 386.16 explanatory information related to the rate increases; 386.17 (iii) an insurer has the right to exclude from the 386.18 disclosure premium rate increases that apply only to blocks of 386.19 business acquired from other nonaffiliated insurers or the 386.20 long-term care policies acquired from other nonaffiliated 386.21 insurers when those increases occurred prior to the acquisition; 386.22 (iv) if an acquiring insurer files for a rate increase on a 386.23 long-term care policy form acquired from nonaffiliated insurers 386.24 or a block of policy forms acquired from nonaffiliated insurers 386.25 on or before the later of the effective date of this section, or 386.26 the end of a 24-month period following the acquisition of the 386.27 block of policies, the acquiring insurer may exclude that rate 386.28 increase from the disclosure. However, the nonaffiliated 386.29 selling company must include the disclosure of that rate 386.30 increase according to item (i); and 386.31 (v) if the acquiring insurer in item (iv) files for a 386.32 subsequent rate increase, even within the 24-month period, on 386.33 the same policy form acquired from nonaffiliated insurers or 386.34 block of policy forms acquired from nonaffiliated insurers 386.35 referenced in item (iv), the acquiring insurer shall make all 386.36 disclosures required by this subdivision, including disclosure 387.1 of the earlier rate increase referenced in item (iv). 387.2 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an 387.3 acknowledgment at the time of application, unless the method of 387.4 application does not allow for signature at that time, that the 387.5 insurer made the disclosure required under subdivision 2. If, 387.6 due to the method of application, the applicant cannot sign an 387.7 acknowledgment at the time of application, the applicant shall 387.8 sign no later than at the time of delivery of the policy or 387.9 certificate. 387.10 Subd. 4. [FORMS.] An insurer shall use the forms in 387.11 Appendices B and F of the Long-term Care Insurance Model 387.12 Regulation adopted by the National Association of Insurance 387.13 Commissioners to comply with the requirements of subdivisions 1 387.14 and 2. 387.15 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide 387.16 notice of an upcoming premium rate schedule increase, after the 387.17 increase has been approved by the commissioner, to all 387.18 policyholders or certificate holders, if applicable, at least 45 387.19 days prior to the implementation of the premium rate schedule 387.20 increase by the insurer. The notice must include the 387.21 information required by subdivision 2 when the rate increase is 387.22 implemented. 387.23 [EFFECTIVE DATE.] This section is effective the day 387.24 following final enactment. 387.25 Sec. 10. Minnesota Statutes 2000, section 62S.26, is 387.26 amended to read: 387.27 62S.26 [LOSS RATIO.] 387.28 (a) The minimum loss ratio must be at least 60 percent, 387.29 calculated in a manner which provides for adequate reserving of 387.30 the long-term care insurance risk. In evaluating the expected 387.31 loss ratio, the commissioner shall give consideration to all 387.32 relevant factors, including: 387.33 (1) statistical credibility of incurred claims experience 387.34 and earned premiums; 387.35 (2) the period for which rates are computed to provide 387.36 coverage; 388.1 (3) experienced and projected trends; 388.2 (4) concentration of experience within early policy 388.3 duration; 388.4 (5) expected claim fluctuation; 388.5 (6) experience refunds, adjustments, or dividends; 388.6 (7) renewability features; 388.7 (8) all appropriate expense factors; 388.8 (9) interest; 388.9 (10) experimental nature of the coverage; 388.10 (11) policy reserves; 388.11 (12) mix of business by risk classification; and 388.12 (13) product features such as long elimination periods, 388.13 high deductibles, and high maximum limits. 388.14 (b) This section does not apply to policies or certificates 388.15 that are subject to sections 62S.021, 62S.081, and 62S.265, and 388.16 that comply with those sections. 388.17 [EFFECTIVE DATE.] This section is effective the day 388.18 following final enactment. 388.19 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 388.20 Subdivision 1. [APPLICABILITY.] (a) Except as provided in 388.21 paragraph (b), this section applies to any long-term care policy 388.22 or certificate issued in this state on or after January 1, 2002, 388.23 under this chapter or sections 62A.46 to 62A.56. 388.24 (b) For certificates issued on or after the effective date 388.25 of this section under a group long-term care insurance policy as 388.26 defined in section 62S.01, subdivision 15, issued under this 388.27 chapter, that was in force on the effective date of this 388.28 section, this section applies on the policy anniversary 388.29 following June 30, 2002. 388.30 Subd. 2. [NOTICE.] An insurer shall file a requested 388.31 premium rate schedule increase, including an exceptional 388.32 increase, to the commissioner for prior approval at least 60 388.33 days prior to the notice to the policyholders and shall include: 388.34 (1) all information required by section 62S.081; 388.35 (2) certification by a qualified actuary that: 388.36 (i) if the requested premium rate schedule increase is 389.1 implemented and the underlying assumptions, which reflect 389.2 moderately adverse conditions, are realized, no further premium 389.3 rate schedule increases are anticipated; and 389.4 (ii) the premium rate filing complies with this section; 389.5 (3) an actuarial memorandum justifying the rate schedule 389.6 change request that includes: 389.7 (i) lifetime projections of earned premiums and incurred 389.8 claims based on the filed premium rate schedule increase and the 389.9 method and assumptions used in determining the projected values, 389.10 including reflection of any assumptions that deviate from those 389.11 used for pricing other forms currently available for sale; 389.12 (A) annual values for the five years preceding and the 389.13 three years following the valuation date must be provided 389.14 separately; 389.15 (B) the projections must include the development of the 389.16 lifetime loss ratio, unless the rate increase is an exceptional 389.17 increase; 389.18 (C) the projections must demonstrate compliance with 389.19 subdivision 3; and 389.20 (D) for exceptional increases, the projected experience 389.21 must be limited to the increases in claims expenses attributable 389.22 to the approved reasons for the exceptional increase and, if the 389.23 commissioner determines that offsets to higher claim costs may 389.24 exist, the insurer shall use appropriate net projected 389.25 experience; 389.26 (ii) disclosure of how reserves have been incorporated in 389.27 this rate increase whenever the rate increase will trigger 389.28 contingent benefit upon lapse; 389.29 (iii) disclosure of the analysis performed to determine why 389.30 a rate adjustment is necessary, which pricing assumptions were 389.31 not realized and why, and what other actions taken by the 389.32 company have been relied upon by the actuary; 389.33 (iv) a statement that policy design, underwriting, and 389.34 claims adjudication practices have been taken into 389.35 consideration; and 389.36 (v) if it is necessary to maintain consistent premium rates 390.1 for new certificates and certificates receiving a rate increase, 390.2 the insurer shall file composite rates reflecting projections of 390.3 new certificates; 390.4 (4) a statement that renewal premium rate schedules are not 390.5 greater than new business premium rate schedules except for 390.6 differences attributable to benefits, unless sufficient 390.7 justification is provided to the commissioner; and 390.8 (5) sufficient information for review and approval of the 390.9 premium rate schedule increase by the commissioner. 390.10 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 390.11 premium rate schedule increases must be determined according to 390.12 the following requirements: 390.13 (1) exceptional increases must provide that 70 percent of 390.14 the present value of projected additional premiums from the 390.15 exceptional increase will be returned to policyholders in 390.16 benefits; 390.17 (2) premium rate schedule increases must be calculated so 390.18 that the sum of the accumulated value of incurred claims, 390.19 without the inclusion of active life reserves, and the present 390.20 value of future projected incurred claims, without the inclusion 390.21 of active life reserves, will not be less than the sum of the 390.22 following: 390.23 (i) the accumulated value of the initial earned premium 390.24 times 58 percent; 390.25 (ii) 85 percent of the accumulated value of prior premium 390.26 rate schedule increases on an earned basis; 390.27 (iii) the present value of future projected initial earned 390.28 premiums times 58 percent; and 390.29 (iv) 85 percent of the present value of future projected 390.30 premiums not in item (iii) on an earned basis; 390.31 (3) if a policy form has both exceptional and other 390.32 increases, the values in clause (2), items (ii) and (iv), must 390.33 also include 70 percent for exceptional rate increase amounts; 390.34 and 390.35 (4) all present and accumulated values used to determine 390.36 rate increases must use the maximum valuation interest rate for 391.1 contract reserves permitted for valuation of whole life 391.2 insurance policies issued in this state on the same date. The 391.3 actuary shall disclose as part of the actuarial memorandum the 391.4 use of any appropriate averages. 391.5 Subd. 4. [PROJECTIONS.] For each rate increase that is 391.6 implemented, the insurer shall file for approval by the 391.7 commissioner updated projections, as described in subdivision 2, 391.8 clause (3), item (i), annually for the next three years and 391.9 include a comparison of actual results to projected values. The 391.10 commissioner may extend the period to greater than three years 391.11 if actual results are not consistent with projected values from 391.12 prior projections. For group insurance policies that meet the 391.13 conditions in subdivision 11, the projections required by this 391.14 subdivision must be provided to the policyholder in lieu of 391.15 filing with the commissioner. 391.16 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in 391.17 the revised premium rate schedule is greater than 200 percent of 391.18 the comparable rate in the initial premium schedule, lifetime 391.19 projections, as described in subdivision 2, clause (3), item 391.20 (i), must be filed for approval by the commissioner every five 391.21 years following the end of the required period in subdivision 391.22 4. For group insurance policies that meet the conditions in 391.23 subdivision 11, the projections required by this subdivision 391.24 must be provided to the policyholder in lieu of filing with the 391.25 commissioner. 391.26 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 391.27 commissioner has determined that the actual experience following 391.28 a rate increase does not adequately match the projected 391.29 experience and that the current projections under moderately 391.30 adverse conditions demonstrate that incurred claims will not 391.31 exceed proportions of premiums specified in subdivision 3, the 391.32 commissioner may require the insurer to implement any of the 391.33 following: 391.34 (1) premium rate schedule adjustments; or 391.35 (2) other measures to reduce the difference between the 391.36 projected and actual experience. 392.1 (b) In determining whether the actual experience adequately 392.2 matches the projected experience, consideration must be given to 392.3 subdivision 2, clause (3), item (v), if applicable. 392.4 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority 392.5 of the policies or certificates to which the increase is 392.6 applicable are eligible for the contingent benefit upon lapse, 392.7 the insurer shall file: 392.8 (1) a plan, subject to commissioner approval, for improved 392.9 administration or claims processing designed to eliminate the 392.10 potential for further deterioration of the policy form requiring 392.11 further premium rate schedule increases, or both, or a 392.12 demonstration that appropriate administration and claims 392.13 processing have been implemented or are in effect; otherwise, 392.14 the commissioner may impose the condition in subdivision 8, 392.15 paragraph (b); and 392.16 (2) the original anticipated lifetime loss ratio, and the 392.17 premium rate schedule increase that would have been calculated 392.18 according to subdivision 3 had the greater of the original 392.19 anticipated lifetime loss ratio or 58 percent been used in the 392.20 calculations described in subdivision 3, clause (2), items (i) 392.21 and (iii). 392.22 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase 392.23 filing that meets the following criteria, the commissioner shall 392.24 review, for all policies included in the filing, the projected 392.25 lapse rates and past lapse rates during the 12 months following 392.26 each increase to determine if significant adverse lapsation has 392.27 occurred or is anticipated: 392.28 (1) the rate increase is not the first rate increase 392.29 requested for the specific policy form or forms; 392.30 (2) the rate increase is not an exceptional increase; and 392.31 (3) the majority of the policies or certificates to which 392.32 the increase is applicable are eligible for the contingent 392.33 benefit upon lapse. 392.34 (b) If significant adverse lapsation has occurred, is 392.35 anticipated in the filing, or is evidenced in the actual results 392.36 as presented in the updated projections provided by the insurer 393.1 following the requested rate increase, the commissioner may 393.2 determine that a rate spiral exists. Following the 393.3 determination that a rate spiral exists, the commissioner may 393.4 require the insurer to offer, without underwriting, to all 393.5 in-force insureds subject to the rate increase, the option to 393.6 replace existing coverage with one or more reasonably comparable 393.7 products being offered by the insurer or its affiliates. The 393.8 offer must: 393.9 (1) be subject to the approval of the commissioner; 393.10 (2) be based upon actuarially sound principles, but not be 393.11 based upon attained age; and 393.12 (3) provide that maximum benefits under any new policy 393.13 accepted by an insured will be reduced by comparable benefits 393.14 already paid under the existing policy. 393.15 (c) The insurer shall maintain the experience of all the 393.16 replacement insureds separate from the experience of insureds 393.17 originally issued the policy forms. In the event of a request 393.18 for a rate increase on the policy form, the rate increase must 393.19 be limited to the lesser of the maximum rate increase determined 393.20 based on the combined experience and the maximum rate increase 393.21 determined based only upon the experience of the insureds 393.22 originally issued the form plus ten percent. 393.23 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL 393.24 RATES.] If the commissioner determines that the insurer has 393.25 exhibited a persistent practice of filing inadequate initial 393.26 premium rates for long-term care insurance, the commissioner 393.27 may, in addition to the provisions of subdivision 8, take either 393.28 of the following actions: 393.29 (1) prohibit the insurer from filing and marketing 393.30 comparable coverage for a period of up to five years; or 393.31 (2) prohibit the insurer from offering all other similar 393.32 coverages and limit the insurer's marketing of new applications 393.33 for the products that are subject to recent premium rate 393.34 schedule increases. 393.35 Subd. 10. [INCIDENTAL LONG-TERM CARE 393.36 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 394.1 which the long-term care benefits provided by the policy are 394.2 incidental, as defined in section 62S.01, subdivision 17a, if 394.3 the policy complies with all of the following provisions: 394.4 (1) the interest credited internally to determine cash 394.5 value accumulations, including long-term care, if any, are 394.6 guaranteed not to be less than the minimum guaranteed interest 394.7 rate for cash value accumulations without long-term care set 394.8 forth in the policy; 394.9 (2) the portion of the policy that provides insurance 394.10 benefits other than long-term care coverage meets the 394.11 nonforfeiture requirements as applicable in any of the following: 394.12 (i) for life insurance, section 61A.25; 394.13 (ii) for individual deferred annuities, section 61A.245; 394.14 and 394.15 (iii) for variable annuities, section 61A.21; 394.16 (3) the policy meets the disclosure requirements of 394.17 sections 62S.10 and 62S.11 if the policy is governed by chapter 394.18 62S and of section 62A.50 if the policy is governed by sections 394.19 62A.46 to 62A.56; 394.20 (4) the portion of the policy that provides insurance 394.21 benefits other than long-term care coverage meets the 394.22 requirements as applicable in the following: 394.23 (i) policy illustrations to the extent required by state 394.24 law applicable to life insurance; 394.25 (ii) disclosure requirements in state law applicable to 394.26 annuities; and 394.27 (iii) disclosure requirements applicable to variable 394.28 annuities; and 394.29 (5) an actuarial memorandum is filed with the commissioner 394.30 that includes: 394.31 (i) a description of the basis on which the long-term care 394.32 rates were determined; 394.33 (ii) a description of the basis for the reserves; 394.34 (iii) a summary of the type of policy, benefits, 394.35 renewability, general marketing method, and limits on ages of 394.36 issuance; 395.1 (iv) a description and a table of each actuarial assumption 395.2 used. For expenses, an insurer must include percent of premium 395.3 dollars per policy and dollars per unit of benefits, if any; 395.4 (v) a description and a table of the anticipated policy 395.5 reserves and additional reserves to be held in each future year 395.6 for active lives; 395.7 (vi) the estimated average annual premium per policy and 395.8 the average issue age; 395.9 (vii) a statement as to whether underwriting is performed 395.10 at the time of application. The statement must indicate whether 395.11 underwriting is used and, if used, the statement must include a 395.12 description of the type or types of underwriting used, such as 395.13 medical underwriting or functional assessment underwriting. 395.14 Concerning a group policy, the statement must indicate whether 395.15 the enrollee or any dependent will be underwritten and when 395.16 underwriting occurs; and 395.17 (viii) a description of the effect of the long-term care 395.18 policy provision on the required premiums, nonforfeiture values, 395.19 and reserves on the underlying insurance policy, both for active 395.20 lives and those in long-term care claim status. 395.21 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 395.22 not apply to group long-term care insurance policies as defined 395.23 in section 62S.01, subdivision 15, where: 395.24 (1) the policies insure 250 or more persons, and the 395.25 policyholder has 5,000 or more eligible employees of a single 395.26 employer; or 395.27 (2) the policyholder, and not the certificate holders, pays 395.28 a material portion of the premium, which is not less than 20 395.29 percent of the total premium for the group in the calendar year 395.30 prior to the year in which a rate increase is filed. 395.31 [EFFECTIVE DATE.] This section is effective the day 395.32 following final enactment. 395.33 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 395.34 Subdivision 1. [APPLICABILITY.] This section does not 395.35 apply to life insurance policies or riders containing 395.36 accelerated long-term care benefits. 396.1 Subd. 2. [REQUIREMENT.] An insurer must offer each 396.2 prospective policyholder a nonforfeiture benefit in compliance 396.3 with the following requirements: 396.4 (1) a policy or certificate offered with nonforfeiture 396.5 benefits must have coverage elements, eligibility, benefit 396.6 triggers, and benefit length that are the same as coverage to be 396.7 issued without nonforfeiture benefits. The nonforfeiture 396.8 benefit included in the offer must be the benefit described in 396.9 subdivision 5; and 396.10 (2) the offer must be in writing if the nonforfeiture 396.11 benefit is not otherwise described in the outline of coverage or 396.12 other materials given to the prospective policyholder. 396.13 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer 396.14 required to be made under subdivision 2 is rejected, the insurer 396.15 shall provide the contingent benefit upon lapse described in 396.16 this section. 396.17 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After 396.18 rejection of the offer required under subdivision 2, for 396.19 individual and group policies without nonforfeiture benefits 396.20 issued after the effective date of this section, the insurer 396.21 shall provide a contingent benefit upon lapse. 396.22 (b) If a group policyholder elects to make the 396.23 nonforfeiture benefit an option to the certificate holder, a 396.24 certificate shall provide either the nonforfeiture benefit or 396.25 the contingent benefit upon lapse. 396.26 (c) The contingent benefit on lapse must be triggered every 396.27 time an insurer increases the premium rates to a level which 396.28 results in a cumulative increase of the annual premium equal to 396.29 or exceeding the percentage of the insured's initial annual 396.30 premium based on the insured's issue age provided in this 396.31 paragraph, and the policy or certificate lapses within 120 days 396.32 of the due date of the premium increase. Unless otherwise 396.33 required, policyholders shall be notified at least 30 days prior 396.34 to the due date of the premium reflecting the rate increase. 396.35 Triggers for a Substantial Premium Increase 396.36 Percent Increase 397.1 Issue Age Over Initial Premium 397.2 29 and Under 200 397.3 30-34 190 397.4 35-39 170 397.5 40-44 150 397.6 45-49 130 397.7 50-54 110 397.8 55-59 90 397.9 60 70 397.10 61 66 397.11 62 62 397.12 63 58 397.13 64 54 397.14 65 50 397.15 66 48 397.16 67 46 397.17 68 44 397.18 69 42 397.19 70 40 397.20 71 38 397.21 72 36 397.22 73 34 397.23 74 32 397.24 75 30 397.25 76 28 397.26 77 26 397.27 78 24 397.28 79 22 397.29 80 20 397.30 81 19 397.31 82 18 397.32 83 17 397.33 84 16 397.34 85 15 397.35 86 14 397.36 87 13 398.1 88 12 398.2 89 11 398.3 90 and over 10 398.4 (d) On or before the effective date of a substantial 398.5 premium increase as defined in paragraph (c), the insurer shall: 398.6 (1) offer to reduce policy benefits provided by the current 398.7 coverage without the requirement of additional underwriting so 398.8 that required premium payments are not increased; 398.9 (2) offer to convert the coverage to a paid-up status with 398.10 a shortened benefit period according to the terms of subdivision 398.11 5. This option may be elected at any time during the 120-day 398.12 period referenced in paragraph (c); and 398.13 (3) notify the policyholder or certificate holder that a 398.14 default or lapse at any time during the 120-day period 398.15 referenced in paragraph (c) is deemed to be the election of the 398.16 offer to convert in clause (2). 398.17 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 398.18 Benefits continued as nonforfeiture benefits, including 398.19 contingent benefits upon lapse, must be as described in this 398.20 subdivision. 398.21 (b) For purposes of this subdivision, "attained age rating" 398.22 is defined as a schedule of premiums starting from the issue 398.23 date which increases with age at least one percent per year 398.24 prior to age 50, and at least three percent per year beyond age 398.25 50. 398.26 (c) For purposes of this subdivision, the nonforfeiture 398.27 benefit must be of a shortened benefit period providing paid-up, 398.28 long-term care insurance coverage after lapse. The same 398.29 benefits, amounts, and frequency in effect at the time of lapse, 398.30 but not increased thereafter, will be payable for a qualifying 398.31 claim, but the lifetime maximum dollars or days of benefits must 398.32 be determined as specified in paragraph (d). 398.33 (d) The standard nonforfeiture credit is equal to 100 398.34 percent of the sum of all premiums paid, including the premiums 398.35 paid prior to any changes in benefits. The insurer may offer 398.36 additional shortened benefit period options, so long as the 399.1 benefits for each duration equal or exceed the standard 399.2 nonforfeiture credit for that duration. However, the minimum 399.3 nonforfeiture credit must not be less than 30 times the daily 399.4 nursing home benefit at the time of lapse. In either event, the 399.5 calculation of the nonforfeiture credit is subject to the 399.6 limitation of this subdivision. 399.7 (e) The nonforfeiture benefit must begin not later than the 399.8 end of the third year following the policy or certificate issue 399.9 date. The contingent benefit upon lapse must be effective 399.10 during the first three years as well as thereafter. 399.11 (f) Notwithstanding paragraph (e), for a policy or 399.12 certificate with attained age rating, the nonforfeiture benefit 399.13 must begin on the earlier of: 399.14 (1) the end of the tenth year following the policy or 399.15 certificate issue date; or 399.16 (2) the end of the second year following the date the 399.17 policy or certificate is no longer subject to attained age 399.18 rating. 399.19 (g) Nonforfeiture credits may be used for all care and 399.20 services qualifying for benefits under the terms of the policy 399.21 or certificate, up to the limits specified in the policy or 399.22 certificate. 399.23 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer 399.24 while the policy or certificate is in premium-paying status and 399.25 in the paid-up status will not exceed the maximum benefits which 399.26 would be payable if the policy or certificate had remained in 399.27 premium-paying status. 399.28 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 399.29 POLICIES.] There must be no difference in the minimum 399.30 nonforfeiture benefits as required under this section for group 399.31 and individual policies. 399.32 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section 399.33 becomes effective January 1, 2002, and applies as follows: 399.34 (a) Except as provided in paragraph (b), this section 399.35 applies to any long-term care policy issued in this state on or 399.36 after the effective date of this section. 400.1 (b) For certificates issued on or after the effective date 400.2 of this section, under a group long-term care insurance policy 400.3 that was in force on the effective date of this section, the 400.4 provisions of this section do not apply. 400.5 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a 400.6 policy or certificate containing nonforfeiture benefits or a 400.7 contingent benefit on lapse are subject to the loss ratio 400.8 requirements of section 62A.48, subdivision 4, or 62S.26, 400.9 treating the policy as a whole, except for policies or 400.10 certificates that are subject to sections 62S.021, 62S.081, and 400.11 62S.265 and that comply with those sections. 400.12 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine 400.13 whether contingent nonforfeiture upon lapse provisions are 400.14 triggered under subdivision 4, paragraph (c), a replacing 400.15 insurer that purchased or otherwise assumed a block or blocks of 400.16 long-term care insurance policies from another insurer shall 400.17 calculate the percentage increase based on the initial annual 400.18 premium paid by the insured when the policy was first purchased 400.19 from the original insurer. 400.20 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 400.21 benefit for qualified long-term care insurance contracts that 400.22 are level premium contracts must be offered that meets the 400.23 following requirements: 400.24 (1) the nonforfeiture provision must be appropriately 400.25 captioned; 400.26 (2) the nonforfeiture provision must provide a benefit 400.27 available in the event of a default in the payment of any 400.28 premiums and must state that the amount of the benefit may be 400.29 adjusted subsequent to being initially granted only as necessary 400.30 to reflect changes in claims, persistency, and interest as 400.31 reflected in changes in rates for premium paying contracts 400.32 approved by the commissioner for the same contract form; and 400.33 (3) the nonforfeiture provision must provide at least one 400.34 of the following: 400.35 (i) reduced paid-up insurance; 400.36 (ii) extended term insurance; 401.1 (iii) shortened benefit period; or 401.2 (iv) other similar offerings approved by the commissioner. 401.3 [EFFECTIVE DATE.] This section is effective the day 401.4 following final enactment. 401.5 Sec. 13. Minnesota Statutes 2000, section 256.975, is 401.6 amended by adding a subdivision to read: 401.7 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] The 401.8 Minnesota board on aging, either directly or through contract, 401.9 shall promote the provision of employer-sponsored, long-term 401.10 care insurance. The board shall encourage private and public 401.11 sector employers to make long-term care insurance available to 401.12 employees, provide interested employers with information on the 401.13 long-term care insurance product offered to state employees, and 401.14 provide technical assistance to employers in designing long-term 401.15 care insurance products and contacting companies offering 401.16 long-term care insurance products. 401.17 Sec. 14. [256B.0571] [LONG-TERM CARE PARTNERSHIP.] 401.18 Subdivision 1. [DEFINITIONS.] For purposes of this 401.19 section, the following terms have the meanings given them. 401.20 (a) "Home care service" means care described in section 401.21 144A.43. 401.22 (b) "Long-term care insurance" means a policy described in 401.23 section 62S.01. 401.24 (c) "Medical assistance" means the program of medical 401.25 assistance established under section 256B.01. 401.26 (d) "Nursing home" means nursing home as described in 401.27 section 144A.01. 401.28 (e) "Partnership policy" means a long-term care insurance 401.29 policy that meets the requirements under chapter 62S. 401.30 (f) "Partnership program" means the Minnesota partnership 401.31 for long-term care program established under this section. 401.32 Subd. 2. [PARTNERSHIP PROGRAM.] (a) Subject to federal 401.33 waiver approval, the commissioner of human services, along with 401.34 the commissioner of commerce, shall establish the Minnesota 401.35 partnership for long-term care program to provide for the 401.36 financing of long-term care through a combination of private 402.1 insurance and medical assistance. 402.2 (b) An individual who meets the requirements in paragraph 402.3 (c) is eligible to participate in the partnership program. 402.4 (c) The individual must: 402.5 (1) be a Minnesota resident; 402.6 (2) purchase a partnership policy that is delivered, issued 402.7 for delivery, or renewed on or after the effective date of this 402.8 section, and maintains the partnership policy in effect 402.9 throughout the period of participation in the partnership 402.10 program; and 402.11 (3) exhaust the minimum benefits under the partnership 402.12 policy as described in this section. Benefits received under a 402.13 long-term care insurance policy before the effective date of 402.14 this section do not count toward the exhaustion of benefits 402.15 required in this subdivision. 402.16 Subd. 3. [MEDICAL ASSISTANCE ELIGIBILITY.] (a) Upon 402.17 application of an individual who meets the requirements 402.18 described in subdivision 2, the commissioner of human services 402.19 shall determine the individual's eligibility for medical 402.20 assistance according to paragraphs (b) and (c). 402.21 (b) After disregarding financial assets exempted under 402.22 medical assistance eligibility requirements, the department 402.23 shall disregard an additional amount of financial assets equal 402.24 to the dollar amount of coverage under the partnership policy. 402.25 (c) The department shall consider the individual's income 402.26 according to medical assistance eligibility requirements. 402.27 Subd. 4. [FEDERAL APPROVAL.] (a) The commissioner of human 402.28 services shall seek appropriate amendments to the medical 402.29 assistance state plan and shall apply for any necessary waiver 402.30 of medical assistance requirements by the federal Health Care 402.31 Financing Administration to implement the partnership program. 402.32 The state shall not implement the partnership program unless the 402.33 provisions in paragraphs (b) and (c) apply. 402.34 (b) The commissioner shall seek any necessary federal 402.35 waiver of medical assistance requirements. 402.36 (c) Individuals who receive medical assistance under this 403.1 section are exempt from estate recovery requirements under 403.2 section 1917, title XIX of the federal Social Security Act, 403.3 United States Code, title 42, section 1396p. 403.4 Subd. 5. [APPROVED POLICIES.] (a) A partnership policy 403.5 must meet all of the requirements in paragraphs (b) to (h). 403.6 (b) Minimum coverage shall be for a period of not less than 403.7 three years and for a dollar amount equal to 36 months of 403.8 nursing home care at the minimum daily benefit rate determined 403.9 and adjusted under paragraph (c). The policy shall provide for 403.10 home health care benefits to be substituted for nursing home 403.11 care benefits on the basis of two home health care days for one 403.12 nursing home care day. 403.13 (c) Minimum daily benefits shall be $130 for nursing home 403.14 care or $65 for home care. These minimum daily benefit amounts 403.15 shall be adjusted by the department on October 1 of each year, 403.16 based on the health care index used under medical assistance for 403.17 nursing home rate setting. Adjusted minimum daily benefit 403.18 amounts shall be rounded to the nearest whole dollar. 403.19 (d) The insured shall be entitled to designate a third 403.20 party to receive notice if the policy is about to lapse for 403.21 nonpayment of premium, and an additional 30-day grace period for 403.22 payment of premium shall be granted following notification to 403.23 that person. 403.24 (e) The policy must cover all of the following services: 403.25 (1) nursing home stay; 403.26 (2) home care service; 403.27 (3) care management; and 403.28 (4) up to 14 days of nursing care in a hospital while the 403.29 individual is waiting for long-term care placement. 403.30 (f) Payment for service under paragraph (e), clause (4), 403.31 must not exceed the daily benefit amount for nursing home care. 403.32 (g) A partnership policy must offer both options in 403.33 paragraph (h) for an adjusted premium. 403.34 (h) The options are: 403.35 (1) an elimination period of not more than 100 days; and 403.36 (2) nonforfeiture benefits for applicants between the ages 404.1 of 18 and 75. 404.2 ARTICLE 9 404.3 MENTAL HEALTH AND CIVIL COMMITMENT 404.4 Section 1. [145.56] [SUICIDE PREVENTION.] 404.5 Subdivision 1. [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 404.6 PLAN.] The commissioner of health shall make suicide prevention 404.7 an important public health goal of the state and shall conduct 404.8 suicide prevention activities to accomplish that goal using an 404.9 evidence-based, public health approach focused on prevention. 404.10 The commissioner shall refine, coordinate, and implement the 404.11 state's suicide prevention plan, in collaboration with assigned 404.12 staff from the department of human services; the department of 404.13 public safety; the department of children, families, and 404.14 learning; and appropriate agencies, organizations, and 404.15 institutions in the community. 404.16 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 404.17 shall establish a grant program consistent with the policy goals 404.18 of this section to fund: 404.19 (1) community-based programs to provide education, 404.20 outreach, and advocacy services to populations who may be at 404.21 risk for suicide; 404.22 (2) community-based programs that educate natural community 404.23 helpers and gatekeepers, such as family members, spiritual 404.24 leaders, coaches, and business owners, employers, and coworkers, 404.25 on how to prevent suicide by encouraging help-seeking behaviors; 404.26 and 404.27 (3) community-based programs to provide evidence-based 404.28 suicide prevention and intervention education to school staff, 404.29 parents, and students in kindergarten through grade 12. 404.30 (b) Education to populations at risk for suicide and to 404.31 community helpers and gatekeepers must include information on 404.32 the symptoms of depression and other psychiatric illnesses, the 404.33 warning signs of suicide, skills for preventing suicides, and 404.34 making or seeking effective referrals to intervention and 404.35 community resources. 404.36 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 405.1 commissioner shall promote the use of employee assistance and 405.2 workplace programs to support employees with depression and 405.3 other psychiatric illnesses and substance abuse disorders, and 405.4 refer them to services. In promoting these programs, the 405.5 commissioner shall collaborate with employer and professional 405.6 associations, unions, and safety councils. 405.7 (b) The commissioner shall provide training and technical 405.8 assistance to local public health and other community-based 405.9 professionals to provide for integrated implementation of best 405.10 practices for preventing suicides. 405.11 Subd. 4. [COLLECTING AND REPORTING SUICIDE DATA.] The 405.12 commissioner shall coordinate with federal, regional, local, and 405.13 other state agencies to collect, analyze, and annually issue a 405.14 public report on Minnesota-specific data on suicide and suicidal 405.15 behaviors. 405.16 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 405.17 commissioner shall conduct periodic evaluations of the impact of 405.18 and outcomes from implementation of the state's suicide 405.19 prevention plan and each of the activities specified in this 405.20 section. By July 1, 2002, and July 1 of each even-numbered year 405.21 thereafter, the commissioner shall report the results of these 405.22 evaluations to the chairs of the policy and finance committees 405.23 in the house and senate with jurisdiction over health and human 405.24 services issues. 405.25 Sec. 2. Minnesota Statutes 2000, section 245.462, 405.26 subdivision 8, is amended to read: 405.27 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 405.28 treatment services," or "day treatment program" means a 405.29 structured program of treatment and care provided to an adult in 405.30 or by: (1) a hospital accredited by the joint commission on 405.31 accreditation of health organizations and licensed under 405.32 sections 144.50 to 144.55; (2) a community mental health center 405.33 under section 245.62; or (3) an entity that is under contract 405.34 with the county board to operate a program that meets the 405.35 requirements of section 245.4712, subdivision 2, and Minnesota 405.36 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 406.1 group psychotherapy and other intensive therapeutic services 406.2 that are provided at least one day a week by a multidisciplinary 406.3 staff under the clinical supervision of a mental health 406.4 professional. Day treatment may include education and 406.5 consultation provided to families and other individuals as part 406.6 of the treatment process. The services are aimed at stabilizing 406.7 the adult's mental health status, providing mental health 406.8 services, and developing and improving the adult's independent 406.9 living and socialization skills. The goal of day treatment is 406.10 to reduce or relieve mental illness and to enable the adult to 406.11 live in the community. Day treatment services are not a part of 406.12 inpatient or residential treatment services. Day treatment 406.13 services are distinguished from day care by their structured 406.14 therapeutic program of psychotherapy services. The commissioner 406.15 may limit medical assistance reimbursement for day treatment to 406.16 15 hours per week per person instead of the three hours per day 406.17 per person specified in Minnesota Rules, part 9505.0323, subpart 406.18 15. 406.19 Sec. 3. Minnesota Statutes 2000, section 245.462, 406.20 subdivision 18, is amended to read: 406.21 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 406.22 professional" means a person providing clinical services in the 406.23 treatment of mental illness who is qualified in at least one of 406.24 the following ways: 406.25 (1) in psychiatric nursing: a registered nurse who is 406.26 licensed under sections 148.171 to 148.285, and who is certified 406.27 as a clinical specialist in adult psychiatric and mental health 406.28 nursing by a national nurse certification organization or who 406.29 has a master's degree in nursing or one of the behavioral 406.30 sciences or related fields from an accredited college or 406.31 university or its equivalent, with at least 4,000 hours of 406.32 post-master's supervised experience in the delivery of clinical 406.33 services in the treatment of mental illness; 406.34 (2) in clinical social work: a person licensed as an 406.35 independent clinical social worker under section 148B.21, 406.36 subdivision 6, or a person with a master's degree in social work 407.1 from an accredited college or university, with at least 4,000 407.2 hours of post-master's supervised experience in the delivery of 407.3 clinical services in the treatment of mental illness; 407.4 (3) in psychology:a psychologistan individual licensed 407.5 by the board of psychology under sections 148.88 to 148.98 who 407.6 has stated to the board of psychology competencies in the 407.7 diagnosis and treatment of mental illness; 407.8 (4) in psychiatry: a physician licensed under chapter 147 407.9 and certified by the American board of psychiatry and neurology 407.10 or eligible for board certification in psychiatry; 407.11 (5) in marriage and family therapy: the mental health 407.12 professional must be a marriage and family therapist licensed 407.13 under sections 148B.29 to 148B.39 with at least two years of 407.14 post-master's supervised experience in the delivery of clinical 407.15 services in the treatment of mental illness; or 407.16 (6) in allied fields: a person with a master's degree from 407.17 an accredited college or university in one of the behavioral 407.18 sciences or related fields, with at least 4,000 hours of 407.19 post-master's supervised experience in the delivery of clinical 407.20 services in the treatment of mental illness. 407.21 Sec. 4. Minnesota Statutes 2000, section 245.462, is 407.22 amended by adding a subdivision to read: 407.23 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.] 407.24 "Significant impairment in functioning" means a condition, 407.25 including significant suicidal ideation or thoughts of harming 407.26 self or others, which harmfully affects, recurrently or 407.27 consistently, a person's activities of daily living in 407.28 employment, housing, family, and social relationships, or 407.29 education. 407.30 Sec. 5. Minnesota Statutes 2000, section 245.4871, 407.31 subdivision 10, is amended to read: 407.32 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day 407.33 treatment services," or "day treatment program" means a 407.34 structured program of treatment and care provided to a child in: 407.35 (1) an outpatient hospital accredited by the joint 407.36 commission on accreditation of health organizations and licensed 408.1 under sections 144.50 to 144.55; 408.2 (2) a community mental health center under section 245.62; 408.3 (3) an entity that is under contract with the county board 408.4 to operate a program that meets the requirements of section 408.5 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 408.6 9505.0475; or 408.7 (4) an entity that operates a program that meets the 408.8 requirements of section 245.4884, subdivision 2, and Minnesota 408.9 Rules, parts 9505.0170 to 9505.0475, that is under contract with 408.10 an entity that is under contract with a county board. 408.11 Day treatment consists of group psychotherapy and other 408.12 intensive therapeutic services that are provided for a minimum 408.13 three-hour time block by a multidisciplinary staff under the 408.14 clinical supervision of a mental health professional. Day 408.15 treatment may include education and consultation provided to 408.16 families and other individuals as an extension of the treatment 408.17 process. The services are aimed at stabilizing the child's 408.18 mental health status, and developing and improving the child's 408.19 daily independent living and socialization skills. Day 408.20 treatment services are distinguished from day care by their 408.21 structured therapeutic program of psychotherapy services. Day 408.22 treatment services are not a part of inpatient hospital or 408.23 residential treatment services. Day treatment services for a 408.24 child are an integrated set of education, therapy, and family 408.25 interventions. 408.26 A day treatment service must be available to a child at 408.27 least five days a week throughout the year and must be 408.28 coordinated with, integrated with, or part of an education 408.29 program offered by the child's school. 408.30 Sec. 6. Minnesota Statutes 2000, section 245.4871, 408.31 subdivision 27, is amended to read: 408.32 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 408.33 professional" means a person providing clinical services in the 408.34 diagnosis and treatment of children's emotional disorders. A 408.35 mental health professional must have training and experience in 408.36 working with children consistent with the age group to which the 409.1 mental health professional is assigned. A mental health 409.2 professional must be qualified in at least one of the following 409.3 ways: 409.4 (1) in psychiatric nursing, the mental health professional 409.5 must be a registered nurse who is licensed under sections 409.6 148.171 to 148.285 and who is certified as a clinical specialist 409.7 in child and adolescent psychiatric or mental health nursing by 409.8 a national nurse certification organization or who has a 409.9 master's degree in nursing or one of the behavioral sciences or 409.10 related fields from an accredited college or university or its 409.11 equivalent, with at least 4,000 hours of post-master's 409.12 supervised experience in the delivery of clinical services in 409.13 the treatment of mental illness; 409.14 (2) in clinical social work, the mental health professional 409.15 must be a person licensed as an independent clinical social 409.16 worker under section 148B.21, subdivision 6, or a person with a 409.17 master's degree in social work from an accredited college or 409.18 university, with at least 4,000 hours of post-master's 409.19 supervised experience in the delivery of clinical services in 409.20 the treatment of mental disorders; 409.21 (3) in psychology, the mental health professional must bea409.22psychologistan individual licensed by the board of psychology 409.23 under sections 148.88 to 148.98 who has stated to the board of 409.24 psychology competencies in the diagnosis and treatment of mental 409.25 disorders; 409.26 (4) in psychiatry, the mental health professional must be a 409.27 physician licensed under chapter 147 and certified by the 409.28 American board of psychiatry and neurology or eligible for board 409.29 certification in psychiatry; 409.30 (5) in marriage and family therapy, the mental health 409.31 professional must be a marriage and family therapist licensed 409.32 under sections 148B.29 to 148B.39 with at least two years of 409.33 post-master's supervised experience in the delivery of clinical 409.34 services in the treatment of mental disorders or emotional 409.35 disturbances; or 409.36 (6) in allied fields, the mental health professional must 410.1 be a person with a master's degree from an accredited college or 410.2 university in one of the behavioral sciences or related fields, 410.3 with at least 4,000 hours of post-master's supervised experience 410.4 in the delivery of clinical services in the treatment of 410.5 emotional disturbances. 410.6 Sec. 7. Minnesota Statutes 2000, section 245.4876, 410.7 subdivision 1, is amended to read: 410.8 Subdivision 1. [CRITERIA.] Children's mental health 410.9 services required by sections 245.487 to 245.4888 must be: 410.10 (1) based, when feasible, on research findings; 410.11 (2) based on individual clinical, cultural, and ethnic 410.12 needs, and other special needs of the children being served; 410.13 (3) delivered in a manner that improves family functioning 410.14 when clinically appropriate; 410.15 (4) provided in the most appropriate, least restrictive 410.16 setting that meets the requirements in subdivision 1a, and that 410.17 is available to the county board to meet the child's treatment 410.18 needs; 410.19 (5) accessible to all age groups of children; 410.20 (6) appropriate to the developmental age of the child being 410.21 served; 410.22 (7) delivered in a manner that provides accountability to 410.23 the child for the quality of service delivered and continuity of 410.24 services to the child during the years the child needs services 410.25 from the local system of care; 410.26 (8) provided by qualified individuals as required in 410.27 sections 245.487 to 245.4888; 410.28 (9) coordinated with children's mental health services 410.29 offered by other providers; 410.30 (10) provided under conditions that protect the rights and 410.31 dignity of the individuals being served; and 410.32 (11) provided in a manner and setting most likely to 410.33 facilitate progress toward treatment goals. 410.34 Sec. 8. Minnesota Statutes 2000, section 245.4876, is 410.35 amended by adding a subdivision to read: 410.36 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 411.1 child must be provided with mental health services in the least 411.2 restrictive setting that is appropriate to the needs and current 411.3 condition of the individual child. For a child to receive 411.4 mental health services in a residential treatment or acute care 411.5 hospital inpatient setting, the family may not be required to 411.6 demonstrate that services were first provided in a less 411.7 restrictive setting and that the child failed to make progress 411.8 toward or meet treatment goals in the less restrictive setting. 411.9 Sec. 9. Minnesota Statutes 2000, section 245.4885, 411.10 subdivision 1, is amended to read: 411.11 Subdivision 1. [SCREENING REQUIRED.] The county board 411.12 shall, prior to admission, except in the case of emergency 411.13 admission, screen all children referred for treatment of severe 411.14 emotional disturbance to a residential treatment facility or 411.15 informally admitted to a regional treatment center if public 411.16 funds are used to pay for the services. The county board shall 411.17 also screen all children admitted to an acute care hospital for 411.18 treatment of severe emotional disturbance if public funds other 411.19 than reimbursement under chapters 256B and 256D are used to pay 411.20 for the services. If a child is admitted to a residential 411.21 treatment facility or acute care hospital for emergency 411.22 treatment or held for emergency care by a regional treatment 411.23 center under section 253B.05, subdivision 1, screening must 411.24 occur within three working days of admission. Screening shall 411.25 determine whether the proposed treatment: 411.26 (1) is necessary; 411.27 (2) is appropriate to the child's individual treatment 411.28 needs; 411.29 (3) cannot be effectively provided in the child's home; and 411.30 (4) provides a length of stay as short as possible 411.31 consistent with the individual child's need. 411.32 When a screening is conducted, the county board may not 411.33 determine that referral or admission to a residential treatment 411.34 facility or acute care hospital is not appropriate solely 411.35 because services were not first provided to the child in a less 411.36 restrictive setting and the child failed to make progress toward 412.1 or meet treatment goals in the less restrictive setting. 412.2 Screening shall include both a diagnostic assessment and a 412.3 functional assessment which evaluates family, school, and 412.4 community living situations. If a diagnostic assessment or 412.5 functional assessment has been completed by a mental health 412.6 professional within 180 days, a new diagnostic or functional 412.7 assessment need not be completed unless in the opinion of the 412.8 current treating mental health professional the child's mental 412.9 health status has changed markedly since the assessment was 412.10 completed. The child's parent shall be notified if an 412.11 assessment will not be completed and of the reasons. A copy of 412.12 the notice shall be placed in the child's file. Recommendations 412.13 developed as part of the screening process shall include 412.14 specific community services needed by the child and, if 412.15 appropriate, the child's family, and shall indicate whether or 412.16 not these services are available and accessible to the child and 412.17 family. 412.18 During the screening process, the child, child's family, or 412.19 child's legal representative, as appropriate, must be informed 412.20 of the child's eligibility for case management services and 412.21 family community support services and that an individual family 412.22 community support plan is being developed by the case manager, 412.23 if assigned. 412.24 Screening shall be in compliance with section 256F.07 or 412.25 260C.212, whichever applies. Wherever possible, the parent 412.26 shall be consulted in the screening process, unless clinically 412.27 inappropriate. 412.28 The screening process, and placement decision, and 412.29 recommendations for mental health services must be documented in 412.30 the child's record. 412.31 An alternate review process may be approved by the 412.32 commissioner if the county board demonstrates that an alternate 412.33 review process has been established by the county board and the 412.34 times of review, persons responsible for the review, and review 412.35 criteria are comparable to the standards in clauses (1) to (4). 412.36 Sec. 10. Minnesota Statutes 2000, section 245.4886, 413.1 subdivision 1, is amended to read: 413.2 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The 413.3 commissioner shall establish a statewide program to assist 413.4 counties in providing services to children with severe emotional 413.5 disturbance as defined in section 245.4871, subdivision 15, and 413.6 their families; and to young adults meeting the criteria for 413.7 transition services in section 245.4875, subdivision 8, and 413.8 their families. Services must be designed to help each child to 413.9 function and remain with the child's family in the community. 413.10 Transition services to eligible young adults must be designed to 413.11 foster independent living in the community. The commissioner 413.12 shall make grants to counties to establish, operate, or contract 413.13 with private providers to provide the following services in the 413.14 following order of priority when these cannot be reimbursed 413.15 under section 256B.0625: 413.16 (1) family community support services including crisis 413.17 placement and crisis respite care as specified in section 413.18 245.4871, subdivision 17; 413.19 (2) case management services as specified in section 413.20 245.4871, subdivision 3; 413.21 (3) day treatment services as specified in section 413.22 245.4871, subdivision 10; 413.23 (4) professional home-based family treatment as specified 413.24 in section 245.4871, subdivision 31; and 413.25 (5) therapeutic support of foster care as specified in 413.26 section 245.4871, subdivision 34. 413.27 Funding appropriated beginning July 1, 1991, must be used 413.28 by county boards to provide family community support services 413.29 and case management services. Additional services shall be 413.30 provided in the order of priority as identified in this 413.31 subdivision. 413.32 Sec. 11. Minnesota Statutes 2000, section 245.99, 413.33 subdivision 4, is amended to read: 413.34 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 413.35 The commissioner may contract with organizations or government 413.36 units experienced in housing assistance to operate the program 414.1 under this section. This program is not an entitlement. The 414.2 commissioner may take any of the following steps whenever the 414.3 commissioner projects that funds will be inadequate to meet 414.4 demand in a given fiscal year: 414.5 (1) transfer funds from mental health grants in the same 414.6 appropriation; and 414.7 (2) impose statewide restrictions as to the type and amount 414.8 of assistance available to each recipient under this program 414.9 including reducing the income eligibility level, limiting 414.10 reimbursement to a percentage of each recipient's costs, 414.11 limiting housing assistance to 60 days per recipient, or closing 414.12 the program for the remainder of the fiscal year. 414.13 Sec. 12. Minnesota Statutes 2000, section 256.969, 414.14 subdivision 3a, is amended to read: 414.15 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 414.16 the medical assistance program must not be submitted until the 414.17 recipient is discharged. However, the commissioner shall 414.18 establish monthly interim payments for inpatient hospitals that 414.19 have individual patient lengths of stay over 30 days regardless 414.20 of diagnostic category. Except as provided in section 256.9693, 414.21 medical assistance reimbursement for treatment of mental illness 414.22 shall be reimbursed based on diagnostic classifications.The414.23commissioner may selectively contract with hospitals for414.24services within the diagnostic categories relating to mental414.25illness and chemical dependency under competitive bidding when414.26reasonable geographic access by recipients can be assured. No414.27physician shall be denied the privilege of treating a recipient414.28required to use a hospital under contract with the commissioner,414.29as long as the physician meets credentialing standards of the414.30individual hospital.Individual hospital payments established 414.31 under this section and sections 256.9685, 256.9686, and 414.32 256.9695, in addition to third party and recipient liability, 414.33 for discharges occurring during the rate year shall not exceed, 414.34 in aggregate, the charges for the medical assistance covered 414.35 inpatient services paid for the same period of time to the 414.36 hospital. This payment limitation shall be calculated 415.1 separately for medical assistance and general assistance medical 415.2 care services. The limitation on general assistance medical 415.3 care shall be effective for admissions occurring on or after 415.4 July 1, 1991. Services that have rates established under 415.5 subdivision 11 or 12, must be limited separately from other 415.6 services. After consulting with the affected hospitals, the 415.7 commissioner may consider related hospitals one entity and may 415.8 merge the payment rates while maintaining separate provider 415.9 numbers. The operating and property base rates per admission or 415.10 per day shall be derived from the best Medicare and claims data 415.11 available when rates are established. The commissioner shall 415.12 determine the best Medicare and claims data, taking into 415.13 consideration variables of recency of the data, audit 415.14 disposition, settlement status, and the ability to set rates in 415.15 a timely manner. The commissioner shall notify hospitals of 415.16 payment rates by December 1 of the year preceding the rate 415.17 year. The rate setting data must reflect the admissions data 415.18 used to establish relative values. Base year changes from 1981 415.19 to the base year established for the rate year beginning January 415.20 1, 1991, and for subsequent rate years, shall not be limited to 415.21 the limits ending June 30, 1987, on the maximum rate of increase 415.22 under subdivision 1. The commissioner may adjust base year 415.23 cost, relative value, and case mix index data to exclude the 415.24 costs of services that have been discontinued by the October 1 415.25 of the year preceding the rate year or that are paid separately 415.26 from inpatient services. Inpatient stays that encompass 415.27 portions of two or more rate years shall have payments 415.28 established based on payment rates in effect at the time of 415.29 admission unless the date of admission preceded the rate year in 415.30 effect by six months or more. In this case, operating payment 415.31 rates for services rendered during the rate year in effect and 415.32 established based on the date of admission shall be adjusted to 415.33 the rate year in effect by the hospital cost index. 415.34 [EFFECTIVE DATE.] This section is effective July 1, 2002. 415.35 Sec. 13. [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 415.36 WITH MENTAL ILLNESS.] 416.1 The commissioner shall establish a continuing care benefit 416.2 program for persons with mental illness, in which persons with 416.3 mental illness may obtain acute care hospital inpatient 416.4 treatment for mental illness for up to 45 days beyond that 416.5 allowed by section 256.969. Persons with mental illness who are 416.6 eligible for medical assistance may obtain inpatient treatment 416.7 under this program in hospital beds for which the commissioner 416.8 contracts under this section. The commissioner may selectively 416.9 contract with hospitals to provide this benefit through 416.10 competitive bidding when reasonable geographic access by 416.11 recipients can be assured. Payments under this section shall 416.12 not affect payments under section 256.969. The commissioner may 416.13 contract externally with a utilization review organization to 416.14 authorize persons with mental illness to access the continuing 416.15 care benefit program. The commissioner, as part of the 416.16 contracts with hospitals, shall establish admission criteria to 416.17 allow persons with mental illness to access the continuing care 416.18 benefit program. If a court orders acute care hospital 416.19 inpatient treatment for mental illness for a person, the person 416.20 may obtain the treatment under the continuing care benefit 416.21 program. The commissioner shall not require, as part of the 416.22 admission criteria, any commitment or petition under chapter 416.23 253B as a condition of accessing the program. This benefit is 416.24 not available for people who are also eligible for Medicare and 416.25 who have not exhausted their annual or lifetime inpatient 416.26 psychiatric benefit under Medicare. If a recipient is enrolled 416.27 in a prepaid plan, this program is included in the plan's 416.28 coverage. 416.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 416.30 Sec. 14. [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 416.31 SERVICES.] 416.32 Subdivision 1. [SCOPE.] Medical assistance covers adult 416.33 rehabilitative mental health services as defined in subdivision 416.34 2, subject to federal approval, if provided to recipients as 416.35 defined in subdivision 3 and provided by a qualified provider 416.36 entity meeting the standards in this section and by a qualified 417.1 individual provider working within the provider's scope of 417.2 practice and identified in the recipient's individual treatment 417.3 plan as defined in section 245.462, subdivision 14, and if 417.4 determined to be medically necessary according to section 62Q.53. 417.5 Subd. 2. [DEFINITIONS.] For purposes of this section, the 417.6 following terms have the meanings given them. 417.7 (a) "Adult rehabilitative mental health services" means 417.8 mental health services which are rehabilitative and enable the 417.9 recipient to develop and enhance psychiatric stability, social 417.10 competencies, personal and emotional adjustment, and independent 417.11 living and community skills, when these abilities are impaired 417.12 by the symptoms of mental illness. Adult rehabilitative mental 417.13 health services are also appropriate when provided to enable a 417.14 recipient to retain stability and functioning, if the recipient 417.15 would be at risk of significant functional decompensation or 417.16 more restrictive service settings without these services. 417.17 (1) Adult rehabilitative mental health services instruct, 417.18 assist, and support the recipient in areas such as: 417.19 interpersonal communication skills, community resource 417.20 utilization and integration skills, crisis assistance, relapse 417.21 prevention skills, health care directives, budgeting and 417.22 shopping skills, healthy lifestyle skills and practices, cooking 417.23 and nutrition skills, transportation skills, medication 417.24 education and monitoring, mental illness symptom management 417.25 skills, household management skills, employment-related skills, 417.26 and transition to community living services. 417.27 (2) These services shall be provided to the recipient on a 417.28 one-to-one basis in the recipient's home or another community 417.29 setting or in groups. 417.30 (b) "Medication education services" means services provided 417.31 individually or in groups which focus on educating the recipient 417.32 about mental illness and symptoms; the role and effects of 417.33 medications in treating symptoms of mental illness; and the side 417.34 effects of medications. Medication education is coordinated 417.35 with medication management services, and does not duplicate it. 417.36 Medication education services are provided by physicians, 418.1 pharmacists, or registered nurses. 418.2 (c) "Transition to community living services" means 418.3 services which maintain continuity of contact between the 418.4 rehabilitation services provider and the recipient and which 418.5 facilitate discharge from a hospital, residential treatment 418.6 program under Minnesota Rules, chapter 9505, board and lodging 418.7 facility, or nursing home. Transition to community living 418.8 services are not intended to provide other areas of adult 418.9 rehabilitative mental health services. 418.10 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 418.11 individual who: 418.12 (1) is age 18 or older; 418.13 (2) is diagnosed with a medical condition, such as mental 418.14 illness or traumatic brain injury, for which adult 418.15 rehabilitative mental health services are needed; 418.16 (3) has substantial disability and functional impairment in 418.17 three or more of the areas listed in section 245.462, 418.18 subdivision 11a, so that self-sufficiency is markedly reduced; 418.19 and 418.20 (4) has had a recent diagnostic assessment by a qualified 418.21 professional that documents adult rehabilitative mental health 418.22 services are medically necessary to address identified 418.23 disability and functional impairments and individual recipient 418.24 goals. 418.25 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 418.26 entity must be: 418.27 (1) a county operated entity certified by the state; or 418.28 (2) a noncounty entity certified by the entity's host 418.29 county. 418.30 (b) The certification process is a determination as to 418.31 whether the entity meets the standards in this subdivision. The 418.32 certification must specify which adult rehabilitative mental 418.33 health services the entity is qualified to provide. 418.34 (c) If an entity seeks to provide services outside its host 418.35 county, it must obtain additional certification from each county 418.36 in which it will provide services. The additional certification 419.1 must be based on the adequacy of the entity's knowledge of that 419.2 county's local health and human service system, and the ability 419.3 of the entity to coordinate its services with the other services 419.4 available in that county. 419.5 (d) Recertification must occur at least every two years. 419.6 (e) The commissioner may intervene at any time and 419.7 decertify providers with cause. The decertification is subject 419.8 to appeal to the state. A county board may recommend that the 419.9 state decertify a provider for cause. 419.10 (f) The adult rehabilitative mental health services 419.11 provider entity must meet the following standards: 419.12 (1) have capacity to recruit, hire, manage, and train 419.13 mental health professionals, mental health practitioners, and 419.14 mental health rehabilitation workers; 419.15 (2) have adequate administrative ability to ensure 419.16 availability of services; 419.17 (3) ensure adequate preservice and inservice training for 419.18 staff; 419.19 (4) ensure that mental health professionals, mental health 419.20 practitioners, and mental health rehabilitation workers are 419.21 skilled in the delivery of the specific adult rehabilitative 419.22 mental health services provided to the individual eligible 419.23 recipient; 419.24 (5) ensure that staff is capable of implementing culturally 419.25 specific services that are culturally competent and appropriate 419.26 as determined by the recipient's culture, beliefs, values, and 419.27 language as identified in the individual treatment plan; 419.28 (6) ensure enough flexibility in service delivery to 419.29 respond to the changing and intermittent care needs of a 419.30 recipient as identified by the recipient and the individual 419.31 treatment plan; 419.32 (7) ensure that the mental health professional or mental 419.33 health practitioner, who is under the clinical supervision of a 419.34 mental health professional, involved in a recipient's services 419.35 participates in the development of the individual treatment 419.36 plan; 420.1 (8) assist the recipient in arranging needed crisis 420.2 assessment, intervention, and stabilization services; 420.3 (9) ensure that services are coordinated with other 420.4 recipient mental health services providers and the county mental 420.5 health authority and the federally recognized American Indian 420.6 authority and necessary others after obtaining the consent of 420.7 the recipient. Services must also be coordinated with the 420.8 recipient's case manager or care coordinator, if the recipient 420.9 is receiving case management or care coordination services; 420.10 (10) develop and maintain recipient files, individual 420.11 treatment plans, and contact charting; 420.12 (11) develop and maintain staff training and personnel 420.13 files; 420.14 (12) submit information as required by the state; 420.15 (13) establish and maintain a quality assurance plan to 420.16 evaluate the outcome of services provided; 420.17 (14) keep all necessary records required by law; 420.18 (15) deliver services as required by section 245.461; 420.19 (16) comply with all applicable laws; 420.20 (17) be an enrolled Medicaid provider; 420.21 (18) maintain a quality assurance plan to determine 420.22 specific service outcomes and the recipient's satisfaction with 420.23 services; and 420.24 (19) develop and maintain written policies and procedures 420.25 regarding service provision and administration of the provider 420.26 entity. 420.27 (g) The commissioner shall develop statewide procedures for 420.28 provider certification, including timelines for counties to 420.29 certify qualified providers. 420.30 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 420.31 rehabilitative mental health services must be provided by 420.32 qualified individual provider staff of a certified provider 420.33 entity. Individual provider staff must be qualified under one 420.34 of the following criteria: 420.35 (1) a mental health professional as defined in section 420.36 245.462, subdivision 18, clauses (1) to (5); 421.1 (2) a mental health practitioner as defined in section 421.2 245.462, subdivision 17. The mental health practitioner must 421.3 work under the clinical supervision of a mental health 421.4 professional; or 421.5 (3) a mental health rehabilitation worker. A mental health 421.6 rehabilitation worker means a staff person working under the 421.7 direction of a mental health practitioner or mental health 421.8 professional, and under the clinical supervision of a mental 421.9 health professional in the implementation of rehabilitative 421.10 mental health services as identified in the recipient's 421.11 individual treatment plan; and who: 421.12 (i) is at least 21 years of age; 421.13 (ii) has a high school diploma or equivalent; 421.14 (iii) has successfully completed 30 hours of training 421.15 during the past two years in all of the following areas: 421.16 recipient rights, recipient-centered individual treatment 421.17 planning, behavioral terminology, mental illness, co-occurring 421.18 mental illness and substance abuse, psychotropic medications and 421.19 side effects, functional assessment, local community resources, 421.20 adult vulnerability, recipient confidentiality; and 421.21 (iv) meets the qualifications in (A) or (B): 421.22 (A) has an associate of arts degree in one of the 421.23 behavioral sciences or human services, or is a registered nurse 421.24 without a bachelor's degree, or who within the previous ten 421.25 years has: 421.26 (1) three years of personal life experience with serious 421.27 and persistent mental illness; 421.28 (2) three years of life experience as a primary caregiver 421.29 to an adult with a serious mental illness or traumatic brain 421.30 injury; or 421.31 (3) 4,000 hours of supervised paid work experience in the 421.32 delivery of mental health services to adults with a serious 421.33 mental illness or traumatic brain injury; or 421.34 (B)(1) be fluent in the non-English language or competent 421.35 in the culture of the ethnic group to which at least 50 percent 421.36 of the mental health rehabilitation worker's clients belong; 422.1 (2) receives during the first 2,000 hours of work, monthly 422.2 documented individual clinical supervision by a mental health 422.3 professional; 422.4 (3) has 18 hours of documented field supervision by a 422.5 mental health professional or practitioner during the first 160 422.6 hours of contact work with recipients, and at least six hours of 422.7 field supervision quarterly during the following year; 422.8 (4) has review and cosignature of charting of recipient 422.9 contacts during field supervision by a mental health 422.10 professional or practitioner; and 422.11 (5) has 40 hours of additional continuing education on 422.12 mental health topics during the first year of employment. 422.13 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 422.14 health rehabilitation workers must receive ongoing continuing 422.15 education training of at least 30 hours every two years in areas 422.16 of mental illness and mental health services and other areas 422.17 specific to the population being served. Mental health 422.18 rehabilitation workers must also be subject to the ongoing 422.19 direction and clinical supervision standards in paragraphs (c) 422.20 and (d). 422.21 (b) Mental health practitioners must receive ongoing 422.22 continuing education training as required by their professional 422.23 license; or if the practitioner is not licensed, the 422.24 practitioner must receive ongoing continuing education training 422.25 of at least 30 hours every two years in areas of mental illness 422.26 and mental health services. Mental health practitioners must 422.27 meet the ongoing clinical supervision standards in paragraph (c). 422.28 (c) A mental health professional providing clinical 422.29 supervision of staff delivering adult rehabilitative mental 422.30 health services must provide the following guidance: 422.31 (1) review the information in the recipient's file; 422.32 (2) review and approve initial and updates of individual 422.33 treatment plans; 422.34 (3) meet with mental health rehabilitation workers and 422.35 practitioners, individually or in small groups, at least monthly 422.36 to discuss treatment topics of interest to the workers and 423.1 practitioners; 423.2 (4) meet with mental health rehabilitation workers and 423.3 practitioners, individually or in small groups, at least monthly 423.4 to discuss treatment plans of recipients, and approve by 423.5 signature and document in the recipient's file any resulting 423.6 plan updates; 423.7 (5) meet at least twice a month with the directing mental 423.8 health practitioner, if there is one, to review needs of the 423.9 adult rehabilitative mental health services program, review 423.10 staff on-site observations and evaluate mental health 423.11 rehabilitation workers, plan staff training, review program 423.12 evaluation and development, and consult with the directing 423.13 practitioner; 423.14 (6) be available for urgent consultation as the individual 423.15 recipient needs or the situation necessitates; and 423.16 (7) provide clinical supervision by full- or part-time 423.17 mental health professionals employed by or under contract with 423.18 the provider entity. 423.19 (d) An adult rehabilitative mental health services provider 423.20 entity must have a treatment director who is a mental health 423.21 practitioner or mental health professional. The treatment 423.22 director must ensure the following: 423.23 (1) while delivering direct services to recipients, a newly 423.24 hired mental health rehabilitation worker must be directly 423.25 observed delivering services to recipients by the mental health 423.26 practitioner or mental health professional for at least six 423.27 hours per 40 hours worked during the first 160 hours that the 423.28 mental health rehabilitation worker works; 423.29 (2) the mental health rehabilitation worker must receive 423.30 ongoing on-site direct service observation by a mental health 423.31 professional or mental health practitioner for at least six 423.32 hours for every six months of employment; 423.33 (3) progress notes are reviewed from on-site service 423.34 observation prepared by the mental health rehabilitation worker 423.35 and mental health practitioner for accuracy and consistency with 423.36 actual recipient contact and the individual treatment plan and 424.1 goals; 424.2 (4) immediate availability by phone or in person for 424.3 consultation by a mental health professional or a mental health 424.4 practitioner to the mental health rehabilitation services worker 424.5 during service provision; 424.6 (5) oversee the identification of changes in individual 424.7 recipient treatment strategies, revise the plan and communicate 424.8 treatment instructions and methodologies as appropriate to 424.9 ensure that treatment is implemented correctly; 424.10 (6) model service practices which: respect the recipient, 424.11 include the recipient in planning and implementation of the 424.12 individual treatment plan, recognize the recipient's strengths, 424.13 collaborate and coordinate with other involved parties and 424.14 providers; 424.15 (7) ensure that mental health practitioners and mental 424.16 health rehabilitation workers are able to effectively 424.17 communicate with the recipients, significant others, and 424.18 providers; and 424.19 (8) oversee the record of the results of on-site 424.20 observation and charting evaluation and corrective actions taken 424.21 to modify the work of the mental health practitioners and mental 424.22 health rehabilitation workers. 424.23 (e) A mental health practitioner who is providing treatment 424.24 direction for a provider entity must receive supervision at 424.25 least monthly from a mental health professional to: 424.26 (1) identify and plan for general needs of the recipient 424.27 population served; 424.28 (2) identify and plan to address provider entity program 424.29 needs and effectiveness; 424.30 (3) identify and plan provider entity staff training and 424.31 personnel needs and issues; and 424.32 (4) plan, implement, and evaluate provider entity quality 424.33 improvement programs. 424.34 Subd. 7. [PERSONNEL FILE.] The adult rehabilitative mental 424.35 health services provider entity must maintain a personnel file 424.36 on each staff. Each file must contain: 425.1 (1) an annual performance review; 425.2 (2) a summary of on-site service observations and charting 425.3 review; 425.4 (3) a criminal background check of all direct service 425.5 staff; 425.6 (4) evidence of academic degree and qualifications; 425.7 (5) a copy of professional license; 425.8 (6) any job performance recognition and disciplinary 425.9 actions; 425.10 (7) any individual staff written input into own personnel 425.11 file; 425.12 (8) all clinical supervision provided; and 425.13 (9) documentation of compliance with continuing education 425.14 requirements. 425.15 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 425.16 rehabilitative mental health services must complete a diagnostic 425.17 assessment as defined in section 245.462, subdivision 9, within 425.18 five days after the recipient's second visit or within 30 days 425.19 after intake, whichever occurs first. In cases where a 425.20 diagnostic assessment is available that reflects the recipient's 425.21 current status, and has been completed within 180 days preceding 425.22 admission, an update must be completed. An update shall include 425.23 a written summary by a mental health professional of the 425.24 recipient's current mental health status and service needs. If 425.25 the recipient's mental health status has changed significantly 425.26 since the adult's most recent diagnostic assessment, a new 425.27 diagnostic assessment is required. 425.28 Subd. 9. [FUNCTIONAL ASSESSMENT.] Providers of adult 425.29 rehabilitative mental health services must complete a written 425.30 functional assessment as defined in section 245.462, subdivision 425.31 11a, for each recipient. The functional assessment must be 425.32 completed within 30 days of intake, and reviewed and updated at 425.33 least every six months after it is developed, unless there is a 425.34 significant change in the functioning of the recipient. If 425.35 there is a significant change in functioning, the assessment 425.36 must be updated. A single functional assessment can meet case 426.1 management and adult rehabilitative mental health services 426.2 requirements, if agreed to by the recipient. Unless the 426.3 recipient refuses, the recipient must have significant 426.4 participation in the development of the functional assessment. 426.5 Subd. 10. [INDIVIDUAL TREATMENT PLAN.] All providers of 426.6 adult rehabilitative mental health services must develop and 426.7 implement an individual treatment plan for each recipient. The 426.8 provisions in clauses (1) and (2) apply: 426.9 (1) Individual treatment plan means a plan of intervention, 426.10 treatment, and services for an individual recipient written by a 426.11 mental health professional or by a mental health practitioner 426.12 under the clinical supervision of a mental health professional. 426.13 The individual treatment plan must be based on diagnostic and 426.14 functional assessments. To the extent possible, the development 426.15 and implementation of a treatment plan must be a collaborative 426.16 process involving the recipient, and with the permission of the 426.17 recipient, the recipient's family and others in the recipient's 426.18 support system. Providers of adult rehabilitative mental health 426.19 services must develop the individual treatment plan within 30 426.20 calendar days of intake. The treatment plan must be updated at 426.21 least every six months thereafter, or more often when there is 426.22 significant change in the recipient's situation or functioning, 426.23 or in services or service methods to be used, or at the request 426.24 of the recipient or the recipient's legal guardian. 426.25 (2) The individual treatment plan must include: 426.26 (i) a list of problems identified in the assessment; 426.27 (ii) the recipient's strengths and resources; 426.28 (iii) concrete, measurable goals to be achieved, including 426.29 time frames for achievement; 426.30 (iv) specific objectives directed toward the achievement of 426.31 each one of the goals; 426.32 (v) documentation of participants in the treatment planning. 426.33 The recipient, if possible, must be a participant. The 426.34 recipient or the recipient's legal guardian must sign the 426.35 treatment plan, or documentation must be provided why this was 426.36 not possible. A copy of the plan must be given to the recipient 427.1 or legal guardian. Referral to formal services must be 427.2 arranged, including specific providers where applicable; 427.3 (vi) cultural considerations, resources, and needs of the 427.4 recipient must be included; 427.5 (vii) planned frequency and type of services must be 427.6 initiated; and 427.7 (viii) clear progress notes on outcome of goals. 427.8 (3) The individual community support plan defined in 427.9 section 245.462, subdivision 12, may serve as the individual 427.10 treatment plan if there is involvement of a mental health case 427.11 manager, and with the approval of the recipient. The individual 427.12 community support plan must include the criteria in clause (2). 427.13 Subd. 11. [RECIPIENT FILE.] Providers of adult 427.14 rehabilitative mental health services must maintain a file for 427.15 each recipient that contains the following information: 427.16 (1) diagnostic assessment or verification of its location, 427.17 that is current and that was reviewed by a mental health 427.18 professional who is employed by or under contract with the 427.19 provider entity; 427.20 (2) functional assessments; 427.21 (3) individual treatment plans signed by the recipient and 427.22 the mental health professional, or if the recipient refused to 427.23 sign the plan, the date and reason stated by the recipient as to 427.24 why the recipient would not sign the plan; 427.25 (4) recipient history; 427.26 (5) signed release forms; 427.27 (6) recipient health information and current medications; 427.28 (7) emergency contacts for the recipient; 427.29 (8) case records which document the date of service, the 427.30 place of service delivery, signature of the person providing the 427.31 service, nature, extent and units of service, and place of 427.32 service delivery; 427.33 (9) contacts, direct or by telephone, with recipient's 427.34 family or others, other providers, or other resources for 427.35 service coordination; 427.36 (10) summary of recipient case reviews by staff; and 428.1 (11) written information by the recipient that the 428.2 recipient requests be included in the file. 428.3 Subd. 12. [ADDITIONAL REQUIREMENTS.] (a) Providers of 428.4 adult rehabilitative mental health services must comply with the 428.5 requirements relating to referrals for case management in 428.6 section 245.467, subdivision 4. 428.7 (b) Adult rehabilitative mental health services are 428.8 provided for most recipients in the recipient's home and 428.9 community. Services may also be provided at the home of a 428.10 relative or significant other, job site, psychosocial clubhouse, 428.11 drop-in center, social setting, classroom, or other places in 428.12 the community. Except for "transition to community services," 428.13 the place of service does not include a regional treatment 428.14 center, nursing home, residential treatment facility licensed 428.15 under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 428.16 or an acute care hospital. 428.17 (c) Adult rehabilitative mental health services may be 428.18 provided in group settings if appropriate to each participating 428.19 recipient's needs and treatment plan. A group is defined as two 428.20 to ten clients, at least one of whom is a recipient, who is 428.21 concurrently receiving a service which is identified in this 428.22 section. The service and group must be specified in the 428.23 recipient's treatment plan. No more than two qualified staff 428.24 may bill Medicaid for services provided to the same group of 428.25 recipients. If two adult rehabilitative mental health workers 428.26 bill for recipients in the same group session, they must each 428.27 bill for different recipients. 428.28 Subd. 13. [EXCLUDED SERVICES.] The following services are 428.29 excluded from reimbursement as adult rehabilitative mental 428.30 health services: 428.31 (1) recipient transportation services; 428.32 (2) a service provided and billed by a provider who is not 428.33 enrolled to provide adult rehabilitative mental health service; 428.34 (3) adult rehabilitative mental health services performed 428.35 by volunteers; 428.36 (4) provider performance of household tasks, chores, or 429.1 related activities, such as laundering clothes, moving the 429.2 recipient's household, housekeeping, and grocery shopping for 429.3 the recipient; 429.4 (5) direct billing of time spent "on call" when not 429.5 delivering services to recipients; 429.6 (6) activities which are primarily social or recreational 429.7 in nature, rather than rehabilitative, for the individual 429.8 recipient, as determined by the individual's needs and treatment 429.9 plan; 429.10 (7) job-specific skills services, such as on-the-job 429.11 training; 429.12 (8) provider service time included in case management 429.13 reimbursement; 429.14 (9) outreach services to potential recipients; 429.15 (10) a mental health service that is not medically 429.16 necessary; and 429.17 (11) any services provided by a hospital, board and 429.18 lodging, or residential facility to an individual who is a 429.19 patient in or resident of that facility. 429.20 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 429.21 STATE STAFF.] When rehabilitative services are provided by 429.22 qualified state staff who are assigned to pilot projects under 429.23 section 245.4661, the county or other local entity to which the 429.24 qualified state staff are assigned may consider these staff part 429.25 of the local provider entity for which certification is sought 429.26 under this section, and may bill the medical assistance program 429.27 for qualifying services provided by the qualified state staff. 429.28 Notwithstanding section 256.025, subdivision 2, payments for 429.29 services provided by state staff who are assigned to adult 429.30 mental health initiatives shall only be made from federal funds. 429.31 Sec. 15. [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 429.32 SERVICES.] 429.33 Subdivision 1. [SCOPE.] Medical assistance covers adult 429.34 mental health crisis response services as defined in subdivision 429.35 2, paragraphs (c) to (e), subject to federal approval, if 429.36 provided to a recipient as defined in subdivision 3 and provided 430.1 by a qualified provider entity as defined in this section and by 430.2 a qualified individual provider working within the provider's 430.3 scope of practice and as defined in this subdivision and 430.4 identified in the recipient's individual crisis treatment plan 430.5 as defined in subdivision 10 and if determined to be medically 430.6 necessary. 430.7 Subd. 2. [DEFINITIONS.] For purposes of this section, the 430.8 following terms have the meanings given them. 430.9 (a) "Mental health crisis" is an adult behavioral, 430.10 emotional, or psychiatric situation which, but for the provision 430.11 of crisis response services, would likely result in 430.12 significantly reduced levels of functioning in primary 430.13 activities of daily living, or in an emergency situation, or in 430.14 the placement of the recipient in a more restrictive setting, 430.15 including, but not limited to, inpatient hospitalization. 430.16 (b) "Mental health emergency" is an adult behavioral, 430.17 emotional, or psychiatric situation which causes an immediate 430.18 need for mental health services and is consistent with section 430.19 62Q.55. 430.20 A mental health crisis or emergency is determined for 430.21 medical assistance service reimbursement by a physician, a 430.22 mental health professional, or crisis mental health practitioner 430.23 with input from the recipient whenever possible. 430.24 (c) "Mental health crisis assessment" means an immediate 430.25 face-to-face assessment by a physician, a mental health 430.26 professional, or mental health practitioner under the clinical 430.27 supervision of a mental health professional, following a 430.28 screening that suggests that the adult may be experiencing a 430.29 mental health crisis or mental health emergency situation. 430.30 (d) "Mental health mobile crisis intervention services" 430.31 means face-to-face, short-term intensive mental health services 430.32 initiated during a mental health crisis or mental health 430.33 emergency to help the recipient cope with immediate stressors, 430.34 identify and utilize available resources and strengths, and 430.35 begin to return to the recipient's baseline level of functioning. 430.36 (1) This service is provided on-site by a mobile crisis 431.1 intervention team outside of an inpatient hospital setting. 431.2 Mental health mobile crisis intervention services must be 431.3 available 24 hours a day, seven days a week. 431.4 (2) The initial screening must consider other available 431.5 services to determine which service intervention would best 431.6 address the recipient's needs and circumstances. 431.7 (3) The mobile crisis intervention team must be available 431.8 to meet promptly face-to-face with a person in mental health 431.9 crisis or emergency in a community setting. 431.10 (4) The intervention must consist of a mental health crisis 431.11 assessment and a crisis treatment plan. 431.12 (5) The treatment plan must include recommendations for any 431.13 needed crisis stabilization services for the recipient. 431.14 (e) "Mental health crisis stabilization services" means 431.15 individualized mental health services provided to a recipient 431.16 following crisis intervention services which are designed to 431.17 restore the recipient to the recipient's prior functional 431.18 level. Mental health crisis stabilization services may be 431.19 provided in the recipient's home, the home of a family member or 431.20 friend of the recipient, another community setting, or a 431.21 short-term supervised, licensed residential program. Mental 431.22 health crisis stabilization does not include partial 431.23 hospitalization or day treatment. 431.24 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 431.25 individual who: 431.26 (1) is age 18 or older; 431.27 (2) is screened as possibly experiencing a mental health 431.28 crisis or emergency where a mental health crisis assessment is 431.29 needed; and 431.30 (3) is assessed as experiencing a mental health crisis or 431.31 emergency, and mental health crisis intervention or crisis 431.32 intervention and stabilization services are determined to be 431.33 medically necessary. 431.34 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 431.35 entity is an entity that meets the standards listed in paragraph 431.36 (b) and: 432.1 (1) is a county board operated entity; or 432.2 (2) is a provider entity that is under contract with the 432.3 county board in the county where the potential crisis or 432.4 emergency is occurring. To provide services under this section, 432.5 the provider entity must directly provide the services; or if 432.6 services are subcontracted, the provider entity must maintain 432.7 responsibility for services and billing. 432.8 (b) The adult mental health crisis response services 432.9 provider entity must meet the following standards: 432.10 (1) has the capacity to recruit, hire, and manage and train 432.11 mental health professionals, practitioners, and rehabilitation 432.12 workers; 432.13 (2) has adequate administrative ability to ensure 432.14 availability of services; 432.15 (3) is able to ensure adequate preservice and in-service 432.16 training; 432.17 (4) is able to ensure that staff providing these services 432.18 are skilled in the delivery of mental health crisis response 432.19 services to recipients; 432.20 (5) is able to ensure that staff are capable of 432.21 implementing culturally specific treatment identified in the 432.22 individual treatment plan that is meaningful and appropriate as 432.23 determined by the recipient's culture, beliefs, values, and 432.24 language; 432.25 (6) is able to ensure enough flexibility to respond to the 432.26 changing intervention and care needs of a recipient as 432.27 identified by the recipient during the service partnership 432.28 between the recipient and providers; 432.29 (7) is able to ensure that mental health professionals and 432.30 mental health practitioners have the communication tools and 432.31 procedures to communicate and consult promptly about crisis 432.32 assessment and interventions as services occur; 432.33 (8) is able to coordinate these services with county 432.34 emergency services and mental health crisis services; 432.35 (9) is able to ensure that mental health crisis assessment 432.36 and mobile crisis intervention services are available 24 hours a 433.1 day, seven days a week; 433.2 (10) is able to ensure that services are coordinated with 433.3 other mental health service providers, county mental health 433.4 authorities, or federally recognized American Indian authorities 433.5 and others as necessary, with the consent of the adult. 433.6 Services must also be coordinated with the recipient's case 433.7 manager if the adult is receiving case management services; 433.8 (11) is able to ensure that crisis intervention services 433.9 are provided in a manner consistent with sections 245.461 to 433.10 245.486; 433.11 (12) is able to submit information as required by the 433.12 state; 433.13 (13) maintains staff training and personnel files; 433.14 (14) is able to establish and maintain a quality assurance 433.15 and evaluation plan to evaluate the outcomes of services and 433.16 recipient satisfaction; 433.17 (15) is able to keep records as required by applicable 433.18 laws; 433.19 (16) is able to comply with all applicable laws and 433.20 statutes; 433.21 (17) is an enrolled medical assistance provider; and 433.22 (18) develops and maintains written policies and procedures 433.23 regarding service provision and administration of the provider 433.24 entity including safety of staff and recipients in high risk 433.25 situations. 433.26 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 433.27 QUALIFICATIONS.] For provision of adult mental health mobile 433.28 crisis intervention services, a mobile crisis intervention team 433.29 is comprised of at least two mental health professionals as 433.30 defined in section 245.462, subdivision 18, clauses (1) to (5), 433.31 or a combination of at least one mental health professional and 433.32 one mental health practitioner as defined in section 245.462, 433.33 subdivision 17, with the required mental health crisis training 433.34 and under the clinical supervision of a mental health 433.35 professional on the team. The team must have at least two 433.36 people with at least one member providing on-site crisis 434.1 intervention services when needed. Team members must be 434.2 experienced in mental health assessment, crisis intervention 434.3 techniques, and clinical decision-making under emergency 434.4 conditions and have knowledge of local services and resources. 434.5 The team must recommend and coordinate the team's services with 434.6 appropriate local resources such as the county social services 434.7 agency, mental health services, and local law enforcement when 434.8 necessary. 434.9 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 434.10 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 434.11 crisis intervention services, a screening of the potential 434.12 crisis situation must be conducted. The screening may use the 434.13 resources of crisis assistance and emergency services as defined 434.14 in sections 245.462, subdivision 6, and 245.469, subdivisions 1 434.15 and 2. The screening must gather information, determine whether 434.16 a crisis situation exists, identify parties involved, and 434.17 determine an appropriate response. 434.18 (b) If a crisis exists, a crisis assessment must be 434.19 completed. A crisis assessment evaluates any immediate needs 434.20 for which emergency services are needed and, as time permits, 434.21 the recipient's current life situation, sources of stress, 434.22 mental health problems and symptoms, strengths, cultural 434.23 considerations, support network, vulnerabilities, and current 434.24 functioning. 434.25 (c) If the crisis assessment determines mobile crisis 434.26 intervention services are needed, the intervention services must 434.27 be provided promptly. As opportunity presents during the 434.28 intervention, at least two members of the mobile crisis 434.29 intervention team must confer directly or by telephone about the 434.30 assessment, treatment plan, and actions taken and needed. At 434.31 least one of the team members must be on-site providing crisis 434.32 intervention services. If providing on-site crisis intervention 434.33 services, a mental health practitioner must seek clinical 434.34 supervision as required in subdivision 8. 434.35 (d) The mobile crisis intervention team must develop an 434.36 initial, brief crisis treatment plan as soon as appropriate but 435.1 no later than 24 hours after the initial face-to-face 435.2 intervention. The plan must address the needs and problems 435.3 noted in the crisis assessment and include measurable short-term 435.4 goals, cultural considerations, and frequency and type of 435.5 services to be provided to achieve the goals and reduce or 435.6 eliminate the crisis. The treatment plan must be updated as 435.7 needed to reflect current goals and services. 435.8 (e) The team must document which short-term goals have been 435.9 met, and when no further crisis intervention services are 435.10 required. 435.11 (f) If the recipient's crisis is stabilized, but the 435.12 recipient needs a referral to other services, the team must 435.13 provide referrals to these services. If the recipient has a 435.14 case manager, planning for other services must be coordinated 435.15 with the case manager. 435.16 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 435.17 stabilization services must be provided by qualified staff of a 435.18 crisis stabilization services provider entity and must meet the 435.19 following standards: 435.20 (1) a crisis stabilization treatment plan must be developed 435.21 which meets the criteria in subdivision 11; 435.22 (2) staff must be qualified as defined in subdivision 8; 435.23 and 435.24 (3) services must be delivered according to the treatment 435.25 plan and include face-to-face contact with the recipient by 435.26 qualified staff for further assessment, help with referrals, 435.27 updating of the crisis stabilization treatment plan, supportive 435.28 counseling, skills training, and collaboration with other 435.29 service providers in the community. 435.30 (b) If crisis stabilization services are provided in a 435.31 supervised, licensed residential setting, the recipient must be 435.32 contacted face-to-face daily by a qualified mental health 435.33 practitioner or mental health professional. The program must 435.34 have 24-hour-a-day residential staffing which may include staff 435.35 who do not meet the qualifications in subdivision 8. The 435.36 residential staff must have 24-hour-a-day immediate direct or 436.1 telephone access to a qualified mental health professional or 436.2 practitioner. 436.3 (c) If crisis stabilization services are provided in a 436.4 supervised, licensed residential setting that serves no more 436.5 than four adult residents, and no more than two are recipients 436.6 of crisis stabilization services, the residential staff must 436.7 include, for at least eight hours per day, at least one 436.8 individual who meets the qualifications in subdivision 8. 436.9 (d) If crisis stabilization services are provided in a 436.10 supervised, licensed residential setting that serves more than 436.11 four adult residents, and one or more are recipients of crisis 436.12 stabilization services, the residential staff must include, for 436.13 24 hours a day, at least one individual who meets the 436.14 qualifications in subdivision 8. During the first 48 hours that 436.15 a recipient is in the residential program, the residential 436.16 program must have at least two staff working 24 hours a day. 436.17 Staffing levels may be adjusted thereafter according to the 436.18 needs of the recipient as specified in the crisis stabilization 436.19 treatment plan. 436.20 Subd. 8. [ADULT CRISIS STABILIZATION STAFF 436.21 QUALIFICATIONS.] (a) Adult mental health crisis stabilization 436.22 services must be provided by qualified individual staff of a 436.23 qualified provider entity. Individual provider staff must have 436.24 the following qualifications: 436.25 (1) be a mental health professional as defined in section 436.26 245.462, subdivision 18, clauses (1) to (5); 436.27 (2) be a mental health practitioner as defined in section 436.28 245.462, subdivision 17. The mental health practitioner must 436.29 work under the clinical supervision of a mental health 436.30 professional; or 436.31 (3) be a mental health rehabilitation worker who meets the 436.32 criteria in section 256B.0623, subdivision 5, clause (3); works 436.33 under the direction of a mental health practitioner as defined 436.34 in section 245.462, subdivision 17, or under direction of a 436.35 mental health professional; and works under the clinical 436.36 supervision of a mental health professional. 437.1 (b) Mental health practitioners and mental health 437.2 rehabilitation workers must have completed at least 30 hours of 437.3 training in crisis intervention and stabilization during the 437.4 past two years. 437.5 Subd. 9. [SUPERVISION.] Mental health practitioners may 437.6 provide crisis assessment and mobile crisis intervention 437.7 services if the following clinical supervision requirements are 437.8 met: 437.9 (1) the mental health provider entity must accept full 437.10 responsibility for the services provided; 437.11 (2) the mental health professional of the provider entity, 437.12 who is an employee or under contract with the provider entity, 437.13 must be available by phone or in person for clinical 437.14 supervision; 437.15 (3) the mental health professional is consulted, in person 437.16 or by phone, during the first three hours when a mental health 437.17 practitioner provides on-site service; 437.18 (4) the mental health professional must: 437.19 (i) review and approve of the tentative crisis assessment 437.20 and crisis treatment plan; 437.21 (ii) document the consultation; and 437.22 (iii) sign the crisis assessment and treatment plan within 437.23 the next business day; 437.24 (5) if the mobile crisis intervention services continue 437.25 into a second calendar day, a mental health professional must 437.26 contact the recipient face-to-face on the second day to provide 437.27 services and update the crisis treatment plan; and 437.28 (6) the on-site observation must be documented in the 437.29 recipient's record and signed by the mental health professional. 437.30 Subd. 10. [RECIPIENT FILE.] Providers of mobile crisis 437.31 intervention or crisis stabilization services must maintain a 437.32 file for each recipient containing the following information: 437.33 (1) individual crisis treatment plans signed by the 437.34 recipient, mental health professional, and mental health 437.35 practitioner who developed the crisis treatment plan, or if the 437.36 recipient refused to sign the plan, the date and reason stated 438.1 by the recipient as to why the recipient would not sign the 438.2 plan; 438.3 (2) signed release forms; 438.4 (3) recipient health information and current medications; 438.5 (4) emergency contacts for the recipient; 438.6 (5) case records which document the date of service, place 438.7 of service delivery, signature of the person providing the 438.8 service, and the nature, extent, and units of service. Direct 438.9 or telephone contact with the recipient's family or others 438.10 should be documented; 438.11 (6) required clinical supervision by mental health 438.12 professionals; 438.13 (7) summary of the recipient's case reviews by staff; and 438.14 (8) any written information by the recipient that the 438.15 recipient wants in the file. 438.16 Documentation in the file must comply with all requirements of 438.17 the commissioner. 438.18 Subd. 11. [TREATMENT PLAN.] The individual crisis 438.19 stabilization treatment plan must include, at a minimum: 438.20 (1) a list of problems identified in the assessment; 438.21 (2) a list of the recipient's strengths and resources; 438.22 (3) concrete, measurable short-term goals and tasks to be 438.23 achieved, including time frames for achievement; 438.24 (4) specific objectives directed toward the achievement of 438.25 each one of the goals; 438.26 (5) documentation of the participants involved in the 438.27 service planning. The recipient, if possible, must be a 438.28 participant. The recipient or the recipient's legal guardian 438.29 must sign the service plan or documentation must be provided why 438.30 this was not possible. A copy of the plan must be given to the 438.31 recipient and the recipient's legal guardian. The plan should 438.32 include services arranged, including specific providers where 438.33 applicable; 438.34 (6) planned frequency and type of services initiated; 438.35 (7) a crisis response action plan if a crisis should occur; 438.36 (8) clear progress notes on outcome of goals; 439.1 (9) a written plan must be completed within 24 hours of 439.2 beginning services with the recipient; and 439.3 (10) a treatment plan must be developed by a mental health 439.4 professional or mental health practitioner under the clinical 439.5 supervision of a mental health professional. The mental health 439.6 professional must approve and sign all treatment plans. 439.7 Subd. 12. [EXCLUDED SERVICES.] The following services are 439.8 excluded from reimbursement under this section: 439.9 (1) room and board services; 439.10 (2) services delivered to a recipient while admitted to an 439.11 inpatient hospital; 439.12 (3) recipient transportation costs may be covered under 439.13 other medical assistance provisions, but transportation services 439.14 are not an adult mental health crisis response service; 439.15 (4) services provided and billed by a provider who is not 439.16 enrolled under medical assistance to provide adult mental health 439.17 crisis response services; 439.18 (5) services performed by volunteers; 439.19 (6) direct billing of time spent "on call" when not 439.20 delivering services to a recipient; 439.21 (7) provider service time included in case management 439.22 reimbursement. When a provider is eligible to provide more than 439.23 one type of medical assistance service, the recipient must have 439.24 a choice of provider for each service, unless otherwise provided 439.25 for by law; 439.26 (8) outreach services to potential recipients; and 439.27 (9) a mental health service that is not medically necessary. 439.28 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 439.29 subdivision 20, is amended to read: 439.30 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 439.31 extent authorized by rule of the state agency, medical 439.32 assistance covers case management services to persons with 439.33 serious and persistent mental illness and children with severe 439.34 emotional disturbance. Services provided under this section 439.35 must meet the relevant standards in sections 245.461 to 439.36 245.4888, the Comprehensive Adult and Children's Mental Health 440.1 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 440.2 9505.0322, excluding subpart 10. 440.3 (b) Entities meeting program standards set out in rules 440.4 governing family community support services as defined in 440.5 section 245.4871, subdivision 17, are eligible for medical 440.6 assistance reimbursement for case management services for 440.7 children with severe emotional disturbance when these services 440.8 meet the program standards in Minnesota Rules, parts 9520.0900 440.9 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 440.10 (c) Medical assistance and MinnesotaCare payment for mental 440.11 health case management shall be made on a monthly basis. In 440.12 order to receive payment for an eligible child, the provider 440.13 must document at least a face-to-face contact with the child, 440.14 the child's parents, or the child's legal representative. To 440.15 receive payment for an eligible adult, the provider must 440.16 document: 440.17 (1) at least a face-to-face contact with the adult or the 440.18 adult's legal representative; or 440.19 (2) at least a telephone contact with the adult or the 440.20 adult's legal representative and document a face-to-face contact 440.21 with the adult or the adult's legal representative within the 440.22 preceding two months. 440.23 (d) Payment for mental health case management provided by 440.24 county or state staff shall be based on the monthly rate 440.25 methodology under section 256B.094, subdivision 6, paragraph 440.26 (b), with separate rates calculated for child welfare and mental 440.27 health, and within mental health, separate rates for children 440.28 and adults. 440.29 (e) Payment for mental health case management provided by 440.30 Indian health services or by agencies operated by Indian tribes 440.31 may be made according to this section or other relevant 440.32 federally approved rate setting methodology. 440.33 (f) Payment for mental health case management provided by 440.34county-contractedvendors who contract with a county or Indian 440.35 tribe shall be based on a monthly rate negotiated by the host 440.36 county or tribe. The negotiated rate must not exceed the rate 441.1 charged by the vendor for the same service to other payers. If 441.2 the service is provided by a team of contracted vendors, the 441.3 county or tribe may negotiate a team rate with a vendor who is a 441.4 member of the team. The team shall determine how to distribute 441.5 the rate among its members. No reimbursement received by 441.6 contracted vendors shall be returned to the county or tribe, 441.7 except to reimburse the county or tribe for advance funding 441.8 provided by the county or tribe to the vendor. 441.9(f)(g) If the service is provided by a team which includes 441.10 contracted vendors, tribal staff, and county or state staff, the 441.11 costs for county or state staff participation in the team shall 441.12 be included in the rate for county-provided services. In this 441.13 case, the contracted vendor, the tribal agency, and the county 441.14 may each receive separate payment for services provided by each 441.15 entity in the same month. In order to prevent duplication of 441.16 services,the countyeach entity must document, in the 441.17 recipient's file, the need for team case management and a 441.18 description of the roles of the team members. 441.19(g)(h) The commissioner shall calculate the nonfederal 441.20 share of actual medical assistance and general assistance 441.21 medical care payments for each county, based on the higher of 441.22 calendar year 1995 or 1996, by service date, project that amount 441.23 forward to 1999, and transfer one-half of the result from 441.24 medical assistance and general assistance medical care to each 441.25 county's mental health grants under sections 245.4886 and 441.26 256E.12 for calendar year 1999. The annualized minimum amount 441.27 added to each county's mental health grant shall be $3,000 per 441.28 year for children and $5,000 per year for adults. The 441.29 commissioner may reduce the statewide growth factor in order to 441.30 fund these minimums. The annualized total amount transferred 441.31 shall become part of the base for future mental health grants 441.32 for each county. 441.33(h)(i) Any net increase in revenue to the county or tribe 441.34 as a result of the change in this section must be used to 441.35 provide expanded mental health services as defined in sections 441.36 245.461 to 245.4888, the Comprehensive Adult and Children's 442.1 Mental Health Acts, excluding inpatient and residential 442.2 treatment. For adults, increased revenue may also be used for 442.3 services and consumer supports which are part of adult mental 442.4 health projects approved under Laws 1997, chapter 203, article 442.5 7, section 25. For children, increased revenue may also be used 442.6 for respite care and nonresidential individualized 442.7 rehabilitation services as defined in section 245.492, 442.8 subdivisions 17 and 23. "Increased revenue" has the meaning 442.9 given in Minnesota Rules, part 9520.0903, subpart 3. 442.10(i)(j) Notwithstanding section 256B.19, subdivision 1, the 442.11 nonfederal share of costs for mental health case management 442.12 shall be provided by the recipient's county of responsibility, 442.13 as defined in sections 256G.01 to 256G.12, from sources other 442.14 than federal funds or funds used to match other federal 442.15 funds. If the service is provided by a tribal agency, the 442.16 nonfederal share, if any, shall be provided by the recipient's 442.17 tribe. 442.18(j)(k) The commissioner may suspend, reduce, or terminate 442.19 the reimbursement to a provider that does not meet the reporting 442.20 or other requirements of this section. The county of 442.21 responsibility, as defined in sections 256G.01 to 256G.12, or, 442.22 if applicable, the tribal agency, is responsible for any federal 442.23 disallowances. The county or tribe may share this 442.24 responsibility with its contracted vendors. 442.25(k)(l) The commissioner shall set aside a portion of the 442.26 federal funds earned under this section to repay the special 442.27 revenue maximization account under section 256.01, subdivision 442.28 2, clause (15). The repayment is limited to: 442.29 (1) the costs of developing and implementing this section; 442.30 and 442.31 (2) programming the information systems. 442.32(l)(m) Notwithstanding section 256.025, subdivision 2, 442.33 payments to counties and tribal agencies for case management 442.34 expenditures under this section shall only be made from federal 442.35 earnings from services provided under this section. Payments to 442.36contractedcounty-contracted vendors shall include both the 443.1 federal earnings and the county share. 443.2(m)(n) Notwithstanding section 256B.041, county payments 443.3 for the cost of mental health case management services provided 443.4 by county or state staff shall not be made to the state 443.5 treasurer. For the purposes of mental health case management 443.6 services provided by county or state staff under this section, 443.7 the centralized disbursement of payments to counties under 443.8 section 256B.041 consists only of federal earnings from services 443.9 provided under this section. 443.10(n)(o) Case management services under this subdivision do 443.11 not include therapy, treatment, legal, or outreach services. 443.12(o)(p) If the recipient is a resident of a nursing 443.13 facility, intermediate care facility, or hospital, and the 443.14 recipient's institutional care is paid by medical assistance, 443.15 payment for case management services under this subdivision is 443.16 limited to the last 30 days of the recipient's residency in that 443.17 facility and may not exceed more than two months in a calendar 443.18 year. 443.19(p)(q) Payment for case management services under this 443.20 subdivision shall not duplicate payments made under other 443.21 program authorities for the same purpose. 443.22(q)(r) By July 1, 2000, the commissioner shall evaluate 443.23 the effectiveness of the changes required by this section, 443.24 including changes in number of persons receiving mental health 443.25 case management, changes in hours of service per person, and 443.26 changes in caseload size. 443.27(r)(s) For each calendar year beginning with the calendar 443.28 year 2001, the annualized amount of state funds for each county 443.29 determined under paragraph(g)(h) shall be adjusted by the 443.30 county's percentage change in the average number of clients per 443.31 month who received case management under this section during the 443.32 fiscal year that ended six months prior to the calendar year in 443.33 question, in comparison to the prior fiscal year. 443.34(s)(t) For counties receiving the minimum allocation of 443.35 $3,000 or $5,000 described in paragraph(g)(h), the adjustment 443.36 in paragraph(r)(s) shall be determined so that the county 444.1 receives the higher of the following amounts: 444.2 (1) a continuation of the minimum allocation in paragraph 444.3(g)(h); or 444.4 (2) an amount based on that county's average number of 444.5 clients per month who received case management under this 444.6 section during the fiscal year that ended six months prior to 444.7 the calendar year in question,in comparison to the prior fiscal444.8year,times the average statewide grant per person per month for 444.9 counties not receiving the minimum allocation. 444.10(t)(u) The adjustments in paragraphs(r) and(s) and (t) 444.11 shall be calculated separately for children and adults. 444.12 Sec. 17. Minnesota Statutes 2000, section 256B.0625, is 444.13 amended by adding a subdivision to read: 444.14 Subd. 43. [APPEAL PROCESS.] If a county contract or 444.15 certification is required to enroll as an authorized provider of 444.16 mental health services under medical assistance, and if a county 444.17 refuses to grant the necessary contract or certification, the 444.18 provider may appeal the county decision to the commissioner. A 444.19 recipient may initiate an appeal on behalf of a provider who has 444.20 been denied certification. The commissioner shall determine 444.21 whether the provider meets applicable standards under state laws 444.22 and rules based on an independent review of the facts, including 444.23 comments from the county review. If the commissioner finds that 444.24 the provider meets the applicable standards, the commissioner 444.25 shall enroll the provider as an authorized provider. The 444.26 commissioner shall develop procedures for providers and 444.27 recipients to appeal a county decision to refuse to enroll a 444.28 provider. After the commissioner makes a decision regarding an 444.29 appeal, the county, provider, or recipient may request that the 444.30 commissioner reconsider the commissioner's initial decision. The 444.31 commissioner's reconsideration decision is final and not subject 444.32 to further appeal. 444.33 Sec. 18. Minnesota Statutes 2000, section 256B.0625, is 444.34 amended by adding a subdivision to read: 444.35 Subd. 44. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 444.36 assistance covers provider travel time if a recipient's 445.1 individual treatment plan requires the provision of mental 445.2 health services outside of the provider's normal place of 445.3 business. This does not include any travel time which is 445.4 included in other billable services, and is only covered when 445.5 the mental health service being provided to a recipient is 445.6 covered under medical assistance. 445.7 Sec. 19. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 445.8 SERVICES.] 445.9 Payment for medication management provided to psychiatric 445.10 patients, outpatient mental health services, day treatment 445.11 services, home-based mental health services, and family 445.12 community support services shall be paid at: 445.13 (1) for services rendered on or after July 1, 2001, and 445.14 before July 1, 2002, the lower of (i) submitted charges, or (ii) 445.15 the 73rd percentile of the 50th percentile of 1999 charges; and 445.16 (2) for services rendered on or after July 1, 2002, the 445.17 lower of (i) submitted charges, or (ii) the 75th percentile of 445.18 the 50th percentile of 1999 charges. 445.19 Sec. 20. Minnesota Statutes 2000, section 260C.201, 445.20 subdivision 1, is amended to read: 445.21 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 445.22 the child is in need of protection or services or neglected and 445.23 in foster care, it shall enter an order making any of the 445.24 following dispositions of the case: 445.25 (1) place the child under the protective supervision of the 445.26 local social services agency or child-placing agency in the home 445.27 of a parent of the child under conditions prescribed by the 445.28 court directed to the correction of the child's need for 445.29 protection or services, or: 445.30 (i) the court may order the child into the home of a parent 445.31 who does not otherwise have legal custody of the child, however, 445.32 an order under this section does not confer legal custody on 445.33 that parent; 445.34 (ii) if the court orders the child into the home of a 445.35 father who is not adjudicated, he must cooperate with paternity 445.36 establishment proceedings regarding the child in the appropriate 446.1 jurisdiction as one of the conditions prescribed by the court 446.2 for the child to continue in his home; 446.3 (iii) the court may order the child into the home of a 446.4 noncustodial parent with conditions and may also order both the 446.5 noncustodial and the custodial parent to comply with the 446.6 requirements of a case plan under subdivision 2; 446.7 (2) transfer legal custody to one of the following: 446.8 (i) a child-placing agency; or 446.9 (ii) the local social services agency. 446.10 In placing a child whose custody has been transferred under 446.11 this paragraph, the agencies shall follow the requirements of 446.12 section 260C.193, subdivision 3; 446.13 (3) if the child has been adjudicated as a child in need of 446.14 protection or services because the child is in need of special 446.15treatment andservices or carefor reasons of physical or mental446.16healthto treat or ameliorate a physical or mental disability, 446.17 the court may order the child's parent, guardian, or custodian 446.18 to provide it. If the parent, guardian, or custodian fails or 446.19 is unable to provide this treatment or care, the court may order 446.20 it provided. The court may also order the child's health plan 446.21 company to provide mental health services to the child under 446.22 section 62Q.535. Absent specific written findings by the court 446.23 that the child's disability is the result of abuse or neglect by 446.24 the child's parent or guardian, the court shall not transfer 446.25 legal custody of the child for the purpose of obtaining special 446.26 treatment or care solely because the parent is unable to provide 446.27 the treatment or care. If the court's order for mental health 446.28 treatment is based on a diagnosis made by a treatment 446.29 professional, the court may order that the diagnosing 446.30 professional not provide the treatment to the child if it finds 446.31 that such an order is in the child's best interests; or 446.32 (4) if the court believes that the child has sufficient 446.33 maturity and judgment and that it is in the best interests of 446.34 the child, the court may order a child 16 years old or older to 446.35 be allowed to live independently, either alone or with others as 446.36 approved by the court under supervision the court considers 447.1 appropriate, if the county board, after consultation with the 447.2 court, has specifically authorized this dispositional 447.3 alternative for a child. 447.4 (b) If the child was adjudicated in need of protection or 447.5 services because the child is a runaway or habitual truant, the 447.6 court may order any of the following dispositions in addition to 447.7 or as alternatives to the dispositions authorized under 447.8 paragraph (a): 447.9 (1) counsel the child or the child's parents, guardian, or 447.10 custodian; 447.11 (2) place the child under the supervision of a probation 447.12 officer or other suitable person in the child's own home under 447.13 conditions prescribed by the court, including reasonable rules 447.14 for the child's conduct and the conduct of the parents, 447.15 guardian, or custodian, designed for the physical, mental, and 447.16 moral well-being and behavior of the child; or with the consent 447.17 of the commissioner of corrections, place the child in a group 447.18 foster care facility which is under the commissioner's 447.19 management and supervision; 447.20 (3) subject to the court's supervision, transfer legal 447.21 custody of the child to one of the following: 447.22 (i) a reputable person of good moral character. No person 447.23 may receive custody of two or more unrelated children unless 447.24 licensed to operate a residential program under sections 245A.01 447.25 to 245A.16; or 447.26 (ii) a county probation officer for placement in a group 447.27 foster home established under the direction of the juvenile 447.28 court and licensed pursuant to section 241.021; 447.29 (4) require the child to pay a fine of up to $100. The 447.30 court shall order payment of the fine in a manner that will not 447.31 impose undue financial hardship upon the child; 447.32 (5) require the child to participate in a community service 447.33 project; 447.34 (6) order the child to undergo a chemical dependency 447.35 evaluation and, if warranted by the evaluation, order 447.36 participation by the child in a drug awareness program or an 448.1 inpatient or outpatient chemical dependency treatment program; 448.2 (7) if the court believes that it is in the best interests 448.3 of the child and of public safety that the child's driver's 448.4 license or instruction permit be canceled, the court may order 448.5 the commissioner of public safety to cancel the child's license 448.6 or permit for any period up to the child's 18th birthday. If 448.7 the child does not have a driver's license or permit, the court 448.8 may order a denial of driving privileges for any period up to 448.9 the child's 18th birthday. The court shall forward an order 448.10 issued under this clause to the commissioner, who shall cancel 448.11 the license or permit or deny driving privileges without a 448.12 hearing for the period specified by the court. At any time 448.13 before the expiration of the period of cancellation or denial, 448.14 the court may, for good cause, order the commissioner of public 448.15 safety to allow the child to apply for a license or permit, and 448.16 the commissioner shall so authorize; 448.17 (8) order that the child's parent or legal guardian deliver 448.18 the child to school at the beginning of each school day for a 448.19 period of time specified by the court; or 448.20 (9) require the child to perform any other activities or 448.21 participate in any other treatment programs deemed appropriate 448.22 by the court. 448.23 To the extent practicable, the court shall enter a 448.24 disposition order the same day it makes a finding that a child 448.25 is in need of protection or services or neglected and in foster 448.26 care, but in no event more than 15 days after the finding unless 448.27 the court finds that the best interests of the child will be 448.28 served by granting a delay. If the child was under eight years 448.29 of age at the time the petition was filed, the disposition order 448.30 must be entered within ten days of the finding and the court may 448.31 not grant a delay unless good cause is shown and the court finds 448.32 the best interests of the child will be served by the delay. 448.33 (c) If a child who is 14 years of age or older is 448.34 adjudicated in need of protection or services because the child 448.35 is a habitual truant and truancy procedures involving the child 448.36 were previously dealt with by a school attendance review board 449.1 or county attorney mediation program under section 260A.06 or 449.2 260A.07, the court shall order a cancellation or denial of 449.3 driving privileges under paragraph (b), clause (7), for any 449.4 period up to the child's 18th birthday. 449.5 (d) In the case of a child adjudicated in need of 449.6 protection or services because the child has committed domestic 449.7 abuse and been ordered excluded from the child's parent's home, 449.8 the court shall dismiss jurisdiction if the court, at any time, 449.9 finds the parent is able or willing to provide an alternative 449.10 safe living arrangement for the child, as defined in Laws 1997, 449.11 chapter 239, article 10, section 2. 449.12 Sec. 21. [299A.76] [SUICIDE STATISTICS.] 449.13 (a) The commissioner of public safety shall not: 449.14 (1) include any statistics on committing suicide or 449.15 attempting suicide in any compilation of crime statistics 449.16 published by the commissioner; or 449.17 (2) label as a crime statistic, any data on committing 449.18 suicide or attempting suicide. 449.19 (b) This section does not apply to the crimes of aiding 449.20 suicide under section 609.215, subdivision 1, or aiding 449.21 attempted suicide under section 609.215, subdivision 2, or to 449.22 statistics directly related to the commission of a crime. 449.23 Sec. 22. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 449.24 CARE BENEFIT PROGRAM.] 449.25 When the continuing care benefit program for persons with 449.26 mental illness under Minnesota Statutes, section 256.9693 is 449.27 established, the commissioner of human services shall notify 449.28 counties, health plan companies with prepaid medical assistance 449.29 contracts, health care providers, and enrollees of the benefit 449.30 program through bulletins, workshops, and other meetings. 449.31 [EFFECTIVE DATE.] This section is effective July 1, 2002. 449.32 Sec. 23. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 449.33 PERSONS.] 449.34 The commissioner of human services shall study and make 449.35 recommendations on how Medicare-eligible persons with mental 449.36 illness may obtain acute care hospital inpatient treatment for 450.1 mental illness for a length of stay beyond that allowed by the 450.2 diagnostic classifications for mental illness according to 450.3 Minnesota Statutes, section 256.969, subdivision 3a. The study 450.4 and recommendations shall be reported to the legislature by 450.5 January 15, 2002. 450.6 Sec. 24. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 450.7 RESIDENTIAL SERVICES GRANTS.] 450.8 The commissioner of human services shall review funding 450.9 methods for adult residential services grants under Minnesota 450.10 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 450.11 system that takes into account client difficulty of care as 450.12 manifested by client physical, mental, or behavioral 450.13 conditions. The payment system must provide reimbursement for 450.14 education, consultation, and support services provided to 450.15 families and other individuals as an extension of the treatment 450.16 process. The commissioner shall present recommendations and 450.17 draft legislation for an adult residential services payment 450.18 system to the legislature by January 15, 2002. The 450.19 recommendations must address whether additional funding for 450.20 adult residential services grants is necessary for the provision 450.21 of high quality services under a payment reimbursement system. 450.22 ARTICLE 10 450.23 ASSISTANCE PROGRAMS 450.24 Section 1. Minnesota Statutes 2000, section 256.01, 450.25 subdivision 18, is amended to read: 450.26 Subd. 18. [IMMIGRATION STATUS VERIFICATIONS.] (a) 450.27 Notwithstanding any waiver of this requirement by the secretary 450.28 of the United States Department of Health and Human Services, 450.29 effective July 1, 2001, the commissioner shall utilize the 450.30 Systematic Alien Verification for Entitlements (SAVE) program to 450.31 conduct immigration status verifications: 450.32 (1) as required under United States Code, title 8, section 450.33 1642; 450.34 (2) for all applicants for food assistance benefits, 450.35 whether under the federal food stamp program, the MFIP or work 450.36 first program, or the Minnesota food assistance program; 451.1 (3) for all applicants for general assistance medical care, 451.2 except assistance for an emergency medical condition, for 451.3 immunization with respect to an immunizable disease, or for 451.4 testing and treatment of symptoms of a communicable disease; and 451.5 (4) for all applicants for general assistance, Minnesota 451.6 supplemental aid, MinnesotaCare, or group residential housing, 451.7 when the benefits provided by these programs would fall under 451.8 the definition of "federal public benefit" under United States 451.9 Code, title 8, section 1642, if federal funds were used to pay 451.10 for all or part of the benefits. 451.11The commissioner shall report to the Immigration and451.12Naturalization Service all undocumented persons who have been451.13identified through application verification procedures or by the451.14self-admission of an applicant for assistance. Reports made451.15under this subdivision must comply with the requirements of451.16section 411A of the Social Security Act, as amended, and United451.17States Code, title 8, section 1644.451.18 (b) The commissioner shall comply with the reporting 451.19 requirements under United States Code, title 42, section 611a, 451.20 and any federal regulation or guidance adopted under that law. 451.21 Sec. 2. Minnesota Statutes 2000, section 256D.053, 451.22 subdivision 1, is amended to read: 451.23 Subdivision 1. [PROGRAM ESTABLISHED.] The Minnesota food 451.24 assistance program is established to provide food assistance to 451.25 legal noncitizens residing in this state who are ineligible to 451.26 participate in the federal Food Stamp Program solely due to the 451.27 provisions of section 402 or 403 of Public Law Number 104-193, 451.28 as authorized by Title VII of the 1997 Emergency Supplemental 451.29 Appropriations Act, Public Law Number 105-18, and as amended by 451.30 Public Law Number 105-185. 451.31 Beginning July 1,20022003, the Minnesota food assistance 451.32 program is limited to those noncitizens described in this 451.33 subdivision who are 50 years of age or older. 451.34 Sec. 3. [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 451.35 STATE MONEY.] 451.36 Beginning October 1, 2001, and each year thereafter, the 452.1 commissioner of human services must treat financial assistance 452.2 expenditures made to or on behalf of any minor child under 452.3 section 256J.02, subdivision 2, clause (1), who is a resident of 452.4 this state under section 256J.12, and who is part of a 452.5 two-parent eligible household as expenditures under a separately 452.6 funded state program and report those expenditures to the 452.7 federal Department of Health and Human Services as separate 452.8 state program expenditures under Code of Federal Regulations, 452.9 title 45, section 263.5. 452.10 Sec. 4. Minnesota Statutes 2000, section 256J.09, 452.11 subdivision 1, is amended to read: 452.12 Subdivision 1. [WHERE TO APPLY.] To apply for assistance a 452.13 person mustapply for assistance atsubmit a signed application 452.14 to the county agency in the county where that person lives. 452.15 Sec. 5. Minnesota Statutes 2000, section 256J.09, 452.16 subdivision 2, is amended to read: 452.17 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 452.18 INFORMATION.] When a person inquires about assistance, a county 452.19 agency mustinform a person who inquires about assistance about: 452.20 (1) explain the eligibility requirementsfor assistanceof, 452.21 and how to apply for, diversionary assistance, including452.22diversionary assistance andas provided in section 256J.47; 452.23 emergency assistance.as provided in section 256J.48; MFIP as 452.24 provided in section 256J.10; or any other assistance for which 452.25 the person may be eligible; and 452.26A county agency must(2) offer the person brochures 452.27 developed or approved by the commissioner that describe how to 452.28 apply for assistance. 452.29 Sec. 6. Minnesota Statutes 2000, section 256J.09, 452.30 subdivision 3, is amended to read: 452.31 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 452.32 agency must offer, in person or by mail, the application forms 452.33 prescribed by the commissioner as soon as a person makes a 452.34 written or oral inquiry. At that time, the county agency must: 452.35 (1) inform the person that assistance begins with the date 452.36 the signed application is received by the county agency or the 453.1 date all eligibility criteria are met, whichever is later. The453.2county agency must; 453.3 (2) inform theapplicantperson that any delay in 453.4 submitting the application will reduce the amount of assistance 453.5 paid for the month of application. A county agency must; 453.6 (3) inform a person that the person may submit the 453.7 application before an interviewappointment. To apply for453.8assistance, a person must submit a signed application to the453.9county agency.; 453.10 (4) explain the information that will be verified during 453.11 the application process by the county agency as provided in 453.12 section 256J.32; 453.13 (5) inform a person about the county agency's average 453.14 application processing time and explain how the application will 453.15 be processed under subdivision 5; 453.16 (6) explain how to contact the county agency if a person's 453.17 application information changes and how to withdraw the 453.18 application; 453.19 (7) inform a person that the next step in the application 453.20 process is an interview and what a person must do if the 453.21 application is approved including, but not limited to, attending 453.22 orientation under section 256J.45 and complying with employment 453.23 and training services requirements in sections 256J.52 to 453.24 256J.55; 453.25 (8) explain the child care and transportation services that 453.26 are available under paragraph (c) to enable caregivers to attend 453.27 the interview, screening, and orientation; and 453.28 (9) identify any language barriers and arrange for 453.29 translation assistance during appointments, including, but not 453.30 limited to, screening under subdivision 3a, orientation under 453.31 section 256J.45, and the initial assessment under section 453.32 256J.52. 453.33 (b) Upon receipt of a signed application, the county agency 453.34 must stamp the date of receipt on the face of the application. 453.35 The county agency must process the application within the time 453.36 period required under subdivision 5. An applicant may withdraw 454.1 the application at any time by giving written or oral notice to 454.2 the county agency. The county agency must issue a written 454.3 notice confirming the withdrawal. The notice must inform the 454.4 applicant of the county agency's understanding that the 454.5 applicant has withdrawn the application and no longer wants to 454.6 pursue it. When, within ten days of the date of the agency's 454.7 notice, an applicant informs a county agency, in writing, that 454.8 the applicant does not wish to withdraw the application, the 454.9 county agency must reinstate the application and finish 454.10 processing the application. 454.11 (c) Upon a participant's request, the county agency must 454.12 arrange for transportation and child care or reimburse the 454.13 participant for transportation and child care expenses necessary 454.14 to enable participants to attend the screening under subdivision 454.15 3a and orientation under section 256J.45. 454.16 Sec. 7. Minnesota Statutes 2000, section 256J.09, is 454.17 amended by adding a subdivision to read: 454.18 Subd. 3a. [SCREENING.] The county agency, or at county 454.19 option, the county's employment and training service provider as 454.20 defined in section 256J.49, must screen each applicant to 454.21 determine immediate needs and to determine if the applicant may 454.22 be eligible for: 454.23 (1) another program that is not partially funded through 454.24 the federal temporary assistance to needy families block grant 454.25 under Title I of Public Law Number 104-193, including the 454.26 expedited issuance of food stamps under section 256J.28, 454.27 subdivision 1. If the applicant may be eligible for another 454.28 program, a county caseworker must provide the appropriate 454.29 referral to the program; 454.30 (2) the diversionary assistance program under section 454.31 256J.47; or 454.32 (3) the emergency assistance program under section 256J.48. 454.33 Sec. 8. Minnesota Statutes 2000, section 256J.09, is 454.34 amended by adding a subdivision to read: 454.35 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 454.36 If the applicant is not diverted from applying for MFIP, and if 455.1 the applicant meets the MFIP eligibility requirements, then a 455.2 county agency must: 455.3 (1) identify an applicant who is under the age of 20 and 455.4 explain to the applicant the assessment procedures and 455.5 employment plan requirements for minor parents under section 455.6 256J.54; 455.7 (2) explain to the applicant the eligibility criteria for 455.8 an exemption under the family violence provisions in section 455.9 256J.52, subdivision 6, and explain what an applicant should do 455.10 to develop an alternative employment plan; 455.11 (3) determine if an applicant qualifies for an exemption 455.12 under section 256J.56 from employment and training services 455.13 requirements, explain how a person should report to the county 455.14 agency any status changes, and explain that an applicant who is 455.15 exempt may volunteer to participate in employment and training 455.16 services; 455.17 (4) for applicants who are not exempt from the requirement 455.18 to attend orientation, arrange for an orientation under section 455.19 256J.45 and an initial assessment under section 256J.52; 455.20 (5) inform an applicant who is not exempt from the 455.21 requirement to attend orientation that failure to attend the 455.22 orientation is considered an occurrence of noncompliance with 455.23 program requirements and will result in an imposition of a 455.24 sanction under section 256J.46; and 455.25 (6) explain how to contact the county agency if an 455.26 applicant has questions about compliance with program 455.27 requirements. 455.28 Sec. 9. Minnesota Statutes 2000, section 256J.15, is 455.29 amended by adding a subdivision to read: 455.30 Subd. 3. [ELIGIBILITY AFTER DISQUALIFICATION DUE TO 455.31 NONCOMPLIANCE.] (a) An applicant who is a member of an 455.32 assistance unit that was disqualified from receiving MFIP under 455.33 section 256J.46, subdivision 1, paragraph (d), clause (3), and 455.34 who applies for MFIP assistance within six months of the date of 455.35 the disqualification is considered to be a new applicant for 455.36 purposes of the property limitations under section 256J.20 and, 456.1 at county option, the payment of assistance provisions under 456.2 section 256J.24, subdivision 8. The county agency must also use 456.3 the initial income test under section 256J.21, subdivision 3, in 456.4 determining the applicant's eligibility for assistance. 456.5 (b) Notwithstanding section 256J.24, subdivisions 5 to 7 456.6 and 9, for an applicant who is eligible for MFIP under this 456.7 subdivision, the residual amount of the grant, after making any 456.8 applicable vendor payments for shelter and utility costs, if 456.9 any, must be reduced by ten percent of the applicable MFIP 456.10 standard of need for an assistance unit of the same size for 456.11 each of the first six months on MFIP before the residual amount 456.12 of the grant is paid to the assistance unit. 456.13 (c) A participant who is disqualified from MFIP a second or 456.14 subsequent time and who is eligible for MFIP under this 456.15 subdivision is considered to have a third occurrence of 456.16 noncompliance and must be sanctioned under section 256J.46, 456.17 subdivision 1, paragraph (d), clause (2), for the first six 456.18 months on MFIP under this subdivision. 456.19 Sec. 10. Minnesota Statutes 2000, section 256J.24, 456.20 subdivision 10, is amended to read: 456.21 Subd. 10. [MFIP EXIT LEVEL.](a) In state fiscal years456.222000 and 2001,The commissioner shall adjust the MFIP earned 456.23 income disregard to ensure that most participants do not lose 456.24 eligibility for MFIP until their income reaches at least 120 456.25 percent of the federal poverty guidelines in effect in October 456.26 of each fiscal year. The adjustment to the disregard shall be 456.27 based on a household size of three, and the resulting earned 456.28 income disregard percentage must be applied to all household 456.29 sizes. The adjustment under this subdivision must be 456.30 implemented at the same time as the October food stamp 456.31 cost-of-living adjustment is reflected in the food portion of 456.32 MFIP transitional standard as required under subdivision 5a. 456.33(b) In state fiscal year 2002 and thereafter, the earned456.34income disregard percentage must be the same as the percentage456.35implemented in October 2000.456.36 Sec. 11. Minnesota Statutes 2000, section 256J.26, 457.1 subdivision 1, is amended to read: 457.2 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 457.3 Applicants or participants who have been convicted of a drug 457.4 offense committed after July 1, 1997, may, if otherwise 457.5 eligible, receive MFIP benefits subject to the following 457.6 conditions: 457.7 (1) Benefits for the entire assistance unit must be paid in 457.8 vendor form for shelter and utilities during any time the 457.9 applicant is part of the assistance unit. 457.10 (2) The convicted applicant or participant shall be subject 457.11 to random drug testing as a condition of continued eligibility 457.12 and following any positive test for an illegal controlled 457.13 substance is subject to the following sanctions: 457.14 (i) for failing a drug test the first time, the 457.15participant's grant shall be reduced by ten percent of the MFIP457.16standard of need, prior to making vendor payments for shelter457.17and utility costs; or457.18(ii) for failing a drug test two or more times, the457.19 residual amount of the participant's grant after making vendor 457.20 payments for shelter and utility costs, if any, must be reduced 457.21 by an amount equal to 30 percent of the MFIP standard of 457.22 need for an assistance unit of the same size. When a sanction 457.23 under this subdivision is in effect, the job counselor must 457.24 attempt to meet with the person face-to-face. During the 457.25 face-to-face meeting, the job counselor must explain the 457.26 consequences of a subsequent drug test failure and inform the 457.27 participant of the right to appeal the sanction under section 457.28 256J.40. If a face-to-face meeting is not possible, the county 457.29 agency must send the participant a notice of adverse action as 457.30 provided in section 256J.31, subdivisions 4 and 5, and must 457.31 include the information required in the face-to-face meeting; or 457.32 (ii) for failing a drug test two times, the participant is 457.33 permanently disqualified from receiving MFIP assistance, both 457.34 the cash and food portions. The assistance unit's MFIP grant 457.35 must be reduced by the amount which would have otherwise been 457.36 made available to the disqualified participant. 458.1 Disqualification under this item does not make a participant 458.2 ineligible for food stamps. Before a disqualification under 458.3 this provision is imposed, the job counselor must attempt to 458.4 meet with the participant face-to-face. During the face-to-face 458.5 meeting, the job counselor must identify other resources that 458.6 may be available to the participant to meet the needs of the 458.7 family and inform the participant of the right to appeal the 458.8 disqualification under section 256J.40. If a face-to-face 458.9 meeting is not possible, the county agency must send the 458.10 participant a notice of adverse action as provided in section 458.11 256J.31, subdivisions 4 and 5, and must include the information 458.12 required in the face-to-face meeting. 458.13 (3) A participant who failsan initiala drug test the 458.14 first time and is under a sanction due to other MFIP program 458.15 requirements is considered to have more than one occurrence of 458.16 noncompliance and is subject to the applicable level of sanction 458.17in clause (2)(ii)as specified under section 256J.46, 458.18 subdivision 1, paragraph (d). 458.19 (b) Applicants requesting only food stamps or participants 458.20 receiving only food stamps, who have been convicted of a drug 458.21 offense that occurred after July 1, 1997, may, if otherwise 458.22 eligible, receive food stamps if the convicted applicant or 458.23 participant is subject to random drug testing as a condition of 458.24 continued eligibility. Following a positive test for an illegal 458.25 controlled substance, the applicant is subject to the following 458.26 sanctions: 458.27 (1) for failing a drug test the first time,food stamps458.28shall be reduced by ten percent of the applicable food stamp458.29allotment; and458.30(2) for failing a drug test two or more times,food stamps 458.31 shall be reduced by an amount equal to 30 percent of the 458.32 applicable food stamp allotment. When a sanction under this 458.33 clause is in effect, a job counselor must attempt to meet with 458.34 the person face-to-face. During the face-to-face meeting, a job 458.35 counselor must explain the consequences of a subsequent drug 458.36 test failure and inform the participant of the right to appeal 459.1 the sanction under section 256J.40. If a face-to-face meeting 459.2 is not possible, a county agency must send the participant a 459.3 notice of adverse action as provided in section 256J.31, 459.4 subdivisions 4 and 5, and must include the information required 459.5 in the face-to-face meeting; and 459.6 (2) for failing a drug test two times, the participant is 459.7 permanently disqualified from receiving food stamps. Before a 459.8 disqualification under this provision is imposed, a job 459.9 counselor must attempt to meet with the participant 459.10 face-to-face. During the face-to-face meeting, the job 459.11 counselor must identify other resources that may be available to 459.12 the participant to meet the needs of the family and inform the 459.13 participant of the right to appeal the disqualification under 459.14 section 256J.40. If a face-to-face meeting is not possible, a 459.15 county agency must send the participant a notice of adverse 459.16 action as provided in section 256J.31, subdivisions 4 and 5, and 459.17 must include the information required in the face-to-face 459.18 meeting. 459.19 (c) For the purposes of this subdivision, "drug offense" 459.20 means an offense that occurred after July 1, 1997, of sections 459.21 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 459.22 means a conviction in another jurisdiction of the possession, 459.23 use, or distribution of a controlled substance, or conspiracy to 459.24 commit any of these offenses, if the offense occurred after July 459.25 1, 1997, and the conviction is a felony offense in that 459.26 jurisdiction, or in the case of New Jersey, a high misdemeanor. 459.27 Sec. 12. Minnesota Statutes 2000, section 256J.31, 459.28 subdivision 4, is amended to read: 459.29 Subd. 4. [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 459.30 must give a participant written notice of all adverse actions 459.31 affecting the participant including payment reductions, 459.32 suspensions, terminations, and use of protective, vendor, or 459.33 two-party payments. The notice of adverse action must be on a 459.34 form prescribed or approved by the commissioner, must be 459.35 understandable at a seventh grade reading level, and must be 459.36 mailed to the last known mailing address provided by the 460.1 participant. A notice written in English must include the 460.2 department of human services language block and must be sent to 460.3 every applicable participant. The county agency must state on 460.4 the notice of adverse action the action it intends to take, the 460.5 reasons for the action, the participant's right to appeal the 460.6 action, the conditions under which assistance can be continued 460.7 pending an appeal decision, and the related consequences of the 460.8 action. 460.9 Sec. 13. Minnesota Statutes 2000, section 256J.32, 460.10 subdivision 7a, is amended to read: 460.11 Subd. 7a. [REQUIREMENT TO REPORT TO IMMIGRATION AND 460.12 NATURALIZATION SERVICES.]Notwithstanding subdivision 7,460.13effective July 1, 2001, the commissioner shall report to the460.14Immigration and Naturalization Services all undocumented persons460.15who have been identified through application verification460.16procedures or by the self-admission of an applicant for460.17assistance. Reports made under this subdivision must comply460.18with the requirements of section 411A of the Social Security460.19Act, as amended, and United States Code, title 8, section 1644.460.20 The commissioner shall comply with the reporting requirements 460.21 under United States Code, title 42, section 611a, and any 460.22 federal regulation or guidance adopted under that law. 460.23 Sec. 14. Minnesota Statutes 2000, section 256J.42, is 460.24 amended by adding a subdivision to read: 460.25 Subd. 6. [CASE REVIEW.] (a) Within 180 days before the end 460.26 of the participant's 60th month on MFIP, the county agency or 460.27 job counselor must review the participant's case to determine if 460.28 the employment plan is still appropriate, or if the participant 460.29 is exempt under section 256J.56 from the employment and training 460.30 services component, and attempt to meet with the participant 460.31 face-to-face. 460.32 (b) During the face-to-face meeting, a county agency or the 460.33 job counselor must: 460.34 (1) inform the participant how many months of counted 460.35 assistance the participant has accrued and when the participant 460.36 is expected to reach the 60th month; 461.1 (2) explain the hardship extension criteria under section 461.2 256J.425 and what the participant should do if the participant 461.3 thinks a hardship extension applies; 461.4 (3) identify other resources that may be available to the 461.5 participant to meet the needs of the family; and 461.6 (4) inform the participant of the right to appeal the case 461.7 closure under section 256J.40. 461.8 (c) If a face-to-face meeting is not possible, the county 461.9 agency must send the participant a notice of adverse action as 461.10 provided in section 256J.31, subdivisions 4 and 5. 461.11 (d) Before a participant's case is closed under this 461.12 section, the county must ensure that: 461.13 (1) the case has been reviewed by the job counselor's 461.14 supervisor or the review team designated in the county's 461.15 approved local service unit plan to determine if the criteria 461.16 for a hardship extension, if requested, were applied 461.17 appropriately; and 461.18 (2) the county agency or the job counselor attempted to 461.19 meet with the participant face-to-face. 461.20 Sec. 15. [256J.425] [HARDSHIP EXTENSIONS.] 461.21 Subdivision 1. [ELIGIBILITY.] An assistance unit subject 461.22 to the time limit under section 256J.42, subdivision 1, in which 461.23 any participant has received 60 counted months of assistance is 461.24 not eligible to receive months of assistance beyond the first 60 461.25 months under a hardship extension, if the participant is not in 461.26 compliance. If there is more than one participant in the 461.27 household, each participant must be in compliance to be eligible 461.28 for a hardship extension. For purposes of determining 461.29 eligibility for a hardship extension, a participant is in 461.30 compliance in any month that the participant has not been 461.31 sanctioned under section 256J.46, subdivision 1, or under 461.32 256J.26, subdivision 1. 461.33 Subd. 2. [ILL OR INCAPACITATED PARTICIPANTS; DEPENDENT 461.34 HOUSEHOLD MEMBER.] (a) An assistance unit subject to the time 461.35 limit in section 256J.42, subdivision 1, in which any 461.36 participant has received 60 counted months of assistance, is 462.1 eligible to receive months of assistance under a hardship 462.2 extension if the participant belongs to any of the following 462.3 groups: 462.4 (1) participants who are suffering from a professionally 462.5 certified illness, injury, or incapacity which is expected to 462.6 continue for more than 30 days and which prevents the person 462.7 from obtaining or retaining employment and who are following the 462.8 treatment recommendations of the health care provider certifying 462.9 the illness, injury, or incapacity; 462.10 (2) participants whose presence in the home is required 462.11 because of the professionally certified illness or incapacity of 462.12 another member in the assistance unit, a relative in the 462.13 household, or a foster child in the household and the illness or 462.14 incapacity is expected to continue for more than 30 days; or 462.15 (3) caregivers with a child or an adult in the household 462.16 who meets the disability or medical criteria for home care 462.17 services under section 256B.0627, subdivision 1, paragraph (c), 462.18 or a home and community-based waiver services program under 462.19 chapter 256B, or meets the criteria for severe emotional 462.20 disturbance under section 245.4871, subdivision 6, or for 462.21 serious and persistent mental illness under section 245.462, 462.22 subdivision 20, paragraph (c). Caregivers in this category are 462.23 presumed to be prevented from obtaining or retaining employment. 462.24 (b) An assistance unit receiving assistance under a 462.25 hardship extension under this subdivision may continue to 462.26 receive assistance under MFIP as long as the participant meets 462.27 the criteria in paragraph (a), clause (1), (2), or (3). A 462.28 county agency or job counselor must, on a quarterly basis, 462.29 review the case file of an assistance unit receiving assistance 462.30 under this subdivision to determine if the participant still 462.31 meets the criteria in paragraph (a), clause (1), (2), or (3). 462.32 Subd. 3. [CERTAIN HARD-TO-EMPLOY PARTICIPANTS.] (a) An 462.33 assistance unit subject to the time limit in section 256J.42, 462.34 subdivision 1, in which any participant has received 60 counted 462.35 months of assistance, is eligible to receive months of 462.36 assistance under a hardship extension if the participant belongs 463.1 to any of the following groups: 463.2 (1) a person who is diagnosed by a licensed physician, 463.3 psychological practitioner, or other qualified professional, as 463.4 mentally retarded or mentally ill, and that condition prevents 463.5 the person from obtaining or retaining employment; 463.6 (2) a person who has been assessed by a vocational 463.7 specialist, job counselor, or the county agency to be 463.8 unemployable for purposes of this subdivision; a person is 463.9 considered employable if positions of employment in the local 463.10 labor market exist, regardless of the current availability of 463.11 openings for those positions, that the person is capable of 463.12 performing. The person's eligibility under this category must 463.13 be reassessed at least annually; or 463.14 (3) a person who is determined by the county agency, 463.15 according to Minnesota Rules, part 9500.1251, subpart 2, item I, 463.16 to be learning disabled, provided that if a rehabilitation plan 463.17 for the person is developed or approved by the county agency, 463.18 the person is following the plan. A rehabilitation plan does 463.19 not replace the requirement to develop and comply with an 463.20 employment plan under section 256J.52. 463.21 (b) An assistance unit receiving assistance under a 463.22 hardship extension under this subdivision may continue to 463.23 receive assistance under MFIP as long as the participant meets 463.24 the criteria in paragraph (a), clause (1), (2), or (3), and all 463.25 participants in the assistance unit remain in compliance with, 463.26 or are exempt from, the employment and training services 463.27 requirements in sections 256J.52 to 256J.55. 463.28 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] A participant who 463.29 received TANF assistance that counted towards the federal 463.30 60-month time limit while the participant complied with a safety 463.31 plan or, after October 1, 2001, an alternative employment plan 463.32 under the MFIP employment and training component is eligible for 463.33 assistance under a hardship extension for a period of time equal 463.34 to the number of months that were counted toward the federal 463.35 60-month time limit while the participant complied with a safety 463.36 plan or, after October 1, 2001, an alternative employment plan 464.1 under the MFIP employment and training component. 464.2 Subd. 5. [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 464.3 participant who received TANF assistance that counted towards 464.4 the federal 60-month time limit while the participant was or 464.5 would have been exempt under section 256J.56, paragraph (a), 464.6 clause (7), from employment and training services requirements 464.7 and who is no longer eligible for assistance under a hardship 464.8 extension under subdivision 2, paragraph (a), clause (3), is 464.9 eligible for assistance under a hardship extension for a period 464.10 of time equal to the number of months that were counted toward 464.11 the federal 60-month time limit while the participant was or 464.12 would have been exempt under section 256J.56, paragraph (a), 464.13 clause (7), from the employment and training services 464.14 requirements. 464.15 (b) A participant who received TANF assistance that counted 464.16 towards the federal 60-month time limit while the participant 464.17 met the state time limit exemption criteria under section 464.18 256J.42, subdivision 5, is eligible for assistance under a 464.19 hardship extension for a period of time equal to the number of 464.20 months that were counted toward the federal 60-month time limit 464.21 while the participant met the state time limit exemption 464.22 criteria under section 256J.42, subdivision 5. 464.23 Sec. 16. Minnesota Statutes 2000, section 256J.45, 464.24 subdivision 1, is amended to read: 464.25 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 464.26 county agency must provide a face-to-face orientation to each 464.27 MFIP caregiverwho is not exempt under section 256J.56,464.28paragraph (a), clause (6) or (8), with a face-to-face464.29orientationunless the caregiver is: 464.30 (1) a single parent, or one parent in a two-parent family, 464.31 employed at least 35 hours per week; or 464.32 (2) a second parent in a two-parent family who is employed 464.33 for 20 or more hours per week provided the first parent is 464.34 employed at least 35 hours per week. 464.35 The county agency must inform caregivers who are not exempt 464.36 undersection 256J.56, paragraph (a), clause (6) or (8),clause 465.1 (1) or (2) that failure to attend the orientation is considered 465.2 an occurrence of noncompliance with program requirements, and 465.3 will result in the imposition of a sanction under section 465.4 256J.46. If the client complies with the orientation 465.5 requirement prior to the first day of the month in which the 465.6 grant reduction is proposed to occur, the orientation sanction 465.7 shall be lifted. 465.8 Sec. 17. Minnesota Statutes 2000, section 256J.46, 465.9 subdivision 1, is amended to read: 465.10 Subdivision 1. [SANCTIONS FORPARTICIPANTS NOT COMPLYING 465.11 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 465.12 good cause to comply with the requirements of this chapter, and 465.13 who is not subject to a sanction under subdivision 2, shall be 465.14 subject to a sanction as provided in this subdivision. Prior to 465.15 the imposition of a sanction, a county agency shall provide a 465.16 notice of intent to sanction under section 256J.57, subdivision 465.17 2, and, when applicable, a notice of adverse action as provided 465.18 in section 256J.31. 465.19 (b) A participant who fails to comply with an alternative 465.20 employment plan must have the plan reviewed by a person trained 465.21 in domestic violence and a job counselor to determine if 465.22 components of the alternative employment plan are still 465.23 appropriate. If the activities are no longer appropriate, the 465.24 plan must be revised with a person trained in domestic violence 465.25 and approved by a job counselor. A participant who fails to 465.26 comply with a plan that is determined not to need revision will 465.27 lose their exemption and be required to comply with regular 465.28 employment services activities. 465.29 (c) A sanction under this subdivision becomes effective the 465.30 month following the month in which a required notice is given. 465.31 A sanction must not be imposed when a participant comes into 465.32 compliance with the requirements for orientation under section 465.33 256J.45 or third-party liability for medical services under 465.34 section 256J.30, subdivision 10, prior to the effective date of 465.35 the sanction. A sanction must not be imposed when a participant 465.36 comes into compliance with the requirements for employment and 466.1 training services under sections 256J.49 to256J.72256J.55 ten 466.2 days prior to the effective date of the sanction. For purposes 466.3 of this subdivision, each month that a participant fails to 466.4 comply with a requirement of this chapter shall be considered a 466.5 separate occurrence of noncompliance. A participant who has had 466.6 one or more sanctions imposed must remain in compliance with the 466.7 provisions of this chapter for six months in order for a 466.8 subsequent occurrence of noncompliance to be considered a first 466.9 occurrence. 466.10(b)(d) Sanctions for noncompliance shall be imposed as 466.11 follows: 466.12 (1) For the first occurrence of noncompliance by a 466.13 participant ina single-parent household or by one participant466.14in a two-parent householdan assistance unit, the assistance 466.15 unit's grant shall be reduced by ten percent of the MFIP 466.16 standard of need for an assistance unit of the same size with 466.17 the residual grant paid to the participant. The reduction in 466.18 the grant amount must be in effect for a minimum of one month 466.19 and shall be removed in the month following the month that the 466.20 participant returns to compliance. 466.21 (2) For a secondor subsequentand third occurrence of 466.22 noncompliance by a participant in an assistance unit, or 466.23 whenbotheach of the participants in a two-parenthousehold are466.24out of complianceassistance unit have a first occurrence of 466.25 noncompliance at the same time, the assistance unit's shelter 466.26 costs shall be vendor paid up to the amount of the cash portion 466.27 of the MFIP grant for which theparticipant'sassistance unit is 466.28 eligible. At county option, the assistance unit's utilities may 466.29 also be vendor paid up to the amount of the cash portion of the 466.30 MFIP grant remaining after vendor payment of the assistance 466.31 unit's shelter costs. The residual amount of the grant after 466.32 vendor payment, if any, must be reduced by an amount equal to 30 466.33 percent of the MFIP standard of need for an assistance unit of 466.34 the same size before the residual grant is paid to the 466.35 assistance unit. The reduction in the grant amount must be in 466.36 effect for a minimum of one month and shall be removed in the 467.1 month following the month thatathe participant in a one-parent 467.2householdassistance unit returns to compliance. In a 467.3 two-parenthouseholdassistance unit, the grant reduction must 467.4 be in effect for a minimum of one month and shall be removed in 467.5 the month following the month both participants return to 467.6 compliance. The vendor payment of shelter costs and, if 467.7 applicable, utilities shall be removed six months after the 467.8 month in which the participant or participants return to 467.9 compliance. If an assistance unit is sanctioned under this 467.10 clause, the participant's case file must be reviewed as required 467.11 under paragraph (e). 467.12 (3) For a fourth occurrence of noncompliance, the 467.13 assistance unit is disqualified from receiving MFIP assistance, 467.14 both the cash and food portions. This disqualification must be 467.15 in effect for a minimum of one full month. Disqualification 467.16 under this clause does not make a participant ineligible for 467.17 food stamps. Before an assistance unit is disqualified under 467.18 this clause, the county must ensure that: 467.19 (i) the case has been reviewed by the job counselor's 467.20 supervisor or the review team designated in the county's 467.21 approved local service unit plan to determine if the review 467.22 required under paragraph (e) has occurred; and 467.23 (ii) the job counselor attempted to meet with the 467.24 participant face-to-face. 467.25(c) No later than during the second month that(e) When a 467.26 sanction under paragraph(b)(d), clause (2), is in effectdue467.27to noncompliance with employment services, the participant's467.28case file must be reviewed to determine if, the county agency or 467.29 job counselor must review the participant's case to determine if 467.30 the employment plan is still appropriate and attempt to meet 467.31 with the participant face-to-face. If a face-to-face meeting is 467.32 not possible, the county agency must send the participant a 467.33 notice of adverse action as provided in section 256J.31, 467.34 subdivisions 4 and 5. 467.35 (1) During the face-to-face meeting, the job counselor must: 467.36 (i) determine whether the continued noncompliance can be 468.1 explained and mitigated by providing a needed preemployment 468.2 activity, as defined in section 256J.49, subdivision 13, clause 468.3 (16), or services under a local intervention grant for 468.4 self-sufficiency under section 256J.625; 468.5 (ii) determine whether the participant qualifies for a good 468.6 cause exception under section 256J.57;or468.7 (iii) determine whether the participant qualifies for an 468.8 exemption under section 256J.56; 468.9 (iv) determine whether the participant qualifies for an 468.10 exemption for victims of family violence under section 256J.52, 468.11 subdivision 6; 468.12 (v) inform the participant of the participant's sanction 468.13 status and explain the consequences of continuing noncompliance; 468.14 (vi) identify other resources that may be available to the 468.15 participant to meet the needs of the family if the participant 468.16 is sanctioned and disqualified from MFIP under paragraph (d), 468.17 clause (3); and 468.18 (vii) inform the participant of the right to appeal under 468.19 section 256J.40. 468.20 (2) If the lack of an identified activity can explain the 468.21 noncompliance, the county must work with the participant to 468.22 provide the identified activity, and the county must restore the 468.23 participant's grant amount to the full amount for which the 468.24 assistance unit is eligible. The grant must be restored 468.25 retroactively to the first day of the month in which the 468.26 participant was found to lack preemployment activities or to 468.27 qualify for an exemptionorunder section 256J.56, a good cause 468.28 exception under section 256J.57, or an exemption for victims of 468.29 family violence under section 256J.52, subdivision 6. 468.30 (3) If the participant is found to qualify for a good cause 468.31 exception or an exemption, the county must restore the 468.32 participant's grant to the full amount for which the assistance 468.33 unit is eligible. 468.34 [EFFECTIVE DATE.] The family violence provisions in 468.35 paragraph (e) are effective October 1, 2001, if the alternative 468.36 employment plan and family violence provisions in section 469.1 256J.52, subdivision 6, are enacted during the 2001 session. 469.2 Sec. 18. Minnesota Statutes 2000, section 256J.46, 469.3 subdivision 2a, is amended to read: 469.4 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 469.5 provisions of subdivisions 1 and 2, for a participant subject to 469.6 a sanction for refusal to comply with child support requirements 469.7 under subdivision 2 and subject to a concurrent sanction for 469.8 refusal to cooperate with other program requirements under 469.9 subdivision 1, sanctions shall be imposed in the manner 469.10 prescribed in this subdivision. 469.11 A participant who has had one or more sanctions imposed 469.12 under this subdivision must remain in compliance with the 469.13 provisions of this chapter for six months in order for a 469.14 subsequent occurrence of noncompliance to be considered a first 469.15 occurrence. Any vendor payment of shelter costs or utilities 469.16 under this subdivision must remain in effect for six months 469.17 after the month in which the participant is no longer subject to 469.18 sanction under subdivision 1. 469.19 (b) If the participant was subject to sanctionfor:469.20(i) noncompliance under subdivision 1 before being subject469.21to sanction for noncooperation under subdivision 2; or469.22(ii) noncooperation under subdivision 2 before being469.23subject to sanction for noncompliance under subdivision 1;under 469.24 subdivision 1 or 2 before being subject to sanction under the 469.25 other of those subdivisions, the participant shall be sanctioned 469.26 as provided in subdivision 1, paragraph(b)(d),clause469.27 clauses (2) and (3), and the requirement that the county conduct 469.28 a review as specified in subdivision 1, paragraph(c)(e), 469.29 remains in effect. 469.30 (c) A participant who first becomes subject to sanction 469.31 under both subdivisions 1 and 2 in the same month is subject to 469.32 sanction as follows: 469.33 (i) in the first month of noncompliance and noncooperation, 469.34 the participant's grant must be reduced by 25 percent of the 469.35 applicable MFIP standard of need, with any residual amount paid 469.36 to the participant; 470.1 (ii) in the second and subsequent months of noncompliance 470.2 and noncooperation, the participant shall be sanctioned as 470.3 provided in subdivision 1, paragraph(b)(d),clauseclauses (2) 470.4 and (3). 470.5 The requirement that the county conduct a review as 470.6 specified in subdivision 1, paragraph(c)(e), remains in effect. 470.7 (d) A participant remains subject to sanction under 470.8 subdivision 2 if the participant: 470.9 (i) returns to compliance and is no longer subject to 470.10 sanction under subdivision 1; or 470.11 (ii) has the sanction under subdivision 1, 470.12 paragraph(b)(d), removed upon completion of the review under 470.13 subdivision 1, paragraph(c)(e). 470.14 A participant remains subject to sanction under subdivision 470.15 1, paragraph(b)(d), if the participant cooperates and is no 470.16 longer subject to sanction under subdivision 2. 470.17 Sec. 19. Minnesota Statutes 2000, section 256J.46, is 470.18 amended by adding a subdivision to read: 470.19 Subd. 3. [SANCTION STATUS AFTER DISQUALIFICATION.] An 470.20 applicant who is a member of an assistance unit that was 470.21 disqualified from receiving MFIP under subdivision 1, paragraph 470.22 (d), clause (3), who applies for MFIP assistance within six 470.23 months of the date of the disqualification, and who is 470.24 determined to be eligible for MFIP assistance, is considered to 470.25 have a first occurrence of noncompliance. An applicant who is a 470.26 member of an assistance unit that was disqualified from MFIP 470.27 under subdivision 1, paragraph (d), clause (3), a second or 470.28 subsequent time, who applies for assistance within six months of 470.29 the date of disqualification, and who is determined to be 470.30 eligible for MFIP assistance, is considered to have a third 470.31 occurrence of noncompliance. The applicant must remain in 470.32 compliance with the provisions of this chapter for six months in 470.33 order for a subsequent occurrence of noncompliance to be 470.34 considered a first occurrence. 470.35 Sec. 20. Minnesota Statutes 2000, section 256J.50, 470.36 subdivision 1, is amended to read: 471.1 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 471.2 OF MFIP.] (a) By January 1, 1998, each county must develop and 471.3 implement an employment and training services component of MFIP 471.4 which is designed to put participants on the most direct path to 471.5 unsubsidized employment. Participation in these services is 471.6 mandatory for all MFIP caregivers, unless the caregiver is 471.7 exempt under section 256J.56. 471.8 (b) A county must provide employment and training services 471.9 under sections 256J.515 to 256J.74 within 30 days after the 471.10 caregiver's participation becomes mandatory under subdivision 471.11 5 or within 30 days of receipt of a request for services from a 471.12 caregiver who under section 256J.42 is no longer eligible to 471.13 receive MFIP but whose income is below 120 percent of the 471.14 federal poverty guidelines for a family of the same size. The 471.15 request must be made within 12 months of the date the 471.16 caregivers' MFIP case was closed. 471.17 Sec. 21. Minnesota Statutes 2000, section 256J.50, 471.18 subdivision 7, is amended to read: 471.19 Subd. 7. [LOCAL SERVICE UNIT PLAN.] (a) Each local or 471.20 county service unit shall prepare and submit a plan as specified 471.21 in section 268.88. 471.22 (b) The plan must include a description of how projects 471.23 funded under the local intervention grants for self-sufficiency 471.24 in section 256J.625, subdivisions 2 and 3, operate in the local 471.25 service unit, including: 471.26 (1) the target populations of hard-to-employ participants 471.27and, working participants in need of job retention and wage 471.28 advancement services, and caregivers who, within the last 12 471.29 months, have been determined under section 256J.42 to no longer 471.30 be eligible to receive MFIP and whose income is below 120 471.31 percent of the federal poverty guidelines for a family of the 471.32 same size, with a description of how individual participant 471.33 needs will be met; 471.34 (2) services that will be provided which may include paid 471.35 work experience, enhanced mental health services, outreach to 471.36 sanctioned families and to caregivers who, within the last 12 472.1 months, have been determined under section 256J.42 to no longer 472.2 be eligible to receive MFIP but whose income is below 120 472.3 percent of the federal poverty guidelines for a family of the 472.4 same size, child care for social services, child care transition 472.5 year set-aside, homeless and housing advocacy, and 472.6 transportation; 472.7 (3) projected expenditures by activity; 472.8 (4) anticipated program outcomes including the anticipated 472.9 impact the intervention efforts will have on performance 472.10 measures under section 256J.751 and on reducing the number of 472.11 MFIP participants expected to reach their 60-month time limit; 472.12 and 472.13 (5) a description of services that are provided or will be 472.14 provided to MFIP participants affected by chemical dependency, 472.15 mental health issues, learning disabilities, or family violence. 472.16 Each plan must demonstrate how the county or tribe is 472.17 working within its organization and with other organizations in 472.18 the community to serve hard-to-employ populations, including how 472.19 organizations in the community were engaged in planning for use 472.20 of these funds, services other entities will provide under the 472.21 plan, and whether multicounty or regional strategies are being 472.22 implemented as part of this plan. 472.23 (c) Activities and expenditures in the plan must enhance or 472.24 supplement MFIP activities without supplanting existing 472.25 activities and expenditures. However, this paragraph does not 472.26 require a county to maintain either: 472.27 (1) its current provision of child care assistance to MFIP 472.28 families through the expenditure of county resources under 472.29 chapter 256E for social services child care assistance if funds 472.30 are appropriated by another law for an MFIP social services 472.31 child care pool; 472.32 (2) its current provision of transition-year child care 472.33 assistance through the expenditure of county resources if funds 472.34 are appropriated by another law for this purpose; or 472.35 (3) its current provision of intensive ESL programs through 472.36 the expenditure of county resources if funds are appropriated by 473.1 another law for intensive ESL grants. 473.2 (d) The plan required under this subdivision must be 473.3 approved before the local or county service unit is eligible to 473.4 receive funds under section 256J.625, subdivisions 2 and 3. 473.5 Sec. 22. Minnesota Statutes 2000, section 256J.56, is 473.6 amended to read: 473.7 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 473.8 EXEMPTIONS.] 473.9 (a) An MFIPcaregiverparticipant is exempt from the 473.10 requirements of sections 256J.52 to 256J.55 if thecaregiver473.11 participant belongs to any of the following groups: 473.12 (1)individualsparticipants who are age 60 or older; 473.13 (2)individualsparticipants who are suffering from a 473.14 professionally certified permanent or temporary illness, injury, 473.15 or incapacity which is expected to continue for more than 30 473.16 days and which prevents the person from obtaining or retaining 473.17 employment. Persons in this category with a temporary illness, 473.18 injury, or incapacity must be reevaluated at least quarterly; 473.19 (3)caregiversparticipants whose presence in the home is 473.20 required because of the professionally certified illness or 473.21 incapacity of another member in the assistance unit, a relative 473.22 in the household, or a foster child in the household and the 473.23 illness or incapacity is expected to continue for more than 30 473.24 days; 473.25 (4) women who are pregnant, if the pregnancy has resulted 473.26 in a professionally certified incapacity that prevents the woman 473.27 from obtaining or retaining employment; 473.28 (5) caregivers of a child under the age of one year who 473.29 personally provide full-time care for the child. This exemption 473.30 may be used for only 12 months in a lifetime. In two-parent 473.31 households, only one parent or other relative may qualify for 473.32 this exemption; 473.33(6) individuals who are single parents, or one parent in a473.34two-parent family, employed at least 35 hours per week;473.35(7) individuals(6) participants experiencing a personal or 473.36 family crisis that makes them incapable of participating in the 474.1 program, as determined by the county agency. If the participant 474.2 does not agree with the county agency's determination, the 474.3 participant may seek professional certification, as defined in 474.4 section 256J.08, that the participant is incapable of 474.5 participating in the program. 474.6 Persons in this exemption category must be reevaluated 474.7 every 60 days; or 474.8(8) second parents in two-parent families employed for 20474.9or more hours per week, provided the first parent is employed at474.10least 35 hours per week; or474.11(9)(7) caregivers with a child or an adult in the 474.12 household who meets the disability or medical criteria for home 474.13 care services under section 256B.0627, subdivision 1, paragraph 474.14 (c), or a home and community-based waiver services program under 474.15 chapter 256B, or meets the criteria for severe emotional 474.16 disturbance under section 245.4871, subdivision 6, or for 474.17 serious and persistent mental illness under section 245.462, 474.18 subdivision 20, paragraph (c). Caregivers in this exemption 474.19 category are presumed to be prevented from obtaining or 474.20 retaining employment. 474.21 A caregiver who is exempt under clause (5) must enroll in 474.22 and attend an early childhood and family education class, a 474.23 parenting class, or some similar activity, if available, during 474.24 the period of time the caregiver is exempt under this section. 474.25 Notwithstanding section 256J.46, failure to attend the required 474.26 activity shall not result in the imposition of a sanction. 474.27 (b) The county agency must provide employment and training 474.28 services to MFIPcaregiversparticipants who are exempt under 474.29 this section, but who volunteer to participate. Exempt 474.30 volunteers may request approval for any work activity under 474.31 section 256J.49, subdivision 13. The hourly participation 474.32 requirements for nonexemptcaregiversparticipants under section 474.33 256J.50, subdivision 5, do not apply to exemptcaregivers474.34 participants who volunteer to participate. 474.35 Sec. 23. Minnesota Statutes 2000, section 256J.57, 474.36 subdivision 2, is amended to read: 475.1 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 475.2 participant fails without good cause to comply with the 475.3 requirements of sections 256J.52 to 256J.55, the job counselor 475.4 or the county agency must provide a notice of intent to sanction 475.5 to the participant specifying the program requirements that were 475.6 not complied with, informing the participant that the county 475.7 agency will impose the sanctions specified in section 256J.46, 475.8 and informing the participant of the opportunity to request a 475.9 conciliation conference as specified in paragraph (b). The 475.10 notice must also state that the participant's continuing 475.11 noncompliance with the specified requirements will result in 475.12 additional sanctions under section 256J.46, without the need for 475.13 additional notices or conciliation conferences under this 475.14 subdivision. The notice, written in English, must include the 475.15 department of human services language block, and must be sent to 475.16 every applicable participant. If the participant does not 475.17 request a conciliation conference within ten calendar days of 475.18 the mailing of the notice of intent to sanction, the job 475.19 counselor must notify the county agency that the assistance 475.20 payment should be reduced. The county must then send a notice 475.21 of adverse action to the participant informing the participant 475.22 of the sanction that will be imposed, the reasons for the 475.23 sanction, the effective date of the sanction, and the 475.24 participant's right to have a fair hearing under section 256J.40. 475.25 (b) The participant may request a conciliation conference 475.26 by sending a written request, by making a telephone request, or 475.27 by making an in-person request. The request must be received 475.28 within ten calendar days of the date the county agency mailed 475.29 the ten-day notice of intent to sanction. If a timely request 475.30 for a conciliation is received, the county agency's service 475.31 provider must conduct the conference within five days of the 475.32 request. The job counselor's supervisor, or a designee of the 475.33 supervisor, must review the outcome of the conciliation 475.34 conference. If the conciliation conference resolves the 475.35 noncompliance, the job counselor must promptly inform the county 475.36 agency and request withdrawal of the sanction notice. 476.1 (c) Upon receiving a sanction notice, the participant may 476.2 request a fair hearing under section 256J.40, without exercising 476.3 the option of a conciliation conference. In such cases, the 476.4 county agency shall not require the participant to engage in a 476.5 conciliation conference prior to the fair hearing. 476.6 (d) If the participant requests a fair hearing or a 476.7 conciliation conference, sanctions will not be imposed until 476.8 there is a determination of noncompliance. Sanctions must be 476.9 imposed as provided in section 256J.46. 476.10 Sec. 24. Minnesota Statutes 2000, section 256J.62, 476.11 subdivision 9, is amended to read: 476.12 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 476.13 request of thecaregiverparticipant, the county may continue to 476.14 provide case management, counseling, or other support services 476.15 to a participantfollowing the participant's achievement of: 476.16 (a) who has achieved the employment goal,; or 476.17 (b) who under section 256J.42 is no longer eligible to 476.18 receive MFIP. 476.19 These services may be provided for up to 12 months 476.20 following termination of the participant's eligibility for MFIP. 476.21A county may expend funds for a specific employment and476.22training service for the duration of that service to a476.23participant if the funds are obligated or expended prior to the476.24participant losing MFIP eligibility.476.25 Sec. 25. Minnesota Statutes 2000, section 256J.625, 476.26 subdivision 1, is amended to read: 476.27 Subdivision 1. [ESTABLISHMENT; GUARANTEED MINIMUM 476.28 ALLOCATION.] (a) The commissioner shall make grants under this 476.29 subdivision to assist county and tribal TANF programs to more 476.30 effectively serve hard-to-employ MFIP participants and 476.31 participants who, within the last 12 months, have been 476.32 determined under section 256J.42 to no longer be eligible to 476.33 receive MFIP but whose income is below 120 percent of the 476.34 federal poverty guidelines for a family of the same size. Funds 476.35 appropriated for local intervention grants for self-sufficiency 476.36 must be allocated first in amounts equal to the guaranteed 477.1 minimum in paragraph (b), and second according to the provisions 477.2 of subdivision 2. Any remaining funds must be allocated 477.3 according to the formula in subdivision 3. Counties or tribes 477.4 must have an approved local service unit plan under section 477.5 256J.50, subdivision 7, paragraph (b), in order to receive and 477.6 expend funds under subdivisions 2 and 3. 477.7 (b) Each county or tribal program shall receive a 477.8 guaranteed minimum annual allocation of $25,000. 477.9 Sec. 26. Minnesota Statutes 2000, section 256J.625, 477.10 subdivision 2, is amended to read: 477.11 Subd. 2. [SET-ASIDE FUNDS.] (a) Of the funds appropriated 477.12 for grants under this section, after the allocation in 477.13 subdivision 1, paragraph (b), is made, 20 percent of the 477.14 remaining funds each year shall be retained by the commissioner 477.15 and awarded to counties or tribes whose approved plans 477.16 demonstrate additional need based on their identification of 477.17 hard-to-employ familiesand, working participants in need of job 477.18 retention and wage advancement services, and participants who 477.19 within the last 12 months, have been determined under section 477.20 256J.42 to no longer be eligible to receive MFIP but whose 477.21 income is below 120 percent of the federal poverty guidelines 477.22 for a family of same size, strong anticipated outcomes for 477.23 families and an effective plan for monitoring performance, or, 477.24 use of a multicounty, multi-entity or regional approach to serve 477.25 hard-to-employ familiesand, working participants in need of job 477.26 retention and wage advancement services, and participants who, 477.27 within the last 12 months, have been determined under section 477.28 256J.42 to no longer be eligible to receive MFIP but whose 477.29 income is below 120 percent of the federal poverty guidelines 477.30 for a family of the same size, who are identified as a target 477.31 population to be served in the plan submitted under section 477.32 256J.50, subdivision 7, paragraph (b). In distributing funds 477.33 under this paragraph, the commissioner must achieve a geographic 477.34 balance. The commissioner may award funds under this paragraph 477.35 to other public, private, or nonprofit entities to deliver 477.36 services in a county or region where the entity or entities 478.1 submit a plan that demonstrates a strong capability to fulfill 478.2 the terms of the plan and where the plan shows an innovative or 478.3 multi-entity approach. 478.4 (b) For fiscal year 2001 only, of the funds available under 478.5 this subdivision the commissioner must allocate funding in the 478.6 amounts specified in article 1, section 2, subdivision 7, for an 478.7 intensive intervention transitional employment training project 478.8 and for nontraditional career assistance and training programs. 478.9 These allocations must occur before any set-aside funds are 478.10 allocated under paragraph (a). 478.11 Sec. 27. Minnesota Statutes 2000, section 256J.625, 478.12 subdivision 4, is amended to read: 478.13 Subd. 4. [USE OF FUNDS.] (a) A county or tribal program 478.14 may use funds allocated under this subdivision to provide 478.15 services to MFIP participants who are hard-to-employ and their 478.16 families. Services provided must be intended to reduce the 478.17 number of MFIP participants who are expected to reach the 478.18 60-month time limit under section 256J.42. Counties, tribes, 478.19 and other entities receiving funds under subdivision 2 or 3 must 478.20 submit semiannual progress reports to the commissioner which 478.21 detail program outcomes. 478.22 (b) Funds allocated under this section may not be used to 478.23 provide benefits that are defined as "assistance" in Code of 478.24 Federal Regulations, title 45, section 260.31, to an assistance 478.25 unit that is only receiving the food portion of MFIP benefits or 478.26 under section 256J.42 is no longer eligible to receive MFIP. 478.27 (c) A county may use funds allocated under this section for 478.28 that part of the match for federal access to jobs transportation 478.29 funds that is TANF-eligible. A county may also use funds 478.30 allocated under this section to enhance transportation choices 478.31 for eligible recipients up to 150 percent of the federal poverty 478.32 guidelines. 478.33 Sec. 28. Minnesota Statutes 2000, section 256J.751, is 478.34 amended to read: 478.35 256J.751 [COUNTY PERFORMANCE MANAGEMENT.] 478.36(a)Subdivision 1. [QUARTERLY COUNTY CASELOAD REPORT.] The 479.1 commissioner shall report quarterly toall countieseach county 479.2 on the county's performance on the following measures: 479.3 (1)percent of MFIP caseload working in paid employment;479.4(2) percentnumber ofMFIP caseloadcases receiving only 479.5 the food portion of assistance; 479.6 (2) number of child-only cases; 479.7 (3) number of minor caregivers; 479.8 (4) number of cases that are exempt from the 60-month time 479.9 limit by the exemption category under section 256J.42; 479.10 (5) number of participants who are exempt from employment 479.11 and training services requirements by the exemption category 479.12 under section 256J.56; 479.13 (6) number of assistance units receiving assistance under a 479.14 hardship extension under section 256J.425; 479.15 (7) number of participants and number of months spent in 479.16 each level of sanction under section 256J.46, subdivision 1; 479.17(3)(8) number of MFIP cases that have left assistance; 479.18(4)(9) federal participation requirements as specified in 479.19 title 1 of Public Law Number 104-193;and479.20(5)(10) median placement wage rate.; and 479.21(b)(11) of each county's total MFIP caseload less the 479.22 number of cases in clauses (1) to (6): 479.23 (i) number of one-parent cases; 479.24 (ii) number of two-parent cases; 479.25 (iii) percent of one-parent cases that are working more 479.26 than 20 hours per week; 479.27 (iv) percent of two-parent cases that are working more than 479.28 20 hours per week; and 479.29 (v) percent of cases that have received more than 36 months 479.30 of assistance. 479.31 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 479.32 shall report quarterly to all counties on each county's 479.33 performance on the following measures: 479.34 (1) percent of MFIP caseload working in paid employment; 479.35 (2) percent of MFIP caseload receiving only the food 479.36 portion of assistance; 480.1 (3) number of MFIP cases that have left assistance; 480.2 (4) federal participation requirements as specified in 480.3 Title 1 of Public Law Number 104-193; 480.4 (5) median placement wage rate; and 480.5 (6) caseload by months of TANF assistance. 480.6 Subd. 3. [ANNUAL REPORT.] The commissioner must report to 480.7 all counties and to the legislature on each county's annual 480.8 performance on the measures required under subdivision 1 by 480.9 racial and ethnic group and, to the extent consistent with state 480.10 and federal law, must include each county's performance on: 480.11 (1) the number of out-of-wedlock births and births to teen 480.12 mothers; and 480.13 (2) number of cases by racial and ethnic group. 480.14 The report must be completed by January 1, 2002, and 480.15 January 1 of each year thereafter and must comply with sections 480.16 3.195 and 3.197. 480.17 Subd. 4. [DEVELOPMENT OF PERFORMANCE MEASURES.] By January 480.18 1, 2002, the commissioner shall, in consultation with counties, 480.19 develop measures for county performance in addition to those in 480.20paragraph (a)subdivision 1 and 2. In developing these 480.21 measures, the commissioner must consider: 480.22 (1) a measure for MFIP cases that leave assistance due to 480.23 employment; 480.24 (2) job retention after participants leave MFIP; and 480.25 (3) participant's earnings at a follow-up point after the 480.26 participant has left MFIP; and 480.27 (4) the appropriateness of services provided to minority 480.28 groups. 480.29(c)Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE 480.30 STANDARDS.] (a) If sanctions occur for failure to meet the 480.31 performance standards specified in title 1 of Public Law Number 480.32 104-193 of the Personal Responsibility and Work Opportunity Act 480.33 of 1996, the state shall pay 88 percent of the sanction. The 480.34 remaining 12 percent of the sanction will be paid by the 480.35 counties. The county portion of the sanction will be 480.36 distributed across all counties in proportion to each county's 481.1 percentage of the MFIP average monthly caseload during the 481.2 period for which the sanction was applied. 481.3(d)(b) If a county fails to meet the performance standards 481.4 specified in title 1 of Public Law Number 104-193 of the 481.5 Personal Responsibility and Work Opportunity Act of 1996 for any 481.6 year, the commissioner shall work with counties to organize a 481.7 joint state-county technical assistance team to work with the 481.8 county. The commissioner shall coordinate any technical 481.9 assistance with other departments and agencies including the 481.10 departments of economic security and children, families, and 481.11 learning as necessary to achieve the purpose of this paragraph. 481.12 Sec. 29. Minnesota Statutes 2000, section 256K.25, 481.13 subdivision 1, is amended to read: 481.14 Subdivision 1. [ESTABLISHMENT AND PURPOSE.] (a) The 481.15 commissioner shall establish a supportive housing and managed 481.16 care pilot projectin two counties, one within the seven-county481.17metropolitan area and one outside of that area,to determine 481.18 whether the integrated delivery of employment services, 481.19 supportive services, housing, and health care into a single, 481.20 flexible program will: 481.21 (1) reduce public expenditures on homeless families with 481.22 minor children, homeless noncustodial parents, and other 481.23 homeless individuals; 481.24 (2) increase the employment rates of these persons; and 481.25 (3) provide a new alternative to providing services to this 481.26 hard-to-serve population. 481.27 (b) The commissioner shall create a program for counties 481.28 for the purpose of providing integrated intensive and 481.29 individualized case management services, employment services, 481.30 health care services, rent subsidies or other short- or 481.31 medium-term housing assistance, and other supportive services to 481.32 eligible families and individuals. Minimum project and 481.33 application requirements shall be developed by the commissioner 481.34 in cooperation with counties and their nonprofit partners with 481.35 the goal to provide the maximum flexibility in program design. 481.36 (c) Services available under this project must be 482.1 coordinated with available health care services for an eligible 482.2 project participant. 482.3 Sec. 30. Minnesota Statutes 2000, section 256K.25, 482.4 subdivision 3, is amended to read: 482.5 Subd. 3. [COUNTY ELIGIBILITY.] (a) A county may request 482.6 funding under this pilot project if the county: 482.7 (1) agrees to develop, in cooperation with nonprofit 482.8 partners, a supportive housing and managed care pilot project 482.9 that integrates the delivery of employment services, supportive 482.10 services, housing and health care for eligible families and 482.11 individuals, or agrees to contract with an existing integrated 482.12 program; 482.13 (2) for eligible participants who are also MFIP recipients, 482.14 agrees to develop, in cooperation with nonprofit partners, 482.15 procedures to ensure that the services provided under the pilot 482.16 project are closely coordinated with the services provided under 482.17 MFIP;and482.18 (3) develops a method for evaluating the quality of the 482.19 integrated services provided and the amount of any resulting 482.20 cost savings to the county and state.; and 482.21 (4) addresses in the pilot design the prevalence in the 482.22 homeless population served those individuals with mental 482.23 illness, a history of substance abuse, or HIV. 482.24 (b) Preference may be given to counties that cooperate with 482.25 other counties participating in the pilot project for purposes 482.26 of evaluation and counties that provide additional funding. 482.27 Sec. 31. Minnesota Statutes 2000, section 256K.25, 482.28 subdivision 4, is amended to read: 482.29 Subd. 4. [PARTICIPANT ELIGIBILITY.] (a) In order tobe482.30eligiblemeet initial eligibility criteria for the pilot 482.31 project, the county must determine that a participant is 482.32 homeless or is at risk of homelessness; has a mental illness, a482.33history of substance abuse, or HIV;and is a family that meets 482.34 the criteria in paragraph (b) or is an individual who meets the 482.35 criteria in paragraph (c). 482.36 (b) An eligible family must include a minor child or a 483.1 pregnant woman, and: 483.2 (1) be receiving or be eligible for MFIP assistance under 483.3 chapter 256J; or 483.4 (2) include an adult caregiver who is employed or is 483.5 receiving employment and training services, and have household 483.6 income below the MFIP exit level in section 256J.24, subdivision 483.7 10. 483.8 (c) An eligible individual must: 483.9 (1) meet the eligibility requirements of the group 483.10 residential housing program under section 256I.04, subdivision 483.11 1; or 483.12 (2) be a noncustodial parent who is employed or is 483.13 receiving employment and training services, and have household 483.14 income below the MFIP exit level in section 256J.24, subdivision 483.15 10. 483.16 (d) Counties participating in the pilot project may develop 483.17 and initiate disenrollment criteria, subject to approval by the 483.18 commissioner of human services. 483.19 Sec. 32. Minnesota Statutes 2000, section 256K.25, 483.20 subdivision 5, is amended to read: 483.21 Subd. 5. [FUNDING.] A county may request funding from the 483.22 commissioner for a specified number ofTANF-eligibleproject 483.23 participants. The commissioner shall review the request for 483.24 compliance with subdivisions 1 to 4 and may approve or 483.25 disapprove the request. If other funds are available, the 483.26 commissioner may allocate funding for project participants who 483.27 meet the eligibility requirements of subdivision 4, paragraph 483.28 (c). The commissioner may also redirect funds to the pilot 483.29 project. 483.30 Sec. 33. Minnesota Statutes 2000, section 256K.25, 483.31 subdivision 6, is amended to read: 483.32 Subd. 6. [REPORT.] Participating counties and the 483.33 commissioner shall collaborate to prepare and issue an annual 483.34 report, beginning December 1, 2001, to the chairs of the 483.35 appropriate legislative committees on the pilot project's use of 483.36 public resources, including other funds leveraged for this 484.1 initiative,and an assessment of the feasibility of financing 484.2 the pilot through other health and human services programs, the 484.3 employment and housing status of the families and individuals 484.4 served in the project, and the cost-effectiveness of the 484.5 project. The annual report must also evaluate the pilot project 484.6 with respect to the following project goals: that participants 484.7 will lead more productive, healthier, more stable and better 484.8 quality lives; that the teams created under the project to 484.9 deliver services for each project participant will be 484.10 accountable for ensuring that services are more appropriate, 484.11 cost-effective and well-coordinated; and that the system-wide 484.12 costs of serving this population, and the inappropriate use of 484.13 emergency, crisis-oriented or institutional services, will be 484.14 materially reduced. The commissioner shall provide data that 484.15 may be needed to evaluate the project to participating counties 484.16 that request the data. 484.17 Sec. 34. Minnesota Statutes 2000, section 268.0122, 484.18 subdivision 2, is amended to read: 484.19 Subd. 2. [SPECIFIC POWERS.] The commissioner of economic 484.20 security shall: 484.21 (1) administer and supervise all forms of unemployment 484.22 benefits provided for under federal and state laws that are 484.23 vested in the commissioner, including make investigations and 484.24 audits, secure and transmit information, and make available 484.25 services and facilities as the commissioner considers necessary 484.26 or appropriate to facilitate the administration of any other 484.27 states, or the federal Economic Security Law, and accept and use 484.28 information, services, and facilities made available by other 484.29 states or the federal government; 484.30 (2) administer and supervise all employment and training 484.31 services assigned to the department under federal or state law; 484.32 (3) review and comment on local service unit plans and 484.33 community investment program plans and approve or disapprove the 484.34 plans; 484.35 (4) establish and maintain administrative units necessary 484.36 to perform administrative functions common to all divisions of 485.1 the department; 485.2 (5) supervise the county boards of commissioners, local 485.3 service units, and any other units of government designated in 485.4 federal or state law as responsible for employment and training 485.5 programs; 485.6 (6) establish administrative standards and payment 485.7 conditions for providers of employment and training services; 485.8 (7) act as the agent of, and cooperate with, the federal 485.9 government in matters of mutual concern, including the 485.10 administration of any federal funds granted to the state to aid 485.11 in the performance of functions of the commissioner; 485.12 (8) obtain reports from local service units and service 485.13 providers for the purpose of evaluating the performance of 485.14 employment and training services;and485.15 (9) review and comment on plans for Indian tribe employment 485.16 and training services and approve or disapprove the plans; and 485.17 (10) require all general employment and training programs 485.18 that receive state funds to make available information about 485.19 opportunities for women in nontraditional careers in the trades 485.20 and technical occupations. 485.21 Sec. 35. Laws 1997, chapter 203, article 9, section 21, as 485.22 amended by Laws 1998, chapter 407, article 6, section 111, and 485.23 Laws 2000, chapter 488, article 10, section 28, is amended to 485.24 read: 485.25 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 485.26 (a) Effective on the date specified, the following persons 485.27 will be ineligible for general assistance and general assistance 485.28 medical care under Minnesota Statutes, chapter 256D, group 485.29 residential housing under Minnesota Statutes, chapter 256I, and 485.30 MFIP assistance under Minnesota Statutes, chapter 256J, funded 485.31 with state money: 485.32 (1) Beginning July 1, 2002, persons who are terminated from 485.33 or denied Supplemental Security Income due to the 1996 changes 485.34 in the federal law making persons whose alcohol or drug 485.35 addiction is a material factor contributing to the person's 485.36 disability ineligible for Supplemental Security Income, and are 486.1 eligible for general assistance under Minnesota Statutes, 486.2 section 256D.05, subdivision 1, paragraph (a), clause (15), 486.3 general assistance medical care under Minnesota Statutes, 486.4 chapter 256D, or group residential housing under Minnesota 486.5 Statutes, chapter 256I; 486.6 (2) Beginning July 1, 2002, legal noncitizens who are 486.7 ineligible for Supplemental Security Income due to the 1996 486.8 changes in federal law making certain noncitizens ineligible for 486.9 these programs due to their noncitizen status; and 486.10 (3) Beginning July 1,20012002, legal noncitizens who are 486.11 eligible for MFIP assistance, either the cash assistance portion 486.12 or the food assistance portion, funded entirely with state money. 486.13 (b) State money that remains unspent due to changes in 486.14 federal law enacted after May 12, 1997, that reduce state 486.15 spending for legal noncitizens or for persons whose alcohol or 486.16 drug addiction is a material factor contributing to the person's 486.17 disability, or enacted after February 1, 1998, that reduce state 486.18 spending for food benefits for legal noncitizens shall not 486.19 cancel and shall be deposited in the TANF reserve account. 486.20 Sec. 36. [REPORT ON ASSESSMENT OF COUNTY PERFORMANCE.] 486.21 By January 15, 2003, the commissioner, in consultation with 486.22 counties, must report to the chairs of the house and senate 486.23 committees having jurisdiction over human services, on a 486.24 proposal for assessing county performance using a methodology 486.25 that controls for demographic, economic, and other variables 486.26 that may impact county achievement of MFIP performance 486.27 outcomes. The proposal must recommend how state and federal 486.28 funds may be allocated to counties to encourage and reward high 486.29 performance. 486.30 Sec. 37. [REPEALER.] 486.31 Minnesota Statutes 2000, sections 256J.42, subdivision 4; 486.32 256J.44; and 256J.46, subdivision 1a, are repealed. 486.33 ARTICLE 11 486.34 DHS LICENSING 486.35 Section 1. Minnesota Statutes 2000, section 13.46, 486.36 subdivision 4, is amended to read: 487.1 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 487.2 (1) "licensing data" means all data collected, maintained, 487.3 used, or disseminated by the welfare system pertaining to 487.4 persons licensed or registered or who apply for licensure or 487.5 registration or who formerly were licensed or registered under 487.6 the authority of the commissioner of human services; 487.7 (2) "client" means a person who is receiving services from 487.8 a licensee or from an applicant for licensure; and 487.9 (3) "personal and personal financial data" means social 487.10 security numbers, identity of and letters of reference, 487.11 insurance information, reports from the bureau of criminal 487.12 apprehension, health examination reports, and social/home 487.13 studies. 487.14 (b)(1) Except as provided in paragraph (c), the following 487.15 data on current and former licensees are public: name, address, 487.16 telephone number of licensees, licensed capacity, type of client 487.17 preferred, variances granted, type of dwelling, name and 487.18 relationship of other family members, previous license history, 487.19 class of license, and the existence and status of complaints. 487.20 When disciplinary action has been taken against a licensee or 487.21 the complaint is resolved, the following data are public: the 487.22 substance of the complaint, the findings of the investigation of 487.23 the complaint, the record of informal resolution of a licensing 487.24 violation, orders of hearing, findings of fact, conclusions of 487.25 law, and specifications of the final disciplinary action 487.26 contained in the record of disciplinary action. 487.27 (2) The following data on persons subject to 487.28 disqualification under section 245A.04 in connection with a 487.29 license to provide family day care for children, child care 487.30 center services, foster care for children in the provider's 487.31 home, or foster care or day care services for adults in the 487.32 provider's home, are public: the nature of any disqualification 487.33 set aside under section 245A.04, subdivision 3b, and the reasons 487.34 for setting aside the disqualification; and the reasons for 487.35 granting any variance under section 245A.04, subdivision 9. 487.36 (3) When maltreatment is substantiated under section 488.1 626.556 or 626.557 and the victim and the substantiated 488.2 perpetrator are affiliated with a program licensed under chapter 488.3 245A, the commissioner of human services, local social services 488.4 agency, or county welfare agency may inform the license holder 488.5 where the maltreatment occurred of the identity of the 488.6 substantiated perpetrator and the victim. 488.7 (c) The following are private data on individuals under 488.8 section 13.02, subdivision 12, or nonpublic data under section 488.9 13.02, subdivision 9: personal and personal financial data on 488.10 family day care program and family foster care program 488.11 applicants and licensees and their family members who provide 488.12 services under the license. 488.13 (d) The following are private data on individuals: the 488.14 identity of persons who have made reports concerning licensees 488.15 or applicants that appear in inactive investigative data, and 488.16 the records of clients or employees of the licensee or applicant 488.17 for licensure whose records are received by the licensing agency 488.18 for purposes of review or in anticipation of a contested 488.19 matter. The names of reporters under sections 626.556 and 488.20 626.557 may be disclosed only as provided in section 626.556, 488.21 subdivision 11, or 626.557, subdivision 12b. 488.22 (e) Data classified as private, confidential, nonpublic, or 488.23 protected nonpublic under this subdivision become public data if 488.24 submitted to a court or administrative law judge as part of a 488.25 disciplinary proceeding in which there is a public hearing 488.26 concerning the disciplinary action. 488.27 (f) Data generated in the course of licensing 488.28 investigations that relate to an alleged violation of law are 488.29 investigative data under subdivision 3. 488.30 (g) Data that are not public data collected, maintained, 488.31 used, or disseminated under this subdivision that relate to or 488.32 are derived from a report as defined in section 626.556, 488.33 subdivision 2, are subject to the destruction provisions of 488.34 section 626.556, subdivision 11. 488.35 (h) Upon request, not public data collected, maintained, 488.36 used, or disseminated under this subdivision that relate to or 489.1 are derived from a report of substantiated maltreatment as 489.2 defined in section 626.556 or 626.557 may be exchanged with the 489.3 department of health for purposes of completing background 489.4 studies pursuant to section 144.057. 489.5 (i) Data on individuals collected according to licensing 489.6 activities under chapter 245A, and data on individuals collected 489.7 by the commissioner of human services according to maltreatment 489.8 investigations under sections 626.556 and 626.557, may be shared 489.9 with the department of human rights, the department of health, 489.10 the department of corrections, the ombudsman for mental health 489.11 and retardation, and the individual's professional regulatory 489.12 board when there is reason to believe that laws or standards 489.13 under the jurisdiction of those agencies may have been violated. 489.14 (j) In addition to the notice of determinations required 489.15 under section 626.556, subdivision 10f, if the commissioner or 489.16 the local social services agency has determined that an 489.17 individual is a substantiated perpetrator of maltreatment of a 489.18 child based on sexual abuse, as defined in section 626.556, 489.19 subdivision 2, and the commissioner or local social services 489.20 agency knows that the individual is a person responsible for a 489.21 child's care in another facility, the commissioner or local 489.22 social services agency shall notify the head of that facility of 489.23 this determination. The notification must include an 489.24 explanation of the individual's available appeal rights and the 489.25 status of any appeal. If a notice is given under this 489.26 paragraph, the government entity making the notification shall 489.27 provide a copy of the notice to the individual who is the 489.28 subject of the notice. 489.29 [EFFECTIVE DATE.] This section is effective July 1, 2001. 489.30 Sec. 2. Minnesota Statutes 2000, section 144.057, 489.31 subdivision 3, is amended to read: 489.32 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 489.33 shall review and decide reconsideration requests, including the 489.34 granting of variances, in accordance with the procedures and 489.35 criteria contained in chapter 245A and Minnesota Rules, parts 489.36 9543.3000 to 9543.3090. The commissioner's decision shall be 490.1 provided to the individual and to the department of human 490.2 services. The commissioner's decision to grant or deny a 490.3 reconsideration of disqualification is the final administrative 490.4 agency action except for the provisions under section 245A.04, 490.5 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 490.6 [EFFECTIVE DATE.] This section is effective January 1, 2002. 490.7 Sec. 3. Minnesota Statutes 2000, section 214.104, is 490.8 amended to read: 490.9 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 490.10 REGARDINGDISQUALIFICATIONS FORMALTREATMENT.] 490.11 (a) A health-related licensing board shall make 490.12 determinations as to whetherlicenseesregulated persons who are 490.13 under the board's jurisdiction should bedisqualified under490.14section 245A.04, subdivision 3d, from positions allowing direct490.15contact with persons receiving servicesthe subject of 490.16 disciplinary or corrective action because of substantiated 490.17 maltreatment under section 626.556 or 626.557.A determination490.18under this section may be done as part of an investigation under490.19section 214.103.The board shall make a determinationwithin 90490.20days ofupon receipt, and after the review, of an investigation 490.21 memorandum or other notice of substantiated maltreatment under 490.22 section 626.556 or 626.557, or of a notice from the commissioner 490.23 of human services that a background study of alicensee490.24 regulated person shows substantiated maltreatment.The board490.25shall also make a determination under this section upon490.26consideration of the licensure of an individual who was subject490.27to disqualification before licensure because of substantiated490.28maltreatment.490.29(b) In making a determination under this section, the board490.30shall consider the nature and extent of any injury or harm490.31resulting from the conduct that would constitute grounds for490.32disqualification, the seriousness of the misconduct, the extent490.33that disqualification is necessary to protect persons receiving490.34services or the public, and other factors specified in section490.35245A.04, subdivision 3b, paragraph (b).490.36(c) The board shall determine the duration and extent of491.1the disqualification or may establish conditions under which the491.2licensee may hold a position allowing direct contact with491.3persons receiving services or in a licensed facility.491.4 (b) Upon completion of its review of a report of 491.5 substantiated maltreatment, the board shall notify the 491.6 commissioner of human servicesand the lead agency that491.7conducted an investigation under section 626.556 or 626.557, as491.8applicable,of its determination. The board shall notify the 491.9 commissioner of human services if, following a review of the 491.10 report of substantiated maltreatment, the board determines that 491.11 it does not have jurisdiction in the matter and the commissioner 491.12 shall make the appropriate disqualification decision regarding 491.13 the regulated person as otherwise provided in chapter 245A. The 491.14 board shall also notify the commissioner of health or the 491.15 commissioner of human services immediately upon receipt of 491.16 knowledge of a facility or program allowing a regulated person 491.17 to provide direct contact services at the facility or program 491.18 while not complying with requirements placed on the regulated 491.19 person. 491.20 (c) In addition to any other remedy provided by law, the 491.21 board may, through its designated board member, temporarily 491.22 suspend the license of a licensee; deny a credential to an 491.23 applicant; or require the regulated person to be continuously 491.24 supervised, if the board finds there is probable cause to 491.25 believe the regulated person referred to the board according to 491.26 paragraph (a) poses an immediate risk of harm to vulnerable 491.27 persons. The board shall consider all relevant information 491.28 available, which may include but is not limited to: 491.29 (1) the extent the action is needed to protect persons 491.30 receiving services or the public; 491.31 (2) the recency of the maltreatment; 491.32 (3) the number of incidents of maltreatment; 491.33 (4) the intrusiveness or violence of the maltreatment; and 491.34 (5) the vulnerability of the victim of maltreatment. 491.35 The action shall take effect upon written notice to the 491.36 regulated person, served by certified mail, specifying the 492.1 statute violated. The board shall notify the commissioner of 492.2 health or the commissioner of human services of the suspension 492.3 or denial of a credential. The action shall remain in effect 492.4 until the board issues a temporary stay or a final order in the 492.5 matter after a hearing or upon agreement between the board and 492.6 the regulated person. At the time the board issues the notice, 492.7 the regulated person shall inform the board of all settings in 492.8 which the regulated person is employed or practices and the 492.9 board shall inform all known employment and practice settings of 492.10 the board action and schedule a disciplinary hearing to be held 492.11 under chapter 14. The board shall provide the regulated person 492.12 with at least 30 days' notice of the hearing, unless the parties 492.13 agree to a hearing date that provides less than 30 days notice, 492.14 and shall schedule the hearing to begin no later than 90 days 492.15 after issuance of the notice of hearing. 492.16 [EFFECTIVE DATE.] This section is effective July 1, 2001. 492.17 Sec. 4. Minnesota Statutes 2000, section 245A.03, 492.18 subdivision 2b, is amended to read: 492.19 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 492.20 clause (2), does not apply to: 492.21 (1) a child care provider who as an applicant for licensure 492.22 or as a license holder has received a license denial under 492.23 section 245A.05, afineconditional license under section 492.24 245A.06, or a sanction under section 245A.07 from the 492.25 commissioner that has not been reversed on appeal; or 492.26 (2) a child care provider, or a child care provider who has 492.27 a household member who, as a result of a licensing process, has 492.28 a disqualification under this chapter that has not been set 492.29 aside by the commissioner. 492.30 [EFFECTIVE DATE.] This section is effective January 1, 2002. 492.31 Sec. 5. Minnesota Statutes 2000, section 245A.04, 492.32 subdivision 3a, is amended to read: 492.33 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 492.34 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 492.35 commissioner shall notify the applicant or license holder and 492.36 the individual who is the subject of the study, in writing or by 493.1 electronic transmission, of the results of the study. When the 493.2 study is completed, a notice that the study was undertaken and 493.3 completed shall be maintained in the personnel files of the 493.4 program. For studies on individuals pertaining to a license to 493.5 provide family day care or group family day care, foster care 493.6 for children in the provider's own home, or foster care or day 493.7 care services for adults in the provider's own home, the 493.8 commissioner is not required to provide a separate notice of the 493.9 background study results to the individual who is the subject of 493.10 the study unless the study results in a disqualification of the 493.11 individual. 493.12 The commissioner shall notify the individual studied if the 493.13 information in the study indicates the individual is 493.14 disqualified from direct contact with persons served by the 493.15 program. The commissioner shall disclose the information 493.16 causing disqualification and instructions on how to request a 493.17 reconsideration of the disqualification to the individual 493.18 studied. An applicant or license holder who is not the subject 493.19 of the study shall be informed that the commissioner has found 493.20 information that disqualifies the subject from direct contact 493.21 with persons served by the program. However, only the 493.22 individual studied must be informed of the information contained 493.23 in the subject's background study unless theonlybasis for the 493.24 disqualification is failure to cooperate, substantiated 493.25 maltreatment under section 626.556 or 626.557, the Data 493.26 Practices Act provides for release of the information, or the 493.27 individual studied authorizes the release of the 493.28 information. When a disqualification is based on the subject's 493.29 failure to cooperate with the background study or substantiated 493.30 maltreatment under section 626.556 or 626.557, the agency that 493.31 initiated the study shall be informed by the commissioner of the 493.32 reason for the disqualification. 493.33 (b) Except as provided in subdivision 3d, paragraph (b), if 493.34 the commissioner determines that the individual studied has a 493.35 disqualifying characteristic, the commissioner shall review the 493.36 information immediately available and make a determination as to 494.1 the subject's immediate risk of harm to persons served by the 494.2 program where the individual studied will have direct contact. 494.3 The commissioner shall consider all relevant information 494.4 available, including the following factors in determining the 494.5 immediate risk of harm: the recency of the disqualifying 494.6 characteristic; the recency of discharge from probation for the 494.7 crimes; the number of disqualifying characteristics; the 494.8 intrusiveness or violence of the disqualifying characteristic; 494.9 the vulnerability of the victim involved in the disqualifying 494.10 characteristic; and the similarity of the victim to the persons 494.11 served by the program where the individual studied will have 494.12 direct contact. The commissioner may determine that the 494.13 evaluation of the information immediately available gives the 494.14 commissioner reason to believe one of the following: 494.15 (1) The individual poses an imminent risk of harm to 494.16 persons served by the program where the individual studied will 494.17 have direct contact. If the commissioner determines that an 494.18 individual studied poses an imminent risk of harm to persons 494.19 served by the program where the individual studied will have 494.20 direct contact, the individual and the license holder must be 494.21 sent a notice of disqualification. The commissioner shall order 494.22 the license holder to immediately remove the individual studied 494.23 from direct contact. The notice to the individual studied must 494.24 include an explanation of the basis of this determination. 494.25 (2) The individual poses a risk of harm requiring 494.26 continuous supervision while providing direct contact services 494.27 during the period in which the subject may request a 494.28 reconsideration. If the commissioner determines that an 494.29 individual studied poses a risk of harm that requires continuous 494.30 supervision, the individual and the license holder must be sent 494.31 a notice of disqualification. The commissioner shall order the 494.32 license holder to immediately remove the individual studied from 494.33 direct contact services or assure that the individual studied is 494.34 within sight or hearing of another staff person when providing 494.35 direct contact services during the period in which the 494.36 individual may request a reconsideration of the 495.1 disqualification. If the individual studied does not submit a 495.2 timely request for reconsideration, or the individual submits a 495.3 timely request for reconsideration, but the disqualification is 495.4 not set aside for that license holder, the license holder will 495.5 be notified of the disqualification and ordered to immediately 495.6 remove the individual from any position allowing direct contact 495.7 with persons receiving services from the license holder. 495.8 (3) The individual does not pose an imminent risk of harm 495.9 or a risk of harm requiring continuous supervision while 495.10 providing direct contact services during the period in which the 495.11 subject may request a reconsideration. If the commissioner 495.12 determines that an individual studied does not pose a risk of 495.13 harm that requires continuous supervision, only the individual 495.14 must be sent a notice of disqualification. The license holder 495.15 must be sent a notice that more time is needed to complete the 495.16 individual's background study. If the individual studied 495.17 submits a timely request for reconsideration, and if the 495.18 disqualification is set aside for that license holder, the 495.19 license holder will receive the same notification received by 495.20 license holders in cases where the individual studied has no 495.21 disqualifying characteristic. If the individual studied does 495.22 not submit a timely request for reconsideration, or the 495.23 individual submits a timely request for reconsideration, but the 495.24 disqualification is not set aside for that license holder, the 495.25 license holder will be notified of the disqualification and 495.26 ordered to immediately remove the individual from any position 495.27 allowing direct contact with persons receiving services from the 495.28 license holder. 495.29 (c) County licensing agencies performing duties under this 495.30 subdivision may develop an alternative system for determining 495.31 the subject's immediate risk of harm to persons served by the 495.32 program, providing the notices under paragraph (b), and 495.33 documenting the action taken by the county licensing agency. 495.34 Each county licensing agency's implementation of the alternative 495.35 system is subject to approval by the commissioner. 495.36 Notwithstanding this alternative system, county licensing 496.1 agencies shall complete the requirements of paragraph (a). 496.2 [EFFECTIVE DATE.] This section is effective July 1, 2001. 496.3 Sec. 6. Minnesota Statutes 2000, section 245A.04, 496.4 subdivision 3b, is amended to read: 496.5 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 496.6 individual who is the subject of the disqualification may 496.7 request a reconsideration of the disqualification. 496.8 The individual must submit the request for reconsideration 496.9 to the commissioner in writing. A request for reconsideration 496.10 for an individual who has been sent a notice of disqualification 496.11 under subdivision 3a, paragraph (b), clause (1) or (2), must be 496.12 submitted within 30 calendar days of the disqualified 496.13 individual's receipt of the notice of disqualification. A 496.14 request for reconsideration for an individual who has been sent 496.15 a notice of disqualification under subdivision 3a, paragraph 496.16 (b), clause (3), must be submitted within 15 calendar days of 496.17 the disqualified individual's receipt of the notice of 496.18 disqualification. An individual who was determined to have 496.19 maltreated a child under section 626.556 or a vulnerable adult 496.20 under section 626.557, and who was disqualified under this 496.21 section on the basis of serious or recurring maltreatment, may 496.22 request reconsideration of both the maltreatment and the 496.23 disqualification determinations. The request for 496.24 reconsideration of the maltreatment determination and the 496.25 disqualification must be submitted within 30 calendar days of 496.26 the individual's receipt of the notice of disqualification. 496.27 Removal of a disqualified individual from direct contact shall 496.28 be ordered if the individual does not request reconsideration 496.29 within the prescribed time, and for an individual who submits a 496.30 timely request for reconsideration, if the disqualification is 496.31 not set aside. The individual must present information showing 496.32 that: 496.33 (1) the information the commissioner relied upon is 496.34 incorrect or inaccurate. If the basis of a reconsideration 496.35 request is that a maltreatment determination or disposition 496.36 under section 626.556 or 626.557 is incorrect, and the 497.1 commissioner has issued a final order in an appeal of that 497.2 determination or disposition under section 256.045 or 245A.08, 497.3 subdivision 5, the commissioner's order is conclusive on the 497.4 issue of maltreatment. If the individual did not request 497.5 reconsideration of the maltreatment determination, the 497.6 maltreatment determination is deemed conclusive; or 497.7 (2) the subject of the study does not pose a risk of harm 497.8 to any person served by the applicant or license holder. 497.9 (b) The commissioner shall rescind the disqualification if 497.10 the commissioner finds that the information relied on to 497.11 disqualify the subject is incorrect. The commissioner may set 497.12 aside the disqualification under this section if the 497.13 commissioner finds that theinformation the commissioner relied497.14upon is incorrect or theindividual does not pose a risk of harm 497.15 to any person served by the applicant or license holder. In 497.16 determining that an individual does not pose a risk of harm, the 497.17 commissioner shall consider the consequences of the event or 497.18 events that lead to disqualification, whether there is more than 497.19 one disqualifying event, the vulnerability of the victim at the 497.20 time of the event, the time elapsed without a repeat of the same 497.21 or similar event, documentation of successful completion by the 497.22 individual studied of training or rehabilitation pertinent to 497.23 the event, and any other information relevant to 497.24 reconsideration. In reviewing a disqualification under this 497.25 section, the commissioner shall give preeminent weight to the 497.26 safety of each person to be served by the license holder or 497.27 applicant over the interests of the license holder or applicant. 497.28 (c) Unless the information the commissioner relied on in 497.29 disqualifying an individual is incorrect, the commissioner may 497.30 not set aside the disqualification of an individual in 497.31 connection with a license to provide family day care for 497.32 children, foster care for children in the provider's own home, 497.33 or foster care or day care services for adults in the provider's 497.34 own home if: 497.35 (1) less than ten years have passed since the discharge of 497.36 the sentence imposed for the offense; and the individual has 498.1 been convicted of a violation of any offense listed in sections 498.2 609.20 (manslaughter in the first degree), 609.205 (manslaughter 498.3 in the second degree), criminal vehicular homicide under 609.21 498.4 (criminal vehicular homicide and injury), 609.215 (aiding 498.5 suicide or aiding attempted suicide), felony violations under 498.6 609.221 to 609.2231 (assault in the first, second, third, or 498.7 fourth degree), 609.713 (terroristic threats), 609.235 (use of 498.8 drugs to injure or to facilitate crime), 609.24 (simple 498.9 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 498.10 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 498.11 first or second degree), 609.71 (riot), burglary in the first or 498.12 second degree under 609.582 (burglary), 609.66 (dangerous 498.13 weapon), 609.665 (spring guns), 609.67 (machine guns and 498.14 short-barreled shotguns), 609.749 (harassment; stalking), 498.15 152.021 or 152.022 (controlled substance crime in the first or 498.16 second degree), 152.023, subdivision 1, clause (3) or (4), or 498.17 subdivision 2, clause (4) (controlled substance crime in the 498.18 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 498.19 (controlled substance crime in the fourth degree), 609.224, 498.20 subdivision 2, paragraph (c) (fifth-degree assault by a 498.21 caregiver against a vulnerable adult), 609.228 (great bodily 498.22 harm caused by distribution of drugs), 609.23 (mistreatment of 498.23 persons confined), 609.231 (mistreatment of residents or 498.24 patients), 609.2325 (criminal abuse of a vulnerable adult), 498.25 609.233 (criminal neglect of a vulnerable adult), 609.2335 498.26 (financial exploitation of a vulnerable adult), 609.234 (failure 498.27 to report), 609.265 (abduction), 609.2664 to 609.2665 498.28 (manslaughter of an unborn child in the first or second degree), 498.29 609.267 to 609.2672 (assault of an unborn child in the first, 498.30 second, or third degree), 609.268 (injury or death of an unborn 498.31 child in the commission of a crime), 617.293 (disseminating or 498.32 displaying harmful material to minors), a gross misdemeanor 498.33 offense under 609.324, subdivision 1 (other prohibited acts), a 498.34 gross misdemeanor offense under 609.378 (neglect or endangerment 498.35 of a child), a gross misdemeanor offense under 609.377 498.36 (malicious punishment of a child), 609.72, subdivision 3 499.1 (disorderly conduct against a vulnerable adult); or an attempt 499.2 or conspiracy to commit any of these offenses, as each of these 499.3 offenses is defined in Minnesota Statutes; or an offense in any 499.4 other state, the elements of which are substantially similar to 499.5 the elements of any of the foregoing offenses; 499.6 (2) regardless of how much time has passed since the 499.7 discharge of the sentence imposed for the offense, the 499.8 individual was convicted of a violation of any offense listed in 499.9 sections 609.185 to 609.195 (murder in the first, second, or 499.10 third degree), 609.2661 to 609.2663 (murder of an unborn child 499.11 in the first, second, or third degree), a felony offense under 499.12 609.377 (malicious punishment of a child), a felony offense 499.13 under 609.324, subdivision 1 (other prohibited acts), a felony 499.14 offense under 609.378 (neglect or endangerment of a child), 499.15 609.322 (solicitation, inducement, and promotion of 499.16 prostitution), 609.342 to 609.345 (criminal sexual conduct in 499.17 the first, second, third, or fourth degree), 609.352 499.18 (solicitation of children to engage in sexual conduct), 617.246 499.19 (use of minors in a sexual performance), 617.247 (possession of 499.20 pictorial representations of a minor), 609.365 (incest), a 499.21 felony offense under sections 609.2242 and 609.2243 (domestic 499.22 assault), a felony offense of spousal abuse, a felony offense of 499.23 child abuse or neglect, a felony offense of a crime against 499.24 children, or an attempt or conspiracy to commit any of these 499.25 offenses as defined in Minnesota Statutes, or an offense in any 499.26 other state, the elements of which are substantially similar to 499.27 any of the foregoing offenses; 499.28 (3) within the seven years preceding the study, the 499.29 individual committed an act that constitutes maltreatment of a 499.30 child under section 626.556, subdivision 10e, and that resulted 499.31 in substantial bodily harm as defined in section 609.02, 499.32 subdivision 7a, or substantial mental or emotional harm as 499.33 supported by competent psychological or psychiatric evidence; or 499.34 (4) within the seven years preceding the study, the 499.35 individual was determined under section 626.557 to be the 499.36 perpetrator of a substantiated incident of maltreatment of a 500.1 vulnerable adult that resulted in substantial bodily harm as 500.2 defined in section 609.02, subdivision 7a, or substantial mental 500.3 or emotional harm as supported by competent psychological or 500.4 psychiatric evidence. 500.5 In the case of any ground for disqualification under 500.6 clauses (1) to (4), if the act was committed by an individual 500.7 other than the applicant or license holder residing in the 500.8 applicant's or license holder's home, the applicant or license 500.9 holder may seek reconsideration when the individual who 500.10 committed the act no longer resides in the home. 500.11 The disqualification periods provided under clauses (1), 500.12 (3), and (4) are the minimum applicable disqualification 500.13 periods. The commissioner may determine that an individual 500.14 should continue to be disqualified from licensure because the 500.15 license holder or applicant poses a risk of harm to a person 500.16 served by that individual after the minimum disqualification 500.17 period has passed. 500.18 (d) The commissioner shall respond in writing or by 500.19 electronic transmission to all reconsideration requests for 500.20 which the basis for the request is that the information relied 500.21 upon by the commissioner to disqualify is incorrect or 500.22 inaccurate within 30 working days of receipt of a request and 500.23 all relevant information. If the basis for the request is that 500.24 the individual does not pose a risk of harm, the commissioner 500.25 shall respond to the request within 15 working days after 500.26 receiving the request for reconsideration and all relevant 500.27 information. If the request is based on both the correctness or 500.28 accuracy of the information relied on to disqualify the 500.29 individual and the risk of harm, the commissioner shall respond 500.30 to the request within 45 working days after receiving the 500.31 request for reconsideration and all relevant information. If 500.32 the disqualification is set aside, the commissioner shall notify 500.33 the applicant or license holder in writing or by electronic 500.34 transmission of the decision. 500.35 (e) Except as provided in subdivision 3c,the500.36commissioner's decision to disqualify an individual, including501.1the decision to grant or deny a rescission or set aside a501.2disqualification under this section, is the final administrative501.3agency action and shall not be subject to further review in a501.4contested case under chapter 14 involving a negative licensing501.5appeal taken in response to the disqualification or involving an501.6accuracy and completeness appeal under section 13.04.if a 501.7 disqualification is not set aside or is not rescinded, an 501.8 individual who was disqualified on the basis of a preponderance 501.9 of evidence that the individual committed an act or acts that 501.10 meet the definition of any of the crimes lists in subdivision 501.11 3d, paragraph (a), clauses (1) to (4); or for failure to make 501.12 required reports under section 626.556, subdivision 3, or 501.13 626.557, subdivision 3, pursuant to subdivision 3d, paragraph 501.14 (a), clause (4), may request a fair hearing under section 501.15 256.045. Except as provided under subdivision 3c, the 501.16 commissioner's final order for an individual under this 501.17 paragraph is conclusive on the issue of disqualification, 501.18 including for purposes of subsequent studies conducted under 501.19 section 245A.04, subdivision 3, and is the only administrative 501.20 appeal of the final agency determination, specifically, 501.21 including a challenge to the accuracy and completeness of data 501.22 under section 13.04. 501.23 (f) Except as provided under subdivision 3c, if an 501.24 individual was disqualified on the basis of a determination of 501.25 maltreatment under section 626.556 or 626.557, which was serious 501.26 or recurring, and the individual has requested reconsideration 501.27 of the maltreatment determination under section 626.556, 501.28 subdivision 10i, or 626.557, subdivision 9d, and also requested 501.29 reconsideration of the disqualification under this subdivision, 501.30 reconsideration of the maltreatment determination and 501.31 reconsideration of the disqualification shall be consolidated 501.32 into a single reconsideration. For maltreatment and 501.33 disqualification determinations made by county agencies, the 501.34 consolidated reconsideration shall be conducted by the county 501.35 agency. Except as provided under subdivision 3c, if an 501.36 individual who was disqualified on the basis of serious or 502.1 recurring maltreatment requests a fair hearing on the 502.2 maltreatment determination under section 626.556, subdivision 502.3 10i, or 626.557, subdivision 9d, the scope of the fair hearing 502.4 under section 256.045 shall include the maltreatment 502.5 determination and the disqualification. Except as provided 502.6 under subdivision 3c, the commissioner's final order for an 502.7 individual under this paragraph is conclusive on the issue of 502.8 maltreatment and disqualification, including for purposes of 502.9 subsequent studies conducted under subdivision 3, and is the 502.10 only administrative appeal of the final agency determination, 502.11 specifically, including a challenge to the accuracy and 502.12 completeness of data under section 13.04. 502.13 [EFFECTIVE DATE.] This section is effective January 1, 2002. 502.14 Sec. 7. Minnesota Statutes 2000, section 245A.04, 502.15 subdivision 3c, is amended to read: 502.16 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding 502.17 subdivision 3b, paragraphs (e) and (f), if a disqualification is 502.18 not set aside, a person who is an employee of an employer, as 502.19 defined in section 179A.03, subdivision 15, may request a 502.20 contested case hearing under chapter 14. If the 502.21 disqualification which was not set aside or was not rescinded 502.22 was based on a maltreatment determination, the scope of the 502.23 contested case hearing shall include the maltreatment 502.24 determination and the disqualification. In such cases, a fair 502.25 hearing shall not be conducted under section 256.045. Rules 502.26 adopted under this chapter may not preclude an employee in a 502.27 contested case hearing for disqualification from submitting 502.28 evidence concerning information gathered under subdivision 3, 502.29 paragraph (e). 502.30 (b) If a disqualification for which reconsideration was 502.31 requested and which was not set aside or was not rescinded under 502.32 subdivision 3b is the basis for a denial of a license under 502.33 section 245A.05 or a licensing sanction under section 245A.07, 502.34 the license holder has the right to a contested case hearing 502.35 under chapter 14 and Minnesota Rules, parts 1400.8510 to 502.36 1400.8612 and successor rules. The appeal must be submitted in 503.1 accordance with section 245A.05 or 245A.07, subdivision 3. As 503.2 provided for under section 245A.08, subdivision 2a, the scope of 503.3 the consolidated contested case hearing shall include the 503.4 disqualification and the licensing sanction or denial of a 503.5 license. If the disqualification was based on a determination 503.6 of substantiated serious or recurring maltreatment under section 503.7 626.556 or 626.557, the appeal must be submitted in accordance 503.8 with sections 245A.07, subdivision 3, and 626.556, subdivision 503.9 10i, or 626.557, subdivision 9d. As provided for under section 503.10 245A.08, subdivision 2a, the scope of the contested case hearing 503.11 shall include the maltreatment determination, the 503.12 disqualification, and the licensing sanction or denial of a 503.13 license. In such cases, a fair hearing shall not be conducted 503.14 under section 256.045. 503.15 (c) If a maltreatment determination or disqualification, 503.16 which was not set aside or was not rescinded under subdivision 503.17 3b, is the basis for a denial of a license under section 245A.05 503.18 or a licensing sanction under section 245A.07, and the 503.19 disqualified subject is an individual other than the license 503.20 holder and upon whom a background study must be conducted under 503.21 subdivision 3, the hearing of all parties may be consolidated 503.22 into a single contested case hearing upon consent of all parties 503.23 and the administrative law judge. 503.24 (d) The commissioner's final order under section 245A.08, 503.25 subdivision 5, is conclusive on the issue of maltreatment and 503.26 disqualification, including for purposes of subsequent 503.27 background studies. The contested case hearing under this 503.28 subdivision is the only administrative appeal of the final 503.29 agency determination, specifically, including a challenge to the 503.30 accuracy and completeness of data under section 13.04. 503.31 [EFFECTIVE DATE.] This section is effective January 1, 2002. 503.32 Sec. 8. Minnesota Statutes 2000, section 245A.04, 503.33 subdivision 3d, is amended to read: 503.34 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in 503.35 paragraph (b), when a background study completed under 503.36 subdivision 3 shows any of the following: a conviction of one 504.1 or more crimes listed in clauses (1) to (4); the individual has 504.2 admitted to or a preponderance of the evidence indicates the 504.3 individual has committed an act or acts that meet the definition 504.4 of any of the crimes listed in clauses (1) to (4); or an 504.5 investigation results in an administrative determination listed 504.6 under clause (4), the individual shall be disqualified from any 504.7 position allowing direct contact with persons receiving services 504.8 from the license holder and for individuals studied under 504.9 section 245A.04, subdivision 3, paragraph (c), clauses (2), (6), 504.10 and (7), in H.F. 1381, if enacted, the individual shall also be 504.11 disqualified from access to persons receiving services from the 504.12 license holder: 504.13 (1) regardless of how much time has passed since the 504.14 discharge of the sentence imposed for the offense, and unless 504.15 otherwise specified, regardless of the level of the conviction, 504.16 the individual was convicted of any of the following offenses: 504.17 sections 609.185 (murder in the first degree); 609.19 (murder in 504.18 the second degree); 609.195 (murder in the third degree); 504.19 609.2661 (murder of an unborn child in the first degree); 504.20 609.2662 (murder of an unborn child in the second degree); 504.21 609.2663 (murder of an unborn child in the third degree); 504.22 609.322 (solicitation, inducement, and promotion of 504.23 prostitution); 609.342 (criminal sexual conduct in the first 504.24 degree); 609.343 (criminal sexual conduct in the second degree); 504.25 609.344 (criminal sexual conduct in the third degree); 609.345 504.26 (criminal sexual conduct in the fourth degree); 609.352 504.27 (solicitation of children to engage in sexual conduct); 609.365 504.28 (incest); felony offense under 609.377 (malicious punishment of 504.29 a child); a felony offense under 609.378 (neglect or 504.30 endangerment of a child); a felony offense under 609.324, 504.31 subdivision 1 (other prohibited acts); 617.246 (use of minors in 504.32 sexual performance prohibited); 617.247 (possession of pictorial 504.33 representations of minors); a felony offense under sections 504.34 609.2242 and 609.2243 (domestic assault), a felony offense of 504.35 spousal abuse, a felony offense of child abuse or neglect, a 504.36 felony offense of a crime against children; or attempt or 505.1 conspiracy to commit any of these offenses as defined in 505.2 Minnesota Statutes, or an offense in any other state or country, 505.3 where the elements are substantially similar to any of the 505.4 offenses listed in this clause; 505.5 (2) if less than 15 years have passed since the discharge 505.6 of the sentence imposed for the offense; and the individual has 505.7 received a felony conviction for a violation of any of these 505.8 offenses: sections 609.20 (manslaughter in the first degree); 505.9 609.205 (manslaughter in the second degree); 609.21 (criminal 505.10 vehicular homicide and injury); 609.215 (suicide); 609.221 to 505.11 609.2231 (assault in the first, second, third, or fourth 505.12 degree); repeat offenses under 609.224 (assault in the fifth 505.13 degree); repeat offenses under 609.3451 (criminal sexual conduct 505.14 in the fifth degree); 609.713 (terroristic threats); 609.235 505.15 (use of drugs to injure or facilitate crime); 609.24 (simple 505.16 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 505.17 609.255 (false imprisonment); 609.561 (arson in the first 505.18 degree); 609.562 (arson in the second degree); 609.563 (arson in 505.19 the third degree); repeat offenses under 617.23 (indecent 505.20 exposure; penalties); repeat offenses under 617.241 (obscene 505.21 materials and performances; distribution and exhibition 505.22 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 505.23 609.67 (machine guns and short-barreled shotguns); 609.749 505.24 (harassment; stalking; penalties); 609.228 (great bodily harm 505.25 caused by distribution of drugs); 609.2325 (criminal abuse of a 505.26 vulnerable adult); 609.2664 (manslaughter of an unborn child in 505.27 the first degree); 609.2665 (manslaughter of an unborn child in 505.28 the second degree); 609.267 (assault of an unborn child in the 505.29 first degree); 609.2671 (assault of an unborn child in the 505.30 second degree); 609.268 (injury or death of an unborn child in 505.31 the commission of a crime); 609.52 (theft); 609.2335 (financial 505.32 exploitation of a vulnerable adult); 609.521 (possession of 505.33 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 505.34 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 505.35 forged check); 609.635 (obtaining signature by false pretense); 505.36 609.27 (coercion); 609.275 (attempt to coerce); 609.687 506.1 (adulteration); 260C.301 (grounds for termination of parental 506.2 rights); and chapter 152 (drugs; controlled substance). An 506.3 attempt or conspiracy to commit any of these offenses, as each 506.4 of these offenses is defined in Minnesota Statutes; or an 506.5 offense in any other state or country, the elements of which are 506.6 substantially similar to the elements of the offenses in this 506.7 clause. If the individual studied is convicted of one of the 506.8 felonies listed in this clause, but the sentence is a gross 506.9 misdemeanor or misdemeanor disposition, the lookback period for 506.10 the conviction is the period applicable to the disposition, that 506.11 is the period for gross misdemeanors or misdemeanors; 506.12 (3) if less than ten years have passed since the discharge 506.13 of the sentence imposed for the offense; and the individual has 506.14 received a gross misdemeanor conviction for a violation of any 506.15 of the following offenses: sections 609.224 (assault in the 506.16 fifth degree); 609.2242 and 609.2243 (domestic assault); 506.17 violation of an order for protection under 518B.01, subdivision 506.18 14; 609.3451 (criminal sexual conduct in the fifth degree); 506.19 repeat offenses under 609.746 (interference with privacy); 506.20 repeat offenses under 617.23 (indecent exposure); 617.241 506.21 (obscene materials and performances); 617.243 (indecent 506.22 literature, distribution); 617.293 (harmful materials; 506.23 dissemination and display to minors prohibited); 609.71 (riot); 506.24 609.66 (dangerous weapons); 609.749 (harassment; stalking; 506.25 penalties); 609.224, subdivision 2, paragraph (c) (assault in 506.26 the fifth degree by a caregiver against a vulnerable adult); 506.27 609.23 (mistreatment of persons confined); 609.231 (mistreatment 506.28 of residents or patients); 609.2325 (criminal abuse of a 506.29 vulnerable adult); 609.233 (criminal neglect of a vulnerable 506.30 adult); 609.2335 (financial exploitation of a vulnerable adult); 506.31 609.234 (failure to report maltreatment of a vulnerable adult); 506.32 609.72, subdivision 3 (disorderly conduct against a vulnerable 506.33 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 506.34 a child); 609.377 (malicious punishment of a child); 609.324, 506.35 subdivision 1a (other prohibited acts; minor engaged in 506.36 prostitution); 609.33 (disorderly house); 609.52 (theft); 507.1 609.582 (burglary); 609.631 (check forgery; offering a forged 507.2 check); 609.275 (attempt to coerce); or an attempt or conspiracy 507.3 to commit any of these offenses, as each of these offenses is 507.4 defined in Minnesota Statutes; or an offense in any other state 507.5 or country, the elements of which are substantially similar to 507.6 the elements of any of the offenses listed in this clause. If 507.7 the defendant is convicted of one of the gross misdemeanors 507.8 listed in this clause, but the sentence is a misdemeanor 507.9 disposition, the lookback period for the conviction is the 507.10 period applicable to misdemeanors; or 507.11 (4) if less than seven years have passed since the 507.12 discharge of the sentence imposed for the offense; and the 507.13 individual has received a misdemeanor conviction for a violation 507.14 of any of the following offenses: sections 609.224 (assault in 507.15 the fifth degree); 609.2242 (domestic assault); violation of an 507.16 order for protection under 518B.01 (Domestic Abuse Act); 507.17 violation of an order for protection under 609.3232 (protective 507.18 order authorized; procedures; penalties); 609.746 (interference 507.19 with privacy); 609.79 (obscene or harassing phone calls); 507.20 609.795 (letter, telegram, or package; opening; harassment); 507.21 617.23 (indecent exposure; penalties); 609.2672 (assault of an 507.22 unborn child in the third degree); 617.293 (harmful materials; 507.23 dissemination and display to minors prohibited); 609.66 507.24 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 507.25 exploitation of a vulnerable adult); 609.234 (failure to report 507.26 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 507.27 (coercion); or an attempt or conspiracy to commit any of these 507.28 offenses, as each of these offenses is defined in Minnesota 507.29 Statutes; or an offense in any other state or country, the 507.30 elements of which are substantially similar to the elements of 507.31 any of the offenses listed in this clause; failure to make 507.32 required reports under section 626.556, subdivision 3, or 507.33 626.557, subdivision 3, for incidents in which: (i) the final 507.34 disposition under section 626.556 or 626.557 was substantiated 507.35 maltreatment, and (ii) the maltreatment was recurring or 507.36 serious; or substantiated serious or recurring maltreatment of a 508.1 minor under section 626.556 or of a vulnerable adult under 508.2 section 626.557 for which there is a preponderance of evidence 508.3 that the maltreatment occurred, and that the subject was 508.4 responsible for the maltreatment. 508.5 For the purposes of this section, "serious maltreatment" 508.6 means sexual abuse; maltreatment resulting in death; or 508.7 maltreatment resulting in serious injury which reasonably 508.8 requires the care of a physician whether or not the care of a 508.9 physician was sought; or abuse resulting in serious injury. For 508.10 purposes of this section, "abuse resulting in serious injury" 508.11 means: bruises, bites, skin laceration or tissue damage; 508.12 fractures; dislocations; evidence of internal injuries; head 508.13 injuries with loss of consciousness; extensive second-degree or 508.14 third-degree burns and other burns for which complications are 508.15 present; extensive second-degree or third-degree frostbite, and 508.16 others for which complications are present; irreversible 508.17 mobility or avulsion of teeth; injuries to the eyeball; 508.18 ingestion of foreign substances and objects that are harmful; 508.19 near drowning; and heat exhaustion or sunstroke. For purposes 508.20 of this section, "care of a physician" is treatment received or 508.21 ordered by a physician, but does not include diagnostic testing, 508.22 assessment, or observation. For the purposes of this section, 508.23 "recurring maltreatment" means more than one incident of 508.24 maltreatment for which there is a preponderance of evidence that 508.25 the maltreatment occurred, and that the subject was responsible 508.26 for the maltreatment. For purposes of this section, "access" 508.27 means physical access to an individual receiving services or the 508.28 individual's personal property without continuous, direct 508.29 supervision as defined in section 245A.04, subdivision 3. 508.30 (b)IfExcept for background studies related to child 508.31 foster care, adult foster care, or family child care licensure, 508.32 when the subject of a background study islicensedregulated by 508.33 a health-related licensing board as defined in chapter 214, and 508.34 the regulated person has been determined to have been 508.35 responsible for substantiated maltreatment under section 626.556 508.36 or 626.557, instead of the commissioner making a decision 509.1 regarding disqualification, the board shall makethea 509.2 determinationregarding a disqualification under this509.3subdivision based on a finding of substantiated maltreatment509.4under section 626.556 or 626.557. The commissioner shall notify509.5the health-related licensing board if a background study shows509.6that a licensee would be disqualified because of substantiated509.7maltreatment and the board shall make a determination under509.8section 214.104.whether to impose disciplinary or corrective 509.9 action under chapter 214. 509.10 (1) The commissioner shall notify the health-related 509.11 licensing board: 509.12 (i) upon completion of a background study that produces a 509.13 record showing that the individual was determined to have been 509.14 responsible for substantiated maltreatment; 509.15 (ii) upon the commissioner's completion of an investigation 509.16 that determined the individual was responsible for substantiated 509.17 maltreatment; or 509.18 (iii) upon receipt from another agency of a finding of 509.19 substantiated maltreatment for which the individual was 509.20 responsible. 509.21 (2) The commissioner's notice shall indicate whether the 509.22 individual would have been disqualified by the commissioner for 509.23 the substantiated maltreatment if the individual were not 509.24 regulated by the board. The commissioner shall concurrently 509.25 send a copy of this notice to the individual. 509.26 (3) Notwithstanding the exclusion from this subdivision for 509.27 individuals who provide child foster care, adult foster care, or 509.28 family child care, when the commissioner or a local agency has 509.29 reason to believe that the direct contact services provided by 509.30 the individual may fall within the jurisdiction of a 509.31 health-related licensing board, a referral shall be made to the 509.32 board as provided in this section. 509.33 (4) If, upon review of the information provided by the 509.34 commissioner, a health-related licensing board informs the 509.35 commissioner that the board does not have jurisdiction to take 509.36 disciplinary or corrective action, the commissioner shall make 510.1 the appropriate disqualification decision regarding the 510.2 individual as otherwise provided in this chapter. 510.3 (5) The commissioner has the authority to monitor the 510.4 facility's compliance with any requirements that the 510.5 health-related licensing board places on regulated persons 510.6 practicing in a facility either during the period pending a 510.7 final decision on a disciplinary or corrective action or as a 510.8 result of a disciplinary or corrective action. The commissioner 510.9 has the authority to order the immediate removal of a regulated 510.10 person from direct contact or access when a board issues an 510.11 order of temporary suspension based on a determination that the 510.12 regulated person poses an immediate risk of harm to persons 510.13 receiving services in a licensed facility. 510.14 (6) A facility that allows a regulated person to provide 510.15 direct contact services while not complying with the 510.16 requirements imposed by the health-related licensing board is 510.17 subject to action by the commissioner as specified under 510.18 sections 245A.06 and 245A.07. 510.19 (7) The commissioner shall notify a health-related 510.20 licensing board immediately upon receipt of knowledge of 510.21 noncompliance with requirements placed on a facility or upon a 510.22 person regulated by the board. 510.23 [EFFECTIVE DATE.] This section is effective July 1, 2001. 510.24 Sec. 9. Minnesota Statutes 2000, section 245A.05, is 510.25 amended to read: 510.26 245A.05 [DENIAL OF APPLICATION.] 510.27 The commissioner may deny a license if an applicant fails 510.28 to comply with applicable laws or rules, or knowingly withholds 510.29 relevant information from or gives false or misleading 510.30 information to the commissioner in connection with an 510.31 application for a license or during an investigation. An 510.32 applicant whose application has been denied by the commissioner 510.33 must be given notice of the denial. Notice must be given by 510.34 certified mail. The notice must state the reasons the 510.35 application was denied and must inform the applicant of the 510.36 right to a contested case hearing under chapter 14 and Minnesota 511.1 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 511.2 applicant may appeal the denial by notifying the commissioner in 511.3 writing by certified mail within 20 calendar days after 511.4 receiving notice that the application was denied. Section 511.5 245A.08 applies to hearings held to appeal the commissioner's 511.6 denial of an application. 511.7 [EFFECTIVE DATE.] This section is effective January 1, 2002. 511.8 Sec. 10. Minnesota Statutes 2000, section 245A.06, is 511.9 amended to read: 511.10 245A.06 [CORRECTION ORDER ANDFINESCONDITIONAL LICENSE.] 511.11 Subdivision 1. [CONTENTS OF CORRECTION ORDERSOR FINESAND 511.12 CONDITIONAL LICENSES.] (a) If the commissioner finds that the 511.13 applicant or license holder has failed to comply with an 511.14 applicable law or rule and this failure does not imminently 511.15 endanger the health, safety, or rights of the persons served by 511.16 the program, the commissioner may issue a correction order and 511.17 an order of conditional license toor impose a fine onthe 511.18 applicant or license holder. When issuing a conditional 511.19 license, the commissioner shall consider the nature, chronicity, 511.20 or severity of the violation of law or rule and the effect of 511.21 the violation on the health, safety, or rights of persons served 511.22 by the program. The correction order orfineconditional 511.23 license must state: 511.24 (1) the conditions that constitute a violation of the law 511.25 or rule; 511.26 (2) the specific law or rule violated; 511.27 (3) the time allowed to correct each violation; and 511.28 (4) if afine is imposed, the amount of the finelicense is 511.29 made conditional, the length and terms of the conditional 511.30 license. 511.31 (b) Nothing in this section prohibits the commissioner from 511.32 proposing a sanction as specified in section 245A.07, prior to 511.33 issuing a correction order orfineconditional license. 511.34 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the 511.35 applicant or license holder believes that the contents of the 511.36 commissioner's correction order are in error, the applicant or 512.1 license holder may ask the department of human services to 512.2 reconsider the parts of the correction order that are alleged to 512.3 be in error. The request for reconsideration must be in writing 512.4 and received by the commissioner within 20 calendar days after 512.5 receipt of the correction order by the applicant or license 512.6 holder, and: 512.7 (1) specify the parts of the correction order that are 512.8 alleged to be in error; 512.9 (2) explain why they are in error; and 512.10 (3) include documentation to support the allegation of 512.11 error. 512.12 A request for reconsideration does not stay any provisions 512.13 or requirements of the correction order. The commissioner's 512.14 disposition of a request for reconsideration is final and not 512.15 subject to appeal under chapter 14. 512.16 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds 512.17 that the applicant or license holder has not corrected the 512.18 violations specified in the correction order or conditional 512.19 license, the commissioner may impose a fine and order other 512.20 licensing sanctions pursuant to section 245A.07.If a fine was512.21imposed and the violation was not corrected, the commissioner512.22may impose an additional fine. This section does not prohibit512.23the commissioner from seeking a court order, denying an512.24application, or suspending, revoking, or making conditional the512.25license in addition to imposing a fine.512.26 Subd. 4. [NOTICE OFFINECONDITIONAL LICENSE; 512.27 RECONSIDERATION OFFINECONDITIONAL LICENSE.]A license holder512.28who is ordered to pay a fineIf a license is made conditional, 512.29 the license holder must be notified of the order by certified 512.30 mail. The notice must be mailed to the address shown on the 512.31 application or the last known address of the license holder. 512.32 The notice must state the reasons thefineconditional license 512.33 was ordered and must inform the license holder of the 512.34responsibility for payment of fines in subdivision 7 and the512.35 right to request reconsideration of thefineconditional license 512.36 by the commissioner. The license holder may request 513.1 reconsideration of the orderto forfeit a fineof conditional 513.2 license by notifying the commissioner by certified mailwithin513.320 calendar days after receiving the order. The request must be 513.4 in writing and must be received by the commissioner within ten 513.5 calendar days after the license holder received the order. The 513.6 license holder may submit with the request for reconsideration 513.7 written argument or evidence in support of the request for 513.8 reconsideration. A timely request for reconsideration shall 513.9 stayforfeiture of the fineimposition of the terms of the 513.10 conditional license until the commissioner issues a decision on 513.11 the request for reconsideration.The request for513.12reconsideration must be in writing and:513.13(1) specify the parts of the violation that are alleged to513.14be in error;513.15(2) explain why they are in error;513.16(3) include documentation to support the allegation of513.17error; and513.18(4) any other information relevant to the fine or the513.19amount of the fine.513.20 The commissioner's disposition of a request for 513.21 reconsideration is final and not subject to appeal under chapter 513.22 14. 513.23Subd. 5. [FORFEITURE OF FINES.] The license holder shall513.24pay the fines assessed on or before the payment date specified513.25in the commissioner's order. If the license holder fails to513.26fully comply with the order, the commissioner shall issue a513.27second fine or suspend the license until the license holder513.28complies. If the license holder receives state funds, the513.29state, county, or municipal agencies or departments responsible513.30for administering the funds shall withhold payments and recover513.31any payments made while the license is suspended for failure to513.32pay a fine.513.33Subd. 5a. [ACCRUAL OF FINES.] A license holder shall513.34promptly notify the commissioner of human services, in writing,513.35when a violation specified in an order to forfeit is corrected.513.36If upon reinspection the commissioner determines that a514.1violation has not been corrected as indicated by the order to514.2forfeit, the commissioner may issue a second fine. The514.3commissioner shall notify the license holder by certified mail514.4that a second fine has been assessed. The license holder may514.5request reconsideration of the second fine under the provisions514.6of subdivision 4.514.7Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as514.8follows:514.9(1) the license holder shall forfeit $1,000 for each514.10occurrence of violation of law or rule prohibiting the514.11maltreatment of children or the maltreatment of vulnerable514.12adults, including but not limited to corporal punishment,514.13illegal or unauthorized use of physical, mechanical, or chemical514.14restraints, and illegal or unauthorized use of aversive or514.15deprivation procedures;514.16(2) the license holder shall forfeit $200 for each514.17occurrence of a violation of law or rule governing matters of514.18health, safety, or supervision, including but not limited to the514.19provision of adequate staff to child or adult ratios; and514.20(3) the license holder shall forfeit $100 for each514.21occurrence of a violation of law or rule other than those514.22included in clauses (1) and (2).514.23For the purposes of this section, "occurrence" means each514.24violation identified in the commissioner's forfeiture order.514.25Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a514.26fine has been assessed, the license holder may not avoid payment514.27by closing, selling, or otherwise transferring the licensed514.28program to a third party. In such an event, the license holder514.29will be personally liable for payment. In the case of a514.30corporation, each controlling individual is personally and514.31jointly liable for payment.514.32Fines for child care centers must be assessed according to514.33this section.514.34 [EFFECTIVE DATE.] This section is effective January 1, 2002. 514.35 Sec. 11. Minnesota Statutes 2000, section 245A.07, is 514.36 amended to read: 515.1 245A.07 [SANCTIONS.] 515.2 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to 515.3ordering forfeiture of finesmaking a license conditional under 515.4 section 245A.06, the commissioner may propose to suspend,or 515.5 revoke, or make conditionalthe license, impose a fine, or 515.6 secure an injunction against the continuing operation of the 515.7 program of a license holder who does not comply with applicable 515.8 law or rule. When applying sanctions authorized under this 515.9 section, the commissioner shall consider the nature, chronicity, 515.10 or severity of the violation of law or rule and the effect of 515.11 the violation on the health, safety, or rights of persons served 515.12 by the program. 515.13 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER515.14TO HEALTH, SAFETY, OR RIGHTSTEMPORARY IMMEDIATE SUSPENSION.] (a) 515.15 If the license holder's actions or failure to comply with 515.16 applicable law or rulehas placedposes an imminent risk of harm 515.17 to the health, safety, or rights of persons served by the 515.18 programin imminent danger, the commissioner shall act 515.19 immediately to temporarily suspend the license. No state funds 515.20 shall be made available or be expended by any agency or 515.21 department of state, county, or municipal government for use by 515.22 a license holder regulated under this chapter while a license is 515.23 under immediate suspension. A notice stating the reasons for 515.24 the immediate suspension and informing the license holder of the 515.25 right toa contested casean expedited hearing under chapter 515.26 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 515.27 successor rules, must be delivered by personal service to the 515.28 address shown on the application or the last known address of 515.29 the license holder. The license holder may appeal an order 515.30 immediately suspending a license. The appeal of an order 515.31 immediately suspending a license must be made in writing by 515.32 certified mail and must be received by the commissioner within 515.33 five calendar days after the license holder receives notice that 515.34 the license has been immediately suspended. A license holder 515.35 and any controlling individual shall discontinue operation of 515.36 the program upon receipt of the commissioner's order to 516.1 immediately suspend the license. 516.2 (b) The commissioner is liable to the license holder for 516.3 actual damages for days of lost service in an amount not more 516.4 than $50,000 when: 516.5 (1) the commissioner immediately suspends a license under 516.6 paragraph (a); and 516.7 (2) the administrative law judge recommends, after a review 516.8 of the facts in an expedited hearing under chapter 14 and 516.9 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 516.10 rules, that reasonable cause did not exist at the time the 516.11 commissioner issued the immediate suspension. 516.12 (c) If the commissioner immediately suspends a license 516.13 under paragraph (a) and the administrative law judge recommends 516.14 that reasonable cause exists for the immediate suspension, the 516.15 commissioner is not liable to the license holder. 516.16 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 516.17 Within five working days of receipt of the license holder's 516.18 timely appeal, the commissioner shall request assignment of an 516.19 administrative law judge. The request must include a proposed 516.20 date, time, and place of a hearing. A hearing must be conducted 516.21 by an administrative law judge within 30 calendar days of the 516.22 request for assignment, unless an extension is requested by 516.23 either party and granted by the administrative law judge for 516.24 good cause. The commissioner shall issue a notice of hearing by 516.25 certified mail at least ten working days before the hearing. 516.26 The scope of the hearing shall be limited solely to the issue of 516.27 whether the temporary immediate suspension should remain in 516.28 effect pending the commissioner's final order under section 516.29 245A.08, regarding a licensing sanction issued under subdivision 516.30 3 following the immediate suspension. The burden of proof in 516.31 expedited hearings under this subdivision shall be limited to 516.32 the commissioner's demonstration that reasonable cause exists to 516.33 believe that the license holder's actions or failure to comply 516.34 with applicable law or rule poses an imminent risk of harm to 516.35 the health, safety, or rights of persons served by the program. 516.36 (b) The administrative law judge shall issue findings of 517.1 fact, conclusions, and a recommendation within ten working days 517.2 from the date of hearing. The commissioner's final order shall 517.3 be issued within ten working days from receipt of the 517.4 recommendation of the administrative law judge. Within 90 517.5 calendar days after a final order affirming an immediate 517.6 suspension, the commissioner shall make a determination 517.7 regarding whether a final licensing sanction shall be issued 517.8 under subdivision 3. The license holder shall continue to be 517.9 prohibited from operation of the program during this 90-day 517.10 period. 517.11 Subd. 3. [LICENSE SUSPENSION, REVOCATION,DENIALOR 517.12CONDITIONAL LICENSEFINE.] The commissioner may suspend,or 517.13 revoke, make conditional, or denya license, or impose a fine if 517.14an applicant ora license holder fails to comply fully with 517.15 applicable laws or rules, or knowingly withholds relevant 517.16 information from or gives false or misleading information to the 517.17 commissioner in connection with an application for a license or 517.18 during an investigation. A license holder who has had a license 517.19 suspended, revoked, ormade conditionalhas been ordered to pay 517.20 a fine must be given notice of the action by certified mail. 517.21 The notice must be mailed to the address shown on the 517.22 application or the last known address of the license holder. 517.23 The notice must state the reasons the license was suspended, 517.24 revoked, ormade conditionala fine was ordered. 517.25 (a) If the license was suspended or revoked, the notice 517.26 must inform the license holder of the right to a contested case 517.27 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 517.28 1400.8612 and successor rules. The license holder may appeal an 517.29 order suspending or revoking a license. The appeal of an order 517.30 suspending or revoking a license must be made in writing by 517.31 certified mail and must be received by the commissioner within 517.32 ten calendar days after the license holder receives notice that 517.33 the license has been suspended or revoked. 517.34 (b)If the license was made conditional, the notice must517.35inform the license holder of the right to request a517.36reconsideration by the commissioner. The request for518.1reconsideration must be made in writing by certified mail and518.2must be received by the commissioner within ten calendar days518.3after the license holder receives notice that the license has518.4been made conditional. The license holder may submit with the518.5request for reconsideration written argument or evidence in518.6support of the request for reconsideration. The commissioner's518.7disposition of a request for reconsideration is final and is not518.8subject to appeal under chapter 14.(1) If the license holder 518.9 was ordered to pay a fine, the notice must inform the license 518.10 holder of the responsibility for payment of fines and the right 518.11 to a contested case hearing under chapter 14 and Minnesota 518.12 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 518.13 appeal of an order to pay a fine must be made in writing by 518.14 certified mail and must be received by the commissioner within 518.15 ten calendar days after the license holder receives notice that 518.16 the fine has been ordered. 518.17 (2) The license holder shall pay the fines assessed on or 518.18 before the payment date specified. If the license holder fails 518.19 to fully comply with the order, the commissioner may issue a 518.20 second fine or suspend the license until the license holder 518.21 complies. If the license holder receives state funds, the 518.22 state, county, or municipal agencies or departments responsible 518.23 for administering the funds shall withhold payments and recover 518.24 any payments made while the license is suspended for failure to 518.25 pay a fine. A timely appeal shall stay payment of the fine 518.26 until the commissioner issues a final order. 518.27 (3) A license holder shall promptly notify the commissioner 518.28 of human services, in writing, when a violation specified in the 518.29 order to forfeit a fine is corrected. If upon reinspection the 518.30 commissioner determines that a violation has not been corrected 518.31 as indicated by the order to forfeit a fine, the commissioner 518.32 may issue a second fine. The commissioner shall notify the 518.33 license holder by certified mail that a second fine has been 518.34 assessed. The license holder may appeal the second fine as 518.35 provided under this subdivision. 518.36 (4) Fines shall be assessed as follows: the license holder 519.1 shall forfeit $1,000 for each determination of maltreatment of a 519.2 child under section 626.556 or the maltreatment of a vulnerable 519.3 adult under section 626.557; the license holder shall forfeit 519.4 $200 for each occurrence of a violation of law or rule governing 519.5 matters of health, safety, or supervision, including but not 519.6 limited to the provision of adequate staff to child or adult 519.7 ratios, and failure to submit a background study; and the 519.8 license holder shall forfeit $100 for each occurrence of a 519.9 violation of law or rule other than those subject to a $1,000 or 519.10 $200 fine above. For purposes of this section, "occurrence" 519.11 means each violation identified in the commissioner's fine order. 519.12 (5) When a fine has been assessed, the license holder may 519.13 not avoid payment by closing, selling, or otherwise transferring 519.14 the licensed program to a third party. In such an event, the 519.15 license holder will be personally liable for payment. In the 519.16 case of a corporation, each controlling individual is personally 519.17 and jointly liable for payment. 519.18 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder 519.19 licensed to place children for adoption fails to provide 519.20 services as described in the disclosure form required by section 519.21 259.37, subdivision 2, the sanctions under this section may be 519.22 imposed. 519.23 [EFFECTIVE DATE.] This section is effective January 1, 2002. 519.24 Sec. 12. Minnesota Statutes 2000, section 245A.08, is 519.25 amended to read: 519.26 245A.08 [HEARINGS.] 519.27 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 519.28 Upon receiving a timely appeal or petition pursuant to 519.29 section 245A.04, subdivision 3c, 245A.05, or 245A.07, 519.30 subdivision 3, the commissioner shall issue a notice of and 519.31 order for hearing to the appellant under chapter 14 and 519.32 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 519.33 rules. 519.34 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided 519.35 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 519.36 subdivision 3, the appellant may be represented by counsel and 520.1 has the right to call, examine, and cross-examine witnesses. 520.2 The administrative law judge may require the presence of 520.3 witnesses and evidence by subpoena on behalf of any party. 520.4 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR 520.5 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 520.6 DISQUALIFICATIONS.] (a) When a denial of a license under section 520.7 245A.05 or a licensing sanction under section 245A.07, 520.8 subdivision 3, is based on a disqualification for which 520.9 reconsideration was requested and which was not set aside or was 520.10 not rescinded under section 245A.04, subdivision 3b, the scope 520.11 of the contested case hearing shall include the disqualification 520.12 and the licensing sanction or denial of a license. When the 520.13 licensing sanction or denial of a license is based on a 520.14 determination of maltreatment under section 626.556 or 626.557, 520.15 or a disqualification for serious or recurring maltreatment 520.16 which was not set aside or was not rescinded, the scope of the 520.17 contested case hearing shall include the maltreatment 520.18 determination, disqualification, and the licensing sanction or 520.19 denial of a license. In such cases, a fair hearing under 520.20 section 256.045 shall not be conducted as provided for in 520.21 sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 520.22 (b) In consolidated contested case hearings regarding 520.23 sanctions issued in family child care, child foster care, and 520.24 adult foster care, the county attorney shall defend the 520.25 commissioner's orders in accordance with section 245A.16, 520.26 subdivision 4. 520.27 (c) The commissioner's final order under subdivision 5 is 520.28 the final agency action on the issue of maltreatment and 520.29 disqualification, including for purposes of subsequent 520.30 background studies under section 245A.04, subdivision 3, and is 520.31 the only administrative appeal of the final agency 520.32 determination, specifically, including a challenge to the 520.33 accuracy and completeness of data under section 13.04. 520.34 (d) When consolidated hearings under this subdivision 520.35 involve a licensing sanction based on a previous maltreatment 520.36 determination for which the commissioner has issued a final 521.1 order in an appeal of that determination under section 256.045, 521.2 or the individual failed to exercise the right to appeal the 521.3 previous maltreatment determination under section 626.556, 521.4 subdivision 10i, or 626.557, subdivision 9d, the commissioner's 521.5 order is conclusive on the issue of maltreatment. In such 521.6 cases, the scope of the administrative law judge's review shall 521.7 be limited to the disqualification and the licensing sanction or 521.8 denial of a license. In the case of a denial of a license or a 521.9 licensing sanction issued to a facility based on a maltreatment 521.10 determination regarding an individual who is not the license 521.11 holder or a household member, the scope of the administrative 521.12 law judge's review includes the maltreatment determination. 521.13 (e) If a maltreatment determination or disqualification, 521.14 which was not set aside or was not rescinded under section 521.15 245A.04, subdivision 3b, is the basis for a denial of a license 521.16 under section 245A.05 or a licensing sanction under section 521.17 245A.07, and the disqualified subject is an individual other 521.18 than the license holder and upon whom a background study must be 521.19 conducted under section 245A.04, subdivision 3, the hearings of 521.20 all parties may be consolidated into a single contested case 521.21 hearing upon consent of all parties and the administrative law 521.22 judge. 521.23 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding 521.24suspension, immediate suspension, or revocation of a license for521.25family day care or foster carea licensing sanction under 521.26 section 245A.07, including consolidated hearings under 521.27 subdivision 2a, the commissioner may demonstrate reasonable 521.28 cause for action taken by submitting statements, reports, or 521.29 affidavits to substantiate the allegations that the license 521.30 holder failed to comply fully with applicable law or rule. If 521.31 the commissioner demonstrates that reasonable cause existed, the 521.32 burden of proofin hearings involving suspension, immediate521.33suspension, or revocation of a family day care or foster care521.34licenseshifts to the license holder to demonstrate by a 521.35 preponderance of the evidence that the license holder was in 521.36 full compliance with those laws or rules that the commissioner 522.1 alleges the license holder violated, at the time that the 522.2 commissioner alleges the violations of law or rules occurred. 522.3 (b) At a hearing on denial of an application, the applicant 522.4 bears the burden of proof to demonstrate by a preponderance of 522.5 the evidence that the appellant has complied fully withsections522.6245A.01 to 245A.15this chapter and other applicable law or rule 522.7 and that the application should be approved and a license 522.8 granted. 522.9(c) At all other hearings under this section, the522.10commissioner bears the burden of proof to demonstrate, by a522.11preponderance of the evidence, that the violations of law or522.12rule alleged by the commissioner occurred.522.13 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 522.14 administrative law judge shall recommend whether or not the 522.15 commissioner's order should be affirmed. The recommendations 522.16 must be consistent with this chapter and the rules of the 522.17 commissioner. The recommendations must be in writing and 522.18 accompanied by findings of fact and conclusions and must be 522.19 mailed to the parties by certified mail to their last known 522.20 addresses as shown on the license or application. 522.21 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 522.22 considering the findings of fact, conclusions, and 522.23 recommendations of the administrative law judge, the 522.24 commissioner shall issue a final order. The commissioner shall 522.25 consider, but shall not be bound by, the recommendations of the 522.26 administrative law judge. The appellant must be notified of the 522.27 commissioner's final order as required by chapter 14 and 522.28 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 522.29 rules. The notice must also contain information about the 522.30 appellant's rights under chapter 14 and Minnesota Rules, parts 522.31 1400.8510 to 1400.8612 and successor rules. The institution of 522.32 proceedings for judicial review of the commissioner's final 522.33 order shall not stay the enforcement of the final order except 522.34 as provided in section 14.65. A license holder and each 522.35 controlling individual of a license holder whose license has 522.36 been revoked because of noncompliance with applicable law or 523.1 rule must not be granted a license for five years following the 523.2 revocation. An applicant whose application was denied must not 523.3 be granted a license for two years following a denial, unless 523.4 the applicant's subsequent application contains new information 523.5 which constitutes a substantial change in the conditions that 523.6 caused the previous denial. 523.7 [EFFECTIVE DATE.] This section is effective January 1, 2002. 523.8 Sec. 13. Minnesota Statutes 2000, section 245A.16, 523.9 subdivision 1, is amended to read: 523.10 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 523.11 County agencies and private agencies that have been designated 523.12 or licensed by the commissioner to perform licensing functions 523.13 and activities under section 245A.04, to recommend denial of 523.14 applicants under section 245A.05, to issue correction orders, to 523.15 issue variances, and recommendfinesa conditional license under 523.16 section 245A.06, or to recommend suspending,or revoking, and523.17making licenses probationarya license or issuing a fine under 523.18 section 245A.07, shall comply with rules and directives of the 523.19 commissioner governing those functions and with this section. 523.20 (b) For family day care programs, the commissioner may 523.21 authorize licensing reviews every two years after a licensee has 523.22 had at least one annual review. 523.23 [EFFECTIVE DATE.] This section is effective January 1, 2002. 523.24 Sec. 14. Minnesota Statutes 2000, section 245B.08, 523.25 subdivision 3, is amended to read: 523.26 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this 523.27 subdivision shall be construed to limit the commissioner's 523.28 authority to suspend,or revoke a license, ormake conditional523.29 issue a fine at any timea licenseunder section 245A.07; make 523.30 correction orders andrequire finesmake a license conditional 523.31 for failure to comply with applicable laws or rules under 523.32 section 245A.06; or deny an application for license under 523.33 section 245A.05. 523.34 [EFFECTIVE DATE.] This section is effective January 1, 2002. 523.35 Sec. 15. Minnesota Statutes 2000, section 256.045, 523.36 subdivision 3, is amended to read: 524.1 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency 524.2 hearings are available for the following: (1) any person 524.3 applying for, receiving or having received public assistance, 524.4 medical care, or a program of social services granted by the 524.5 state agency or a county agency or the federal Food Stamp Act 524.6 whose application for assistance is denied, not acted upon with 524.7 reasonable promptness, or whose assistance is suspended, 524.8 reduced, terminated, or claimed to have been incorrectly paid; 524.9 (2) any patient or relative aggrieved by an order of the 524.10 commissioner under section 252.27; (3) a party aggrieved by a 524.11 ruling of a prepaid health plan; (4) except as provided under 524.12 chapter 245A, any individual or facility determined by a lead 524.13 agency to have maltreated a vulnerable adult under section 524.14 626.557 after they have exercised their right to administrative 524.15 reconsideration under section 626.557; (5) any person whose 524.16 claim for foster care payment according to a placement of the 524.17 child resulting from a child protection assessment under section 524.18 626.556 is denied or not acted upon with reasonable promptness, 524.19 regardless of funding source; (6) any person to whom a right of 524.20 appeal according to this section is given by other provision of 524.21 law; (7) an applicant aggrieved by an adverse decision to an 524.22 application for a hardship waiver under section 524.23 256B.15;or(8) except as provided under chapter 245A, an 524.24 individual or facility determined to have maltreated a minor 524.25 under section 626.556, after the individual or facility has 524.26 exercised the right to administrative reconsideration under 524.27 section 626.556; or (9) except as provided under chapter 245A, 524.28 an individual disqualified under section 245A.04, subdivision 524.29 3d, on the basis of serious or recurring maltreatment; a 524.30 preponderance of the evidence that the individual has committed 524.31 an act or acts that meet the definition of any of the crimes 524.32 listed in section 245A.04, subdivision 3d, paragraph (a), 524.33 clauses (1) to (4); or for failing to make reports required 524.34 under section 626.556, subdivision 3, or 626.557, subdivision 524.35 3. Hearings regarding a maltreatment determination under clause 524.36 (4) or (8) and a disqualification under this clause in which the 525.1 basis for a disqualification is serious or recurring 525.2 maltreatment, which has not been set aside or rescinded under 525.3 section 245A.04, subdivision 3b, shall be consolidated into a 525.4 single fair hearing. In such cases, the scope of review by the 525.5 human services referee shall include both the maltreatment 525.6 determination and the disqualification. The failure to exercise 525.7 the right to an administrative reconsideration shall not be a 525.8 bar to a hearing under this section if federal law provides an 525.9 individual the right to a hearing to dispute a finding of 525.10 maltreatment. Individuals and organizations specified in this 525.11 section may contest the specified action, decision, or final 525.12 disposition before the state agency by submitting a written 525.13 request for a hearing to the state agency within 30 days after 525.14 receiving written notice of the action, decision, or final 525.15 disposition, or within 90 days of such written notice if the 525.16 applicant, recipient, patient, or relative shows good cause why 525.17 the request was not submitted within the 30-day time limit. 525.18 The hearing for an individual or facility under clause 525.19 (4)or, (8), or (9) is the only administrative appeal to the 525.20 final agency determination specifically, including a challenge 525.21 to the accuracy and completeness of data under section 13.04. 525.22 Hearings requested under clause (4) apply only to incidents of 525.23 maltreatment that occur on or after October 1, 1995. Hearings 525.24 requested by nursing assistants in nursing homes alleged to have 525.25 maltreated a resident prior to October 1, 1995, shall be held as 525.26 a contested case proceeding under the provisions of chapter 14. 525.27 Hearings requested under clause (8) apply only to incidents of 525.28 maltreatment that occur on or after July 1, 1997. A hearing for 525.29 an individual or facility under clause (8) is only available 525.30 when there is no juvenile court or adult criminal action 525.31 pending. If such action is filed in either court while an 525.32 administrative review is pending, the administrative review must 525.33 be suspended until the judicial actions are completed. If the 525.34 juvenile court action or criminal charge is dismissed or the 525.35 criminal action overturned, the matter may be considered in an 525.36 administrative hearing. 526.1 For purposes of this section, bargaining unit grievance 526.2 procedures are not an administrative appeal. 526.3 The scope of hearings involving claims to foster care 526.4 payments under clause (5) shall be limited to the issue of 526.5 whether the county is legally responsible for a child's 526.6 placement under court order or voluntary placement agreement 526.7 and, if so, the correct amount of foster care payment to be made 526.8 on the child's behalf and shall not include review of the 526.9 propriety of the county's child protection determination or 526.10 child placement decision. 526.11 (b) A vendor of medical care as defined in section 256B.02, 526.12 subdivision 7, or a vendor under contract with a county agency 526.13 to provide social services under section 256E.08, subdivision 4, 526.14 is not a party and may not request a hearing under this section, 526.15 except if assisting a recipient as provided in subdivision 4. 526.16 (c) An applicant or recipient is not entitled to receive 526.17 social services beyond the services included in the amended 526.18 community social services plan developed under section 256E.081, 526.19 subdivision 3, if the county agency has met the requirements in 526.20 section 256E.081. 526.21 (d) The commissioner may summarily affirm the county or 526.22 state agency's proposed action without a hearing when the sole 526.23 issue is an automatic change due to a change in state or federal 526.24 law. 526.25 [EFFECTIVE DATE.] This section is effective January 1, 2002. 526.26 Sec. 16. Minnesota Statutes 2000, section 256.045, 526.27 subdivision 3b, is amended to read: 526.28 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 526.29 DISQUALIFICATION HEARINGS.] The state human services referee 526.30 shall determine that maltreatment has occurred if a 526.31 preponderance of evidence exists to support the final 526.32 disposition under sections 626.556 and 626.557. For purposes of 526.33 hearings regarding disqualification, the state human services 526.34 referee shall affirm the proposed disqualification in an appeal 526.35 under subdivision 3, paragraph (a), clause (9), if a 526.36 preponderance of the evidence shows the individual has: 527.1 (1) committed maltreatment under section 626.556 or 527.2 626.557, which is serious or recurring; 527.3 (2) committed an act or acts meeting the definition of any 527.4 of the crimes listed in section 245A.04, subdivision 3d, 527.5 paragraph (a), clauses (1) to (4); or 527.6 (3) failed to make required reports under section 626.556 527.7 or 626.557 for incidents in which: 527.8 (i) the final disposition under section 626.556 or 626.557 527.9 was substantiated maltreatment; and 527.10 (ii) the maltreatment was recurring or serious; or 527.11 substantiated serious or recurring maltreatment of a minor under 527.12 section 626.556 or of a vulnerable adult under section 626.557 527.13 for which there is a preponderance of evidence that the 527.14 maltreatment occurred, and that the subject was responsible for 527.15 the maltreatment. If the disqualification is affirmed, the 527.16 state human services referee shall determine whether the 527.17 individual poses a risk of harm in accordance with the 527.18 requirements of section 245A.04, subdivision 3b. 527.19 The state human services referee shall recommend an order 527.20 to the commissioner of health or human services, as applicable, 527.21 who shall issue a final order. The commissioner shall affirm, 527.22 reverse, or modify the final disposition. Any order of the 527.23 commissioner issued in accordance with this subdivision is 527.24 conclusive upon the parties unless appeal is taken in the manner 527.25 provided in subdivision 7. Except as provided under section 527.26 245A.04, subdivisions 3b, paragraphs (e) and (f); and 3c, in any 527.27 licensing appeal under chapter 245A and sections 144.50 to 527.28 144.58 and 144A.02 to 144A.46, the commissioner's determination 527.29 as to maltreatment is conclusive. 527.30 [EFFECTIVE DATE.] This section is effective January 1, 2002. 527.31 Sec. 17. Minnesota Statutes 2000, section 256.045, 527.32 subdivision 4, is amended to read: 527.33 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 527.34 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 527.35 according to the provisions of the federal Social Security Act 527.36 and the regulations implemented in accordance with that act to 528.1 enable this state to qualify for federal grants-in-aid, and 528.2 according to the rules and written policies of the commissioner 528.3 of human services. County agencies shall install equipment 528.4 necessary to conduct telephone hearings. A state human services 528.5 referee may schedule a telephone conference hearing when the 528.6 distance or time required to travel to the county agency offices 528.7 will cause a delay in the issuance of an order, or to promote 528.8 efficiency, or at the mutual request of the parties. Hearings 528.9 may be conducted by telephone conferences unless the applicant, 528.10 recipient, former recipient, person, or facility contesting 528.11 maltreatment objects. The hearing shall not be held earlier 528.12 than five days after filing of the required notice with the 528.13 county or state agency. The state human services referee shall 528.14 notify all interested persons of the time, date, and location of 528.15 the hearing at least five days before the date of the hearing. 528.16 Interested persons may be represented by legal counsel or other 528.17 representative of their choice, including a provider of therapy 528.18 services, at the hearing and may appear personally, testify and 528.19 offer evidence, and examine and cross-examine witnesses. The 528.20 applicant, recipient, former recipient, person, or facility 528.21 contesting maltreatment shall have the opportunity to examine 528.22 the contents of the case file and all documents and records to 528.23 be used by the county or state agency at the hearing at a 528.24 reasonable time before the date of the hearing and during the 528.25 hearing. In hearings under subdivision 3, paragraph (a), 528.26 clauses (4)and, (8), and (9), either party may subpoena the 528.27 private data relating to the investigation prepared by the 528.28 agency under section 626.556 or 626.557 that is not otherwise 528.29 accessible under section 13.04, provided the identity of the 528.30 reporter may not be disclosed. 528.31 (b) The private data obtained by subpoena in a hearing 528.32 under subdivision 3, paragraph (a), clause (4)or, (8), or (9), 528.33 must be subject to a protective order which prohibits its 528.34 disclosure for any other purpose outside the hearing provided 528.35 for in this section without prior order of the district court. 528.36 Disclosure without court order is punishable by a sentence of 529.1 not more than 90 days imprisonment or a fine of not more than 529.2 $700, or both. These restrictions on the use of private data do 529.3 not prohibit access to the data under section 13.03, subdivision 529.4 6. Except for appeals under subdivision 3, paragraph (a), 529.5 clauses (4), (5),and(8), and (9), upon request, the county 529.6 agency shall provide reimbursement for transportation, child 529.7 care, photocopying, medical assessment, witness fee, and other 529.8 necessary and reasonable costs incurred by the applicant, 529.9 recipient, or former recipient in connection with the appeal. 529.10 All evidence, except that privileged by law, commonly accepted 529.11 by reasonable people in the conduct of their affairs as having 529.12 probative value with respect to the issues shall be submitted at 529.13 the hearing and such hearing shall not be "a contested case" 529.14 within the meaning of section 14.02, subdivision 3. The agency 529.15 must present its evidence prior to or at the hearing, and may 529.16 not submit evidence after the hearing except by agreement of the 529.17 parties at the hearing, provided the petitioner has the 529.18 opportunity to respond. 529.19 [EFFECTIVE DATE.] This section is effective January 1, 2002. 529.20 Sec. 18. Minnesota Statutes 2000, section 626.556, 529.21 subdivision 3, is amended to read: 529.22 Subd. 3. [PERSONS MANDATED TO REPORT.] (a) A person who 529.23 knows or has reason to believe a child is being neglected or 529.24 physically or sexually abused, as defined in subdivision 2, or 529.25 has been neglected or physically or sexually abused within the 529.26 preceding three years, shall immediately report the information 529.27 to the local welfare agency, agency responsible for assessing or 529.28 investigating the report, police department, or the county 529.29 sheriff if the person is: 529.30 (1) a professional or professional's delegate who is 529.31 engaged in the practice of the healing arts, social services, 529.32 hospital administration, psychological or psychiatric treatment, 529.33 child care, education, or law enforcement; or 529.34 (2) employed as a member of the clergy and received the 529.35 information while engaged in ministerial duties, provided that a 529.36 member of the clergy is not required by this subdivision to 530.1 report information that is otherwise privileged under section 530.2 595.02, subdivision 1, paragraph (c). 530.3 The police department or the county sheriff, upon receiving 530.4 a report, shall immediately notify the local welfare agency or 530.5 agency responsible for assessing or investigating the report, 530.6 orally and in writing. The local welfare agency, or agency 530.7 responsible for assessing or investigating the report, upon 530.8 receiving a report, shall immediately notify the local police 530.9 department or the county sheriff orally and in writing. The 530.10 county sheriff and the head of every local welfare agency, 530.11 agency responsible for assessing or investigating reports, and 530.12 police department shall each designate a person within their 530.13 agency, department, or office who is responsible for ensuring 530.14 that the notification duties of this paragraph and paragraph (b) 530.15 are carried out. Nothing in this subdivision shall be construed 530.16 to require more than one report from any institution, facility, 530.17 school, or agency. 530.18 (b) Any person may voluntarily report to the local welfare 530.19 agency, agency responsible for assessing or investigating the 530.20 report, police department, or the county sheriff if the person 530.21 knows, has reason to believe, or suspects a child is being or 530.22 has been neglected or subjected to physical or sexual abuse. 530.23 The police department or the county sheriff, upon receiving a 530.24 report, shall immediately notify the local welfare agency or 530.25 agency responsible for assessing or investigating the report, 530.26 orally and in writing. The local welfare agency or agency 530.27 responsible for assessing or investigating the report, upon 530.28 receiving a report, shall immediately notify the local police 530.29 department or the county sheriff orally and in writing. 530.30 (c) A person mandated to report physical or sexual child 530.31 abuse or neglect occurring within a licensed facility shall 530.32 report the information to the agency specified under 530.33 subdivisions 3b and 3c as responsible forlicensing530.34theassessing or investigating a facility licensed under 530.35 sections 144.50 to 144.58; a facility licensed under section 530.36 241.021;245A.01 to 245A.16; or 245B, ora facility licensed 531.1 under chapter 245A; a school as defined insectionssection 531.2 120A.05, subdivisions 9, 11, and 13; and, or section 124D.10; or 531.3 a nonlicensed personal care provider organization as defined 531.4 insectionssection 256B.04, subdivision 16; and, or section 531.5 256B.0625, subdivision 19.A health or correctionsAn agency 531.6 receiving a report may request the local welfare agency to 531.7 provide assistance pursuant to subdivisions 10, 10a, and 10b. 531.8 (d) Any person mandated to report shall receive a summary 531.9 of the disposition of any report made by that reporter, 531.10 including whether the case has been opened for child protection 531.11 or other services, or if a referral has been made to a community 531.12 organization, unless release would be detrimental to the best 531.13 interests of the child. Any person who is not mandated to 531.14 report shall, upon request to the local welfare agency, receive 531.15 a concise summary of the disposition of any report made by that 531.16 reporter, unless release would be detrimental to the best 531.17 interests of the child. 531.18 (e) For purposes of this subdivision, "immediately" means 531.19 as soon as possible but in no event longer than 24 hours. 531.20 [EFFECTIVE DATE.] This section is effective July 1, 2001. 531.21 Sec. 19. Minnesota Statutes 2000, section 626.556, 531.22 subdivision 3c, is amended to read: 531.23 Subd. 3c. [AGENCY RESPONSIBLE FOR ASSESSING OR 531.24 INVESTIGATING REPORTS OF MALTREATMENT.] The following agencies 531.25 are the administrative agencies responsible for assessing or 531.26 investigating reports of alleged child maltreatment in 531.27 facilities made under this section: 531.28 (1) the county local welfare agency is the agency 531.29 responsible for assessing or investigating allegations of 531.30 maltreatment in child foster care, family child care, and 531.31 legally unlicensed child careand; 531.32 (2) the department of human services is the agency 531.33 responsible for assessing or investigating allegations of 531.34 maltreatment in juvenile correctional facilities licensed under 531.35 section 241.021located in the local welfare agency's county; 531.36(2)(3) the department of human services is the agency 532.1 responsible for assessing or investigating allegations of 532.2 maltreatment in facilities licensed under chapters 245A and 532.3 245B, except for child foster care and family child care; and 532.4(3)(4) the department of health is the agency responsible 532.5 for assessing or investigating allegations of child maltreatment 532.6 in facilities licensed under sections 144.50 to 144.58, and in 532.7 unlicensed home health care. 532.8 [EFFECTIVE DATE.] This section is effective July 1, 2001. 532.9 Sec. 20. Minnesota Statutes 2000, section 626.556, 532.10 subdivision 10b, is amended to read: 532.11 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 532.12 FACILITY.] (a) This section applies to the commissioners of 532.13 human services, health, and children, families, and learning. 532.14 The commissioner of the agency responsible for assessing or 532.15 investigating the report shall immediately investigate if the 532.16 report alleges that: 532.17 (1) a child who is in the care of a facility as defined in 532.18 subdivision 2 is neglected, physically abused, or sexually 532.19 abused by an individual in that facility, or has been so 532.20 neglected or abused by an individual in that facility within the 532.21 three years preceding the report; or 532.22 (2) a child was neglected, physically abused, or sexually 532.23 abused by an individual in a facility defined in subdivision 2, 532.24 while in the care of that facility within the three years 532.25 preceding the report. 532.26 The commissioner of the agency responsible for assessing or 532.27 investigating the report shall arrange for the transmittal to 532.28 the commissioner of reports received by local agencies and may 532.29 delegate to a local welfare agency the duty to investigate 532.30 reports. In conducting an investigation under this section, the 532.31 commissioner has the powers and duties specified for local 532.32 welfare agencies under this section. The commissioner of the 532.33 agency responsible for assessing or investigating the report or 532.34 local welfare agency may interview any children who are or have 532.35 been in the care of a facility under investigation and their 532.36 parents, guardians, or legal custodians. 533.1 (b) Prior to any interview, the commissioner of the agency 533.2 responsible for assessing or investigating the report or local 533.3 welfare agency shall notify the parent, guardian, or legal 533.4 custodian of a child who will be interviewed in the manner 533.5 provided for in subdivision 10d, paragraph (a). If reasonable 533.6 efforts to reach the parent, guardian, or legal custodian of a 533.7 child in an out-of-home placement have failed, the child may be 533.8 interviewed if there is reason to believe the interview is 533.9 necessary to protect the child or other children in the 533.10 facility. The commissioner of the agency responsible for 533.11 assessing or investigating the report or local agency must 533.12 provide the information required in this subdivision to the 533.13 parent, guardian, or legal custodian of a child interviewed 533.14 without parental notification as soon as possible after the 533.15 interview. When the investigation is completed, any parent, 533.16 guardian, or legal custodian notified under this subdivision 533.17 shall receive the written memorandum provided for in subdivision 533.18 10d, paragraph (c). 533.19 (c) In conducting investigations under this subdivision the 533.20commissioner or local welfareagency responsible for assessing 533.21 or investigating the report shallobtainbe given access to 533.22 information consistent with subdivision 10, paragraphs (g), (h), 533.23 (i), and (j), and shall be granted the same access to the 533.24 facility as the facility's licensing agency under the 533.25 corresponding facility licensing statute. A facility that 533.26 denies the investigating agency access to this information shall 533.27 be subject to a negative licensing action by the appropriate 533.28 licensing agency. When the agency responsible for assessing or 533.29 investigating a report under this section and the licensing 533.30 agency for the facility involved are not the same agency, the 533.31 investigating agency and the licensing agency may share not 533.32 public data as necessary to complete the investigation or to 533.33 determine appropriate licensing action. 533.34 (d) Except for foster care and family child care, the 533.35 commissioner has the primary responsibility for the 533.36 investigations and notifications required under subdivisions 10d 534.1 and 10f for reports that allege maltreatment related to the care 534.2 provided by or in facilities licensed by the commissioner. The 534.3 commissioner may request assistance from the local social 534.4 services agency. 534.5 [EFFECTIVE DATE.] This section is effective July 1, 2001. 534.6 Sec. 21. Minnesota Statutes 2000, section 626.556, 534.7 subdivision 10i, is amended to read: 534.8 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 534.9 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 534.10 SERIOUS OR RECURRING MALTREATMENT.] (a) Except as provided under 534.11 paragraph (e), an individual or facility that the commissioner 534.12 or a local social service agency determines has maltreated a 534.13 child, or the child's designee, regardless of the determination, 534.14 who contests the investigating agency's final determination 534.15 regarding maltreatment, may request the investigating agency to 534.16 reconsider its final determination regarding maltreatment. The 534.17 request for reconsideration must be submitted in writing to the 534.18 investigating agency within 15 calendar days after receipt of 534.19 notice of the final determination regarding maltreatment. An 534.20 individual who was determined to have maltreated a child under 534.21 this section and who was disqualified on the basis of serious or 534.22 recurring maltreatment under section 245A.04, subdivision 3d, 534.23 may request reconsideration of the maltreatment determination 534.24 and the disqualification. The request for reconsideration of 534.25 the maltreatment determination and the disqualification must be 534.26 submitted within 30 calendar days of the individual's receipt of 534.27 the notice of disqualification under section 245A.04, 534.28 subdivision 3a. 534.29 (b) Except as provided under paragraphs (e) and (f), if the 534.30 investigating agency denies the request or fails to act upon the 534.31 request within 15 calendar days after receiving the request for 534.32 reconsideration, the person or facility entitled to a fair 534.33 hearing under section 256.045 may submit to the commissioner of 534.34 human services a written request for a hearing under that 534.35 section. 534.36 (c) If, as a result of the reconsideration, the 535.1 investigating agency changes the final determination of 535.2 maltreatment, that agency shall notify the parties specified in 535.3 subdivisions 10b, 10d, and 10f. 535.4 (d) Except as provided under paragraph (f), if an 535.5 individual or facility contests the investigating agency's final 535.6 determination regarding maltreatment by requesting a fair 535.7 hearing under section 256.045, the commissioner of human 535.8 services shall assure that the hearing is conducted and a 535.9 decision is reached within 90 days of receipt of the request for 535.10 a hearing. The time for action on the decision may be extended 535.11 for as many days as the hearing is postponed or the record is 535.12 held open for the benefit of either party. 535.13 (e) If an individual was disqualified under section 535.14 245A.04, subdivision 3d, on the basis of a determination of 535.15 maltreatment, which was serious or recurring, and the individual 535.16 has requested reconsideration of the maltreatment determination 535.17 under paragraph (a) and requested reconsideration of the 535.18 disqualification under section 245A.04, subdivision 3b, 535.19 reconsideration of the maltreatment determination and 535.20 reconsideration of the disqualification shall be consolidated 535.21 into a single reconsideration. If an individual disqualified on 535.22 the basis of a determination of maltreatment, which was serious 535.23 or recurring requests a fair hearing under paragraph (b), the 535.24 scope of the fair hearing shall include the maltreatment 535.25 determination and the disqualification. 535.26 (f) If a maltreatment determination or a disqualification 535.27 based on serious or recurring maltreatment is the basis for a 535.28 denial of a license under section 245A.05 or a licensing 535.29 sanction under section 245A.07, the license holder has the right 535.30 to a contested case hearing under chapter 14 and Minnesota 535.31 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 535.32 provided for under section 245A.08, subdivision 2a, the scope of 535.33 the contested case hearing shall include the maltreatment 535.34 determination, disqualification, and licensing sanction or 535.35 denial of a license. In such cases, a fair hearing regarding 535.36 the maltreatment determination shall not be conducted under 536.1 paragraph (b). If the disqualified subject is an individual 536.2 other than the license holder and upon whom a background study 536.3 must be conducted under section 245A.04, subdivision 3, the 536.4 hearings of all parties may be consolidated into a single 536.5 contested case hearing upon consent of all parties and the 536.6 administrative law judge. 536.7 [EFFECTIVE DATE.] This section is effective January 1, 2002. 536.8 Sec. 22. Minnesota Statutes 2000, section 626.557, 536.9 subdivision 3, is amended to read: 536.10 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who 536.11 has reason to believe that a vulnerable adult is being or has 536.12 been maltreated, or who has knowledge that a vulnerable adult 536.13 has sustained a physical injury which is not reasonably 536.14 explained shall immediately report the information to the common 536.15 entry point. If an individual is a vulnerable adult solely 536.16 because the individual is admitted to a facility, a mandated 536.17 reporter is not required to report suspected maltreatment of the 536.18 individual that occurred prior to admission, unless: 536.19 (1) the individual was admitted to the facility from 536.20 another facility and the reporter has reason to believe the 536.21 vulnerable adult was maltreated in the previous facility; or 536.22 (2) the reporter knows or has reason to believe that the 536.23 individual is a vulnerable adult as defined in section 626.5572, 536.24 subdivision 21, clause (4). 536.25 (b) A person not required to report under the provisions of 536.26 this section may voluntarily report as described above. 536.27 (c) Nothing in this section requires a report of known or 536.28 suspected maltreatment, if the reporter knows or has reason to 536.29 know that a report has been made to the common entry point. 536.30 (d) Nothing in this section shall preclude a reporter from 536.31 also reporting to a law enforcement agency. 536.32 (e) A mandated reporter who knows or has reason to believe 536.33 that an error under section 626.5572, subdivision 17, paragraph 536.34 (c), clause (5), occurred must make a report under this 536.35 subdivision. If the reporter or a facility, at any time 536.36 believes that an investigation by a lead agency will determine 537.1 or should determine that the reported error was not neglect 537.2 according to the criteria under section 626.5572, subdivision 537.3 17, paragraph (c), clause (5), the reporter or facility may 537.4 provide to the common entry point or directly to the lead agency 537.5 information explaining how the event meets the criteria under 537.6 section 626.5572, subdivision 17, paragraph (c), clause (5). 537.7 The lead agency shall consider this information when making an 537.8 initial disposition of the report under subdivision 9c. 537.9 [EFFECTIVE DATE.] This section is effective the day 537.10 following final enactment. 537.11 Sec. 23. Minnesota Statutes 2000, section 626.557, 537.12 subdivision 9d, is amended to read: 537.13 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 537.14 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 537.15 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 537.16 provided under paragraph (e), any individual or facility which a 537.17 lead agency determines has maltreated a vulnerable adult, or the 537.18 vulnerable adult or an interested person acting on behalf of the 537.19 vulnerable adult, regardless of the lead agency's determination, 537.20 who contests the lead agency's final disposition of an 537.21 allegation of maltreatment, may request the lead agency to 537.22 reconsider its final disposition. The request for 537.23 reconsideration must be submitted in writing to the lead agency 537.24 within 15 calendar days after receipt of notice of final 537.25 disposition or, if the request is made by an interested person 537.26 who is not entitled to notice, within 15 days after receipt of 537.27 the notice by the vulnerable adult or the vulnerable adult's 537.28 legal guardian. An individual who was determined to have 537.29 maltreated a vulnerable adult under this section and who was 537.30 disqualified on the basis of serious or recurring maltreatment 537.31 under section 245A.04, subdivision 3d, may request 537.32 reconsideration of the maltreatment determination and the 537.33 disqualification. The request for reconsideration of the 537.34 maltreatment determination and the disqualification must be 537.35 submitted within 30 calendar days of the individual's receipt of 537.36 the notice of disqualification under section 245A.04, 538.1 subdivision 3a. 538.2 (b) Except as provided under paragraphs (e) and (f), if the 538.3 lead agency denies the request or fails to act upon the request 538.4 within 15 calendar days after receiving the request for 538.5 reconsideration, the person or facility entitled to a fair 538.6 hearing under section 256.045, may submit to the commissioner of 538.7 human services a written request for a hearing under that 538.8 statute. The vulnerable adult, or an interested person acting 538.9 on behalf of the vulnerable adult, may request a review by the 538.10 vulnerable adult maltreatment review panel under section 256.021 538.11 if the lead agency denies the request or fails to act upon the 538.12 request, or if the vulnerable adult or interested person 538.13 contests a reconsidered disposition. The lead agency shall 538.14 notify persons who request reconsideration of their rights under 538.15 this paragraph. The request must be submitted in writing to the 538.16 review panel and a copy sent to the lead agency within 30 538.17 calendar days of receipt of notice of a denial of a request for 538.18 reconsideration or of a reconsidered disposition. The request 538.19 must specifically identify the aspects of the agency 538.20 determination with which the person is dissatisfied. 538.21 (c) If, as a result of a reconsideration or review, the 538.22 lead agency changes the final disposition, it shall notify the 538.23 parties specified in subdivision 9c, paragraph (d). 538.24 (d) For purposes of this subdivision, "interested person 538.25 acting on behalf of the vulnerable adult" means a person 538.26 designated in writing by the vulnerable adult to act on behalf 538.27 of the vulnerable adult, or a legal guardian or conservator or 538.28 other legal representative, a proxy or health care agent 538.29 appointed under chapter 145B or 145C, or an individual who is 538.30 related to the vulnerable adult, as defined in section 245A.02, 538.31 subdivision 13. 538.32 (e) If an individual was disqualified under section 538.33 245A.04, subdivision 3d, on the basis of a determination of 538.34 maltreatment, which was serious or recurring, and the individual 538.35 has requested reconsideration of the maltreatment determination 538.36 under paragraph (a) and reconsideration of the disqualification 539.1 under section 245A.04, subdivision 3b, reconsideration of the 539.2 maltreatment determination and requested reconsideration of the 539.3 disqualification shall be consolidated into a single 539.4 reconsideration. If an individual who was disqualified on the 539.5 basis of serious or recurring maltreatment requests a fair 539.6 hearing under paragraph (b), the scope of the fair hearing shall 539.7 include the maltreatment determination and the disqualification. 539.8 (f) If a maltreatment determination or a disqualification 539.9 based on serious or recurring maltreatment is the basis for a 539.10 denial of a license under section 245A.05 or a licensing 539.11 sanction under section 245A.07, the license holder has the right 539.12 to a contested case hearing under chapter 14 and Minnesota 539.13 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 539.14 provided for under section 245A.08, the scope of the contested 539.15 case hearing shall include the maltreatment determination, 539.16 disqualification, and licensing sanction or denial of a 539.17 license. In such cases, a fair hearing shall not be conducted 539.18 under paragraph (b). If the disqualified subject is an 539.19 individual other than the license holder and upon whom a 539.20 background study must be conducted under section 245A.04, 539.21 subdivision 3, the hearings of all parties may be consolidated 539.22 into a single contested case hearing upon consent of all parties 539.23 and the administrative law judge. 539.24 (g) Until August 1, 2002, an individual or facility that 539.25 was determined by the commissioner of human services or the 539.26 commissioner of health to be responsible for neglect under 539.27 section 626.5572, subdivision 17, after October 1, 1995, and 539.28 before August 1, 2001, that believes that the finding of neglect 539.29 does not meet an amended definition of neglect may request a 539.30 reconsideration of the determination of neglect. The 539.31 commissioner of human services or the commissioner of health 539.32 shall mail a notice to the last known address of individuals who 539.33 are eligible to seek this reconsideration. The request for 539.34 reconsideration must state how the established findings no 539.35 longer meet the elements of the definition of neglect. The 539.36 commissioner shall review the request for reconsideration and 540.1 make a determination within 15 calendar days. The 540.2 commissioner's decision on this reconsideration is the final 540.3 agency action. 540.4 (1) For purposes of compliance with the data destruction 540.5 schedule under subdivision 12b, paragraph (d), when a finding of 540.6 substantiated maltreatment has been changed as a result of a 540.7 reconsideration under this paragraph, the date of the original 540.8 finding of a substantiated maltreatment must be used to 540.9 calculate the destruction date. 540.10 (2) For purposes of any background studies under section 540.11 245A.04, when a determination of substantiated maltreatment has 540.12 been changed as a result of a reconsideration under this 540.13 paragraph, any prior disqualification of the individual under 540.14 section 245A.04 that was based on this determination of 540.15 maltreatment shall be rescinded, and for future background 540.16 studies under section 245A.04 the commissioner must not use the 540.17 previous determination of substantiated maltreatment as a basis 540.18 for disqualification or as a basis for referring the 540.19 individual's maltreatment history to a health-related licensing 540.20 board under section 245A.04, subdivision 3d, paragraph (b). 540.21 [EFFECTIVE DATE.] Paragraph (g) of this section is 540.22 effective the day following final enactment. Paragraphs (a), 540.23 (b), (e), and (f) are effective January 1, 2002. 540.24 Sec. 24. Minnesota Statutes 2000, section 626.5572, 540.25 subdivision 17, is amended to read: 540.26 Subd. 17. [NEGLECT.] "Neglect" means: 540.27 (a) The failure or omission by a caregiver to supply a 540.28 vulnerable adult with care or services, including but not 540.29 limited to, food, clothing, shelter, health care, or supervision 540.30 which is: 540.31 (1) reasonable and necessary to obtain or maintain the 540.32 vulnerable adult's physical or mental health or safety, 540.33 considering the physical and mental capacity or dysfunction of 540.34 the vulnerable adult; and 540.35 (2) which is not the result of an accident or therapeutic 540.36 conduct. 541.1 (b) The absence or likelihood of absence of care or 541.2 services, including but not limited to, food, clothing, shelter, 541.3 health care, or supervision necessary to maintain the physical 541.4 and mental health of the vulnerable adult which a reasonable 541.5 person would deem essential to obtain or maintain the vulnerable 541.6 adult's health, safety, or comfort considering the physical or 541.7 mental capacity or dysfunction of the vulnerable adult. 541.8 (c) For purposes of this section, a vulnerable adult is not 541.9 neglected for the sole reason that: 541.10 (1) the vulnerable adult or a person with authority to make 541.11 health care decisions for the vulnerable adult under sections 541.12 144.651, 144A.44, chapter 145B, 145C, or 252A, or section 541.13 253B.03, or 525.539 to 525.6199, refuses consent or withdraws 541.14 consent, consistent with that authority and within the boundary 541.15 of reasonable medical practice, to any therapeutic conduct, 541.16 including any care, service, or procedure to diagnose, maintain, 541.17 or treat the physical or mental condition of the vulnerable 541.18 adult, or, where permitted under law, to provide nutrition and 541.19 hydration parenterally or through intubation; this paragraph 541.20 does not enlarge or diminish rights otherwise held under law by: 541.21 (i) a vulnerable adult or a person acting on behalf of a 541.22 vulnerable adult, including an involved family member, to 541.23 consent to or refuse consent for therapeutic conduct; or 541.24 (ii) a caregiver to offer or provide or refuse to offer or 541.25 provide therapeutic conduct; or 541.26 (2) the vulnerable adult, a person with authority to make 541.27 health care decisions for the vulnerable adult, or a caregiver 541.28 in good faith selects and depends upon spiritual means or prayer 541.29 for treatment or care of disease or remedial care of the 541.30 vulnerable adult in lieu of medical care, provided that this is 541.31 consistent with the prior practice or belief of the vulnerable 541.32 adult or with the expressed intentions of the vulnerable adult; 541.33 (3) the vulnerable adult, who is not impaired in judgment 541.34 or capacity by mental or emotional dysfunction or undue 541.35 influence, engages in sexual contact with: 541.36 (i) a person including a facility staff person when a 542.1 consensual sexual personal relationship existed prior to the 542.2 caregiving relationship; or 542.3 (ii) a personal care attendant, regardless of whether the 542.4 consensual sexual personal relationship existed prior to the 542.5 caregiving relationship; or 542.6 (4) an individual makes an error in the provision of 542.7 therapeutic conduct to a vulnerable adult which: (i)does not 542.8 result in injury or harm which reasonably requires medical or 542.9 mental health care; or, if it reasonably requires care,542.10 (5) an individual makes an error in the provision of 542.11 therapeutic conduct to a vulnerable adult that results in injury 542.12 or harm which reasonably requires the care of a physician; and: 542.13 (i) the necessary care issought andprovided in a timely 542.14 fashion as dictated by the condition of the vulnerable adult; 542.15and(ii) the injury or harm that required care does not result 542.16 insubstantial acute, orchronic injury or illness, or permanent 542.17 disability above and beyond the vulnerable adult's preexisting 542.18 condition; 542.19(ii) is(iii) the error is not part of a pattern of errors 542.20 by the individual; 542.21 (iv) if in a facility, the error is immediately reported as 542.22 required under section 626.557, and recorded internallyby the542.23employee or person providing servicesin the facilityin order542.24to evaluate and identify corrective action; 542.25 (v) if in a facility, the facility identifies and takes 542.26 corrective action and implements measures designed to reduce the 542.27 risk of further occurrence of this error and similar errors; and 542.28(iii) is(vi) if in a facility, the actions required under 542.29 items (iv) and (v) are sufficiently documented for review and 542.30 evaluation by the facility and any applicable licensing, 542.31 certification, and ombudsman agency; and. 542.32(iv) is not part of a pattern of errors by the individual.542.33 (d) Nothing in this definition requires a caregiver, if 542.34 regulated, to provide services in excess of those required by 542.35 the caregiver's license, certification, registration, or other 542.36 regulation. 543.1 (e) If the findings of an investigation by a lead agency 543.2 result in a determination of substantiated maltreatment for the 543.3 sole reason that the actions required of a facility under 543.4 paragraph (c), clause (5), item (iv), (v), or (vi), were not 543.5 taken, then the facility is subject to a correction order. This 543.6 must not alter the lead agency's determination of mitigating 543.7 factors under section 626.557, subdivision 9c, paragraph (c). 543.8 [EFFECTIVE DATE.] This section is effective the day 543.9 following final enactment. 543.10 Sec. 25. [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 543.11 The commissioner of health or human services, whichever is 543.12 appropriate, shall pursue changes to federal law necessary to 543.13 allow greater discretion on disciplinary activities of 543.14 unlicensed health care workers and apply for necessary federal 543.15 waivers or approval that would allow for a set-aside process 543.16 related to disqualifications for nurse aides in nursing homes by 543.17 July 1, 2002. 543.18 [EFFECTIVE DATE.] This section is effective July 1, 2001. 543.19 Sec. 26. [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 543.20 By January 2002, the commissioner of health shall work with 543.21 providers to examine federal rules and regulations prohibiting 543.22 neglect, abuse, and financial exploitation of residents in 543.23 licensed nursing facilities and shall apply for federal waivers 543.24 to: 543.25 (1) allow the use of Minnesota Statutes, section 626.5572, 543.26 to control the identification and prevention of maltreatment of 543.27 residents in licensed nursing facilities, rather than the 543.28 definitions under federal rules and regulations; and 543.29 (2) allow the use of Minnesota Statutes, sections 214.104, 543.30 245A.04, and 626.557 to control the disqualification or 543.31 discipline of any persons providing services to residents in 543.32 licensed nursing facilities, rather than the nurse aide registry 543.33 or other exclusionary provisions of federal rules and 543.34 regulations. 543.35 [EFFECTIVE DATE.] This section is effective July 1, 2001. 543.36 ARTICLE 12 544.1 MISCELLANEOUS 544.2 Section 1. Minnesota Statutes 2000, section 144.1222, is 544.3 amended by adding a subdivision to read: 544.4 Subd. 2a. [POOLS AT FAMILY DAY CARE OR GROUP FAMILY DAY 544.5 CARE HOMES.] Notwithstanding Minnesota Rules, part 4717.0250, 544.6 subpart 8, a pool that is located at a family day care or group 544.7 family day care home licensed under Minnesota Rules, chapter 544.8 9502, shall not be considered a public pool, and is exempt from 544.9 the requirements for public pools in Minnesota Rules, parts 544.10 4717.0150 to 4717.3975. If the provider chooses to allow 544.11 children cared for at the family day care or group family day 544.12 care home to use the pool located at the home, the provider must 544.13 satisfy the requirements in section 245A.14, subdivision 10. 544.14 Sec. 2. Minnesota Statutes 2000, section 245A.14, is 544.15 amended by adding a subdivision to read: 544.16 Subd. 10. [SWIMMING POOLS; FAMILY DAY CARE AND GROUP 544.17 FAMILY DAY CARE PROVIDERS.] (a) This subdivision governs pools 544.18 located at family day care or group family day care homes 544.19 licensed under Minnesota Rules, chapter 9502. This subdivision 544.20 does not apply to portable wading pools or whirlpools located at 544.21 family day care or group family day care homes licensed under 544.22 Minnesota Rules, chapter 9502. For a provider to be eligible to 544.23 allow a child cared for at the family day care or group family 544.24 day care home to use the pool located at the home, the provider 544.25 must not have had a licensing sanction under section 245A.07 or 544.26 a correction order or fine under section 245A.06 relating to the 544.27 supervision or health and safety of children substantiated by 544.28 the county agency during the prior 24 months, and must satisfy 544.29 the following requirements: 544.30 (1) obtain written consent from a child's parent or legal 544.31 guardian allowing the child to use the pool, and renew the 544.32 parent's or legal guardian's written consent at least annually. 544.33 The written consent must include a statement that the parent or 544.34 legal guardian has received and read materials provided by the 544.35 department of health to the department of human services for 544.36 distribution to all family day care or group family day care 545.1 homes related to the risk of disease transmission as well as 545.2 other health risks associated with swimming pools. The written 545.3 consent must also include a statement that the department of 545.4 health and county agency will not monitor or inspect the 545.5 provider's swimming pool to ensure compliance with the 545.6 requirements in this subdivision; 545.7 (2) enter into a written contract with a child's parent or 545.8 legal guardian, and renew the written contract annually. The 545.9 terms of the written contract must specify that the provider 545.10 agrees to perform all of the requirements in this subdivision; 545.11 (3) attend and successfully complete a pool operator 545.12 training course once every five years. Acceptable training 545.13 courses are: 545.14 (i) the National Swimming Pool Foundation Certified Pool 545.15 Operator course; 545.16 (ii) the National Spa and Pool Institute Tech I and Tech II 545.17 courses (both required); or 545.18 (iii) the National Recreation and Park Association Aquatic 545.19 Facility Operator course; 545.20 (4) require a caregiver trained in first aid and adult and 545.21 child cardiopulmonary resuscitation to supervise and be present 545.22 at the pool with any children in the pool; 545.23 (5) toilet all potty-trained children before they enter the 545.24 pool; 545.25 (6) require all children who are not potty-trained to wear 545.26 swim diapers while in the pool; 545.27 (7) if fecal material enters the pool water, add three 545.28 times the normal shock treatment to the pool water to raise the 545.29 chlorine level to at least 20 parts per million, and close the 545.30 pool to swimming for the 24 hours following the entrance of 545.31 fecal material into the water or until the water pH and 545.32 disinfectant concentration levels have returned to the standards 545.33 specified in clause (9), whichever is later; 545.34 (8) prevent any child from entering the pool who has an 545.35 open wound or any child who has or is suspected of having a 545.36 communicable disease; 546.1 (9) maintain the pool water at a pH of not less than 7.2 546.2 and not more than 8.0, maintain the disinfectant concentration 546.3 between two and five parts per million for chlorine or between 546.4 2.3 and 4.5 parts per million for bromine, and maintain a daily 546.5 record of the pool's operation with pH and disinfectant 546.6 concentration readings on days when children cared for at the 546.7 family day care or group family day care home are present; 546.8 (10) have a disinfectant feeder or feeders; 546.9 (11) have a recirculation system that will clarify and 546.10 disinfect the pool volume of water in ten hours or less; 546.11 (12) maintain the pool's water clarity so that an object on 546.12 the pool floor at the pool's deepest point is easily visible; 546.13 (13) have two or more suction lines in the pool; 546.14 (14) have in place and enforce written safety rules and 546.15 pool policies; 546.16 (15) prohibit diving; 546.17 (16) prohibit pushing or rough play in the pool area; 546.18 (17) have in place at all times a safety rope that divides 546.19 the shallow and deep portions of the pool; 546.20 (18) satisfy any existing local ordinances regarding pool 546.21 installation, decks, and fencing; 546.22 (19) maintain a water temperature of not more than 104 546.23 degrees Fahrenheit and not less than 70 degrees Fahrenheit; and 546.24 (20) for lifesaving equipment, have a United States Coast 546.25 Guard-approved life ring attached to a rope, an exit ladder, and 546.26 a shepherd's hook available at all times to the caregiver 546.27 supervising the pool. 546.28 (b) A violation of this subdivision is grounds for a 546.29 sanction under section 245A.07, or a correction order or fine 546.30 under section 245A.06. If a provider under this subdivision 546.31 receives a licensing sanction or a correction order or fine 546.32 relating to the supervision or health and safety of children, 546.33 the provider is prohibited from allowing a child cared for at 546.34 the family day care or group family day care home to continue to 546.35 use the pool located at the home. 546.36 Sec. 3. Minnesota Statutes 2000, section 246.57, is 547.1 amended by adding a subdivision to read: 547.2 Subd. 7. [SHARED SERVICES ACCOUNT.] Notwithstanding 547.3 subdivision 1, beginning July 1, 2001, $6,000,000 each biennium 547.4 is transferred from the shared services account into which 547.5 receipts for shared services under subdivision 1 are deposited 547.6 to the general fund. This subdivision expires June 30, 2005. 547.7 Sec. 4. Minnesota Statutes 2000, section 252A.02, is 547.8 amended by adding a subdivision to read: 547.9 Subd. 3a. [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship 547.10 service providers" are individuals or agencies that meet the 547.11 ethical conduct and best practice standards of the National 547.12 Guardianship Association, meet the criminal background check 547.13 requirements of section 245A.04, and do not provide any other 547.14 services to the individuals for whom guardianship services are 547.15 provided. 547.16 Sec. 5. Minnesota Statutes 2000, section 252A.02, 547.17 subdivision 12, is amended to read: 547.18 Subd. 12. [COMPREHENSIVE EVALUATION.] "Comprehensive 547.19 evaluation" shall consist of: 547.20 (1) a medical report on the health status and physical 547.21 condition of the proposed ward, prepared under the direction of 547.22 a licensed physician; 547.23 (2) a report on the proposed ward's intellectual capacity 547.24 and functional abilities, specifying the tests and other data 547.25 used in reaching its conclusions, prepared by a psychologist who 547.26 is qualified in the diagnosis of mental retardation; and 547.27 (3) a report from the case manager that includes: 547.28 (i) the most current assessment of individual service needs 547.29 as described in rules of the commissioner; 547.30 (ii) the most current individual service planas described547.31in rules of the commissionerunder section 256B.092, subdivision 547.32 1b; and 547.33 (iii) a description of contacts with and responses of near 547.34 relatives of the proposed ward notifying them that a nomination 547.35 for public guardianship has been made and advising them that 547.36 they may seek private guardianship. 548.1 Each report shall contain recommendations as to the amount 548.2 of assistance and supervision required by the proposed ward to 548.3 function as independently as possible in society. To be 548.4 considered part of the comprehensive evaluation, reports must be 548.5 completed no more than one year before filing the petition under 548.6 section 252A.05. 548.7 Sec. 6. Minnesota Statutes 2000, section 252A.02, 548.8 subdivision 13, is amended to read: 548.9 Subd. 13. [CASE MANAGER.] "Case manager" means the person 548.10 designatedby the county board under rules of the commissioner548.11to provide case management servicesunder section 256B.092. 548.12 Sec. 7. Minnesota Statutes 2000, section 252A.111, 548.13 subdivision 6, is amended to read: 548.14 Subd. 6. [SPECIAL DUTIES.] In exercising powers and duties 548.15 under this chapter, the commissioner shall: 548.16 (1) maintain close contact with the ward, visiting at least 548.17 twice a year; 548.18 (2)prohibit filming a ward in any way that would reveal548.19the identity of the ward unless the commissioner determines the548.20filming to be in the best interests of the ward. The548.21commissioner may give written consent for filming of the ward548.22after permitting and encouraging input by the nearest relative548.23 protect and exercise the legal rights of the ward; 548.24 (3) take actions and make decisions on behalf of the ward 548.25 that encourage and allow the maximum level of independent 548.26 functioning in a manner least restrictive of the ward's personal 548.27 freedom consistent with the need for supervision and protection; 548.28 and 548.29 (4) permit and encourage maximum self-reliance on the part 548.30 of the ward and permit and encourage input by the nearest 548.31 relative of the ward in planning and decision making on behalf 548.32 of the ward. 548.33 Sec. 8. Minnesota Statutes 2000, section 252A.16, 548.34 subdivision 1, is amended to read: 548.35 Subdivision 1. [REVIEW REQUIRED.] The commissioner 548.36 shallproviderequire an annual review of the physical, mental, 549.1 and social adjustment and progress of every ward and 549.2 conservatee. A copy of this review shall be kept on file at the 549.3 department of human services and may be inspected by the ward or 549.4 conservatee, the ward's or conservatee's parents, spouse, or 549.5 relatives and other persons who receive the permission of the 549.6 commissioner. The review shall contain information required 549.7 underrules of the commissionerMinnesota Rules, part 9525.3065, 549.8 subpart 1. 549.9 Sec. 9. Minnesota Statutes 2000, section 252A.19, 549.10 subdivision 2, is amended to read: 549.11 Subd. 2. [PETITION.] The commissioner, ward, or any 549.12 interested person may petition the appointing court or the court 549.13 to which venue has been transferred for an order to remove the 549.14 guardianship or to limit or expand the powers of the 549.15 conservatorship or to appoint a guardian or conservator under 549.16 sections 525.539 to 525.705 or to restore the ward or 549.17 conservatee to full legal capacity or to review de novo any 549.18 decision made by the public guardian or public conservator for 549.19 or on behalf of a ward or conservatee or for any other order as 549.20 the court may deem just and equitable. Section 525.61, 549.21 subdivision 3, does not apply to a petition to remove a public 549.22 guardian. 549.23 Sec. 10. Minnesota Statutes 2000, section 252A.20, 549.24 subdivision 1, is amended to read: 549.25 Subdivision 1. [WITNESS AND ATTORNEY FEES.] In each 549.26 proceeding under sections 252A.01 to 252A.21, the court shall 549.27 allow and order paid to each witness subpoenaed the fees and 549.28 mileage prescribed by law; to each physician, psychologist, or 549.29 social worker who assists in the preparation of the 549.30 comprehensive evaluation and who is not in the employ of the 549.31 local agency,or the state department of human services,or area549.32mental health-mental retardation board,a reasonable sum for 549.33 services and for travel; and to the ward's counsel, when 549.34 appointed by the court, a reasonable sum for travel and for each 549.35 day or portion of a day actually employed in court or actually 549.36 consumed in preparing for the hearing. Upon order the county 550.1 auditor shall issue a warrant on the county treasurer for 550.2 payment of the amount allowed. 550.3 Sec. 11. Minnesota Statutes 2000, section 256.482, 550.4 subdivision 8, is amended to read: 550.5 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 550.6 subdivision 5, the council on disability shall not sunset until 550.7 June 30,20012005. 550.8 Sec. 12. [PUBLIC GUARDIANSHIP ALTERNATIVES.] 550.9 The commissioner of human services shall provide county 550.10 agencies with funds up to the amount appropriated for public 550.11 guardianship alternatives based on proposals by the counties to 550.12 establish private alternatives. 550.13 Sec. 13. [AUTOMATIC DEFIBRILLATOR STUDY.] 550.14 The emergency medical services regulatory board, in 550.15 consultation with the department of public safety, shall study 550.16 and report to the legislature by December 15, 2002, regarding 550.17 the availability of automatic defibrillators outside the 550.18 seven-county metropolitan area. The report shall include 550.19 recommendations to make these devices accessible within a 550.20 reasonable distance throughout the nonmetropolitan area, 550.21 including recommendations for funding their acquisition and 550.22 distribution. 550.23 Sec. 14. [REPEALER.] 550.24 Minnesota Statutes 2000, section 252A.111, subdivision 3, 550.25 is repealed. 550.26 ARTICLE 13 550.27 APPROPRIATIONS 550.28 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 550.29 The sums shown in the columns marked "APPROPRIATIONS" are 550.30 appropriated from the general fund, or any other named fund, to 550.31 the agencies and for the purposes specified in the following 550.32 sections of this article, to be available for the fiscal years 550.33 indicated for each purpose. The figures "2002" and "2003" where 550.34 used in this article, mean that the appropriation or 550.35 appropriations listed under them are available for the fiscal 550.36 year ending June 30, 2002, or June 30, 2003, respectively. 551.1 Where a dollar amount appears in parentheses, it means a 551.2 reduction of an appropriation. 551.3 SUMMARY BY FUND 551.4 APPROPRIATIONS BIENNIAL 551.5 2002 2003 TOTAL 551.6 General $3,083,573,000 $3,390,338,000 $6,473,911,000 551.7 State Government 551.8 Special Revenue 35,517,000 37,259,000 72,776,000 551.9 Health Care 551.10 Access 214,712,000 269,923,000 484,635,000 551.11 Federal TANF 318,103,000 277,420,000 595,523,000 551.12 Lottery Cash Flow 1,300,000 1,300,000 2,600,000 551.13 TOTAL $3,653,205,000 $3,976,240,000 $7,629,445,000 551.14 APPROPRIATIONS 551.15 Available for the Year 551.16 Ending June 30 551.17 2002 2003 551.18 Sec. 2. COMMISSIONER OF 551.19 HUMAN SERVICES 551.20 Subdivision 1. Total 551.21 Appropriation $3,468,138,000 $3,792,416,000 551.22 Summary by Fund 551.23 General 2,960,344,000 3,270,094,000 551.24 State Government 551.25 Special Revenue 507,000 507,000 551.26 Health Care 551.27 Access 207,884,000 263,095,000 551.28 Federal TANF 298,103,000 257,420,000 551.29 Lottery Cash Flow 1,300,000 1,300,000 551.30 [APPROPRIATION FOR COURT-ORDERED MENTAL 551.31 HEALTH TREATMENT.] Of the general fund 551.32 appropriation, $2,289,000 in fiscal 551.33 year 2002 and $2,289,000 in fiscal year 551.34 2003 are for the cost of implementing 551.35 H.F. 560, if enacted. This 551.36 appropriation is available only if H.F. 551.37 560 is enacted. 551.38 [APPROPRIATIONS FOR CIVIL COMMITMENT.] 551.39 (a) Of the general fund appropriation, 551.40 $3,386,000 in fiscal year 2003 is for 551.41 the cost of implementing H.F. 281, if 551.42 enacted. This appropriation is 551.43 available only if H.F. 281 is enacted. 551.44 (b) Of the general fund appropriation, 551.45 $155,000 in fiscal year 2003 is 551.46 appropriated to the commissioner to be 551.47 transferred to the Minnesota supreme 551.48 court for costs associated with 551.49 petitions filed for judicial 551.50 commitment. This appropriation is 552.1 available only if H.F. 281 is enacted. 552.2 [APPROPRIATIONS FOR CHILD SUPPORT.] (1) 552.3 Of the general fund appropriation, 552.4 $32,000 in fiscal year 2002 and $32,000 552.5 in fiscal year 2003 are for the cost of 552.6 implementing H.F. 1807, if enacted. 552.7 This appropriation is available only if 552.8 H.F. 1807 is enacted. 552.9 (2) Of the general fund appropriation, 552.10 $435,000 in fiscal year 2002 is for the 552.11 cost of implementing H.F. 1446, if 552.12 enacted. This appropriation is 552.13 available only if H.F. 1446 is enacted. 552.14 [APPROPRIATION FOR PATIENT 552.15 PROTECTIONS.] (a) Of the general fund 552.16 appropriation, $248,000 in fiscal year 552.17 2002 and $591,000 in fiscal year 2003 552.18 are for the cost of implementing the 552.19 patient protection provisions in H.F. 552.20 560, if enacted. This appropriation is 552.21 available only if H.F. 560 is enacted. 552.22 (b) Of the health care access fund 552.23 appropriation, $106,000 in fiscal year 552.24 2002 and $255,000 in fiscal year 2003 552.25 are for the cost of implementing H.F. 552.26 560, if enacted. This appropriation is 552.27 available only if H.F. 560 is enacted. 552.28 [RECEIPTS FOR SYSTEMS PROJECTS.] 552.29 Appropriations and federal receipts for 552.30 information system projects for MAXIS, 552.31 PRISM, MMIS, and SSIS must be deposited 552.32 in the state system account authorized 552.33 in Minnesota Statutes, section 552.34 256.014. Money appropriated for 552.35 computer projects approved by the 552.36 Minnesota office of technology, funded 552.37 by the legislature, and approved by the 552.38 commissioner of finance may be 552.39 transferred from one project to another 552.40 and from development to operations as 552.41 the commissioner of human services 552.42 considers necessary. Any unexpended 552.43 balance in the appropriation for these 552.44 projects does not cancel but is 552.45 available for ongoing development and 552.46 operations. 552.47 [GIFTS.] Notwithstanding Minnesota 552.48 Statutes, chapter 7, the commissioner 552.49 may accept on behalf of the state 552.50 additional funding from sources other 552.51 than state funds for the purpose of 552.52 financing the cost of assistance 552.53 program grants or nongrant 552.54 administration. All additional funding 552.55 is appropriated to the commissioner for 552.56 use as designated by the grantor of 552.57 funding. 552.58 [SYSTEMS CONTINUITY.] In the event of 552.59 disruption of technical systems or 552.60 computer operations, the commissioner 552.61 may use available grant appropriations 552.62 to ensure continuity of payments for 552.63 maintaining the health, safety, and 552.64 well-being of clients served by 553.1 programs administered by the department 553.2 of human services. Grant funds must be 553.3 used in a manner consistent with the 553.4 original intent of the appropriation. 553.5 [SPECIAL REVENUE FUND INFORMATION.] On 553.6 December 1, 2001, and December 1, 2002, 553.7 the commissioner shall provide the 553.8 chairs of the house health and human 553.9 services finance committee and the 553.10 senate health, human services, and 553.11 corrections budget division with 553.12 detailed fund balance information for 553.13 each special revenue fund account. 553.14 [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 553.15 Federal administrative reimbursement 553.16 resulting from MinnesotaCare outreach 553.17 grants and the Minnesota senior health 553.18 options project are appropriated to the 553.19 commissioner for these activities. Any 553.20 balance from this appropriation 553.21 remaining at the end of the biennium 553.22 shall be transferred to the general 553.23 fund. 553.24 [NONFEDERAL SHARE TRANSFERS.] The 553.25 nonfederal share of activities for 553.26 which federal administrative 553.27 reimbursement is appropriated to the 553.28 commissioner may be transferred to the 553.29 special revenue fund. Any balance from 553.30 this appropriation remaining at the end 553.31 of the biennium shall be transferred to 553.32 the general fund. 553.33 [MAJOR SYSTEMS TRANSFER.] (1) 553.34 $22,600,000 of funds available in the 553.35 state systems account authorized in 553.36 Minnesota Statutes, section 256.014, is 553.37 transferred to the general fund for the 553.38 biennium ending June 30, 2003. 553.39 (2) $1,400,000 of funds available in 553.40 the state systems account authorized in 553.41 Minnesota Statutes, section 256.014, is 553.42 transferred to the general fund for the 553.43 biennium ending June 30, 2005. 553.44 Notwithstanding section 13 of this 553.45 article, this rider does not expire on 553.46 June 30, 2003. 553.47 [TANF FUNDS APPROPRIATED TO OTHER 553.48 ENTITIES.] Any expenditures from the 553.49 TANF block grant shall be expended in 553.50 accordance with the requirements and 553.51 limitations of part A of title IV of 553.52 the Social Security Act, as amended, 553.53 and any other applicable federal 553.54 requirement or limitation. Prior to 553.55 any expenditure of these funds, the 553.56 commissioner shall assure that funds 553.57 are expended in compliance with the 553.58 requirements and limitations of federal 553.59 law and that any reporting requirements 553.60 of federal law are met. It shall be 553.61 the responsibility of any entity to 553.62 which these funds are appropriated to 553.63 implement a memorandum of understanding 553.64 with the commissioner that provides the 553.65 necessary assurance of compliance prior 554.1 to any expenditure of funds. The 554.2 commissioner shall receipt TANF funds 554.3 appropriated to other state agencies 554.4 and coordinate all related interagency 554.5 accounting transactions necessary to 554.6 implement these appropriations. 554.7 Unexpended TANF funds appropriated to 554.8 any state, local, or nonprofit entity 554.9 cancel at the end of the state fiscal 554.10 year unless appropriating language 554.11 permits otherwise. 554.12 [TANF FUNDS TRANSFERRED TO OTHER 554.13 FEDERAL GRANTS.] The commissioner must 554.14 authorize transfers from TANF to other 554.15 federal block grants so that funds are 554.16 available to meet the annual 554.17 expenditure needs as appropriated. 554.18 Transfers may be authorized prior to 554.19 the expenditure year with the agreement 554.20 of the receiving entity. Transferred 554.21 funds must be expended in the year for 554.22 which the funds were appropriated 554.23 unless appropriation language permits 554.24 otherwise. In accelerating transfer 554.25 authorizations, the commissioner must 554.26 aim to preserve the future potential 554.27 transfer capacity from TANF to other 554.28 block grants. 554.29 [TANF MAINTENANCE OF EFFORT.] (a) In 554.30 order to meet the basic maintenance of 554.31 effort (MOE) requirements of the TANF 554.32 block grant specified under Code of 554.33 Federal Regulations, title 45, section 554.34 263.1, the commissioner may only report 554.35 nonfederal money expended for allowable 554.36 activities listed in the following 554.37 clauses as TANF MOE expenditures: 554.38 (1) MFIP cash and food assistance 554.39 benefits under Minnesota Statutes, 554.40 chapter 256J; 554.41 (2) the child care assistance programs 554.42 under Minnesota Statutes, sections 554.43 119B.03 and 119B.05, and county child 554.44 care administrative costs under 554.45 Minnesota Statutes, section 119B.15; 554.46 (3) state and county MFIP 554.47 administrative costs under Minnesota 554.48 Statutes, chapters 256J and 256K; 554.49 (4) state, county, and tribal MFIP 554.50 employment services under Minnesota 554.51 Statutes, chapters 256J and 256K; and 554.52 (5) expenditures made on behalf of 554.53 noncitizen MFIP recipients who qualify 554.54 for the medical assistance without 554.55 federal financial participation program 554.56 under Minnesota Statutes, section 554.57 256B.06, subdivision 4, paragraphs (d), 554.58 (e), and (j). 554.59 (b) The commissioner shall ensure that 554.60 sufficient qualified nonfederal 554.61 expenditures are made each year to meet 554.62 the state's TANF MOE requirements. For 554.63 the activities listed in paragraph (a), 555.1 clauses (2) to (5), the commissioner 555.2 may only report expenditures that are 555.3 excluded from the definition of 555.4 assistance under Code of Federal 555.5 Regulations, title 45, section 260.31. 555.6 (c) If nonfederal expenditures for the 555.7 programs and purposes listed in 555.8 paragraph (a) are insufficient to meet 555.9 the state's TANF MOE requirements, the 555.10 commissioner shall recommend additional 555.11 allowable sources of nonfederal 555.12 expenditures to the legislature, if the 555.13 legislature is or will be in session to 555.14 take action to specify additional 555.15 sources of nonfederal expenditures for 555.16 TANF MOE before a federal penalty is 555.17 imposed. The commissioner shall 555.18 otherwise provide notice to the 555.19 legislative commission on planning and 555.20 fiscal policy under paragraph (e). 555.21 (d) If the commissioner uses authority 555.22 granted under Laws 1999, chapter 245, 555.23 article 1, section 10, or similar 555.24 authority granted by a subsequent 555.25 legislature, to meet the state's TANF 555.26 MOE requirements in a reporting period, 555.27 the commissioner shall inform the 555.28 chairs of the appropriate legislative 555.29 committees about all transfers made 555.30 under that authority for this purpose. 555.31 (e) If the commissioner determines that 555.32 nonfederal expenditures under paragraph 555.33 (a) are insufficient to meet TANF MOE 555.34 expenditure requirements, and if the 555.35 legislature is not or will not be in 555.36 session to take timely action to avoid 555.37 a federal penalty, the commissioner may 555.38 report nonfederal expenditures from 555.39 other allowable sources as TANF MOE 555.40 expenditures after the requirements of 555.41 this paragraph are met. The 555.42 commissioner may report nonfederal 555.43 expenditures in addition to those 555.44 specified under paragraph (a) as 555.45 nonfederal TANF MOE expenditures, but 555.46 only ten days after the commissioner of 555.47 finance has first submitted the 555.48 commissioner's recommendations for 555.49 additional allowable sources of 555.50 nonfederal TANF MOE expenditures to the 555.51 members of the legislative commission 555.52 on planning and fiscal policy for their 555.53 review. 555.54 (f) The commissioner of finance shall 555.55 not incorporate any changes in federal 555.56 TANF expenditures or nonfederal 555.57 expenditures for TANF MOE that may 555.58 result from reporting additional 555.59 allowable sources of nonfederal TANF 555.60 MOE expenditures under the interim 555.61 procedures in paragraph (e) into the 555.62 February or November forecasts required 555.63 under Minnesota Statutes, section 555.64 16A.103, unless the commissioner of 555.65 finance has approved the additional 555.66 sources of expenditures under paragraph 555.67 (e). 556.1 (g) The provisions of Minnesota 556.2 Statutes, section 256.011, subdivision 556.3 3, which require that federal grants or 556.4 aids secured or obtained under that 556.5 subdivision be used to reduce any 556.6 direct appropriations provided by law, 556.7 do not apply if the grants or aids are 556.8 federal TANF funds. 556.9 (h) Notwithstanding section 14 of this 556.10 article, paragraphs (a) to (h) expire 556.11 June 30, 2005. 556.12 Subd. 2. Agency Management 556.13 General 34,500,000 32,971,000 556.14 State Government 556.15 Special Revenue 392,000 392,000 556.16 Health Care 556.17 Access 3,591,000 3,602,000 556.18 Federal TANF 546,000 454,000 556.19 The amounts that may be spent from the 556.20 appropriation for each purpose are as 556.21 follows: 556.22 (a) Financial Operations 556.23 General 6,708,000 6,708,000 556.24 Health Care 556.25 Access 803,000 803,000 556.26 Federal TANF 546,000 454,000 556.27 (b) Legal and Regulation Operations 556.28 General 8,682,000 8,305,000 556.29 State Government 556.30 Special Revenue 392,000 392,000 556.31 Health Care 556.32 Access 233,000 244,000 556.33 [CORE LICENSING ACTIVITIES.] Of the 556.34 general fund appropriation, $1,138,000 556.35 in fiscal year 2002 and $923,000 in 556.36 fiscal year 2003 is to support 14 new 556.37 licensor positions. Of this amount, 556.38 $72,000 in fiscal year 2002 and 556.39 $107,000 in fiscal year 2003 is to 556.40 cover maintenance and operational costs 556.41 for a new computer system, which will 556.42 provide public access to licensing 556.43 information. In order to receive 556.44 continued appropriations for these 556.45 purposes, by January 1, 2003, the 556.46 commissioner shall: 556.47 (1) reduce the average length of time 556.48 to complete investigations of licensing 556.49 complaints within 75 days; 556.50 (2) complete all licensing reviews 556.51 within the one-year and two-year 556.52 intervals set forth in statutes; and 557.1 (3) complete negative licensing action 557.2 decisions within 45 days of county 557.3 recommendations. 557.4 [EXPEDITED MALTREATMENT 557.5 INVESTIGATIONS.] Of the general fund 557.6 appropriation, $359,000 in fiscal year 557.7 2002 and $277,000 in fiscal year 2003 557.8 are for one senior investigator 557.9 position, three investigator positions, 557.10 and one-half of a clerical position to 557.11 achieve the goals for expedited 557.12 maltreatment investigations. In order 557.13 to receive continued appropriations for 557.14 this purpose, by January 1, 2003, the 557.15 commissioner shall reduce the average 557.16 length of time to complete maltreatment 557.17 investigations to 60 days. 557.18 [PUBLIC GUARDIANSHIP INCENTIVES.] Of 557.19 the general fund appropriation, 557.20 $250,000 in fiscal year 2002 and 557.21 $250,000 in fiscal year 2003 is to be 557.22 used for the purposes of providing 557.23 fiscal incentives to encourage counties 557.24 to establish private alternatives. 557.25 (c) Management Operations 557.26 General 19,110,000 17,958,000 557.27 Health Care 557.28 Access 2,555,000 2,555,000 557.29 Subd. 3. Administrative Reimbursement/ 557.30 Pass Through 557.31 Federal TANF 60,565 51,992 557.32 Subd. 4. Children's Services Grants 557.33 General 59,320,000 59,833,000 557.34 Federal TANF 6,290,000 6,290,000 557.35 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 557.36 Federal funds available during fiscal 557.37 year 2002 and fiscal year 2003, for 557.38 adoption incentive grants are 557.39 appropriated to the commissioner for 557.40 these purposes. 557.41 [TANF TRANSFER TO SOCIAL SERVICES.] 557.42 $4,650,000 is appropriated to the 557.43 commissioner in fiscal year 2002 and in 557.44 fiscal year 2003 for purposes of 557.45 increasing services for families with 557.46 children whose incomes are at or below 557.47 200 percent of the federal poverty 557.48 guidelines. The commissioner shall 557.49 authorize a sufficient transfer of 557.50 funds from the state's federal TANF 557.51 block grant to the state's federal 557.52 social services block grant to meet 557.53 this appropriation. 557.54 [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 557.55 CONCURRENT PERMANENCY PLANNING.] 557.56 Notwithstanding Minnesota Statutes, 557.57 section 256E.07, $4,650,000 in fiscal 557.58 year 2002 and $4,650,000 in fiscal year 558.1 2003 in social services block grant 558.2 funds allocated to the commissioner 558.3 under title XX of the Social Security 558.4 Act are available for distribution to 558.5 counties under the formula in Minnesota 558.6 Statutes, section 260C.213, for the 558.7 purposes of concurrent permanency 558.8 planning. 558.9 Subd. 5. Children's Services Management 558.10 General 5,487,000 5,487,000 558.11 Subd. 6. Basic Health Care Grants 558.12 Summary by Fund 558.13 General 1,113,870,000 1,317,141,000 558.14 Health Care 558.15 Access 188,642,000 243,842,000 558.16 The amounts that may be spent from this 558.17 appropriation for each purpose are as 558.18 follows: 558.19 (a) MinnesotaCare Grants 558.20 Health Care 558.21 Access 188,642,000 243,842,000 558.22 [MINNESOTACARE FEDERAL RECEIPTS.] 558.23 Receipts received as a result of 558.24 federal participation pertaining to 558.25 administrative costs of the Minnesota 558.26 health care reform waiver shall be 558.27 deposited as nondedicated revenue in 558.28 the health care access fund. Receipts 558.29 received as a result of federal 558.30 participation pertaining to grants 558.31 shall be deposited in the federal fund 558.32 and shall offset health care access 558.33 funds for payments to providers. 558.34 [MINNESOTACARE FUNDING.] The 558.35 commissioner may expend money 558.36 appropriated from the health care 558.37 access fund for MinnesotaCare in either 558.38 fiscal year of the biennium. 558.39 (b) MA Basic Health Care Grants - 558.40 Families and Children 558.41 General 433,298,000 517,563,000 558.42 (c) MA Basic Health Care Grants - 558.43 Elderly and Disabled 558.44 General 511,946,000 604,451,000 558.45 [MEDICALLY NEEDY STANDARD AND FEDERAL 558.46 AUTHORIZATION.] If federal 558.47 authorization to use the medical 558.48 assistance income standard in Minnesota 558.49 Statutes, section 256B.056, subdivision 558.50 4, as the medically needy standard is 558.51 not obtained, the commissioner shall 558.52 use all resulting savings to provide 558.53 services under the home and 558.54 community-based waiver for persons with 558.55 mental retardation and related 559.1 conditions. 559.2 (d) General Assistance Medical Care 559.3 General 155,744,000 176,748,000 559.4 (e) Health Care Grants - Other Assistance 559.5 General 12,882,000 18,379,000 559.6 Health Care 559.7 Access 750,000 750,000 559.8 Subd. 7. Basic Health Care Management 559.9 General 20,715,000 20,665,000 559.10 Health Care 559.11 Access 13,583,000 13,583,000 559.12 The amounts that may be spent from this 559.13 appropriation for each purpose are as 559.14 follows: 559.15 (a) Health Care Policy Administration 559.16 General 2,807,000 2,812,000 559.17 Health Care 559.18 Access 562,000 562,000 559.19 (b) Health Care Operations 559.20 General 17,908,000 17,853,000 559.21 Health Care 559.22 Access 13,021,000 13,021,000 559.23 [PREPAID MEDICAL PROGRAMS.] The 559.24 nonfederal share of the prepaid medical 559.25 assistance program fund, which has been 559.26 appropriated to fund county managed 559.27 care advocacy and enrollment operating 559.28 costs, shall be disbursed as grants 559.29 using either a reimbursement or block 559.30 grant mechanism. 559.31 Subd. 8. State-Operated Services 559.32 General 205,868,000 199,287,000 559.33 The amounts that may be spent from this 559.34 appropriation for each purpose are as 559.35 follows: 559.36 [MITIGATION RELATED TO STATE-OPERATED 559.37 SERVICES RESTRUCTURING.] Money 559.38 appropriated to finance mitigation 559.39 expenses related to restructuring 559.40 state-operated services programs and 559.41 administrative services may be 559.42 transferred between fiscal years within 559.43 the biennium. 559.44 [STATE-OPERATED SERVICES CHEMICAL 559.45 DEPENDENCY PROGRAMS.] When the 559.46 operations of the state-operated 559.47 services chemical dependency fund 559.48 created in Minnesota Statutes, section 559.49 246.18, subdivision 2, are impeded by 559.50 projected cash deficiencies resulting 560.1 from delays in the receipt of grants, 560.2 dedicated income, or other similar 560.3 receivables, and when the deficiencies 560.4 would be corrected within the budget 560.5 period involved, the commissioner of 560.6 finance may transfer general fund cash 560.7 reserves into this account as necessary 560.8 to meet cash demands. The cash flow 560.9 transfers must be returned to the 560.10 general fund in the fiscal year that 560.11 the transfer was made. Any interest 560.12 earned on general fund cash flow 560.13 transfers accrues to the general fund 560.14 and not the state-operated services 560.15 chemical dependency fund. 560.16 [STATE-OPERATED SERVICES 560.17 RESTRUCTURING.] For purposes of 560.18 restructuring state-operated services, 560.19 any state-operated services employee 560.20 whose position is to be eliminated 560.21 shall be afforded the options provided 560.22 in applicable collective bargaining 560.23 agreements. All salary and mitigation 560.24 allocations from fiscal year 2002 shall 560.25 be carried forward into fiscal year 560.26 2003. Provided there is no conflict 560.27 with any collective bargaining 560.28 agreement, any state-operated services 560.29 position reduction must only be 560.30 accomplished through mitigation, 560.31 attrition, transfer, and other measures 560.32 as provided in state or applicable 560.33 collective bargaining agreements and in 560.34 Minnesota Statutes, section 252.50, 560.35 subdivision 11, and not through layoff. 560.36 [REPAIRS AND BETTERMENTS.] The 560.37 commissioner may transfer unencumbered 560.38 appropriation balances between fiscal 560.39 years within the biennium for the state 560.40 residential facilities repairs and 560.41 betterments account and special 560.42 equipment. 560.43 Subd. 9. Continuing Care Grants 560.44 General 1,367,177,000 1,483,241,000 560.45 Lottery Cash Flow 1,158,000 1,158,000 560.46 The amounts that may be spent from this 560.47 appropriation for each purpose are as 560.48 follows: 560.49 (a) Community Social Services 560.50 Block Grants 560.51 48,718,000 49,695,000 560.52 [CSSA TRADITIONAL APPROPRIATION.] 560.53 Notwithstanding Minnesota Statutes, 560.54 section 256E.06, subdivisions 1 and 2, 560.55 the appropriations available under that 560.56 section in fiscal years 2002 and 2003 560.57 must be distributed to each county 560.58 proportionately to the aid received by 560.59 the county in calendar year 2000. 560.60 (b) Aging Adult Service Grants 561.1 10,300,000 10,532,000 561.2 [COUNTY PLANNING AND SERVICE 561.3 DEVELOPMENT.] Of this appropriation, 561.4 $1,200,000 in fiscal year 2002 and 561.5 $1,600,000 in fiscal year 2003 are for 561.6 distribution to county boards for 561.7 planning and development of community 561.8 services for the elderly as required 561.9 under Minnesota Statutes, section 561.10 256B.437, subdivision 2. For Phase I 561.11 funding to develop the initial biennial 561.12 plan addendum, the commissioner shall 561.13 distribute a minimum of $10,000 to each 561.14 county on July 1, 2001. In a county 561.15 with more than 10,000 persons over 65 561.16 years, the funding allocation shall be 561.17 $15,000; with more than 30,000 persons 561.18 over 65 years - $20,000; with more than 561.19 50,000 persons over 65 years - $25,000; 561.20 and with more than 100,000 persons over 561.21 65 years - $30,000. Upon submission of 561.22 the completed biennial plan addendum, 561.23 the commissioner shall distribute Phase 561.24 II funding to each county for 561.25 development of community-based services 561.26 no later than January 1, 2002. For 561.27 counties with less than 4,500 persons 561.28 under 65 years, the Phase II allocation 561.29 shall be $10,000. For counties with 561.30 more than 4,500 persons over 65 years, 561.31 the Phase II allocation shall be $2.23 561.32 per person over 65 years. Any 561.33 remaining funds shall be available as 561.34 targeted funds distributed to counties 561.35 with designated critical access sites. 561.36 Phase I funding may be carried over by 561.37 the county into 2002 and 2003 for the 561.38 development of services. 561.39 (c) Deaf and Hard-of-Hearing 561.40 Services Grants 561.41 1,923,000 1,825,000 561.42 [SERVICES TO DEAF PERSONS WITH MENTAL 561.43 ILLNESS.] Of this appropriation, 561.44 $100,000 in fiscal year 2002 and 561.45 $100,000 in fiscal year 2003 is for a 561.46 grant to a nonprofit agency that 561.47 currently serves deaf and 561.48 hard-of-hearing adults with mental 561.49 illness through residential programs 561.50 and supportive housing outreach 561.51 activities. The grant must be used to 561.52 continue and maintain community support 561.53 services for deaf and hard-of-hearing 561.54 adults with mental illness who use or 561.55 wish to use sign language as their 561.56 primary means of communication. 561.57 (d) Mental Health Grants 561.58 General 50,014,000 51,525,000 561.59 Lottery Cash Flow 1,158,000 1,158,000 561.60 (e) Community Support Grants 561.61 12,698,000 12,920,000 562.1 (f) Medical Assistance Long-Term 562.2 Care Waivers and Home Care 562.3 452,689,000 533,489,000 562.4 [PROVIDER RATE INCREASES.] (1) The 562.5 commissioner shall increase 562.6 reimbursement rates by 3.0 percent the 562.7 first year of the biennium and by 3.0 562.8 percent the second year for the 562.9 providers listed in paragraph (2). The 562.10 increases shall be effective for 562.11 services rendered on or after July 1 of 562.12 each year. 562.13 (2) The rate increases described in 562.14 this section shall be provided to home 562.15 and community-based waivered services 562.16 for persons with mental retardation or 562.17 related conditions under Minnesota 562.18 Statutes, section 256B.501; home and 562.19 community-based waivered services for 562.20 the elderly under Minnesota Statutes, 562.21 section 256B.0915; waivered services 562.22 under community alternatives for 562.23 disabled individuals under Minnesota 562.24 Statutes, section 256B.49; community 562.25 alternative care waivered services 562.26 under Minnesota Statutes, section 562.27 256B.49; traumatic brain injury 562.28 waivered services under Minnesota 562.29 Statutes, section 256B.49; nursing 562.30 services and home health services under 562.31 Minnesota Statutes, section 256B.0625, 562.32 subdivision 6a; personal care services 562.33 and nursing supervision of personal 562.34 care services under Minnesota Statutes, 562.35 section 256B.0625, subdivision 19a; 562.36 private-duty nursing services under 562.37 Minnesota Statutes, section 256B.0625, 562.38 subdivision 7; day training and 562.39 habilitation services for adults with 562.40 mental retardation or related 562.41 conditions under Minnesota Statutes, 562.42 sections 252.40 to 252.46; alternative 562.43 care services under Minnesota Statutes, 562.44 section 256B.0913; adult residential 562.45 program grants under Minnesota Rules, 562.46 parts 9535.2000 to 9535.3000; adult and 562.47 family community support grants under 562.48 Minnesota Rules, parts 9535.1700 to 562.49 9535.1760; semi-independent living 562.50 services under Minnesota Statutes, 562.51 section 252.275, including SILS funding 562.52 under county social services grants 562.53 formerly funded under Minnesota 562.54 Statutes, chapter 256I; community 562.55 support services for deaf and 562.56 hard-of-hearing adults with mental 562.57 illness who use or wish to use sign 562.58 language as their primary means of 562.59 communication; and living skills 562.60 training programs for persons with 562.61 intractable epilepsy who need 562.62 assistance in the transition to 562.63 independent living; and group 562.64 residential housing supplementary 562.65 service rate under Minnesota Statutes, 562.66 section 256I.05, subdivision 1a. 562.67 (g) Medical Assistance Long-Term 563.1 Care Facilities 563.2 590,959,000 599,839,000 563.3 [MORATORIUM EXCEPTIONS.] During each 563.4 year of the biennium beginning July 1, 563.5 2001, the commissioner of health may 563.6 approve moratorium exception projects 563.7 under Minnesota Statutes, section 563.8 144A.073, for which the full annualized 563.9 state share of medical assistance costs 563.10 does not exceed $2,000,000. 563.11 [NURSING FACILITY OPERATED BY THE RED 563.12 LAKE BAND OF CHIPPEWA INDIANS.] (1) The 563.13 medical assistance payment rates for 563.14 the 47-bed nursing facility operated by 563.15 the Red Lake Band of Chippewa Indians 563.16 must be calculated according to 563.17 allowable reimbursement costs under the 563.18 medical assistance program, as 563.19 specified in Minnesota Statutes, 563.20 section 246.50, and are subject to the 563.21 facility-specific Medicare upper limits. 563.22 (2) In addition, the commissioner shall 563.23 make available rate adjustments for the 563.24 biennium beginning July 1, 2001, on the 563.25 same basis as the adjustments provided 563.26 to nursing facilities under Minnesota 563.27 Statutes, section 256B.431. The 563.28 commissioner must use the facility's 563.29 final 2000 and 2001 Medicare cost 563.30 reports to calculate the adjustments. 563.31 This rate increase shall become part of 563.32 the facility's base rate for future 563.33 rate years. 563.34 [ICF/MR DISALLOWANCES.] Of this 563.35 appropriation, $65,000 in each fiscal 563.36 year is to reimburse a four-bed ICF/MR 563.37 in Ramsey county for disallowance 563.38 resulting from field audit findings. 563.39 The commissioner shall exempt these 563.40 facilities from the provisions of 563.41 Minnesota Statutes, section 256B.501, 563.42 subdivision 5b, paragraph (d), clause 563.43 (6), for the rate years beginning 563.44 October 1, 1996, and October 1, 1997. 563.45 [COMMUNITY SERVICES DEVELOPMENT GRANTS 563.46 PROGRAM.] Of this appropriation, 563.47 $18,000,000 for the biennium ending 563.48 June 30, 2003, is to the commissioner 563.49 for grants under Minnesota Statutes, 563.50 section 256.9754. Unexpended 563.51 appropriations in fiscal year 2002 do 563.52 not cancel but are available to the 563.53 commissioner for these purposes in 563.54 fiscal year 2003. This is a one-time 563.55 appropriation and shall not become part 563.56 of the base-level funding for the 563.57 2004-2005 biennium. 563.58 [LONG-TERM CARE CONSULTATION SERVICES.] 563.59 Long-term care consultation services 563.60 payments to all counties shall continue 563.61 at the payment amount in effect for 563.62 preadmission screening in fiscal year 563.63 2001. 564.1 (h) Alternative Care Grants 564.2 General 75,764,000 89,646,000 564.3 [ALTERNATIVE CARE TRANSFER.] Any money 564.4 allocated to the alternative care 564.5 program that is not spent for the 564.6 purposes indicated does not cancel but 564.7 shall be transferred to the medical 564.8 assistance account. 564.9 [ALTERNATIVE CARE APPROPRIATION.] The 564.10 commissioner may expend the money 564.11 appropriated for the alternative care 564.12 program for that purpose in either year 564.13 of the biennium. 564.14 (i) Group Residential Housing 564.15 General 78,712,000 86,807,000 564.16 (j) Chemical Dependency 564.17 Entitlement Grants 564.18 General 39,459,000 41,045,000 564.19 (k) Chemical Dependency 564.20 Nonentitlement Grants 564.21 General 5,941,000 5,918,000 564.22 [CONSOLIDATED CHEMICAL DEPENDENCY 564.23 TREATMENT FUND ONE-TIME TRANSFER.] 564.24 $9,367,000 of funds available in the 564.25 consolidated chemical dependency 564.26 treatment fund general reserve account 564.27 is transferred in fiscal year 2002 to 564.28 the general fund. 564.29 Subd. 10. Continuing Care Management 564.30 General 24,546,000 23,928,000 564.31 State Government 564.32 Special Revenue 115,000 115,000 564.33 Lottery Cash Flow 142,000 142,000 564.34 [COUNTY INVOLVEMENT COSTS.] Of this 564.35 appropriation, up to $481,000 in fiscal 564.36 year 2002 and up to $642,000 in fiscal 564.37 year 2003 are for the commissioner to 564.38 allocate to counties for resident 564.39 relocation costs resulting from planned 564.40 closures under Minnesota Statutes, 564.41 section 256B.437, and resident 564.42 relocations under Minnesota Statutes, 564.43 section 144A.161. Unexpended funds for 564.44 fiscal year 2002 do not cancel but are 564.45 available to the commissioner for this 564.46 purpose in fiscal year 2003. 564.47 [REGION 10 QUALITY ASSURANCE 564.48 COMMISSION.] (1) Of the appropriation 564.49 from the general fund for the biennium 564.50 ending June 30, 2003, $548,000 is to 564.51 the commissioner of human services to 564.52 be allocated to the region 10 quality 564.53 assurance commission for operating 564.54 costs of the alternative quality 564.55 assurance licensing project and for 565.1 grants to counties participating in 565.2 that project. 565.3 (2) $50,000 is appropriated from the 565.4 general fund to the commissioner of 565.5 human services for the biennium ending 565.6 June 30, 2003, for the region 10 565.7 quality assurance commission to conduct 565.8 the evaluation required under Minnesota 565.9 Statutes, section 256B.0951, 565.10 subdivision 9. 565.11 (3) $150,000 is appropriated from the 565.12 general fund to the commissioner of 565.13 human services for the biennium ending 565.14 June 30, 2003, for the commissioner to 565.15 conduct the project evaluation required 565.16 for the federal 1115 waiver of ICF/MR 565.17 regulations. 565.18 Subd. 11. Economic Support Grants 565.19 General 91,086,000 90,136,000 565.20 Federal TANF 228,209,000 197,741,000 565.21 The amounts that may be spent from this 565.22 appropriation for each purpose are as 565.23 follows: 565.24 (a) Assistance to Families Grants 565.25 General 25,237,000 21,821,000 565.26 Federal TANF 164,745,000 133,553,000 565.27 (b) Work Grants 565.28 General 9,844,000 9,844,000 565.29 Federal TANF 62,203,000 61,403,000 565.30 [NONTRADITIONAL CAREER ASSISTANCE.] Of 565.31 the federal TANF appropriation, 565.32 $500,000 for fiscal year 2002 and 565.33 $500,000 for fiscal year 2003 is for 565.34 grants for nontraditional career 565.35 assistance training programs under 565.36 Minnesota Statutes, section 256K.30. 565.37 This is a one-time appropriation and 565.38 shall not be added to the base-level 565.39 funding in the 2004-2005 biennium. 565.40 [SUPPORTIVE HOUSING AND MANAGED CARE 565.41 PILOT PROJECT.] Of the general fund 565.42 appropriation, $2,000,000 in fiscal 565.43 year 2002 and $5,000,000 in fiscal year 565.44 2003 is for the supportive housing and 565.45 managed care pilot project under 565.46 Minnesota Statutes, section 256K.25. 565.47 This appropriation may be transferred 565.48 between fiscal years within the 565.49 biennium. 565.50 [INTENSIVE INTERVENTION TRANSITIONAL 565.51 EMPLOYMENT TRAINING PROJECT.] Of the 565.52 federal TANF appropriation, $800,000 565.53 for the biennium ending June 30, 2003, 565.54 is for the Southeast Asian 565.55 collaborative in Hennepin county for an 565.56 intensive intervention transitional 566.1 employment training project, which 566.2 serves TANF-eligible recipients, and 566.3 which moves refugee and immigrant 566.4 welfare recipients into unsubsidized 566.5 employment leading to 566.6 self-sufficiency. The commissioner 566.7 must select one of the five partners in 566.8 the collaborative as the fiscal agent 566.9 for the project. The primary effort of 566.10 the project must be on intensive 566.11 employment skills training, including 566.12 workplace English and overcoming 566.13 cultural barriers, and on specialized 566.14 training in fields of work which 566.15 involve a credit-based curriculum. For 566.16 recipients without a high school 566.17 diploma or a GED, extra effort shall be 566.18 made to help the recipient meet the 566.19 "ability to benefit test" so the 566.20 recipient can receive financial aid for 566.21 further training. During the 566.22 specialized training, efforts should be 566.23 made to involve the recipients with an 566.24 internship program and retention 566.25 specialist. A minor amount of the 566.26 grant may be used for other efforts to 566.27 make the recipient families more 566.28 self-sufficient as provided within TANF 566.29 rules. This is a one-time 566.30 appropriation and shall not be added to 566.31 the base-level funding for the 566.32 2004-2005 biennium. 566.33 [LOCAL INTERVENTION GRANTS FOR 566.34 SELF-SUFFICIENCY CARRYFORWARD.] 566.35 Unexpended funds appropriated for local 566.36 intervention grants under Minnesota 566.37 Statutes, section 256J.625, for fiscal 566.38 year 2002 do not cancel but are 566.39 available to the commissioner for these 566.40 purposes in fiscal year 2003. 566.41 (c) Economic Support Grants - 566.42 Other Assistance 566.43 General 4,682,000 6,931,000 566.44 Federal TANF 1,001,000 2,525,000 566.45 [TANF TRANSFER TO CHILD CARE AND 566.46 DEVELOPMENT BLOCK GRANT.] $1,526,000 566.47 for fiscal year 2003 is appropriated to 566.48 the commissioner of children, families, 566.49 and learning for the purposes of 566.50 Minnesota Statutes, section 119B.05. 566.51 The commissioner of human services 566.52 shall authorize a sufficient transfer 566.53 of funds from the state's federal TANF 566.54 block grant to the state's child care 566.55 and development fund block grant to 566.56 meet this appropriation. 566.57 [WORKING FAMILY TAX CREDITS.] (1) On a 566.58 regular basis, the commissioner of 566.59 revenue, with the assistance of the 566.60 commissioner of human services, shall 566.61 calculate the value of the refundable 566.62 portion of the Minnesota working family 566.63 credits provided under Minnesota 566.64 Statutes, section 290.0671, that 566.65 qualifies for federal reimbursement 567.1 from the temporary assistance for needy 567.2 families block grant. The commissioner 567.3 of revenue shall provide the 567.4 commissioner of human services with 567.5 such expenditure records and 567.6 information as are necessary to support 567.7 draws of federal funds. 567.8 (2) Federal TANF funds, as specified in 567.9 this paragraph, are appropriated to the 567.10 commissioner of human services based on 567.11 calculations under paragraph (a) of 567.12 working family tax credit expenditures 567.13 that qualify for reimbursement from the 567.14 TANF block grant for income tax refunds 567.15 payable in federal fiscal years 567.16 beginning October 1, 2001. The draws 567.17 of federal TANF funds shall be made on 567.18 a regular basis based on calculations 567.19 of credit expenditures by the 567.20 commissioner of revenue. Up to the 567.21 following amounts of federal TANF draws 567.22 are appropriated to the commissioner of 567.23 human services to deposit in the 567.24 general fund: in fiscal year 2002, 567.25 $25,000,000; and in fiscal year 2003, 567.26 $16,000,000. 567.27 (d) Child Support Enforcement 567.28 General 4,239,000 4,239,000 567.29 Federal TANF 260,000 260,000 567.30 [CHILD SUPPORT PAYMENT CENTER.] 567.31 Payments to the commissioner from other 567.32 governmental units, private 567.33 enterprises, and individuals for 567.34 services performed by the child support 567.35 payment center must be deposited in the 567.36 state systems account authorized under 567.37 Minnesota Statutes, section 256.014. 567.38 These payments are appropriated to the 567.39 commissioner for the operation of the 567.40 child support payment center or system, 567.41 according to Minnesota Statutes, 567.42 section 256.014. 567.43 (e) General Assistance 567.44 General 17,156,000 15,700,000 567.45 [GENERAL ASSISTANCE STANDARD.] The 567.46 commissioner shall set the monthly 567.47 standard of assistance for general 567.48 assistance units consisting of an adult 567.49 recipient who is childless and 567.50 unmarried or living apart from his or 567.51 her parents or a legal guardian at 567.52 $203. The commissioner may reduce this 567.53 amount in accordance with Laws 1997, 567.54 chapter 85, article 3, section 54. 567.55 (f) Minnesota Supplemental Aid 567.56 General 29,678,000 31,351,000 567.57 (g) Refugee Services 567.58 General 250,000 250,000 568.1 Subd. 12. Economic Support 568.2 Management 568.3 General 37,775,000 37,405,000 568.4 Health Care 568.5 Access 1,318,000 1,318,000 568.6 Federal TANF 2,493,000 943,000 568.7 The amounts that may be spent from this 568.8 appropriation for each purpose are as 568.9 follows: 568.10 (a) Economic Support Policy 568.11 Administration 568.12 General 6,528,000 6,191,000 568.13 Federal TANF 2,493,000 943,000 568.14 [FOOD STAMP ADMINISTRATIVE 568.15 REIMBURSEMENT.] The commissioner shall 568.16 reduce quarterly food stamp 568.17 administrative reimbursement to 568.18 counties in fiscal years 2002 and 2003 568.19 by the amount that the United States 568.20 Department of Health and Human Services 568.21 determines to be the county random 568.22 moment study share of the food stamp 568.23 adjustment under Public Law Number 568.24 105-185. The reductions shall be 568.25 allocated to each county in proportion 568.26 to each county's contribution, if any, 568.27 to the amount of the adjustment. Any 568.28 adjustment to medical assistance 568.29 administrative reimbursement that is 568.30 based on the United States Department 568.31 of Health and Human Services' 568.32 determinations under Public Law Number 568.33 105-185 shall be distributed to 568.34 counties in the same manner. 568.35 [EMPLOYMENT SERVICES TRACKING SYSTEM.] 568.36 Of the federal TANF appropriation, 568.37 $1,750,000 in fiscal year 2002 and 568.38 $200,000 in fiscal year 2003 are for 568.39 development of an employment tracking 568.40 system in collaboration with the 568.41 department of economic security. 568.42 Unexpended funds in fiscal year 2002 do 568.43 not cancel but are available to the 568.44 commissioner for these purposes in 568.45 fiscal year 2003. This is a one-time 568.46 appropriation and shall not be added to 568.47 the base-level funding for the 568.48 2004-2005 biennium. 568.49 (b) Economic Support Operations 568.50 General 31,247,000 31,214,000 568.51 Health Care 568.52 Access 1,318,000 1,318,000 568.53 Federal TANF ...,-0-,... ...,-0-,... 568.54 [SPENDING AUTHORITY FOR FOOD STAMP 568.55 ENHANCED FUNDING.] In the event that 568.56 Minnesota qualifies for United States 568.57 Department of Agriculture Food and 569.1 Nutrition Services Food Stamp Program 569.2 enhanced funding beginning in federal 569.3 fiscal year 1998, the money is 569.4 appropriated to the commissioner for 569.5 the purposes of the program. The 569.6 commissioner shall retain 25 percent of 569.7 the enhanced funding for the Minnesota 569.8 food assistance program, with the 569.9 remaining 75 percent divided among the 569.10 counties according to a formula that 569.11 takes into account each county's impact 569.12 on the statewide food stamp error rate. 569.13 [FINANCIAL INSTITUTION DATA MATCH AND 569.14 PAYMENT OF FEES.] The commissioner is 569.15 authorized to allocate up to $310,000 569.16 each year in fiscal year 2002 and 569.17 fiscal year 2003 from the PRISM special 569.18 revenue account to make payments to 569.19 financial institutions in exchange for 569.20 performing data matches between account 569.21 information held by financial 569.22 institutions and the public authority's 569.23 database of child support obligors as 569.24 authorized by Minnesota Statutes, 569.25 section 13B.06, subdivision 7. 569.26 Sec. 3. COMMISSIONER OF HEALTH 569.27 Subdivision 1. Total 569.28 Appropriation 138,657,000 138,848,000 569.29 Summary by Fund 569.30 General 87,619,000 86,160,000 569.31 State Government 569.32 Special Revenue 24,210,000 25,860,000 569.33 Health Care 569.34 Access 6,828,000 6,828,000 569.35 Federal TANF 20,000,000 20,000,000 569.36 Subd. 2. Family and 569.37 Community Health 72,535,000 72,847,000 569.38 Summary by Fund 569.39 General 47,943,000 47,256,000 569.40 State Government 569.41 Special Revenue 936,000 1,935,000 569.42 Health Care 569.43 Access 3,656,000 3,656,000 569.44 Federal TANF 20,000,000 20,000,000 569.45 [ELIMINATING HEALTH DISPARITIES.] Of 569.46 the general fund appropriation, 569.47 $6,000,000 each year is for reducing 569.48 health disparities. Of the amounts 569.49 available: 569.50 (1) $1,500,000 each year is for 569.51 competitive grants under Minnesota 569.52 Statutes, section 145.928, subdivision 569.53 7, to eligible applicants to reduce 569.54 health disparities in infant mortality 569.55 rates and adult and child immunization 570.1 rates. 570.2 (2) $2,000,000 each year is for 570.3 competitive grants under Minnesota 570.4 Statutes, section 145.928, subdivision 570.5 8, to eligible applicants to reduce 570.6 health disparities in breast and 570.7 cervical cancer screening rates, 570.8 HIV/AIDS and sexually transmitted 570.9 infection rates, cardiovascular disease 570.10 rates, diabetes rates, and rates of 570.11 accidental injuries and violence. 570.12 (3) $500,000 each year is for grants 570.13 under Minnesota Statutes, section 570.14 145.928, subdivision 9, to community 570.15 health boards as defined in Minnesota 570.16 Statutes, section 145A.02, to improve 570.17 access to health screening and 570.18 follow-up services for refugee 570.19 populations. 570.20 (4) $2,000,000 each year is for grants 570.21 to community health boards as defined 570.22 in Minnesota Statutes, section 145A.02, 570.23 according to the formula in Minnesota 570.24 Statutes, section 145.882, subdivision 570.25 4a, to provide services targeted at 570.26 reducing maternal and child health 570.27 disparities. 570.28 [TEEN PREGNANCY PREVENTION.] 570.29 $20,000,000 from the TANF fund for the 570.30 2002-2003 biennium is appropriated to 570.31 the commissioner of health for a teen 570.32 pregnancy prevention program. Of the 570.33 amounts available: 570.34 (1) $3,500,000 in fiscal year 2002 and 570.35 $5,000,000 in fiscal year 2003 are for 570.36 teen pregnancy prevention disparity 570.37 grants under Minnesota Statutes, 570.38 section 145.9257, subdivision 6. 570.39 (2) $3,000,000 in fiscal year 2002 and 570.40 $3,000,000 in fiscal year 2003 are for 570.41 high-risk community teen pregnancy 570.42 prevention grants under Minnesota 570.43 Statutes, section 145.9257, subdivision 570.44 7. 570.45 (3) $2,000,000 in fiscal year 2002 and 570.46 $2,000,000 in fiscal year 2003 are for 570.47 transfer to the commissioner of 570.48 children, families, and learning to 570.49 increase the number of adolescent 570.50 parenting grants. 570.51 (4) $1,500,000 in fiscal year 2002 is 570.52 for one-time grants to public school 570.53 districts to implement an abstinence 570.54 until marriage curriculum and to train 570.55 staff to implement the curriculum. The 570.56 curriculum shall educate adolescents 570.57 that abstinence from sexual activity 570.58 outside of marriage is the expected 570.59 standard and that sexual activity 570.60 outside the context of marriage is 570.61 likely to have harmful emotional, 570.62 physical, and social effects; and shall 570.63 provide an explanation of the value of 571.1 the institution of marriage and a 571.2 discussion of the historical purpose 571.3 and significance of marriage. The 571.4 commissioner of health, in consultation 571.5 with the commissioner of children, 571.6 families, and learning, shall make 571.7 school districts aware of the 571.8 availability of funds for this 571.9 purpose. This appropriation shall not 571.10 become part of the base-level funding 571.11 for this activity. 571.12 [POISON INFORMATION SYSTEM.] Of the 571.13 general fund appropriation, $1,360,000 571.14 each fiscal year is for poison control 571.15 system grants under Minnesota Statutes, 571.16 section 145.93. This is a one-time 571.17 appropriation that shall not become 571.18 part of base-level funding in 2004-2005. 571.19 [SUICIDE PREVENTION.] Of the general 571.20 fund appropriation, $1,100,000 each 571.21 fiscal year is for suicide prevention 571.22 activities under Minnesota Statutes, 571.23 section 145.56. Of the amounts 571.24 available: 571.25 (1) $275,000 each fiscal year is for 571.26 refining, coordinating, and 571.27 implementing the suicide prevention 571.28 plan according to Minnesota Statutes, 571.29 section 145.56, subdivisions 1, 3, 4, 571.30 and 5. 571.31 (2) $825,000 each fiscal year is to 571.32 fund community-based programs under 571.33 Minnesota Statutes, section 145.56, 571.34 subdivision 2. 571.35 [TANF HOME VISITING PROGRAM.] Of the 571.36 federal TANF appropriation, $10,000,000 571.37 in fiscal year 2002 and $10,000,000 in 571.38 fiscal year 2003 are for family home 571.39 visiting programs under Minnesota 571.40 Statutes, section 145A.17. These 571.41 amounts include $7,000,000 in fiscal 571.42 year 2002 and $7,000,000 in fiscal year 571.43 2003 of appropriations to the 571.44 commissioner of human services for 571.45 transfer to the commissioner of health 571.46 authorized in Laws 2000, chapter 488, 571.47 article 13, section 15, subdivision 6, 571.48 clause (3), as amended by Laws 2000, 571.49 chapter 499, sections 22 and 39. 571.50 [TANF HOME VISITING CARRYFORWARD.] Any 571.51 unexpended balance of the TANF funds 571.52 appropriated for family home visiting 571.53 in the first year of the biennium does 571.54 not cancel but is available for the 571.55 second year. 571.56 [TEEN PREGNANCY PREVENTION 571.57 CARRYFORWARD.] Any unexpended balance 571.58 of the TANF funds appropriated for teen 571.59 pregnancy prevention in the first 571.60 fiscal year of the biennium does not 571.61 cancel but is available for the second 571.62 year. 571.63 [WIC TRANSFERS.] The general fund 572.1 appropriation for the women, infants, 572.2 and children (WIC) food supplement 572.3 program is available for either year of 572.4 the biennium. Transfers of these funds 572.5 between fiscal years must be either to 572.6 maximize federal funds or to minimize 572.7 fluctuations in the number of program 572.8 participants. 572.9 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 572.10 NEEDS CARRYFORWARD.] General fund 572.11 appropriations for treatment services 572.12 in the services for Minnesota children 572.13 with special health needs program are 572.14 available for either year of the 572.15 biennium. 572.16 [ONE-TIME REDUCTION FOR FAMILY PLANNING 572.17 SPECIAL PROJECT GRANTS.] For fiscal 572.18 year 2003, base-level funding for the 572.19 Family Planning Special Project Grants 572.20 under Minnesota Statutes, section 572.21 145.925, shall be reduced by $690,000. 572.22 Subd. 3. Access and Quality 572.23 Improvement 31,350,000 30,400,000 572.24 Summary by Fund 572.25 General 21,160,000 20,194,000 572.26 State Government 572.27 Special Revenue 7,018,000 7,034,000 572.28 Health Care 572.29 Access 3,172,000 3,172,000 572.30 [HEALTH CARE SAFETY NET.] (1) Of the 572.31 general fund appropriation, $5,000,000 572.32 each year is for a grant program to aid 572.33 safety net community clinics. 572.34 (2) $5,000,000 each year is for a grant 572.35 program to provide rural hospital 572.36 capital improvement grants described in 572.37 Minnesota Statutes, section 144.148. 572.38 Subd. 4. Health Protection 29,808,000 30,639,000 572.39 Summary by Fund 572.40 General 13,699,000 13,895,000 572.41 State Government 572.42 Special Revenue 16,109,000 16,744,000 572.43 [EMERGING HEALTH THREATS.] (a) Of the 572.44 general fund appropriation, $2,200,000 572.45 in the first year and $2,400,000 in the 572.46 second year are to increase the state 572.47 capacity to identify and respond to 572.48 emerging health threats. 572.49 (b) Of these amounts, $1,900,000 in the 572.50 first year and $2,100,000 in the second 572.51 year are to expand state laboratory 572.52 capacity to identify infectious disease 572.53 organisms, evaluate environmental 572.54 contaminants, develop new analytical 572.55 techniques, provide emergency response, 572.56 and support local government by 573.1 training health care system workers to 573.2 deal with biological and chemical 573.3 health threats. 573.4 (c) $300,000 each year is to train, 573.5 consult, and otherwise assist local 573.6 officials responding to clandestine 573.7 drug laboratories and minimizing health 573.8 risks to responders and the public. 573.9 Subd. 5. Management and 573.10 Support Services 4,964,000 4,962,000 573.11 Summary by Fund 573.12 General 4,817,000 4,815,000 573.13 State Government 573.14 Special Revenue 147,000 147,000 573.15 Sec. 4. VETERANS NURSING 573.16 HOMES BOARD 30,336,000 28,784,000 573.17 [VETERANS HOMES SPECIAL REVENUE 573.18 ACCOUNT.] The general fund 573.19 appropriations made to the board may be 573.20 transferred to a veterans homes special 573.21 revenue account in the special revenue 573.22 fund in the same manner as other 573.23 receipts are deposited according to 573.24 Minnesota Statutes, section 198.34, and 573.25 are appropriated to the board for the 573.26 operation of board facilities and 573.27 programs. 573.28 [SETTING COST OF CARE.] The cost of 573.29 care for the domiciliary residents at 573.30 the Minneapolis veterans home for 573.31 fiscal year 2002 and fiscal year 2003 573.32 shall be calculated based on 100 573.33 percent occupancy at each facility. 573.34 [DEFICIENCY FUNDING.] Of the general 573.35 fund appropriation in fiscal year 2002, 573.36 $2,000,000 is available with the 573.37 approval of the commissioner of 573.38 finance. Approval of the commissioner 573.39 of finance is contingent upon review of 573.40 the board's submittal of a report 573.41 outlining the following: 573.42 (1) a long-term revenue outlook for the 573.43 homes; 573.44 (2) a review and recommendation of 573.45 alternative funding sources for the 573.46 homes' operations; and 573.47 (3) administrative and service options 573.48 to bring cost growth in line with 573.49 revenues. 573.50 Sec. 5. HEALTH-RELATED BOARDS 573.51 Subdivision 1. Total 573.52 Appropriation 10,800,000 10,892,000 573.53 [STATE GOVERNMENT SPECIAL REVENUE 573.54 FUND.] The appropriations in this 573.55 section are from the state government 573.56 special revenue fund. 574.1 [NO SPENDING IN EXCESS OF REVENUES.] 574.2 The commissioner of finance shall not 574.3 permit the allotment, encumbrance, or 574.4 expenditure of money appropriated in 574.5 this section in excess of the 574.6 anticipated biennial revenues or 574.7 accumulated surplus revenues from fees 574.8 collected by the boards. Neither this 574.9 provision nor Minnesota Statutes, 574.10 section 214.06, applies to transfers 574.11 from the general contingent account. 574.12 Subd. 2. Board of Chiropractic 574.13 Examiners 361,000 361,000 574.14 Subd. 3. Board of Dentistry 806,000 806,000 574.15 Subd. 4. Board of Dietetic 574.16 and Nutrition Practice 95,000 95,000 574.17 Subd. 5. Board of Marriage and 574.18 Family Therapy 111,000 111,000 574.19 Subd. 6. Board of Medical 574.20 Practice 3,270,000 3,270,000 574.21 Subd. 7. Board of Nursing 2,704,000 2,772,000 574.22 [HEALTH PROFESSIONAL SERVICES 574.23 ACTIVITY.] Of these appropriations, 574.24 $534,000 in fiscal year 2002 and 574.25 $566,000 in fiscal year 2003 are for 574.26 the Health Professional Services 574.27 Activity. 574.28 Subd. 8. Board of Nursing 574.29 Home Administrators 194,000 186,000 574.30 Subd. 9. Board of Optometry 90,000 90,000 574.31 Subd. 10. Board of Pharmacy 1,301,000 1,316,000 574.32 [ADMINISTRATIVE SERVICES UNIT.] Of this 574.33 appropriation, $433,000 the first year 574.34 and $441,000 the second year are for 574.35 the health boards administrative 574.36 services unit. The administrative 574.37 services unit may receive and expend 574.38 reimbursements for services performed 574.39 for other agencies. 574.40 Subd. 11. Board of Physical Therapy 185,000 185,000 574.41 Subd. 12. Board of Podiatry 52,000 42,000 574.42 Subd. 13. Board of Psychology 653,000 647,000 574.43 Subd. 14. Board of Social Work 825,000 832,000 574.44 Subd. 15. Board of Veterinary 574.45 Medicine 153,000 179,000 574.46 Sec. 6. EMERGENCY MEDICAL 574.47 SERVICES BOARD 3,033,000 3,037,000 574.48 Summary by Fund 574.49 General 3,033,000 3,037,000 574.50 [COMPREHENSIVE ADVANCED LIFE SUPPORT 574.51 (CALS).] $500,000 in fiscal year 2002 575.1 and $500,000 in fiscal year 2003 are 575.2 for the comprehensive advanced life 575.3 support educational program under 575.4 Minnesota Statutes, section 144E.37. 575.5 Sec. 7. COUNCIL ON DISABILITY 692,000 714,000 575.6 Sec. 8. OMBUDSMAN FOR MENTAL 575.7 HEALTH AND MENTAL RETARDATION 1,378,000 1,378,000 575.8 Sec. 9. OMBUDSMAN 575.9 FOR FAMILIES 171,000 171,000 575.10 Sec. 10. TRANSFERS 575.11 Subdivision 1. Grants 575.12 The commissioner of human services, 575.13 with the approval of the commissioner 575.14 of finance, and after notification of 575.15 the chair of the senate health and 575.16 family security budget division and the 575.17 chair of the house health and human 575.18 services finance committee, may 575.19 transfer unencumbered appropriation 575.20 balances for the biennium ending June 575.21 30, 2003, within fiscal years among the 575.22 MFIP, general assistance, general 575.23 assistance medical care, medical 575.24 assistance, Minnesota supplemental aid, 575.25 and group residential housing programs, 575.26 and the entitlement portion of the 575.27 chemical dependency consolidated 575.28 treatment fund, and between fiscal 575.29 years of the biennium. 575.30 Subd. 2. Administration 575.31 Positions, salary money, and nonsalary 575.32 administrative money may be transferred 575.33 within the departments of human 575.34 services and health and within the 575.35 programs operated by the veterans 575.36 nursing homes board as the 575.37 commissioners and the board consider 575.38 necessary, with the advance approval of 575.39 the commissioner of finance. The 575.40 commissioner or the board shall inform 575.41 the chairs of the house health and 575.42 human services finance committee and 575.43 the senate health and family security 575.44 budget division quarterly about 575.45 transfers made under this provision. 575.46 Sec. 11. INDIRECT COSTS NOT TO 575.47 FUND PROGRAMS. 575.48 The commissioners of health and of 575.49 human services shall not use indirect 575.50 cost allocations to pay for the 575.51 operational costs of any program for 575.52 which they are responsible. 575.53 Sec. 12. CARRYOVER LIMITATION 575.54 None of the appropriations in this 575.55 article which are allowed to be carried 575.56 forward from fiscal year 2002 to fiscal 575.57 year 2003 shall become part of the base 575.58 level funding for the 2004-2005 575.59 biennial budget, unless specifically 576.1 directed by the legislature. 576.2 Sec. 13. SUNSET OF UNCODIFIED LANGUAGE 576.3 All uncodified language contained in 576.4 this article expires on June 30, 2003, 576.5 unless a different expiration date is 576.6 explicit. 576.7 Sec. 14. [246.141] [PROJECT LABOR.] 576.8 Wages for project labor may be paid by the commissioner out 576.9 of repairs and betterments money if the individual is to be 576.10 engaged in a construction project or a repair project of 576.11 short-term and nonrecurring nature. Compensation for project 576.12 labor shall be based on the prevailing wage rates, as defined in 576.13 section 177.42, subdivision 6. Project laborers are excluded 576.14 from the provisions of sections 43A.22 to 43A.30, and shall not 576.15 be eligible for state-paid insurance and benefits.