HF 2412

1st Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health and human services; modifying 
  1.3             provisions relating to health; health department; 
  1.4             abortions; abortion reporting; human services; human 
  1.5             services department; long-term care; medical 
  1.6             assistance; general assistance medical care; 
  1.7             MinnesotaCare; senior drug program; home and 
  1.8             community-based waivers; services for persons with 
  1.9             disabilities; medical assistance reimbursement for 
  1.10            special education and other services; county-based 
  1.11            purchasing; group residential housing; state-operated 
  1.12            services; chemical dependency; mental health; 
  1.13            Minnesota family investment program; general 
  1.14            assistance program; child support enforcement; 
  1.15            adoption; recreational licenses; paternity; children 
  1.16            in need of protection or services; termination of 
  1.17            parental rights; child protection; the regulation of 
  1.18            health plan companies and utilization review 
  1.19            organizations; veterans nursing homes board; 
  1.20            health-related licensing boards; emergency medical 
  1.21            services regulatory board; Minnesota state council on 
  1.22            disability; ombudsman for mental health and mental 
  1.23            retardation; ombudsman for families; modifying fees; 
  1.24            providing penalties; requiring reports; appropriating 
  1.25            money; amending Minnesota Statutes 1998, sections 
  1.26            13.46, subdivision 2; 13.99, by adding a subdivision; 
  1.27            15.059, subdivision 5a; 16C.10, subdivision 5; 31.96; 
  1.28            62D.11, subdivision 1; 62J.04, subdivision 3; 62J.06; 
  1.29            62J.07, subdivisions 1 and 3; 62J.09, subdivision 8; 
  1.30            62J.2930, subdivision 3; 62J.451, subdivisions 6a, 6b, 
  1.31            and 6c; 62J.69, by adding subdivisions; 62J.77; 
  1.32            62M.01; 62M.02, subdivisions 3, 4, 5, 6, 7, 9, 10, 11, 
  1.33            12, 17, 20, 21, and by adding a subdivision; 62M.03, 
  1.34            subdivisions 1 and 3; 62M.04, subdivisions 1, 2, 3, 
  1.35            and 4; 62M.05; 62M.06; 62M.07; 62M.09, subdivision 3; 
  1.36            62M.10, subdivisions 2, 5, and 7; 62M.12; 62M.15; 
  1.37            62Q.03, subdivision 5a; 62Q.075; 62Q.106; 62Q.19, 
  1.38            subdivisions 1, 2, 5a, and 6; 62R.06, subdivision 1; 
  1.39            62T.04; 72A.201, subdivision 4a; 122A.09, subdivision 
  1.40            4; 125A.08; 125A.21, subdivision 1; 125A.74, 
  1.41            subdivisions 1 and 2; 125A.744, subdivision 3; 
  1.42            125A.76, subdivision 2; 144.121, by adding a 
  1.43            subdivision; 144.147; 144.1483; 144.1492, subdivision 
  1.44            3; 144.413, subdivision 2; 144.414, subdivision 1; 
  1.45            144.4165; 144.56, subdivision 2b; 144.99, subdivision 
  1.46            1, and by adding a subdivision; 144A.073; 144A.10, by 
  2.1             adding subdivisions; 144A.4605, subdivision 2; 
  2.2             144D.01, subdivision 4; 145.924; 145.9255, 
  2.3             subdivisions 1 and 4; 148.5194; 245.462, subdivisions 
  2.4             4 and 17; 245.4711, subdivision 1; 245.4712, 
  2.5             subdivision 2; 245.4871, subdivisions 4 and 26; 
  2.6             245.4881, subdivision 1; 245B.05, subdivision 7; 
  2.7             245B.07, subdivisions 5, 8, and 10; 246.18, 
  2.8             subdivision 6; 252.28, subdivision 1; 252.32, 
  2.9             subdivision 3a; 252.46, subdivision 6; 253B.045, by 
  2.10            adding subdivisions; 253B.07, subdivision 1; 253B.185, 
  2.11            by adding a subdivision; 254A.07, subdivision 2; 
  2.12            254B.01, by adding a subdivision; 254B.02, subdivision 
  2.13            3; 254B.03, subdivisions 1 and 2; 254B.05, subdivision 
  2.14            1; 256.01, subdivisions 2, 6, and by adding a 
  2.15            subdivision; 256.014, by adding a subdivision; 
  2.16            256.485; 256.87, subdivision 1a; 256.955, subdivisions 
  2.17            2, 3, 4, 7, and 9; 256.9685, subdivision 1a; 256.969, 
  2.18            subdivision 1; 256.978, subdivision 1; 256B.04, 
  2.19            subdivision 16, and by adding a subdivision; 256B.055, 
  2.20            subdivision 3a; 256B.056, subdivision 4; 256B.057, by 
  2.21            adding a subdivision; 256B.0575; 256B.0625, 
  2.22            subdivisions 6a, 8, 8a, 13, 17, 19c, 26, 28, 30, 32, 
  2.23            35, and by adding subdivisions; 256B.0627, 
  2.24            subdivisions 1, 2, 4, 5, 8, and by adding 
  2.25            subdivisions; 256B.0635, subdivision 3; 256B.0911, 
  2.26            subdivision 6; 256B.0913, subdivisions 5, 10, and 12; 
  2.27            256B.0916; 256B.0917, subdivision 8; 256B.094, 
  2.28            subdivisions 3, 5, and 6; 256B.0951, subdivisions 1 
  2.29            and 3; 256B.0955; 256B.431, subdivision 17, and by 
  2.30            adding a subdivision; 256B.434, subdivisions 3 and 13; 
  2.31            256B.435; 256B.48, subdivisions 1, 1a, 1b, and 6; 
  2.32            256B.50, subdivision 1e; 256B.501, subdivision 8a, and 
  2.33            by adding a subdivision; 256B.5011, subdivisions 1 and 
  2.34            2; 256B.69, subdivisions 3a, 5a, 5b, 6a, 6b, and by 
  2.35            adding subdivisions; 256B.692, subdivision 2; 256B.75; 
  2.36            256B.76; 256B.77, subdivisions 7a, 8, 10, 14, and by 
  2.37            adding subdivisions; 256D.03, subdivision 4; 256D.06, 
  2.38            subdivision 5; 256F.03, subdivision 5; 256F.05, 
  2.39            subdivision 8; 256F.10, subdivisions 1, 4, 6, 7, 8, 
  2.40            and 10; 256I.04, subdivision 3; 256I.05, subdivisions 
  2.41            1, 1a, and by adding a subdivision; 256J.02, 
  2.42            subdivision 2; 256J.08, subdivisions 11, 65, 82, 86a, 
  2.43            and by adding subdivisions; 256J.11, subdivisions 2 
  2.44            and 3; 256J.12, subdivisions 1a and 2; 256J.14; 
  2.45            256J.20, subdivision 3; 256J.21, subdivisions 2, 3, 
  2.46            and 4; 256J.24, subdivisions 2, 3, 7, 8, and 9; 
  2.47            256J.26, subdivision 1; 256J.30, subdivisions 2, 7, 8, 
  2.48            and 9; 256J.31, subdivisions 5 and 12; 256J.32, 
  2.49            subdivisions 4 and 6; 256J.33; 256J.34, subdivisions 
  2.50            1, 3, and 4; 256J.35; 256J.36; 256J.37, subdivisions 
  2.51            1, 1a, 2, 9, and 10; 256J.38, subdivision 4; 256J.39, 
  2.52            subdivision 1; 256J.42, subdivisions 1 and 5; 256J.43; 
  2.53            256J.45, subdivision 1, and by adding a subdivision; 
  2.54            256J.46, subdivisions 1, 2, and 2a; 256J.47, 
  2.55            subdivision 4; 256J.48, subdivisions 2 and 3; 256J.50, 
  2.56            subdivision 1; 256J.515; 256J.52, subdivisions 1, 3, 
  2.57            4, 5, and by adding a subdivision; 256J.54, 
  2.58            subdivision 2; 256J.55, subdivision 4; 256J.56; 
  2.59            256J.62, subdivisions 1, 6, 7, 8, 9, and by adding a 
  2.60            subdivision; 256J.67, subdivision 4; 256J.74, 
  2.61            subdivision 2; 256J.76, subdivisions 1, 2, and 4; 
  2.62            256L.01, subdivision 4; 256L.04, subdivisions 2, 8, 
  2.63            and 13; 256L.05, subdivision 4; 256L.06, subdivision 
  2.64            3; 256L.07; 256L.15, subdivisions 1, 1b, and 2; 
  2.65            257.071, subdivisions 1, 1d, and 4; 257.62, 
  2.66            subdivision 5; 257.75, subdivision 2; 257.85, 
  2.67            subdivisions 2, 3, 7, 9, and 11; 259.29, subdivision 
  2.68            2; 259.67, subdivisions 6 and 7; 259.73; 259.85, 
  2.69            subdivisions 2, 3, and 5; 259.89, by adding a 
  2.70            subdivision; 260.012; 260.015, subdivisions 13 and 29; 
  2.71            260.131, subdivision 1a; 260.133, subdivision 1; 
  3.1             260.135, by adding a subdivision; 260.155, 
  3.2             subdivisions 4 and 8; 260.172, subdivision 1, and by 
  3.3             adding a subdivision; 260.181, subdivision 3; 260.191, 
  3.4             subdivisions 1 and 3b; 260.192; 260.221, subdivisions 
  3.5             1, 1b, 1c, 3, and 5; 518.10; 518.551, by adding a 
  3.6             subdivision; 518.57, subdivision 3; 518.5851, by 
  3.7             adding a subdivision; 518.5853, by adding a 
  3.8             subdivision; 518.64, subdivision 2; 548.09, 
  3.9             subdivision 1; 548.091, subdivisions 1, 1a, 2a, 3a, 4, 
  3.10            10, 11, 12, and by adding a subdivision; and 552.05, 
  3.11            subdivision 10; Laws 1995, chapter 178, article 2, 
  3.12            section 46, subdivision 10; Laws 1995, chapter 207, 
  3.13            articles 3, section 21; and 8, section 41, as amended; 
  3.14            Laws 1995, chapter 257, article 1, section 35, 
  3.15            subdivision 1; Laws 1997, chapter 225, article 4, 
  3.16            section 4; proposing coding for new law in Minnesota 
  3.17            Statutes, chapters 62J; 62Q; 127A; 144; 144A; 144E; 
  3.18            145; 145A; 214; 245; 246; 252; 256B; 256J; and 518; 
  3.19            repealing Minnesota Statutes 1998, sections 13.99, 
  3.20            subdivision 19m; 62D.11, subdivisions 1b and 2; 
  3.21            62J.78; 62J.79; 62Q.105; 62Q.11; 62Q.30; 144.0723; 
  3.22            144.1475; 144.148; 144.9507, subdivision 4; 144.9511; 
  3.23            144A.33; 145.46; 157.011, subdivision 2; 254A.03, 
  3.24            subdivision 2; 254A.031; 254A.145; 254A.17, 
  3.25            subdivision 1a; 256.973; 256B.434, subdivision 17; 
  3.26            256B.501, subdivision 3g; 256B.5011, subdivision 3; 
  3.27            256D.053, subdivision 4; 256J.03; 256J.62, 
  3.28            subdivisions 2, 3, and 5; 462A.208; 462A.21, 
  3.29            subdivision 19; and 548.091, subdivisions 3, 5, and 6; 
  3.30            Laws 1997, chapter 85, article 1, section 63; Laws 
  3.31            1997, chapter 203, article 7, section 27; Laws 1998, 
  3.32            chapter 407, article 2, section 104; Minnesota Rules, 
  3.33            parts 4685.0100, subparts 4 and 4a; 4685.1700; and 
  3.34            4688.0030. 
  3.35  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  3.36                             ARTICLE 1 
  3.37                           APPROPRIATIONS 
  3.38  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
  3.39     The sums shown in the columns marked "APPROPRIATIONS" are 
  3.40  appropriated from the general fund, or other specified fund, to 
  3.41  the agencies named for the purposes specified in the sections of 
  3.42  article 1, and are available for the fiscal years indicated for 
  3.43  each purpose.  The figures "2000" and "2001," where used in this 
  3.44  article, mean the appropriation or appropriations listed under 
  3.45  them are available for the fiscal year ending June 30, 2000, or 
  3.46  June 30, 2001, respectively.  Where a dollar amount appears in 
  3.47  parentheses, it means a reduction of an appropriation.  
  3.48                          SUMMARY BY FUND 
  3.49  APPROPRIATIONS                                      BIENNIAL
  3.50                            2000          2001           TOTAL
  3.51  General          $2,667,477,000 $2,799,984,000 $5,467,461,000
  3.52  State Government
  3.53  Special Revenue      35,434,000     35,176,000     70,610,000
  4.1   Health Care
  4.2   Access              147,306,000    178,736,000    326,042,000
  4.3   Lottery Prize Fund    1,300,000      1,300,000      2,600,000
  4.4   Trunk Highway         1,708,000      1,737,000      3,445,000
  4.5   TOTAL            $2,853,225,000 $3,016,933,000 $5,870,158,000
  4.6                                              APPROPRIATIONS 
  4.7                                          Available for the Year 
  4.8                                              Ending June 30 
  4.9                                             2000         2001 
  4.10  Sec. 2.  COMMISSIONER OF 
  4.11  HUMAN SERVICES 
  4.12  Subdivision 1.  Total 
  4.13  Appropriation                     $2,699,235,000 $2,862,666,000
  4.14                Summary by Fund
  4.15  General           2,562,526,000 2,694,616,000
  4.16  State Government
  4.17  Special Revenue         485,000       507,000
  4.18  Health Care 
  4.19  Access              134,924,000   166,243,000
  4.20  Lottery Prize Fund    1,300,000      1,300,000 
  4.21  Subd. 2.  Agency Management 
  4.22  General              28,569,000    28,777,000
  4.23  State Government
  4.24  Special Revenue         371,000       392,000
  4.25  Health Care 
  4.26  Access                3,268,000     3,321,000
  4.27  The amounts that may be spent from the 
  4.28  appropriation for each purpose are as 
  4.29  specified: 
  4.30  (a) Financial Operations 
  4.31  General               7,701,000     7,877,000
  4.32  Health Care
  4.33  Access                  691,000       702,000
  4.34  [RECEIPTS FOR SYSTEMS PROJECTS.] 
  4.35  Appropriations and federal receipts for 
  4.36  information system projects for MAXIS, 
  4.37  electronic benefit system, social 
  4.38  services information system, child 
  4.39  support enforcement, and Minnesota 
  4.40  medicaid information system (MMIS II) 
  4.41  must be deposited in the state system 
  4.42  account authorized in Minnesota 
  4.43  Statutes, section 256.014.  Money 
  4.44  appropriated for computer projects 
  4.45  approved by the Minnesota office of 
  4.46  technology, funded by the legislature, 
  4.47  and approved by the commissioner of 
  4.48  finance may be transferred from one 
  4.49  project to another and from development 
  4.50  to operations as the commissioner of 
  4.51  human services considers necessary.  
  5.1   Any unexpended balance in the 
  5.2   appropriation for these projects does 
  5.3   not cancel but is available for ongoing 
  5.4   development and operations. 
  5.5   (b) Legal and Regulation Operations 
  5.6   General               6,569,000     6,671,000
  5.7   State Government
  5.8   Special Revenue         371,000       392,000
  5.9   Health Care
  5.10  Access                  141,000       145,000
  5.11  (c) Management Operations 
  5.12  General              14,229,000    14,229,000
  5.13  Health Care
  5.14  Access                2,436,000     2,474,000
  5.15  Subd. 3.  Children's Grants
  5.16  General              53,692,000    54,773,000
  5.17  [CRISIS NURSERY DEVELOPMENT.] Of this 
  5.18  appropriation, $1,000,000 in fiscal 
  5.19  year 2000 is appropriated to the 
  5.20  commissioner for grants to develop new 
  5.21  crisis nurseries.  Preference must be 
  5.22  given to crisis nursery grantees under 
  5.23  Laws 1998, chapter 407, article 1, 
  5.24  section 2, subdivision 2.  This is a 
  5.25  one-time appropriation that is 
  5.26  available until June 30, 2001, and 
  5.27  shall not become part of base level 
  5.28  funding for crisis nurseries for the 
  5.29  2002-2003 biennium. 
  5.30  Subd. 4.  Children's Services Management
  5.31  General               3,975,000     4,015,000
  5.32  Subd. 5.  Basic Health Care Grants
  5.33                Summary by Fund
  5.34  General             877,993,000   937,069,000
  5.35  Health Care
  5.36  Access              116,439,000   147,484,000
  5.37  The amounts that may be spent from this 
  5.38  appropriation for each purpose are as 
  5.39  specified: 
  5.40  (a) MinnesotaCare Grants
  5.41  Health Care Access  116,439,000   147,484,000
  5.42  (b) Medical Assistance Basic 
  5.43  Health Care Grants; Families and Children
  5.44  General             308,192,000   322,057,000
  5.45  [COMMUNITY DENTAL CLINICS.] Of this 
  5.46  appropriation, $600,000 each year is 
  5.47  for the commissioner to provide 
  5.48  start-up grants to establish community 
  5.49  dental clinics under Minnesota 
  6.1   Statutes, section 256B.76, paragraph 
  6.2   (b), clause (5).  The commissioner 
  6.3   shall award four $150,000 grants each 
  6.4   year, and shall require grant 
  6.5   recipients to match the state grant 
  6.6   with nonstate funding on a one-to-one 
  6.7   basis.  This is a one-time 
  6.8   appropriation and shall not become part 
  6.9   of base level funding for this activity 
  6.10  for the 2002-2003 biennium. 
  6.11  (c) Medical Assistance Basic 
  6.12  Health Care Grants; Elderly and Disabled
  6.13  General             409,919,000   459,980,000
  6.14  [SURCHARGE COMPLIANCE.] In the event 
  6.15  that federal financial participation in 
  6.16  the Minnesota medical assistance 
  6.17  program is reduced as a result of a 
  6.18  determination that the surcharge and 
  6.19  intergovernmental transfers governed by 
  6.20  Minnesota Statutes, sections 256.9657 
  6.21  and 256B.19 are out of compliance with 
  6.22  United States Code, title 42, section 
  6.23  1396b(w), or its implementing 
  6.24  regulations or with any other federal 
  6.25  law designed to restrict provider tax 
  6.26  programs or intergovernmental 
  6.27  transfers, the commissioner shall 
  6.28  appeal the determination to the fullest 
  6.29  extent permitted by law and may ratably 
  6.30  reduce all medical assistance and 
  6.31  general assistance medical care 
  6.32  payments to providers other than the 
  6.33  state of Minnesota in order to 
  6.34  eliminate any shortfall resulting from 
  6.35  the reduced federal funding.  Any 
  6.36  amount later recovered through the 
  6.37  appeals process shall be used to 
  6.38  reimburse providers for any ratable 
  6.39  reductions taken. 
  6.40  [BLOOD PRODUCTS LITIGATION.] To the 
  6.41  extent permitted by federal law, 
  6.42  Minnesota Statutes, sections 256.015, 
  6.43  256B.042, and 256B.15, are waived as 
  6.44  necessary for the limited purpose of 
  6.45  resolving the state's claims in 
  6.46  connection with In re Factor VIII or IX 
  6.47  Concentrate Blood Products Litigation, 
  6.48  MDL-986, No. 93-C7452 (N.D.III.). 
  6.49  (d) General Assistance Medical Care
  6.50  General             143,299,000   129,661,000
  6.51  (e) Basic Health Care; Nonentitlement
  6.52  General              16,583,000    25,371,000
  6.53  [NONPROFIT DENTAL SERVICES GRANT.] Of 
  6.54  this appropriation, $75,000 for the 
  6.55  biennium is to the commissioner for a 
  6.56  grant to a nonprofit dental provider 
  6.57  group operating a dental clinic in Clay 
  6.58  county, to increase access to dental 
  6.59  services for recipients of medical 
  6.60  assistance, general assistance medical 
  6.61  care and MinnesotaCare in the northwest 
  6.62  area of the state.  This is a one-time 
  7.1   appropriation and shall not become part 
  7.2   of base level funding for this activity 
  7.3   for the 2002-2003 biennium. 
  7.4   Subd. 6.  Basic Health Care Management
  7.5   General              23,263,000    23,374,000
  7.6   Health Care
  7.7   Access               13,904,000    14,120,000
  7.8   The amounts that may be spent from this 
  7.9   appropriation for each purpose are as 
  7.10  specified: 
  7.11  (a) Health Care Policy Administration
  7.12  General               3,081,000     3,092,000
  7.13  Health Care 
  7.14  Access                  570,000       582,000
  7.15  [MINNESOTACARE OUTREACH FEDERAL 
  7.16  MATCHING FUNDS.] Any federal matching 
  7.17  funds received as a result of the 
  7.18  MinnesotaCare outreach activities 
  7.19  authorized by Laws 1997, chapter 225, 
  7.20  article 7, section 2, subdivision 1, 
  7.21  shall be deposited in the health care 
  7.22  access fund. 
  7.23  [FEDERAL RECEIPTS FOR ADMINISTRATION.] 
  7.24  Receipts received as a result of 
  7.25  federal participation pertaining to 
  7.26  administrative costs of the Minnesota 
  7.27  health care reform waiver shall be 
  7.28  deposited as nondedicated revenue in 
  7.29  the health care access fund.  Receipts 
  7.30  received as a result of federal 
  7.31  participation pertaining to grants 
  7.32  shall be deposited in the federal fund 
  7.33  and shall offset health care access 
  7.34  funds for payments to providers. 
  7.35  (b) Health Care Operations
  7.36  General              20,182,000    20,282,000
  7.37  Health Care
  7.38  Access               13,334,000    13,538,000
  7.39  [SYSTEMS CONTINUITY.] In the event of 
  7.40  disruption of technical systems or 
  7.41  computer operations, the commissioner 
  7.42  may use available grant appropriations 
  7.43  to ensure continuity of payments for 
  7.44  maintaining the health, safety, and 
  7.45  well-being of clients served by 
  7.46  programs administered by the department 
  7.47  of human services.  Grant funds must be 
  7.48  used in a manner consistent with the 
  7.49  original intent of the appropriation. 
  7.50  [PREPAID MEDICAL PROGRAMS.] The 
  7.51  nonfederal share of the prepaid medical 
  7.52  assistance program fund, which has been 
  7.53  appropriated to fund county managed 
  7.54  care advocacy and enrollment operating 
  7.55  costs, shall be disbursed as grants 
  7.56  using either a reimbursement or block 
  7.57  grant mechanism and may also be 
  8.1   transferred between grants and nongrant 
  8.2   administration costs with approval of 
  8.3   the commissioner of finance. 
  8.4   [ELIGIBILITY DETERMINATION FUNDING.] 
  8.5   Increased federal funds for the costs 
  8.6   of eligibility determination and other 
  8.7   permitted activities that are available 
  8.8   to the state through section 114 of the 
  8.9   Personal Responsibility and Work 
  8.10  Opportunity Reconciliation Act, Public 
  8.11  Law Number 104-193, are appropriated to 
  8.12  the commissioner. 
  8.13  [MINNESOTA SENIOR HEALTH OPTIONS 
  8.14  PROJECT.] Of this appropriation, up to 
  8.15  $200,000 may be transferred to the 
  8.16  Minnesota senior health options project 
  8.17  special revenue account during the 
  8.18  biennium ending June 30, 2001, to serve 
  8.19  as matching funds. 
  8.20  Subd. 7.  State-Operated Services
  8.21  General             206,862,000   211,073,000
  8.22  [REGIONAL TREATMENT CENTER POPULATION.] 
  8.23  If the resident population at the 
  8.24  regional treatment centers is projected 
  8.25  to be higher than the estimates upon 
  8.26  which the medical assistance forecast 
  8.27  and budget recommendations for the 
  8.28  2000-2001 biennium is based, the amount 
  8.29  of the medical assistance appropriation 
  8.30  that is attributable to the cost of 
  8.31  services that would have been provided 
  8.32  as an alternative to regional treatment 
  8.33  center services, including resources 
  8.34  for community placements and waivered 
  8.35  services for persons with mental 
  8.36  retardation and related conditions, is 
  8.37  transferred to the residential 
  8.38  facilities appropriation. 
  8.39  [LEAVE LIABILITIES.] The accrued leave 
  8.40  liabilities of state employees 
  8.41  transferred to state-operated community 
  8.42  service programs may be paid from the 
  8.43  appropriation for state operated 
  8.44  services.  Funds set aside for this 
  8.45  purpose shall not exceed the amount of 
  8.46  the actual leave liability calculated 
  8.47  as of June 30, 2000, and shall be 
  8.48  available until expended.  This 
  8.49  provision is effective the day 
  8.50  following final enactment. 
  8.51  The amounts that may be spent from this 
  8.52  appropriation for each purpose are as 
  8.53  specified: 
  8.54  (a) State-Operated Services;
  8.55  Campus-Based Programs
  8.56  General             185,676,000   189,309,000
  8.57  [MITIGATION RELATED TO DEVELOPMENTAL 
  8.58  DISABILITIES DOWNSIZING.] Money 
  8.59  appropriated to finance mitigation 
  8.60  expenses related to the downsizing of 
  8.61  regional treatment center developmental 
  9.1   disabilities programs may be 
  9.2   transferred between fiscal years within 
  9.3   the biennium. 
  9.4   [REPAIRS AND BETTERMENTS.] The 
  9.5   commissioner may transfer unencumbered 
  9.6   appropriation balances between fiscal 
  9.7   years for the state residential 
  9.8   facilities repairs and betterments 
  9.9   account and special equipment. 
  9.10  [PROJECT LABOR.] Wages for project 
  9.11  labor may be paid by the commissioner 
  9.12  of human services out of repairs and 
  9.13  betterments money if the individual is 
  9.14  to be engaged in a construction project 
  9.15  or a repair project of short-term and 
  9.16  nonrecurring nature.  Compensation for 
  9.17  project labor shall be based on the 
  9.18  prevailing wage rates, as defined in 
  9.19  Minnesota Statutes, section 177.42, 
  9.20  subdivision 6.  Project laborers are 
  9.21  excluded from the provisions of 
  9.22  Minnesota Statutes, sections 43A.22 to 
  9.23  43A.30, and shall not be eligible for 
  9.24  state-paid insurance and benefits. 
  9.25  [DAY TRAINING SERVICES.] In order to 
  9.26  ensure eligible individuals have access 
  9.27  to day training and habilitation 
  9.28  services, the Minnesota extended 
  9.29  treatment options program and state 
  9.30  operated community services operating 
  9.31  according to Minnesota Statutes, 
  9.32  section 252.50, are exempt from the 
  9.33  provisions of Minnesota Statutes, 
  9.34  section 252.41, subdivision 9, clause 
  9.35  (2), until July 1, 2001. 
  9.36  The commissioner shall assure that for 
  9.37  persons subject to this exemption, 
  9.38  alternative private service options 
  9.39  which meet the person's needs shall be 
  9.40  offered to the person and their 
  9.41  guardian at the person's next annual 
  9.42  review meeting.  By January 15, 2000, 
  9.43  the commissioner shall provide 
  9.44  recommendations to the legislature on 
  9.45  action needed to assure that the 
  9.46  Minnesota extended treatment option and 
  9.47  state-operated community services will 
  9.48  comply with Minnesota Statutes, section 
  9.49  252.41, subdivision 9, by July 1, 2001. 
  9.50  [YEAR 2000 COSTS AT RTCS.] Of this 
  9.51  appropriation, $44,000 is for the costs 
  9.52  associated with addressing potential 
  9.53  year 2000 problems.  Of this amount, 
  9.54  $19,000 is available the day following 
  9.55  final enactment. 
  9.56  (b) State-Operated Community
  9.57  Services; Northeast Minnesota
  9.58  Mental Health Services
  9.59  General               3,936,000     3,960,000
  9.60  (c) State-Operated Community 
  9.61  Services; Statewide DD Supports
  9.62  General              15,493,000    16,047,000
 10.1   (d) State-Operated Services; 
 10.2   Enterprise Activities 
 10.3   General               1,757,000     1,757,000
 10.4   [REGIONAL TREATMENT CENTER CHEMICAL 
 10.5   DEPENDENCY PROGRAMS.] When the 
 10.6   operations of the regional treatment 
 10.7   center chemical dependency fund created 
 10.8   in Minnesota Statutes, section 246.18, 
 10.9   subdivision 2, are impeded by projected 
 10.10  cash deficiencies resulting from delays 
 10.11  in the receipt of grants, dedicated 
 10.12  income, or other similar receivables, 
 10.13  and when the deficiencies would be 
 10.14  corrected within the budget period 
 10.15  involved, the commissioner of finance 
 10.16  may transfer general fund cash reserves 
 10.17  into this account as necessary to meet 
 10.18  cash demands.  The cash flow transfers 
 10.19  must be returned to the general fund in 
 10.20  the fiscal year that the transfer was 
 10.21  made.  Any interest earned on general 
 10.22  fund cash flow transfers accrues to the 
 10.23  general fund and not the regional 
 10.24  treatment center chemical dependency 
 10.25  fund. 
 10.26  Subd. 8.  Continuing Care and 
 10.27  Community Support Grants
 10.28  General           1,171,961,000 1,254,399,000
 10.29  Lottery Prize Fund    1,158,000     1,158,000
 10.30  The amounts that may be spent from this 
 10.31  appropriation for each purpose are as 
 10.32  specified: 
 10.33  (a) Community Social Services
 10.34  Block Grants
 10.35      42,309,000     43,201,000 
 10.36  (b) Consumer Support Grants
 10.37       1,123,000      1,123,000 
 10.38  (c) Aging Adult Service Grants
 10.39       8,841,000      7,265,000 
 10.40  [LIVING-AT-HOME/BLOCK NURSE PROGRAM.] 
 10.41  Of this appropriation, $576,000 for the 
 10.42  biennium is to expand the 
 10.43  living-at-home/block nurse program.  Of 
 10.44  this amount, $480,000 for the biennium 
 10.45  is for the commissioner to provide 
 10.46  funding to twelve additional 
 10.47  living-at-home/block nurse programs, 
 10.48  and $96,000 for the biennium is for the 
 10.49  commissioner to provide additional 
 10.50  contract funding for the organization 
 10.51  awarded the contract for the 
 10.52  living-at-home/block nurse program. 
 10.53  [HEALTH INSURANCE COUNSELING AT AREA 
 10.54  AGENCIES ON AGING.] Of this 
 10.55  appropriation, $1,000,000 in fiscal 
 10.56  year 2000 is to the commissioner for 
 10.57  the board on aging, for the board to 
 11.1   award health insurance counseling and 
 11.2   assistance grants to the area agencies 
 11.3   on aging.  Of this amount, $360,000 is 
 11.4   for the area agencies on aging to 
 11.5   provide state-funded health insurance 
 11.6   counseling services, and $640,000 is 
 11.7   for the board to distribute on a 
 11.8   competitive basis to area agencies on 
 11.9   aging, based on criteria that is 
 11.10  jointly developed by the board and the 
 11.11  area agencies on aging.  The senior 
 11.12  linkage line services of the board and 
 11.13  the area agencies on aging must be used 
 11.14  to provide access to the health 
 11.15  insurance counseling programs.  The 
 11.16  board shall explore opportunities for 
 11.17  obtaining alternative funding from 
 11.18  nonstate sources, including 
 11.19  contributions from individuals seeking 
 11.20  the health insurance counseling 
 11.21  services.  This is a one-time 
 11.22  appropriation and shall not become part 
 11.23  of base level funding for this activity 
 11.24  for the 2002-2003 biennium. 
 11.25  (d) Deaf and Hard-of-Hearing 
 11.26  Services Grants
 11.27       1,853,000      1,753,000 
 11.28  [DEAF-BLIND ORIENTATION AND MOBILITY 
 11.29  SERVICES.] Of this appropriation, 
 11.30  $120,000 for the biennium is to the 
 11.31  commissioner for a grant to DeafBlind 
 11.32  Services Minnesota to hire an 
 11.33  orientation and mobility specialist to 
 11.34  work with deaf-blind people.  The 
 11.35  specialist will provide services to 
 11.36  deaf-blind Minnesotans, and training to 
 11.37  teachers and rehabilitation counselors, 
 11.38  on a statewide basis.  This is a 
 11.39  one-time appropriation and shall not 
 11.40  become part of base level funding for 
 11.41  this activity for the 2002-2003 
 11.42  biennium. 
 11.43  [SERVICES TO DEAF PERSONS WITH MENTAL 
 11.44  ILLNESS.] Of this appropriation, 
 11.45  $100,000 each year is to the 
 11.46  commissioner for a grant to a nonprofit 
 11.47  agency that currently serves deaf and 
 11.48  hard-of-hearing adults with mental 
 11.49  illness through residential programs 
 11.50  and supported housing outreach.  The 
 11.51  grant must be used to operate a 
 11.52  community support program for persons 
 11.53  with mental illness that is 
 11.54  communicatively accessible for persons 
 11.55  who are deaf or hard-of-hearing.  This 
 11.56  is a one-time appropriation and shall 
 11.57  not become part of base level funding 
 11.58  for this activity for the 2002-2003 
 11.59  biennium. 
 11.60  (e) Mental Health Grants
 11.61  General              46,930,000    46,261,000
 11.62  Lottery Prize Fund    1,158,000     1,158,000
 11.63  [ADOLESCENT COMPULSIVE GAMBLING GRANT.] 
 12.1   $150,000 each year shall be transferred 
 12.2   by the director of the lottery from the 
 12.3   lottery prize fund created under 
 12.4   Minnesota Statutes, section 349A.10, 
 12.5   subdivision 2, to the general fund.  
 12.6   $150,000 each year is appropriated from 
 12.7   the general fund to the commissioner 
 12.8   for the purposes of a grant to a 
 12.9   compulsive gambling council located in 
 12.10  St. Louis county for a statewide 
 12.11  compulsive gambling prevention and 
 12.12  education project for adolescents. 
 12.13  [ADULT MENTAL ILLNESS CRISIS HOUSING.] 
 12.14  Of this appropriation, $126,000 in 
 12.15  fiscal year 2000 and $174,000 in fiscal 
 12.16  year 2001 is for the adult mental 
 12.17  illness crisis housing assistance 
 12.18  program under Minnesota Statutes, 
 12.19  section 245.99.  This is a one-time 
 12.20  appropriation and shall not become part 
 12.21  of base level funding for this activity 
 12.22  for the 2002-2003 biennium. 
 12.23  [RURAL MENTAL HEALTH SERVICES.] Of this 
 12.24  appropriation, $2,000,000 for the 
 12.25  biennium is to the commissioner for 
 12.26  grants to counties, private nonprofit 
 12.27  organizations or other entities to 
 12.28  provide mental health outreach, 
 12.29  support, intervention, assessment, 
 12.30  treatment and emergency services to 
 12.31  farm families and individuals affected 
 12.32  by the farm crisis.  Of this amount, 
 12.33  $1,000,000 is for grants to the 
 12.34  following counties:  Roseau, Kittson, 
 12.35  Marshall, Pennington, Red Lake, Polk, 
 12.36  Mahnomen, Clay, Wilkin, Becker, and 
 12.37  Norman. 
 12.38  [CRISIS INTERVENTION PROJECT 
 12.39  CARRYFORWARD.] Unexpended funds 
 12.40  appropriated to the commissioner in 
 12.41  Laws 1998, chapter 407, article 1, 
 12.42  section 2, subdivision 6, for fiscal 
 12.43  year 1999 for the action, support, and 
 12.44  prevention project of southeastern 
 12.45  Minnesota, do not cancel but are 
 12.46  available until June 30, 2000.  This 
 12.47  provision is effective the day 
 12.48  following final enactment. 
 12.49  (f) Developmental Disabilities
 12.50  Community Support Grants
 12.51      11,728,000     11,900,000 
 12.52  [SILS FUNDING.] Of this appropriation, 
 12.53  $2,000,000 each year is for 
 12.54  semi-independent living services under 
 12.55  Minnesota Statutes, section 252.275. 
 12.56  This appropriation must be added to the 
 12.57  base level funding for this activity 
 12.58  for the 2002-2003 biennium.  Unexpended 
 12.59  funds for fiscal year 2000 do not 
 12.60  cancel but are available to the 
 12.61  commissioner for this purpose in fiscal 
 12.62  year 2001. 
 12.63  [FAMILY SUPPORT GRANTS.] Of this 
 12.64  appropriation, $2,500,000 each year is 
 13.1   to increase the availability of family 
 13.2   support grants under Minnesota 
 13.3   Statutes, section 252.32.  This 
 13.4   appropriation must be added to the base 
 13.5   level funding for this activity for the 
 13.6   2002-2003 biennium.  Unexpended funds 
 13.7   for fiscal year 2000 do not cancel but 
 13.8   are available to the commissioner for 
 13.9   this purpose in fiscal year 2001. 
 13.10  (g) Medical Assistance Long-Term 
 13.11  Care Waivers and Home Care
 13.12     349,152,000    418,041,000 
 13.13  [FISCAL YEAR 2000 AND FISCAL YEAR 2001 
 13.14  COMMUNITY-BASED PROVIDER RATE 
 13.15  INCREASE.] (1) The commissioner shall 
 13.16  increase reimbursement or allocation 
 13.17  rates by three percent on July 1, 1999, 
 13.18  and an additional three percent on July 
 13.19  1, 2000, for the following services 
 13.20  rendered on or after July 1, 1999:  
 13.21  home and community-based waiver 
 13.22  services for persons with mental 
 13.23  retardation or related conditions under 
 13.24  Minnesota Statutes, section 256B.501; 
 13.25  home and community-based waiver 
 13.26  services for the elderly under 
 13.27  Minnesota Statutes, section 256B.0915; 
 13.28  waivered services under community 
 13.29  alternatives for disabled individuals 
 13.30  under Minnesota Statutes, section 
 13.31  256B.49; community alternative care 
 13.32  waivered services under Minnesota 
 13.33  Statutes, section 256B.49; traumatic 
 13.34  brain injury waivered services under 
 13.35  Minnesota Statutes, section 256B.49; 
 13.36  nursing services and home health 
 13.37  services under Minnesota Statutes, 
 13.38  section 256B.0625, subdivision 6a; 
 13.39  personal care services and nursing 
 13.40  supervision of personal care services 
 13.41  under Minnesota Statutes, section 
 13.42  256B.0625, subdivision 19a; private 
 13.43  duty nursing services under Minnesota 
 13.44  Statutes, section 256B.0625, 
 13.45  subdivision 7; day training and 
 13.46  habilitation services for adults with 
 13.47  mental retardation or related 
 13.48  conditions under Minnesota Statutes, 
 13.49  sections 252.40 to 252.46; alternative 
 13.50  care services under Minnesota Statutes, 
 13.51  section 256B.0913; adult residential 
 13.52  program grants under Minnesota Rules, 
 13.53  parts 9535.2000 to 9535.3000; adult and 
 13.54  family community support grants under 
 13.55  Minnesota Rules, parts 9535.1700 to 
 13.56  9535.1760; semi-independent living 
 13.57  services under Minnesota Statutes, 
 13.58  section 252.275, including 
 13.59  semi-independent living services 
 13.60  funding under county social services 
 13.61  grants formerly funded under Minnesota 
 13.62  Statutes, chapter 256I; day treatment 
 13.63  under Minnesota Rules, part 9505.0323; 
 13.64  nonphysician services provided by 
 13.65  community mental health centers under 
 13.66  Minnesota Statutes, section 256B.0625, 
 13.67  subdivision 5; the skills training 
 13.68  component of (a) family community 
 14.1   support services under Minnesota 
 14.2   Statutes, section 256B.0625, 
 14.3   subdivision 35, (b) therapeutic support 
 14.4   of foster care under Minnesota 
 14.5   Statutes, section 256B.0625, 
 14.6   subdivision 36, and (c) home-based 
 14.7   treatment under Minnesota Rules, part 
 14.8   9505.0324; and community support 
 14.9   services for deaf and hard-of-hearing 
 14.10  adults with mental illness who use or 
 14.11  wish to use sign language as their 
 14.12  primary means of communication. 
 14.13  (2) For services that are administered 
 14.14  through the county, the county board 
 14.15  shall adjust provider contracts as 
 14.16  needed to reflect the rate increases 
 14.17  under this provision. 
 14.18  (3) It is the intention of the 
 14.19  legislature that the compensation 
 14.20  packages of direct-care staff providing 
 14.21  a listed service be increased by three 
 14.22  percent for each fiscal year. 
 14.23  (4) Effective January 1, 2000, and 
 14.24  January 1, 2001, the commissioner shall 
 14.25  increase capitation rates in the 
 14.26  prepaid medical assistance program, 
 14.27  prepaid general assistance medical care 
 14.28  program, and prepaid MinnesotaCare 
 14.29  program as necessary to reflect the 
 14.30  rate increases under this provision. 
 14.31  (5) Section 13, sunset of uncodified 
 14.32  language, does not apply to this 
 14.33  provision. 
 14.34  [DEVELOPMENTAL DISABILITIES WAIVER 
 14.35  SLOTS.] Of this appropriation, 
 14.36  $4,365,000 in fiscal year 2000 and 
 14.37  $11,707,000 in fiscal year 2001 is to 
 14.38  increase the availability of home and 
 14.39  community-based waiver services for 
 14.40  persons with mental retardation or 
 14.41  related conditions.  
 14.42  [TRAUMATIC BRAIN INJURY DEMO PROJECT.] 
 14.43  Of this appropriation, $50,000 in 
 14.44  fiscal year 2000 is for the traumatic 
 14.45  brain injury demonstration project.  
 14.46  This is a one-time appropriation and 
 14.47  shall not become part of the base level 
 14.48  funding for this activity for the 
 14.49  2002-2003 biennium. 
 14.50  (h) Medical Assistance Long-Term
 14.51  Care Facilities
 14.52     545,932,000    565,700,000 
 14.53  [ICF/MR DISALLOWANCES.] Of this 
 14.54  appropriation, $65,000 in fiscal 2000 
 14.55  is to reimburse a four-bed ICF/MR in 
 14.56  Ramsey county for disallowances 
 14.57  resulting from field audit findings.  
 14.58  This is a one-time appropriation and 
 14.59  shall not become part of base level 
 14.60  funding for this activity for the 
 14.61  2002-2003 biennium. 
 15.1   [OLDER ADULT SERVICES PLANNING AND 
 15.2   TRANSITION GRANT PROGRAM.] Of this 
 15.3   appropriation, $1,000,000 each year is 
 15.4   to implement the older adult services 
 15.5   planning and transition grant program 
 15.6   under Minnesota Statutes, section 
 15.7   256B.0918.  These are one-time 
 15.8   appropriations and shall not become 
 15.9   part of base level funding for this 
 15.10  activity for the 2002-2003 biennium. 
 15.11  [COSTS RELATED TO FACILITY 
 15.12  CERTIFICATION.] Of this appropriation, 
 15.13  $168,000 is for the costs of providing 
 15.14  one-half the state share of medical 
 15.15  assistance reimbursement for 
 15.16  residential and day habilitation 
 15.17  services under article 3, section 39.  
 15.18  This amount is available the day 
 15.19  following final enactment. 
 15.20  (i) Alternative Care Grants  
 15.21  General              54,633,000    45,029,000
 15.22  [ALTERNATIVE CARE TRANSFER.] Any money 
 15.23  allocated to the alternative care 
 15.24  program that is not spent for the 
 15.25  purposes indicated does not cancel but 
 15.26  shall be transferred to the medical 
 15.27  assistance account. 
 15.28  [PREADMISSION SCREENING AMOUNT.] The 
 15.29  preadmission screening payment to all 
 15.30  counties shall continue at the payment 
 15.31  amount in effect for fiscal year 1999. 
 15.32  [PAS/AC APPROPRIATION.] The 
 15.33  commissioner may expend the money 
 15.34  appropriated for the alternative care 
 15.35  program for that purpose in either year 
 15.36  of the biennium. 
 15.37  (j) Group Residential Housing
 15.38  General              66,759,000    70,558,000
 15.39  (k) Chemical Dependency
 15.40  Entitlement Grants
 15.41  General              36,373,000    37,240,000
 15.42  (l) Chemical Dependency 
 15.43  Nonentitlement Grants
 15.44  General               6,328,000     6,328,000
 15.45  Subd. 9.  Continuing Care and
 15.46  Community Support Management
 15.47  General              18,260,000    18,676,000
 15.48  State Government 
 15.49  Special Revenue         114,000       115,000
 15.50  Lottery Prize Fund      142,000       142,000
 15.51  [CAMP.] Of this appropriation, $15,000 
 15.52  each year is from the mental health 
 15.53  special projects account, for adults 
 15.54  and children with mental illness from 
 16.1   across the state, for a camping program 
 16.2   which utilizes the Boundary Waters 
 16.3   Canoe Area and is cooperatively 
 16.4   sponsored by client advocacy, mental 
 16.5   health treatment, and outdoor 
 16.6   recreation agencies. 
 16.7   [DEMO PROJECT EXTERNAL ADVOCACY FUNDING 
 16.8   CAP.] Of the appropriation for the 
 16.9   demonstration project for people with 
 16.10  disabilities under Minnesota Statutes, 
 16.11  section 256B.77, no more than $100,000 
 16.12  per year may be paid for external 
 16.13  advocacy under Minnesota Statutes, 
 16.14  section 256B.77, subdivision 14. 
 16.15  [COUNTY ADMINISTRATIVE COST 
 16.16  REIMBURSEMENT.] Of this appropriation, 
 16.17  $600,000 in fiscal year 2000 and 
 16.18  $720,000 in fiscal year 2001 is to 
 16.19  reimburse the nonfederal share of 
 16.20  county administrative costs under 
 16.21  Minnesota Statutes, section 256B.0916, 
 16.22  subdivision 2, for counties that form 
 16.23  partnerships consistent with the 
 16.24  performance measures established by the 
 16.25  commissioner.  This is a one-time 
 16.26  appropriation and shall not become part 
 16.27  of base level funding for this activity 
 16.28  for the 2002-2003 biennium. 
 16.29  [TECHNICAL ASSISTANCE FOR COUNTY 
 16.30  MANAGEMENT.] Of this appropriation, 
 16.31  $125,000 each year for the biennium is 
 16.32  for the commissioner to provide 
 16.33  technical assistance to counties to 
 16.34  improve county management of the home 
 16.35  and community-based waiver services for 
 16.36  persons with mental retardation or 
 16.37  related conditions program, and to 
 16.38  assist counties in forming joint 
 16.39  partnerships.  This is a one-time 
 16.40  appropriation and shall not become part 
 16.41  of base level funding for this activity 
 16.42  for the 2002-2003 biennium. 
 16.43  [REGION 10 QUALITY ASSURANCE 
 16.44  COMMISSION.] (1) Of this appropriation, 
 16.45  $280,000 each year is appropriated to 
 16.46  the commissioner for a grant to the 
 16.47  region 10 quality assurance commission 
 16.48  established under Minnesota Statutes, 
 16.49  section 256B.0951, for the purposes 
 16.50  specified in clauses (2) to (4).  
 16.51  Unexpended funds for fiscal year 2000 
 16.52  do not cancel, but are available to the 
 16.53  commission for fiscal year 2001. 
 16.54  (2) $250,000 each year is for the 
 16.55  operating costs of the alternative 
 16.56  quality assurance licensing system 
 16.57  pilot project, and for the commission 
 16.58  to provide grants to counties 
 16.59  participating in the alternative 
 16.60  quality assurance licensing system 
 16.61  under Minnesota Statutes, section 
 16.62  256B.0953. 
 16.63  (3) $20,000 each year is for the 
 16.64  commission to contract with an 
 16.65  independent entity to conduct a 
 17.1   financial review of the alternative 
 17.2   quality assurance licensing system, 
 17.3   including an evaluation of possible 
 17.4   budgetary savings within the affected 
 17.5   state agencies as the result of 
 17.6   implementing the system. 
 17.7   (4) $10,000 each year is for the 
 17.8   commission, in consultation with the 
 17.9   commissioner of human services, to 
 17.10  establish an ongoing review process for 
 17.11  the alternative quality assurance 
 17.12  licensing system. 
 17.13  Subd. 10.  Economic Support Grants
 17.14  General             140,919,000   123,903,000
 17.15  [GIFTS.] Notwithstanding Minnesota 
 17.16  Statutes, chapter 7, the commissioner 
 17.17  may accept on behalf of the state 
 17.18  additional funding from sources other 
 17.19  than state funds for the purpose of 
 17.20  financing the cost of assistance 
 17.21  program grants or nongrant 
 17.22  administration.  All additional funding 
 17.23  is appropriated to the commissioner for 
 17.24  use as designated by the grantee of 
 17.25  funding. 
 17.26  The amounts that may be spent from this 
 17.27  appropriation for each purpose are as 
 17.28  specified: 
 17.29  (a) Assistance to Families Grants
 17.30  General              65,382,000    66,213,000
 17.31  [FATHER PROJECT.] Of this 
 17.32  appropriation, $12,000 in fiscal year 
 17.33  2000 and $96,000 in fiscal year 2001 is 
 17.34  to offset the increased costs to the 
 17.35  state of implementing waivers for the 
 17.36  FATHER project.  These one-time 
 17.37  appropriations are available until 
 17.38  expended, and shall not become part of 
 17.39  base level funding for this activity 
 17.40  for the 2002-2003 biennium. 
 17.41  [SUPPORTIVE LIVING ARRANGEMENTS FOR 
 17.42  MINORS.] $500,000 for the biennium is 
 17.43  appropriated to the commissioner for 
 17.44  grants to create or expand 
 17.45  adult-supervised supportive living 
 17.46  arrangements under Minnesota Statutes, 
 17.47  section 256J.14, for minor parents who 
 17.48  are MFIP participants and their 
 17.49  children.  The commissioner shall 
 17.50  request proposals from, and award 
 17.51  grants to, interested parties that have 
 17.52  knowledge and experience in the area of 
 17.53  adolescent housing.  This is a one-time 
 17.54  appropriation and shall not become part 
 17.55  of base level funding for this activity 
 17.56  for the 2002-2003 biennium. 
 17.57  (b) Work Grants              
 17.58  General               10,484,000   10,484,000
 17.59  [EMPLOYMENT SERVICES CARRYOVER.] 
 18.1   General fund and federal TANF block 
 18.2   grant appropriations for employment 
 18.3   services that remain unexpended 
 18.4   subsequent to the reallocation process 
 18.5   required in Minnesota Statutes, section 
 18.6   256J.62, do not cancel but are 
 18.7   available for these purposes in fiscal 
 18.8   year 2001. 
 18.9   (c) Child Support Enforcement
 18.10  General               5,359,000     5,359,000
 18.11  [CHILD SUPPORT PAYMENT CENTER.] 
 18.12  Payments to the commissioner from other 
 18.13  governmental units, private 
 18.14  enterprises, and individuals for 
 18.15  services performed by the child support 
 18.16  payment center must be deposited in the 
 18.17  state systems account authorized under 
 18.18  Minnesota Statutes, section 256.014.  
 18.19  These payments are appropriated to the 
 18.20  commissioner for the operation of the 
 18.21  child support payment center or system, 
 18.22  according to Minnesota Statutes, 
 18.23  section 256.014. 
 18.24  [CHILD SUPPORT PAYMENT CENTER 
 18.25  RECOUPMENT ACCOUNT.] The child support 
 18.26  payment center is authorized to 
 18.27  establish an account to cover checks 
 18.28  issued in error or in cases where 
 18.29  insufficient funds are available to pay 
 18.30  the checks.  All recoupments against 
 18.31  payments from the account must be 
 18.32  deposited in the child support payment 
 18.33  center recoupment account and are 
 18.34  appropriated to the commissioner for 
 18.35  the purposes of the account.  Any 
 18.36  unexpended balance in the account does 
 18.37  not cancel, but is available until 
 18.38  expended. 
 18.39  (d) General Assistance
 18.40  General              33,927,000    14,973,000
 18.41  [GENERAL ASSISTANCE STANDARD.] The 
 18.42  commissioner shall set the monthly 
 18.43  standard of assistance for general 
 18.44  assistance units consisting of an adult 
 18.45  recipient who is childless and 
 18.46  unmarried or living apart from his or 
 18.47  her parents or a legal guardian at 
 18.48  $203.  The commissioner may reduce this 
 18.49  amount in accordance with Laws 1997, 
 18.50  chapter 85, article 3, section 54. 
 18.51  (e) Minnesota Supplemental Aid
 18.52  General              25,767,000    26,874,000
 18.53  (f) Refugee Services         
 18.54  General               .,-0-,...     .,-0-,...
 18.55  Subd. 11.  Economic Support  
 18.56  Management
 18.57  General              37,032,000    38,557,000
 19.1   Health Care
 19.2   Access                1,313,000     1,318,000
 19.3   [SPENDING AUTHORITY FOR FOOD STAMP 
 19.4   ENHANCED FUNDING.] In the event that 
 19.5   Minnesota qualifies for United States 
 19.6   Department of Agriculture Food and 
 19.7   Nutrition Services Food Stamp Program 
 19.8   enhanced funding beginning in federal 
 19.9   fiscal year 1998, the money is 
 19.10  appropriated to the commissioner for 
 19.11  the purposes of the program.  The 
 19.12  commissioner may retain 25 percent of 
 19.13  the enhanced funding, with the 
 19.14  remaining 75 percent divided among the 
 19.15  counties according to a formula that 
 19.16  takes into account each county's impact 
 19.17  on the statewide food stamp error rate. 
 19.18  The amounts that may be spent from this 
 19.19  appropriation for each purpose are as 
 19.20  specified: 
 19.21  (a) Economic Support Policy  
 19.22  Administration
 19.23  General               6,832,000     6,951,000
 19.24  (b) Economic Support Operations  
 19.25  General              30,200,000    31,606,000
 19.26  Health Care 
 19.27  Access                1,313,000     1,318,000
 19.28  [ADDITIONAL PRISM STATE SHARE.] Of this 
 19.29  appropriation, $2,700,000 each year is 
 19.30  for additional funding for the state 
 19.31  share of the operations of the 
 19.32  automated child support enforcement 
 19.33  system authorized under Minnesota 
 19.34  Statutes, section 256.014.  These are 
 19.35  one-time appropriations and shall not 
 19.36  become part of base level funding for 
 19.37  this activity for the 2002-2003 
 19.38  biennium. 
 19.39  [PROGRAM INTEGRITY FUNDING 
 19.40  AVAILABILITY.] Unexpended funds 
 19.41  appropriated for the provision of 
 19.42  program integrity activities for fiscal 
 19.43  year 2000 are also available to the 
 19.44  commissioner to fund fraud prevention 
 19.45  and control initiatives, and do not 
 19.46  cancel, but are available to the 
 19.47  commissioner for these purposes for 
 19.48  fiscal year 2001.  Unexpended funds may 
 19.49  be transferred between the fraud 
 19.50  prevention investigation program and 
 19.51  fraud control programs in order to 
 19.52  promote the provisions of Minnesota 
 19.53  Statutes, sections 256.983 and 256.9861.
 19.54  Subd. 12.  Federal TANF Funds       
 19.55  [FEDERAL TANF FUNDS.] (1) Federal 
 19.56  Temporary Assistance for Needy Families 
 19.57  block grant funds authorized under 
 19.58  title I of Public Law Number 104-193, 
 19.59  the Personal Responsibility and Work 
 19.60  Opportunity Reconciliation Act of 1996, 
 20.1   and awarded in federal fiscal years 
 20.2   1997 to 2002 are appropriated to the 
 20.3   commissioner in amounts up to 
 20.4   $236,425,000 in fiscal year 2000 and 
 20.5   $229,243,000 in fiscal year 2001. 
 20.6   (2) Of the amounts in clause (1), 
 20.7   $15,000,000 in fiscal year 2000 and 
 20.8   $15,000,000 in fiscal year 2001 is 
 20.9   transferred to the state's federal 
 20.10  Title XX block grant.  Notwithstanding 
 20.11  the provisions of Minnesota Statutes, 
 20.12  section 256E.07, in each year of the 
 20.13  biennium the commissioner shall 
 20.14  allocate $15,000,000 of the state's 
 20.15  Title XX block grant funds based on the 
 20.16  community social services aids formula 
 20.17  in Minnesota Statutes, section 
 20.18  256E.06.  The commissioner shall ensure 
 20.19  that money allocated to counties under 
 20.20  this provision is used according to the 
 20.21  requirements of United States Code, 
 20.22  title 42, section 604(d)(3)(B).  
 20.23  (3) Of the amounts in clause (1), 
 20.24  $9,700,000 is transferred each year 
 20.25  from the state's federal TANF block 
 20.26  grant to the state's federal Title XX 
 20.27  block grant.  Notwithstanding the 
 20.28  provisions of Minnesota Statutes, 
 20.29  section 256E.07, in each year the 
 20.30  commissioner shall transfer $9,700,000 
 20.31  of the state's Title XX block grant 
 20.32  funds to the family preservation 
 20.33  program under Minnesota Statutes, 
 20.34  chapter 256F.  The commissioner shall 
 20.35  ensure that money allocated under this 
 20.36  provision is used according to the 
 20.37  requirements of United States Code, 
 20.38  title 42, section 604(d)(3)(B).  
 20.39  Unexpended funds from the first year of 
 20.40  the biennium may be carried forward to 
 20.41  the second year.  These are one-time 
 20.42  appropriations that shall not be added 
 20.43  to the base for these programs for the 
 20.44  2002-2003 biennial budget.  The funds 
 20.45  transferred to the family preservation 
 20.46  program shall be used as follows: 
 20.47  (a) $8,900,000 each year is to provide 
 20.48  grants for concurrent permanency 
 20.49  planning under Minnesota Statutes, 
 20.50  section 257.0711.  These funds must be 
 20.51  allocated to counties based on the 
 20.52  allocation formula in Minnesota 
 20.53  Statutes, section 256F.05.  When a 
 20.54  county is in compliance with concurrent 
 20.55  permanency planning requirements, it 
 20.56  may use excess funding from the 
 20.57  allocation under this provision for 
 20.58  other services specified in Minnesota 
 20.59  Statutes, chapter 256F. 
 20.60  (b) $400,000 each year is to provide 
 20.61  grants to Indian tribes for concurrent 
 20.62  permanency planning under Minnesota 
 20.63  Statutes, section 257.0711.  These 
 20.64  funds must be allocated to tribes based 
 20.65  on the allocation formula in Minnesota 
 20.66  Statutes, section 257.3577. 
 21.1   (c) $400,000 each year is for the 
 21.2   commissioner to pay for administrative 
 21.3   costs associated with implementing the 
 21.4   concurrent permanency planning program, 
 21.5   to provide training, and to conduct 
 21.6   external reviews of county child 
 21.7   protection practices that are related 
 21.8   to the child protection services 
 21.9   provisions of Laws 1998, chapter 406, 
 21.10  article 4. 
 21.11  (4) Of the amounts in clause (1), 
 21.12  $5,000,000 each year is appropriated to 
 21.13  the commissioner, to be allocated to 
 21.14  counties and eligible tribal providers 
 21.15  under Minnesota Statutes, section 
 21.16  256J.62.  Counties and eligible tribal 
 21.17  providers must use their allocation 
 21.18  under this clause to reduce the size of 
 21.19  the job counselor caseload of MFIP 
 21.20  participants.  These are one-time 
 21.21  appropriations and shall not become 
 21.22  part of base level funding for the 
 21.23  county employment and training services 
 21.24  block grant for the 2002-2003 biennium. 
 21.25  (5) Of the amounts in clause (1), 
 21.26  $6,200,000 is transferred in fiscal 
 21.27  year 2000 from the state's federal TANF 
 21.28  block grant to the state's federal 
 21.29  Title XX block grant.  Notwithstanding 
 21.30  the provisions of Minnesota Statutes, 
 21.31  section 256E.07, in fiscal year 2000 
 21.32  the commissioner shall allocate 
 21.33  $6,200,000 of the state's Title XX 
 21.34  block grant funds based on the 
 21.35  community social services aids formula 
 21.36  in Minnesota Statutes, section 
 21.37  256E.06.  The commissioner shall ensure 
 21.38  that money allocated under this 
 21.39  provision is used in accordance with 
 21.40  the requirements of United States Code, 
 21.41  title 42, section 604(d)(3)(B).  This 
 21.42  is a one-time appropriation and shall 
 21.43  not become part of the base level 
 21.44  funding for the CSSA block grant. 
 21.45  [TRANSFERS TO TITLE XX FOR CSSA.] When 
 21.46  preparing the governor's budget for the 
 21.47  2002-2003 biennium, the commissioner of 
 21.48  finance shall ensure that the base 
 21.49  level funding for the community social 
 21.50  services aids includes $12,100,000 in 
 21.51  fiscal year 2002 and $12,100,000 in 
 21.52  fiscal year 2003 in funding that is 
 21.53  transferred from the state's federal 
 21.54  TANF block grant to the state's federal 
 21.55  Title XX block grant.  Notwithstanding 
 21.56  the provisions of Minnesota Statutes, 
 21.57  section 256E.07, the commissioner shall 
 21.58  allocate the portion of the state's 
 21.59  community social services aids funding 
 21.60  that is comprised of these transferred 
 21.61  funds based on the community social 
 21.62  services aids formula in Minnesota 
 21.63  Statutes, section 256E.06.  The 
 21.64  commissioner shall ensure that money 
 21.65  allocated under this provision is used 
 21.66  in accordance with the requirements of 
 21.67  United States Code, title 42, section 
 21.68  604(d)(3)(B). Any reductions to the 
 22.1   amount of the state community social 
 22.2   services (CSSA) block grant funding in 
 22.3   fiscal year 2002 or 2003 shall not 
 22.4   reduce the base for the CSSA block 
 22.5   grant for the 2004-2005 biennial 
 22.6   budget.  Section 13, sunset of 
 22.7   uncodified language, does not apply to 
 22.8   this provision. 
 22.9   [TRANSFERS FROM STATE TANF RESERVE.] 
 22.10  $4,666,000 in fiscal year 2000 is 
 22.11  transferred from the state TANF reserve 
 22.12  account to the general fund. 
 22.13  Sec. 3.  COMMISSIONER OF HEALTH
 22.14  Subdivision 1.  Total 
 22.15  Appropriation                        110,404,000    109,530,000
 22.16                Summary by Fund
 22.17  General              75,871,000    75,445,000
 22.18  State Government
 22.19  Special Revenue      24,688,000    24,129,000
 22.20  Health Care
 22.21  Access                9,845,000     9,956,000
 22.22  [INDIRECT COSTS NOT TO FUND PROGRAMS.] 
 22.23  The commissioner shall not use indirect 
 22.24  cost allocations to pay for the 
 22.25  operational costs of any program for 
 22.26  which the commissioner is responsible. 
 22.27  Subd. 2.  Health Systems
 22.28  and Special Populations               78,582,000     77,271,000
 22.29                Summary by Fund
 22.30  General              58,787,000    57,919,000
 22.31  State Government
 22.32  Special Revenue      10,046,000     9,494,000
 22.33  Health Care 
 22.34  Access                9,749,000     9,858,000
 22.35  [PHARMACY INITIATIVES.] Of this general 
 22.36  fund appropriation, $615,000 each year 
 22.37  is for pharmacy initiatives.  Of this 
 22.38  amount, $500,000 each year is for the 
 22.39  commissioner to award grants under 
 22.40  Minnesota Statutes, section 144.1499; 
 22.41  $75,000 each year is for the 
 22.42  commissioner to contract with a 
 22.43  statewide pharmacist association 
 22.44  representing all pharmacy practice 
 22.45  settings to administer the programs 
 22.46  under Minnesota Statutes, sections 
 22.47  144.1498 and 144.1499; and $40,000 each 
 22.48  year is for the commissioner's 
 22.49  administrative costs.  These are 
 22.50  one-time appropriations and shall not 
 22.51  become part of base level funding for 
 22.52  this activity for the 2002-2003 
 22.53  biennium. 
 22.54  [HEALTH CARE PURCHASING ALLIANCES.] Of 
 22.55  this general fund appropriation, 
 22.56  $100,000 each year is appropriated to 
 23.1   the commissioner for grants to two 
 23.2   local organizations to develop health 
 23.3   care purchasing alliances under 
 23.4   Minnesota Statutes, section 62T.02, to 
 23.5   negotiate the purchase of health care 
 23.6   services from licensed entities.  Of 
 23.7   this amount, $50,000 each year is for a 
 23.8   grant to the Southwest Regional 
 23.9   Development Commissioner to coordinate 
 23.10  purchasing alliance development in the 
 23.11  southwest area of the state, and 
 23.12  $50,000 each year is for a grant to the 
 23.13  University of Minnesota extension 
 23.14  services in Crookston to coordinate 
 23.15  purchasing alliance development in the 
 23.16  northwest area of the state.  This is a 
 23.17  one-time appropriation and shall not 
 23.18  become part of base level funding for 
 23.19  this activity for the 2002-2003 
 23.20  biennium. 
 23.21  [WIC TRANSFERS.] The general fund 
 23.22  appropriation for the women, infants, 
 23.23  and children (WIC) food supplement 
 23.24  program is available for either year of 
 23.25  the biennium.  Transfers of these funds 
 23.26  between fiscal years must either be to 
 23.27  maximize federal funds or to minimize 
 23.28  fluctuations in the number of program 
 23.29  participants. 
 23.30  [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
 23.31  NEEDS CARRYOVER.] General fund 
 23.32  appropriations for treatment services 
 23.33  in the services for Minnesota children 
 23.34  with special health needs program are 
 23.35  available for either year of the 
 23.36  biennium. 
 23.37  [FAMILY PLANNING GRANTS.] Of the 
 23.38  general fund appropriation to the 
 23.39  commissioner for grants for family 
 23.40  planning services as defined under 
 23.41  Minnesota Statutes, section 145.925, 
 23.42  subdivision 1a, the commissioner shall 
 23.43  allocate grant funds for the 2000 to 
 23.44  2001 grant funding cycle to entities 
 23.45  that provide natural family planning 
 23.46  services, that applied for grant funds 
 23.47  under Minnesota Statutes, section 
 23.48  145.925, for the 1998 to 1999 grant 
 23.49  funding cycle, and that were approved 
 23.50  for grants but did not receive funding. 
 23.51  [RURAL HOSPITAL IMPROVEMENT GRANTS.] 
 23.52  (a) Of this appropriation, $1,800,000 
 23.53  for the biennium is from the health 
 23.54  care access fund to the commissioner 
 23.55  for planning and implementation 
 23.56  projects under Minnesota Statutes, 
 23.57  section 144.147, subdivision 2, 
 23.58  paragraphs (a) and (b), and $3,800,000 
 23.59  for the biennium is from the health 
 23.60  care access fund for capital 
 23.61  improvement planning and implementation 
 23.62  projects under Minnesota Statutes, 
 23.63  section 144.147, subdivision 2, 
 23.64  paragraph (c).  
 23.65  (b) Of this amount, $300,000 is for the 
 23.66  Westbrook health center for hospital 
 24.1   and clinic improvements.  The 
 24.2   commissioner may provide these funds 
 24.3   upon receipt of information from the 
 24.4   Westbrook health center indicating how 
 24.5   it has fulfilled the requirements of 
 24.6   Minnesota Statutes, section 144.147, 
 24.7   and evidence that it has raised at 
 24.8   least a dollar-for-dollar match from 
 24.9   nonstate sources. 
 24.10  (c) These are one-time appropriations 
 24.11  that shall not be added to the base 
 24.12  level funding for the rural hospital 
 24.13  improvement grant program for the 
 24.14  2002-2003 biennium. 
 24.15  [TOBACCO USE PREVENTION GRANTS FOR 
 24.16  YOUTH.] (1) Of this appropriation, 
 24.17  $7,500,000 each year is from the 
 24.18  general fund to the commissioner for 
 24.19  the purposes specified in clauses (2) 
 24.20  to (5).  These are one-time 
 24.21  appropriations that shall not be added 
 24.22  to the base level funding for tobacco 
 24.23  use reduction and prevention activities 
 24.24  for the 2002-2003 biennium. 
 24.25  (2) $2,000,000 each year is for 
 24.26  competitive grants projects under 
 24.27  Minnesota Statutes, section 145A.135, 
 24.28  subdivision 1. 
 24.29  (3) $4,600,000 each year is for grants 
 24.30  to community health boards under 
 24.31  Minnesota Statutes, section 145A.135, 
 24.32  subdivision 2. 
 24.33  (4) $750,000 each year is available to 
 24.34  the commissioner for costs related to 
 24.35  evaluation, and is available until 
 24.36  expended. 
 24.37  (5) $150,000 each year is available to 
 24.38  the commissioner for administrative 
 24.39  costs.  Unexpended funds for fiscal 
 24.40  year 2000 do not cancel, but are 
 24.41  available for this purpose in fiscal 
 24.42  year 2001. 
 24.43  [MINNESOTA DONOR DECISION CAMPAIGN.] Of 
 24.44  this general fund appropriation, 
 24.45  $1,000,000 for the biennium is to the 
 24.46  commissioner for a grant to fund 
 24.47  initiatives to encourage organ, eye and 
 24.48  tissue donation.  The grant must be 
 24.49  made to a Minnesota organ procurement 
 24.50  organization that is certified by the 
 24.51  Health Care Financing Administration, 
 24.52  or to an entity that is a charitable 
 24.53  entity under section 501(c)(3) of the 
 24.54  Internal Revenue Code and is created by 
 24.55  an organ procurement organization that 
 24.56  is certified by the Health Care 
 24.57  Financing Administration.  Of this 
 24.58  amount, $20,000 each year is to conduct 
 24.59  research and public opinion surveys, to 
 24.60  assess attitudes toward donation before 
 24.61  the initiatives are implemented, and to 
 24.62  assess the effectiveness of the 
 24.63  initiatives after implementation, and 
 24.64  $960,000 for the biennium is to develop 
 25.1   and implement advertising and public 
 25.2   education campaigns to raise awareness 
 25.3   about organ, tissue, and eye donation 
 25.4   and to encourage people to become 
 25.5   donors.  This appropriation is 
 25.6   available only to the extent that it is 
 25.7   matched with an equal amount of 
 25.8   nonstate funds.  This is a one-time 
 25.9   appropriation that is available until 
 25.10  expended, and shall not become part of 
 25.11  base level funding for this activity 
 25.12  for the 2002-2003 biennium. 
 25.13  [TEEN SUICIDE PREVENTION MATERIALS.] Of 
 25.14  this appropriation, $100,000 for the 
 25.15  biennium is for the commissioner to 
 25.16  collect and package informational 
 25.17  materials designed to raise awareness 
 25.18  among teens and adults about 
 25.19  recognizing the signs of depression in 
 25.20  teenagers and preventing teen 
 25.21  suicides.  The commissioner shall 
 25.22  distribute the materials to schools and 
 25.23  other community entities through the 
 25.24  local community health boards.  This is 
 25.25  a one-time appropriation and shall not 
 25.26  become part of base level funding for 
 25.27  this activity for the 2002-2003 
 25.28  biennium. 
 25.29  [STANDARDS FOR SPECIAL CASE AUTOPSIES.] 
 25.30  Of this general fund appropriation, 
 25.31  $20,000 for the biennium is for a grant 
 25.32  to a professional association 
 25.33  representing coroners and medical 
 25.34  examiners in Minnesota to conduct case 
 25.35  studies, and develop and disseminate 
 25.36  guidelines, for autopsy practice in 
 25.37  special cases.  This is a one-time 
 25.38  appropriation and shall not become part 
 25.39  of base level funding for the 2002-2003 
 25.40  biennium. 
 25.41  [HEALTH PLAN COMPANY AND PROVIDER 
 25.42  PERFORMANCE MEASUREMENT; CONSUMER 
 25.43  SURVEYS.] Of this appropriation, 
 25.44  $1,250,000 in fiscal year 2000 and 
 25.45  $1,190,000 in fiscal year 2001 is to 
 25.46  the commissioner for a grant to the 
 25.47  Minnesota health data institute, for 
 25.48  annual reports on health plan company 
 25.49  performance, consumer surveys, and 
 25.50  annual reports on provider organization 
 25.51  performance measurement.  These are 
 25.52  one-time appropriations and shall not 
 25.53  become part of base level funding for 
 25.54  this activity for the 2002-2003 
 25.55  biennium. 
 25.56  [COMMUNITY HEALTH CLINIC GRANTS.] Of 
 25.57  this appropriation, $1,300,000 each 
 25.58  year is appropriated to the 
 25.59  commissioner for grants to 
 25.60  nongovernmental community clinics 
 25.61  offering a sliding fee scale and 
 25.62  demonstrating a commitment to serve a 
 25.63  disproportionate share of low-income 
 25.64  and underserved populations, to 
 25.65  maintain access to health care for 
 25.66  low-income and uninsured populations in 
 25.67  both urban and rural areas.  The 
 26.1   commissioner shall consult with the 
 26.2   neighborhood health care network and 
 26.3   the Minnesota primary care association 
 26.4   on the distribution of the grants.  The 
 26.5   commissioner shall limit each grant 
 26.6   award to $50,000 per clinic in each 
 26.7   fiscal year.  These are one-time 
 26.8   appropriations and shall not become 
 26.9   part of base level funding for this 
 26.10  activity for the 2002-2003 biennium. 
 26.11  [ACCESS TO SUMMARY MINIMUM DATA SET 
 26.12  (MDS).] The commissioner, in 
 26.13  cooperation with the commissioner of 
 26.14  administration, shall work to obtain 
 26.15  access to Minimum Data Set (MDS) data 
 26.16  that is electronically transmitted by 
 26.17  nursing facilities to the health 
 26.18  department.  The MDS data shall be made 
 26.19  available on a quarterly basis to 
 26.20  industry trade associations for use in 
 26.21  quality improvement efforts and 
 26.22  comparative analysis.  The MDS data 
 26.23  shall be provided to the industry trade 
 26.24  associations in the form of summary 
 26.25  aggregate data, without patient 
 26.26  identifiers, to ensure patient 
 26.27  privacy.  The commissioner may charge 
 26.28  for the actual cost of production of 
 26.29  these documents. 
 26.30  Subd. 3.  Health Protection          27,182,000     27,367,000
 26.31                Summary by Fund
 26.32  General              12,721,000    12,917,000
 26.33  State Government 
 26.34  Special Revenue      14,461,000    14,450,000
 26.35  [COLPOSCOPY SERVICES.] Of this 
 26.36  appropriation, $500,000 each year is 
 26.37  for the cancer control section to 
 26.38  provide free or low-cost colposcopy 
 26.39  services to low-income uninsured and 
 26.40  under insured women with abnormal Pap 
 26.41  test results.  This is a one-time 
 26.42  appropriation and shall not become part 
 26.43  of base level funding for this activity 
 26.44  for the 2002-2003 biennium. 
 26.45  Subd. 4.  Management and
 26.46  Support Services                      4,640,000      4,892,000
 26.47                Summary by Fund
 26.48  General               4,363,000     4,609,000
 26.49  State Government
 26.50  Special Revenue         181,000       185,000
 26.51  Health Care
 26.52  Access                   96,000        98,000
 26.53  [YEAR 2000 SURVEY OF FACILITIES AND 
 26.54  WATER SYSTEMS.] Of this general fund 
 26.55  appropriation, $157,000 is for the 
 26.56  costs associated with surveying by July 
 26.57  1, 1999, all hospitals, nursing homes, 
 26.58  nontransient community water systems 
 26.59  operated by a public entity, and 
 27.1   community water supply systems for year 
 27.2   2000 problems and proposed solutions.  
 27.3   Of this amount, $52,000 is available 
 27.4   the day following final enactment. 
 27.5   Sec. 4.  VETERANS NURSING   
 27.6   HOMES BOARD                           26,131,000     27,114,000 
 27.7   [ALLOWANCE FOR FOOD.] The allowance for 
 27.8   food may be adjusted annually to 
 27.9   reflect changes in the producer price 
 27.10  index, as prepared by the United States 
 27.11  Bureau of Labor Statistics, with the 
 27.12  approval of the commissioner of 
 27.13  finance.  Adjustments for fiscal year 
 27.14  2000 and fiscal year 2001 must be based 
 27.15  on the June 1998 and June 1999 producer 
 27.16  price index respectively, but the 
 27.17  adjustment must be prorated if it would 
 27.18  require money in excess of the 
 27.19  appropriation. 
 27.20  [ASSET PRESERVATION; FACILITY REPAIR.] 
 27.21  Of this general fund appropriation, 
 27.22  $1,190,000 each year is for asset 
 27.23  preservation and facility repair.  The 
 27.24  appropriations are available in either 
 27.25  year of the biennium and may be used 
 27.26  for abatement and repair at the Luverne 
 27.27  home.  This appropriation shall become 
 27.28  part of the board's base level funding 
 27.29  for the 2002-2003 biennium. 
 27.30  [LUVERNE EMERGENCY RENOVATIONS.] Of 
 27.31  this appropriation, $229,000 is for the 
 27.32  costs of lost patient revenues due to 
 27.33  emergency renovations at the Luverne 
 27.34  facility.  This amount is available the 
 27.35  day following final enactment. 
 27.36  [VETERANS HOMES SPECIAL REVENUE 
 27.37  ACCOUNT.] The general fund 
 27.38  appropriations made to the board shall 
 27.39  be transferred to a veterans homes 
 27.40  special revenue account in the special 
 27.41  revenue fund in the same manner as 
 27.42  other receipts are deposited according 
 27.43  to Minnesota Statutes, section 198.34, 
 27.44  and are appropriated to the veterans 
 27.45  homes board of directors for the 
 27.46  operation of board facilities and 
 27.47  programs. 
 27.48  [SETTING THE COST OF CARE.] The 
 27.49  veterans homes board may set the cost 
 27.50  of care at the Fergus Falls facility 
 27.51  for fiscal year 2000 based on the cost 
 27.52  of average skilled nursing care 
 27.53  provided to residents of the 
 27.54  Minneapolis veterans home for fiscal 
 27.55  year 2000.  The cost of care for the 
 27.56  domiciliary residence at the 
 27.57  Minneapolis veterans home and the 
 27.58  skilled nursing care residence at the 
 27.59  Luverne veterans home for fiscal years 
 27.60  2000 and 2001 shall be calculated based 
 27.61  on a full census at the respective 
 27.62  facility. 
 27.63  [LICENSED BED CAPACITY FOR MINNEAPOLIS 
 27.64  VETERANS HOME.] The commissioner of 
 28.1   health shall not reduce the licensed 
 28.2   bed capacity for the Minneapolis 
 28.3   veterans home pending completion of the 
 28.4   project authorized by Laws 1990, 
 28.5   chapter 610, article 1, section 9, 
 28.6   subdivision 3. 
 28.7   Sec. 5.  HEALTH RELATED BOARDS
 28.8   Subdivision 1.  Total       
 28.9   Appropriation                         10,261,000     10,540,000 
 28.10  [STATE GOVERNMENT SPECIAL REVENUE 
 28.11  FUND.] The appropriations in this 
 28.12  section are from the state government 
 28.13  special revenue fund. 
 28.14  [NO SPENDING IN EXCESS OF REVENUES.] 
 28.15  The commissioner of finance shall not 
 28.16  permit the allotment, encumbrance, or 
 28.17  expenditure of money appropriated in 
 28.18  this section in excess of the 
 28.19  anticipated biennial revenues or 
 28.20  accumulated surplus revenues from fees 
 28.21  collected by the boards.  Neither this 
 28.22  provision nor Minnesota Statutes, 
 28.23  section 214.06, applies to transfers 
 28.24  from the general contingent account. 
 28.25  Subd. 2.  Board of Chiropractic 
 28.26  Examiners                                350,000        361,000 
 28.27  Subd. 3.  Board of          
 28.28  Dentistry                                783,000        806,000 
 28.29  Subd. 4.  Board of Dietetic 
 28.30  and Nutrition Practice                    92,000         95,000 
 28.31  Subd. 5.  Board of Marriage 
 28.32  and Family Therapy                       107,000        111,000 
 28.33  Subd. 6.  Board of          
 28.34  Medical Practice                       3,687,000      3,814,000 
 28.35  Subd. 7.  Board of          
 28.36  Nursing                                2,202,000      2,245,000 
 28.37  Subd. 8.  Board of Nursing  
 28.38  Home Administrators                      548,000        566,000 
 28.39  Subd. 9.  Board of          
 28.40  Optometry                                 87,000         90,000 
 28.41  Subd. 10.  Board of         
 28.42  Pharmacy                               1,125,000      1,137,000 
 28.43  Subd. 11.  Board of         
 28.44  Podiatry                                  41,000         42,000 
 28.45  Subd. 12.  Board of         
 28.46  Psychology                               450,000        462,000 
 28.47  Subd. 13.  Board of         
 28.48  Social Work                              641,000        658,000 
 28.49  Subd. 14. Board of          
 28.50  Veterinary Medicine                      148,000        153,000 
 28.51  Sec. 6.  EMERGENCY MEDICAL  
 28.52  SERVICES BOARD                         2,500,000      2,323,000 
 29.1                 Summary by Fund
 29.2   General                 792,000       586,000
 29.3   Trunk Highway         1,708,000     1,737,000
 29.4   [COMPREHENSIVE ADVANCED LIFE SUPPORT 
 29.5   (CALS).] Of the general fund 
 29.6   appropriation, $206,000 for the 
 29.7   biennium is for the board to establish 
 29.8   a comprehensive advanced life support 
 29.9   educational program under Minnesota 
 29.10  Statutes, section 144E.37.  This is a 
 29.11  one-time appropriation and shall not 
 29.12  become part of the board's base level 
 29.13  funding for the 2002-2003 biennium. 
 29.14  Sec. 7.  COUNCIL ON DISABILITY           651,000        672,000
 29.15  Sec. 8.  OMBUDSMAN FOR MENTAL 
 29.16  HEALTH AND MENTAL RETARDATION          1,340,000      1,380,000 
 29.17  Sec. 9.  OMBUDSMAN FOR FAMILIES          166,000        171,000
 29.18  Sec. 10.  UNIVERSITY OF MINNESOTA      2,537,000      2,537,000
 29.19                Summary by Fund
 29.20  Health Care Access    2,537,000     2,537,000
 29.21  Sec. 11.  TRANSFERS OF FUNDS 
 29.22  Subdivision 1.  Grant Programs 
 29.23  The commissioner of human services, 
 29.24  with the approval of the commissioner 
 29.25  of finance, and after notification of 
 29.26  the chair of the senate health and 
 29.27  family security budget division and the 
 29.28  chair of the house health and human 
 29.29  services finance committee, may 
 29.30  transfer unencumbered appropriation 
 29.31  balances for the biennium ending June 
 29.32  30, 2001, within fiscal years for the 
 29.33  Minnesota family investment program, 
 29.34  general assistance, general assistance 
 29.35  medical care, medical assistance, 
 29.36  Minnesota supplemental aid, and group 
 29.37  residential housing programs, and the 
 29.38  entitlement portion of the chemical 
 29.39  dependency consolidated treatment fund, 
 29.40  and between fiscal years of the 
 29.41  biennium. 
 29.42  Subd. 2.  Appropriation Transfers 
 29.43  Reported 
 29.44  In addition to the requirements of 
 29.45  Minnesota Statutes, section 16A.285, 
 29.46  when the commissioner of human services 
 29.47  or health, or the veterans nursing 
 29.48  homes board, transfers operational 
 29.49  money between programs under Minnesota 
 29.50  Statutes, section 16A.285, the affected 
 29.51  commissioner or the board chair must 
 29.52  provide the chairs of the house health 
 29.53  and human services finance committee 
 29.54  and the senate health and family 
 29.55  security budget division with 
 29.56  sufficient detail to identify the 
 29.57  account to which the money was 
 30.1   originally appropriated, and the 
 30.2   account to which the money is being 
 30.3   transferred.  Section 13, sunset of 
 30.4   uncodified language, does not apply to 
 30.5   this provision. 
 30.6   Sec. 12.  CARRYOVER LIMITATION
 30.7   None of the appropriations in this act 
 30.8   which are allowed to be carried forward 
 30.9   from fiscal year 2000 to fiscal year 
 30.10  2001 shall become part of the base 
 30.11  level funding for the 2002-2003 
 30.12  biennial budget, unless specifically 
 30.13  directed by the legislature. 
 30.14  Sec. 13.  SUNSET OF UNCODIFIED LANGUAGE
 30.15  All uncodified language contained in 
 30.16  this article expires on June 30, 2001, 
 30.17  unless a different expiration date is 
 30.18  explicit. 
 30.19     Sec. 14.  Minnesota Statutes 1998, section 256.01, 
 30.20  subdivision 2, is amended to read: 
 30.21     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
 30.22  section 241.021, subdivision 2, the commissioner of human 
 30.23  services shall: 
 30.24     (1) Administer and supervise all forms of public assistance 
 30.25  provided for by state law and other welfare activities or 
 30.26  services as are vested in the commissioner.  Administration and 
 30.27  supervision of human services activities or services includes, 
 30.28  but is not limited to, assuring timely and accurate distribution 
 30.29  of benefits, completeness of service, and quality program 
 30.30  management.  In addition to administering and supervising human 
 30.31  services activities vested by law in the department, the 
 30.32  commissioner shall have the authority to: 
 30.33     (a) require county agency participation in training and 
 30.34  technical assistance programs to promote compliance with 
 30.35  statutes, rules, federal laws, regulations, and policies 
 30.36  governing human services; 
 30.37     (b) monitor, on an ongoing basis, the performance of county 
 30.38  agencies in the operation and administration of human services, 
 30.39  enforce compliance with statutes, rules, federal laws, 
 30.40  regulations, and policies governing welfare services and promote 
 30.41  excellence of administration and program operation; 
 30.42     (c) develop a quality control program or other monitoring 
 31.1   program to review county performance and accuracy of benefit 
 31.2   determinations; 
 31.3      (d) require county agencies to make an adjustment to the 
 31.4   public assistance benefits issued to any individual consistent 
 31.5   with federal law and regulation and state law and rule and to 
 31.6   issue or recover benefits as appropriate; 
 31.7      (e) delay or deny payment of all or part of the state and 
 31.8   federal share of benefits and administrative reimbursement 
 31.9   according to the procedures set forth in section 256.017; 
 31.10     (f) make contracts with and grants to public and private 
 31.11  agencies and organizations, both profit and nonprofit, and 
 31.12  individuals, using appropriated funds; and 
 31.13     (g) enter into contractual agreements with federally 
 31.14  recognized Indian tribes with a reservation in Minnesota to the 
 31.15  extent necessary for the tribe to operate a federally approved 
 31.16  family assistance program or any other program under the 
 31.17  supervision of the commissioner.  The commissioner shall consult 
 31.18  with the affected county or counties in the contractual 
 31.19  agreement negotiations, if the county or counties wish to be 
 31.20  included, in order to avoid the duplication of county and tribal 
 31.21  assistance program services.  The commissioner may establish 
 31.22  necessary accounts for the purposes of receiving and disbursing 
 31.23  funds as necessary for the operation of the programs. 
 31.24     (2) Inform county agencies, on a timely basis, of changes 
 31.25  in statute, rule, federal law, regulation, and policy necessary 
 31.26  to county agency administration of the programs. 
 31.27     (3) Administer and supervise all child welfare activities; 
 31.28  promote the enforcement of laws protecting handicapped, 
 31.29  dependent, neglected and delinquent children, and children born 
 31.30  to mothers who were not married to the children's fathers at the 
 31.31  times of the conception nor at the births of the children; 
 31.32  license and supervise child-caring and child-placing agencies 
 31.33  and institutions; supervise the care of children in boarding and 
 31.34  foster homes or in private institutions; and generally perform 
 31.35  all functions relating to the field of child welfare now vested 
 31.36  in the state board of control. 
 32.1      (4) Administer and supervise all noninstitutional service 
 32.2   to handicapped persons, including those who are visually 
 32.3   impaired, hearing impaired, or physically impaired or otherwise 
 32.4   handicapped.  The commissioner may provide and contract for the 
 32.5   care and treatment of qualified indigent children in facilities 
 32.6   other than those located and available at state hospitals when 
 32.7   it is not feasible to provide the service in state hospitals. 
 32.8      (5) Assist and actively cooperate with other departments, 
 32.9   agencies and institutions, local, state, and federal, by 
 32.10  performing services in conformity with the purposes of Laws 
 32.11  1939, chapter 431. 
 32.12     (6) Act as the agent of and cooperate with the federal 
 32.13  government in matters of mutual concern relative to and in 
 32.14  conformity with the provisions of Laws 1939, chapter 431, 
 32.15  including the administration of any federal funds granted to the 
 32.16  state to aid in the performance of any functions of the 
 32.17  commissioner as specified in Laws 1939, chapter 431, and 
 32.18  including the promulgation of rules making uniformly available 
 32.19  medical care benefits to all recipients of public assistance, at 
 32.20  such times as the federal government increases its participation 
 32.21  in assistance expenditures for medical care to recipients of 
 32.22  public assistance, the cost thereof to be borne in the same 
 32.23  proportion as are grants of aid to said recipients. 
 32.24     (7) Establish and maintain any administrative units 
 32.25  reasonably necessary for the performance of administrative 
 32.26  functions common to all divisions of the department. 
 32.27     (8) Act as designated guardian of both the estate and the 
 32.28  person of all the wards of the state of Minnesota, whether by 
 32.29  operation of law or by an order of court, without any further 
 32.30  act or proceeding whatever, except as to persons committed as 
 32.31  mentally retarded.  For children under the guardianship of the 
 32.32  commissioner whose interests would be best served by adoptive 
 32.33  placement, the commissioner may contract with a licensed 
 32.34  child-placing agency to provide adoption services.  A contract 
 32.35  with a licensed child-placing agency must be designed to 
 32.36  supplement existing county efforts and may not replace existing 
 33.1   county programs, unless the replacement is agreed to by the 
 33.2   county board and the appropriate exclusive bargaining 
 33.3   representative or the commissioner has evidence that child 
 33.4   placements of the county continue to be substantially below that 
 33.5   of other counties. 
 33.6      (9) Act as coordinating referral and informational center 
 33.7   on requests for service for newly arrived immigrants coming to 
 33.8   Minnesota. 
 33.9      (10) The specific enumeration of powers and duties as 
 33.10  hereinabove set forth shall in no way be construed to be a 
 33.11  limitation upon the general transfer of powers herein contained. 
 33.12     (11) Establish county, regional, or statewide schedules of 
 33.13  maximum fees and charges which may be paid by county agencies 
 33.14  for medical, dental, surgical, hospital, nursing and nursing 
 33.15  home care and medicine and medical supplies under all programs 
 33.16  of medical care provided by the state and for congregate living 
 33.17  care under the income maintenance programs. 
 33.18     (12) Have the authority to conduct and administer 
 33.19  experimental projects to test methods and procedures of 
 33.20  administering assistance and services to recipients or potential 
 33.21  recipients of public welfare.  To carry out such experimental 
 33.22  projects, it is further provided that the commissioner of human 
 33.23  services is authorized to waive the enforcement of existing 
 33.24  specific statutory program requirements, rules, and standards in 
 33.25  one or more counties.  The order establishing the waiver shall 
 33.26  provide alternative methods and procedures of administration, 
 33.27  shall not be in conflict with the basic purposes, coverage, or 
 33.28  benefits provided by law, and in no event shall the duration of 
 33.29  a project exceed four years.  It is further provided that no 
 33.30  order establishing an experimental project as authorized by the 
 33.31  provisions of this section shall become effective until the 
 33.32  following conditions have been met: 
 33.33     (a) The secretary of health, education, and welfare of the 
 33.34  United States has agreed, for the same project, to waive state 
 33.35  plan requirements relative to statewide uniformity. 
 33.36     (b) A comprehensive plan, including estimated project 
 34.1   costs, shall be approved by the legislative advisory commission 
 34.2   and filed with the commissioner of administration.  
 34.3      (13) According to federal requirements, establish 
 34.4   procedures to be followed by local welfare boards in creating 
 34.5   citizen advisory committees, including procedures for selection 
 34.6   of committee members. 
 34.7      (14) Allocate federal fiscal disallowances or sanctions 
 34.8   which are based on quality control error rates for the aid to 
 34.9   families with dependent children, Minnesota family investment 
 34.10  program-statewide, medical assistance, or food stamp program in 
 34.11  the following manner:  
 34.12     (a) One-half of the total amount of the disallowance shall 
 34.13  be borne by the county boards responsible for administering the 
 34.14  programs.  For the medical assistance, MFIP-S, and AFDC 
 34.15  programs, disallowances shall be shared by each county board in 
 34.16  the same proportion as that county's expenditures for the 
 34.17  sanctioned program are to the total of all counties' 
 34.18  expenditures for the AFDC, MFIP-S, and medical assistance 
 34.19  programs.  For the food stamp program, sanctions shall be shared 
 34.20  by each county board, with 50 percent of the sanction being 
 34.21  distributed to each county in the same proportion as that 
 34.22  county's administrative costs for food stamps are to the total 
 34.23  of all food stamp administrative costs for all counties, and 50 
 34.24  percent of the sanctions being distributed to each county in the 
 34.25  same proportion as that county's value of food stamp benefits 
 34.26  issued are to the total of all benefits issued for all 
 34.27  counties.  Each county shall pay its share of the disallowance 
 34.28  to the state of Minnesota.  When a county fails to pay the 
 34.29  amount due hereunder, the commissioner may deduct the amount 
 34.30  from reimbursement otherwise due the county, or the attorney 
 34.31  general, upon the request of the commissioner, may institute 
 34.32  civil action to recover the amount due. 
 34.33     (b) Notwithstanding the provisions of paragraph (a), if the 
 34.34  disallowance results from knowing noncompliance by one or more 
 34.35  counties with a specific program instruction, and that knowing 
 34.36  noncompliance is a matter of official county board record, the 
 35.1   commissioner may require payment or recover from the county or 
 35.2   counties, in the manner prescribed in paragraph (a), an amount 
 35.3   equal to the portion of the total disallowance which resulted 
 35.4   from the noncompliance, and may distribute the balance of the 
 35.5   disallowance according to paragraph (a).  
 35.6      (15) Develop and implement special projects that maximize 
 35.7   reimbursements and result in the recovery of money to the 
 35.8   state.  For the purpose of recovering state money, the 
 35.9   commissioner may enter into contracts with third parties.  Any 
 35.10  recoveries that result from projects or contracts entered into 
 35.11  under this paragraph shall be deposited in the state treasury 
 35.12  and credited to a special account until the balance in the 
 35.13  account reaches $1,000,000.  When the balance in the account 
 35.14  exceeds $1,000,000, the excess shall be transferred and credited 
 35.15  to the general fund.  All money in the account is appropriated 
 35.16  to the commissioner for the purposes of this paragraph. 
 35.17     (16) Have the authority to make direct payments to 
 35.18  facilities providing shelter to women and their children 
 35.19  according to section 256D.05, subdivision 3.  Upon the written 
 35.20  request of a shelter facility that has been denied payments 
 35.21  under section 256D.05, subdivision 3, the commissioner shall 
 35.22  review all relevant evidence and make a determination within 30 
 35.23  days of the request for review regarding issuance of direct 
 35.24  payments to the shelter facility.  Failure to act within 30 days 
 35.25  shall be considered a determination not to issue direct payments.
 35.26     (17) Have the authority to establish and enforce the 
 35.27  following county reporting requirements:  
 35.28     (a) The commissioner shall establish fiscal and statistical 
 35.29  reporting requirements necessary to account for the expenditure 
 35.30  of funds allocated to counties for human services programs.  
 35.31  When establishing financial and statistical reporting 
 35.32  requirements, the commissioner shall evaluate all reports, in 
 35.33  consultation with the counties, to determine if the reports can 
 35.34  be simplified or the number of reports can be reduced. 
 35.35     (b) The county board shall submit monthly or quarterly 
 35.36  reports to the department as required by the commissioner.  
 36.1   Monthly reports are due no later than 15 working days after the 
 36.2   end of the month.  Quarterly reports are due no later than 30 
 36.3   calendar days after the end of the quarter, unless the 
 36.4   commissioner determines that the deadline must be shortened to 
 36.5   20 calendar days to avoid jeopardizing compliance with federal 
 36.6   deadlines or risking a loss of federal funding.  Only reports 
 36.7   that are complete, legible, and in the required format shall be 
 36.8   accepted by the commissioner.  
 36.9      (c) If the required reports are not received by the 
 36.10  deadlines established in clause (b), the commissioner may delay 
 36.11  payments and withhold funds from the county board until the next 
 36.12  reporting period.  When the report is needed to account for the 
 36.13  use of federal funds and the late report results in a reduction 
 36.14  in federal funding, the commissioner shall withhold from the 
 36.15  county boards with late reports an amount equal to the reduction 
 36.16  in federal funding until full federal funding is received.  
 36.17     (d) A county board that submits reports that are late, 
 36.18  illegible, incomplete, or not in the required format for two out 
 36.19  of three consecutive reporting periods is considered 
 36.20  noncompliant.  When a county board is found to be noncompliant, 
 36.21  the commissioner shall notify the county board of the reason the 
 36.22  county board is considered noncompliant and request that the 
 36.23  county board develop a corrective action plan stating how the 
 36.24  county board plans to correct the problem.  The corrective 
 36.25  action plan must be submitted to the commissioner within 45 days 
 36.26  after the date the county board received notice of noncompliance.
 36.27     (e) The final deadline for fiscal reports or amendments to 
 36.28  fiscal reports is one year after the date the report was 
 36.29  originally due.  If the commissioner does not receive a report 
 36.30  by the final deadline, the county board forfeits the funding 
 36.31  associated with the report for that reporting period and the 
 36.32  county board must repay any funds associated with the report 
 36.33  received for that reporting period. 
 36.34     (f) The commissioner may not delay payments, withhold 
 36.35  funds, or require repayment under paragraph (c) or (e) if the 
 36.36  county demonstrates that the commissioner failed to provide 
 37.1   appropriate forms, guidelines, and technical assistance to 
 37.2   enable the county to comply with the requirements.  If the 
 37.3   county board disagrees with an action taken by the commissioner 
 37.4   under paragraph (c) or (e), the county board may appeal the 
 37.5   action according to sections 14.57 to 14.69. 
 37.6      (g) Counties subject to withholding of funds under 
 37.7   paragraph (c) or forfeiture or repayment of funds under 
 37.8   paragraph (e) shall not reduce or withhold benefits or services 
 37.9   to clients to cover costs incurred due to actions taken by the 
 37.10  commissioner under paragraph (c) or (e). 
 37.11     (18) Allocate federal fiscal disallowances or sanctions for 
 37.12  audit exceptions when federal fiscal disallowances or sanctions 
 37.13  are based on a statewide random sample for the foster care 
 37.14  program under title IV-E of the Social Security Act, United 
 37.15  States Code, title 42, in direct proportion to each county's 
 37.16  title IV-E foster care maintenance claim for that period. 
 37.17     (19) Be responsible for ensuring the detection, prevention, 
 37.18  investigation, and resolution of fraudulent activities or 
 37.19  behavior by applicants, recipients, and other participants in 
 37.20  the human services programs administered by the department. 
 37.21     (20) Require county agencies to identify overpayments, 
 37.22  establish claims, and utilize all available and cost-beneficial 
 37.23  methodologies to collect and recover these overpayments in the 
 37.24  human services programs administered by the department. 
 37.25     (21) Have the authority to administer a drug rebate program 
 37.26  for drugs purchased pursuant to the senior citizen drug program 
 37.27  established under section 256.955 after the beneficiary's 
 37.28  satisfaction of any deductible established in the program.  The 
 37.29  commissioner shall require a rebate agreement from all 
 37.30  manufacturers of covered drugs as defined in section 256B.0625, 
 37.31  subdivision 13.  For each drug, the amount of the rebate shall 
 37.32  be equal to the basic rebate as defined for purposes of the 
 37.33  federal rebate program in United States Code, title 42, section 
 37.34  1396r-8(c)(1).  This basic rebate shall be applied to 
 37.35  single-source and multiple-source drugs.  The manufacturers must 
 37.36  provide full payment within 30 days of receipt of the state 
 38.1   invoice for the rebate within the terms and conditions used for 
 38.2   the federal rebate program established pursuant to section 1927 
 38.3   of title XIX of the Social Security Act.  The manufacturers must 
 38.4   provide the commissioner with any information necessary to 
 38.5   verify the rebate determined per drug.  The rebate program shall 
 38.6   utilize the terms and conditions used for the federal rebate 
 38.7   program established pursuant to section 1927 of title XIX of the 
 38.8   Social Security Act. 
 38.9      (22) Operate the department's communication systems account 
 38.10  established in Laws 1993, First Special Session chapter 1, 
 38.11  article 1, section 2, subdivision 2, to manage shared 
 38.12  communication costs necessary for the operation of the programs 
 38.13  the commissioner supervises.  A communications account may also 
 38.14  be established for each regional treatment center which operates 
 38.15  communications systems.  Each account must be used to manage 
 38.16  shared communication costs necessary for the operations of the 
 38.17  programs the commissioner supervises.  The commissioner may 
 38.18  distribute the costs of operating and maintaining communication 
 38.19  systems to participants in a manner that reflects actual usage. 
 38.20  Costs may include acquisition, licensing, insurance, 
 38.21  maintenance, repair, staff time and other costs as determined by 
 38.22  the commissioner.  Nonprofit organizations and state, county, 
 38.23  and local government agencies involved in the operation of 
 38.24  programs the commissioner supervises may participate in the use 
 38.25  of the department's communications technology and share in the 
 38.26  cost of operation.  The commissioner may accept on behalf of the 
 38.27  state any gift, bequest, devise or personal property of any 
 38.28  kind, or money tendered to the state for any lawful purpose 
 38.29  pertaining to the communication activities of the department.  
 38.30  Any money received for this purpose must be deposited in the 
 38.31  department's communication systems accounts.  Money collected by 
 38.32  the commissioner for the use of communication systems must be 
 38.33  deposited in the state communication systems account, and is 
 38.34  appropriated to the commissioner for purposes of this section. 
 38.35     (23) Receive any federal matching money that is made 
 38.36  available through the medical assistance program for the 
 39.1   consumer satisfaction survey.  Any federal money received for 
 39.2   the survey is appropriated to the commissioner for this 
 39.3   purpose.  The commissioner may expend the federal money received 
 39.4   for the consumer satisfaction survey in either year of the 
 39.5   biennium. 
 39.6      (24) Incorporate cost reimbursement claims from First Call 
 39.7   Minnesota into the federal cost reimbursement claiming processes 
 39.8   of the department according to federal law, rule, and 
 39.9   regulations.  Any reimbursement received is appropriated to the 
 39.10  commissioner and shall be disbursed to First Call Minnesota 
 39.11  according to normal department payment schedules. 
 39.12     Sec. 15.  Minnesota Statutes 1998, section 256.01, is 
 39.13  amended by adding a subdivision to read: 
 39.14     Subd. 17.  [FUND AND ACCOUNT REPORTING REQUIRED.] Annually 
 39.15  on December 1, the commissioner shall provide detailed fund 
 39.16  balance statements to the chairs of the legislative committees 
 39.17  or divisions with jurisdiction over the commissioner's budget 
 39.18  for:  (1) each fund or account used by the commissioner in the 
 39.19  ongoing operations of the agency; (2) each state-operated 
 39.20  computer system under section 256.014, including but not limited 
 39.21  to MAXIS, the current medicaid management information system 
 39.22  (MMIS), the child support enforcement system (PRISM), the 
 39.23  electronic benefit transfer system (EBT), and the executive 
 39.24  information system (EIS); and (3) the social services 
 39.25  information system (SSIS). 
 39.26     Sec. 16.  Minnesota Statutes 1998, section 256.014, is 
 39.27  amended by adding a subdivision to read: 
 39.28     Subd. 4.  [ISSUANCE OPERATIONS CENTER.] Payments to the 
 39.29  commissioner from other governmental units and private 
 39.30  enterprises for:  services performed by the issuance operations 
 39.31  center; or reports generated by the payment and eligibility 
 39.32  systems must be deposited in the account created under 
 39.33  subdivision 2.  These payments are appropriated to the 
 39.34  commissioner for the operation of the issuance center or system, 
 39.35  according to the provisions of this section. 
 39.36     Sec. 17.  Minnesota Statutes 1998, section 256J.39, 
 40.1   subdivision 1, is amended to read: 
 40.2      Subdivision 1.  [PAYMENT POLICY.] The following policies 
 40.3   apply to monthly assistance payments and corrective payments: 
 40.4      (1) Grant payments may be issued in the form of warrants 
 40.5   immediately redeemable in cash, electronic benefits transfer, or 
 40.6   by direct deposit into the recipient's account in a financial 
 40.7   institution. 
 40.8      (2) The commissioner shall mail assistance payment checks 
 40.9   to the address where a caregiver lives unless the county agency 
 40.10  approves an alternate arrangement. 
 40.11     (3) The commissioner shall mail monthly assistance payment 
 40.12  checks within time to allow postal service delivery to occur no 
 40.13  later than the first day of each month.  Monthly assistance 
 40.14  payment checks must be dated the first day of the month.  The 
 40.15  commissioner shall issue electronic benefits transfer payments 
 40.16  so that caregivers have access to the payments no later than the 
 40.17  first of the month.  
 40.18     (4) The commissioner shall issue replacement checks 
 40.19  promptly, but no later than seven calendar days after the 
 40.20  provisions of sections 16A.46; 256.01, subdivision 11; and 
 40.21  471.415 have been met. 
 40.22     (5) The commissioner, with the advance approval of the 
 40.23  commissioner of finance, may issue cash assistance grant 
 40.24  payments up to three days before the first day of each month, 
 40.25  including three days before the start of each state fiscal 
 40.26  year.  Of the money appropriated for cash assistance grant 
 40.27  payments for each fiscal year, up to three percent of the annual 
 40.28  state appropriation is available to the commissioner in the 
 40.29  previous fiscal year.  If that amount is insufficient for the 
 40.30  costs incurred, an additional amount of the appropriation as 
 40.31  needed may be transferred with the advance approval of the 
 40.32  commissioner of finance. 
 40.33     (Effective Date:  Section 17 (256J.39, subdivision 1) is 
 40.34  effective the day following final enactment.) 
 40.35     Sec. 18.  [REPEALER.] 
 40.36     Minnesota Statutes 1998, section 256J.03, is repealed 
 41.1   effective July 2, 1999.  Section 13, sunset of uncodified 
 41.2   language, does not apply to this section. 
 41.3                              ARTICLE 2 
 41.4                          HEALTH DEPARTMENT 
 41.5      Section 1.  Minnesota Statutes 1998, section 13.99, is 
 41.6   amended by adding a subdivision to read: 
 41.7      Subd. 33a.  [ABORTION NOTIFICATION DATA; DATA ON 
 41.8   ENFORCEMENT.] Abortion notification data on individuals 
 41.9   collected and maintained by the commissioner of health are 
 41.10  classified under section 144.3431, subdivision 3.  Data related 
 41.11  to actions taken by the commissioner to enforce abortion 
 41.12  notification data reporting requirements are classified under 
 41.13  section 144.3431, subdivision 4. 
 41.14     Sec. 2.  Minnesota Statutes 1998, section 15.059, 
 41.15  subdivision 5a, is amended to read: 
 41.16     Subd. 5a.  [LATER EXPIRATION.] Notwithstanding subdivision 
 41.17  5, the advisory councils and committees listed in this 
 41.18  subdivision do not expire June 30, 1997.  These groups expire 
 41.19  June 30, 2001, unless the law creating the group or this 
 41.20  subdivision specifies an earlier expiration date. 
 41.21     Investment advisory council, created in section 11A.08; 
 41.22     Intergovernmental information systems advisory council, 
 41.23  created in section 16B.42, expires June 30, 1999; 
 41.24     Feedlot and manure management advisory committee, created 
 41.25  in section 17.136; 
 41.26     Aquaculture advisory committee, created in section 17.49; 
 41.27     Dairy producers board, created in section 17.76; 
 41.28     Pesticide applicator education and examination review 
 41.29  board, created in section 18B.305; 
 41.30     Advisory seed potato certification task force, created in 
 41.31  section 21.112; 
 41.32     Food safety advisory committee, created in section 28A.20; 
 41.33     Minnesota organic advisory task force, created in section 
 41.34  31.95; 
 41.35     Public programs risk adjustment work group, created in 
 41.36  section 62Q.03, expires June 30, 1999; 
 42.1      Workers' compensation self-insurers' advisory committee, 
 42.2   created in section 79A.02; 
 42.3      Youth corps advisory committee, created in section 84.0887; 
 42.4      Iron range off-highway vehicle advisory committee, created 
 42.5   in section 85.013; 
 42.6      Mineral coordinating committee, created in section 93.002; 
 42.7      Game and fish fund citizen advisory committees, created in 
 42.8   section 97A.055; 
 42.9      Wetland heritage advisory committee, created in section 
 42.10  103G.2242; 
 42.11     Wastewater treatment technical advisory committee, created 
 42.12  in section 115.54; 
 42.13     Solid waste management advisory council, created in section 
 42.14  115A.12; 
 42.15     Nuclear waste council, created in section 116C.711; 
 42.16     Genetically engineered organism advisory committee, created 
 42.17  in section 116C.93; 
 42.18     Environment and natural resources trust fund advisory 
 42.19  committee, created in section 116P.06; 
 42.20     Child abuse prevention advisory council, created in section 
 42.21  119A.13; 
 42.22     Chemical abuse and violence prevention council, created in 
 42.23  section 119A.27; 
 42.24     Youth neighborhood services advisory board, created in 
 42.25  section 119A.29; 
 42.26     Interagency coordinating council, created in section 
 42.27  125A.28, expires June 30, 1999; 
 42.28     Desegregation/integration advisory board, created in 
 42.29  section 124D.892; 
 42.30     Nonpublic education council, created in section 123B.445; 
 42.31     Permanent school fund advisory committee, created in 
 42.32  section 127A.30; 
 42.33     Indian scholarship committee, created in section 124D.84, 
 42.34  subdivision 2; 
 42.35     American Indian education committees, created in section 
 42.36  124D.80; 
 43.1      Summer scholarship advisory committee, created in section 
 43.2   124D.95; 
 43.3      Multicultural education advisory committee, created in 
 43.4   section 124D.894; 
 43.5      Male responsibility and fathering grants review committee, 
 43.6   created in section 124D.33; 
 43.7      Library for the blind and physically handicapped advisory 
 43.8   committee, created in section 134.31; 
 43.9      Higher education advisory council, created in section 
 43.10  136A.031; 
 43.11     Student advisory council, created in section 136A.031; 
 43.12     Cancer surveillance advisory committee, created in section 
 43.13  144.672; 
 43.14     Maternal and child health task force, created in section 
 43.15  145.881; 
 43.16     State community health advisory committee, created in 
 43.17  section 145A.10; 
 43.18     Mississippi River Parkway commission, created in section 
 43.19  161.1419; 
 43.20     School bus safety advisory committee, created in section 
 43.21  169.435; 
 43.22     Advisory council on workers' compensation, created in 
 43.23  section 175.007; 
 43.24     Code enforcement advisory council, created in section 
 43.25  175.008; 
 43.26     Medical services review board, created in section 176.103; 
 43.27     Apprenticeship advisory council, created in section 178.02; 
 43.28     OSHA advisory council, created in section 182.656; 
 43.29     Health professionals services program advisory committee, 
 43.30  created in section 214.32; 
 43.31     Rehabilitation advisory council for the blind, created in 
 43.32  section 248.10; 
 43.33     American Indian advisory council, created in section 
 43.34  254A.035; 
 43.35     Alcohol and other drug abuse advisory council, created in 
 43.36  section 254A.04; 
 44.1      Medical assistance drug formulary committee, created in 
 44.2   section 256B.0625; 
 44.3      Home care advisory committee, created in section 256B.071; 
 44.4      Preadmission screening, alternative care, and home and 
 44.5   community-based services advisory committee, created in section 
 44.6   256B.0911; 
 44.7      Traumatic brain injury advisory committee, created in 
 44.8   section 256B.093; 
 44.9      Minnesota commission serving deaf and hard-of-hearing 
 44.10  people, created in section 256C.28; 
 44.11     American Indian child welfare advisory council, created in 
 44.12  section 257.3579; 
 44.13     Juvenile justice advisory committee, created in section 
 44.14  268.29; 
 44.15     Northeast Minnesota economic development fund technical 
 44.16  advisory committees, created in section 298.2213; 
 44.17     Iron range higher education committee, created in section 
 44.18  298.2214; 
 44.19     Northeast Minnesota economic protection trust fund 
 44.20  technical advisory committee, created in section 298.297; 
 44.21     Pipeline safety advisory committee, created in section 
 44.22  299J.06, expires June 30, 1998; 
 44.23     Battered women's advisory council, created in section 
 44.24  611A.34. 
 44.25     Sec. 3.  Minnesota Statutes 1998, section 31.96, is amended 
 44.26  to read: 
 44.27     31.96 [FOOD HANDLER CERTIFICATION.] 
 44.28     The commissioner may require certification of retail food 
 44.29  handlers in establishments licensed under section 28A.05, 
 44.30  paragraph (a), for retail food preparation, handling, and 
 44.31  service practices.  A retail food handler licensed under section 
 44.32  28A.05, paragraph (a), shall comply with the requirements for 
 44.33  the manager certification program under section 157.011, 
 44.34  subdivision 2.  An interagency agreement with the department of 
 44.35  health must be established for the transfer of funds to the 
 44.36  commissioner to cover the cost of administering the manager 
 45.1   certification program. 
 45.2      Sec. 4.  Minnesota Statutes 1998, section 62J.04, 
 45.3   subdivision 3, is amended to read: 
 45.4      Subd. 3.  [COST CONTAINMENT DUTIES.] After obtaining the 
 45.5   advice and recommendations of the Minnesota health care 
 45.6   commission, The commissioner shall: 
 45.7      (1) establish statewide and regional cost containment goals 
 45.8   for total health care spending under this section and collect 
 45.9   data as described in sections 62J.38 to 62J.41 to monitor 
 45.10  statewide achievement of the cost containment goals; 
 45.11     (2) divide the state into no fewer than four regions, with 
 45.12  one of those regions being the Minneapolis/St. Paul metropolitan 
 45.13  statistical area but excluding Chisago, Isanti, Wright, and 
 45.14  Sherburne counties, for purposes of fostering the development of 
 45.15  regional health planning and coordination of health care 
 45.16  delivery among regional health care systems and working to 
 45.17  achieve the cost containment goals; 
 45.18     (3) provide technical assistance to regional coordinating 
 45.19  boards; 
 45.20     (4) monitor the quality of health care throughout the state 
 45.21  and take action as necessary to ensure an appropriate level of 
 45.22  quality; 
 45.23     (5) (4) issue recommendations regarding uniform billing 
 45.24  forms, uniform electronic billing procedures and data 
 45.25  interchanges, patient identification cards, and other uniform 
 45.26  claims and administrative procedures for health care providers 
 45.27  and private and public sector payers.  In developing the 
 45.28  recommendations, the commissioner shall review the work of the 
 45.29  work group on electronic data interchange (WEDI) and the 
 45.30  American National Standards Institute (ANSI) at the national 
 45.31  level, and the work being done at the state and local level.  
 45.32  The commissioner may adopt rules requiring the use of the 
 45.33  Uniform Bill 82/92 form, the National Council of Prescription 
 45.34  Drug Providers (NCPDP) 3.2 electronic version, the Health Care 
 45.35  Financing Administration 1500 form, or other standardized forms 
 45.36  or procedures; 
 46.1      (6) (5) undertake health planning responsibilities as 
 46.2   provided in section 62J.15; 
 46.3      (7) (6) authorize, fund, or promote research and 
 46.4   experimentation on new technologies and health care procedures; 
 46.5      (8) (7) within the limits of appropriations for these 
 46.6   purposes, administer or contract for statewide consumer 
 46.7   education and wellness programs that will improve the health of 
 46.8   Minnesotans and increase individual responsibility relating to 
 46.9   personal health and the delivery of health care services, 
 46.10  undertake prevention programs including initiatives to improve 
 46.11  birth outcomes, expand childhood immunization efforts, and 
 46.12  provide start-up grants for worksite wellness programs; 
 46.13     (9) (8) undertake other activities to monitor and oversee 
 46.14  the delivery of health care services in Minnesota with the goal 
 46.15  of improving affordability, quality, and accessibility of health 
 46.16  care for all Minnesotans; and 
 46.17     (10) (9) make the cost containment goal data available to 
 46.18  the public in a consumer-oriented manner. 
 46.19     Sec. 5.  Minnesota Statutes 1998, section 62J.06, is 
 46.20  amended to read: 
 46.21     62J.06 [IMMUNITY FROM LIABILITY.] 
 46.22     No member of the regional coordinating boards established 
 46.23  under section 62J.09, or the health technology advisory 
 46.24  committee established under section 62J.15, shall be held 
 46.25  civilly or criminally liable for an act or omission by that 
 46.26  person if the act or omission was in good faith and within the 
 46.27  scope of the member's responsibilities under this chapter.  
 46.28     Sec. 6.  Minnesota Statutes 1998, section 62J.07, 
 46.29  subdivision 1, is amended to read: 
 46.30     Subdivision 1.  [LEGISLATIVE OVERSIGHT.] The legislative 
 46.31  commission on health care access reviews the activities of the 
 46.32  commissioner of health, the regional coordinating boards, the 
 46.33  health technology advisory committee, and all other state 
 46.34  agencies involved in the implementation and administration of 
 46.35  this chapter, including efforts to obtain federal approval 
 46.36  through waivers and other means.  
 47.1      Sec. 7.  Minnesota Statutes 1998, section 62J.07, 
 47.2   subdivision 3, is amended to read: 
 47.3      Subd. 3.  [REPORTS TO THE COMMISSION.] The commissioner of 
 47.4   health, the regional coordinating boards, and the health 
 47.5   technology advisory committee shall report on their activities 
 47.6   annually and at other times at the request of the legislative 
 47.7   commission on health care access.  The commissioners of health, 
 47.8   commerce, and human services shall provide periodic reports to 
 47.9   the legislative commission on the progress of rulemaking that is 
 47.10  authorized or required under this chapter and shall notify 
 47.11  members of the commission when a draft of a proposed rule has 
 47.12  been completed and scheduled for publication in the State 
 47.13  Register.  At the request of a member of the commission, a 
 47.14  commissioner shall provide a description and a copy of a 
 47.15  proposed rule. 
 47.16     Sec. 8.  Minnesota Statutes 1998, section 62J.09, 
 47.17  subdivision 8, is amended to read: 
 47.18     Subd. 8.  [REPEALER.] This section is repealed effective 
 47.19  July 1, 2000 1999. 
 47.20     Sec. 9.  Minnesota Statutes 1998, section 62J.2930, 
 47.21  subdivision 3, is amended to read: 
 47.22     Subd. 3.  [CONSUMER INFORMATION.] The information 
 47.23  clearinghouse or another entity designated by the commissioner 
 47.24  shall provide consumer information to health plan company 
 47.25  enrollees to: 
 47.26     (1) assist enrollees in understanding their rights; 
 47.27     (2) explain and assist in the use of all available 
 47.28  complaint systems, including internal complaint systems within 
 47.29  health carriers, community integrated service networks, and the 
 47.30  departments of health and commerce; 
 47.31     (3) provide information on coverage options in each 
 47.32  regional coordinating board region of the state; 
 47.33     (4) provide information on the availability of purchasing 
 47.34  pools and enrollee subsidies; and 
 47.35     (5) help consumers use the health care system to obtain 
 47.36  coverage. 
 48.1      The information clearinghouse or other entity designated by 
 48.2   the commissioner for the purposes of this subdivision shall not: 
 48.3      (1) provide legal services to consumers; 
 48.4      (2) represent a consumer or enrollee; or 
 48.5      (3) serve as an advocate for consumers in disputes with 
 48.6   health plan companies.  
 48.7   Nothing in this subdivision shall interfere with the ombudsman 
 48.8   program established under section 256B.031, subdivision 6, or 
 48.9   other existing ombudsman programs. 
 48.10     Sec. 10.  Minnesota Statutes 1998, section 62J.451, 
 48.11  subdivision 6a, is amended to read: 
 48.12     Subd. 6a.  [HEALTH PLAN COMPANY PERFORMANCE MEASUREMENT.] 
 48.13  As part of the performance measurement plan specified in 
 48.14  subdivision 6, the health data institute shall develop a 
 48.15  mechanism to assess the performance of health plan companies, 
 48.16  and to disseminate this information through reports and other 
 48.17  means annually prepare a report assessing the performance of 
 48.18  health plan companies in Minnesota.  The report shall include 
 48.19  consumer survey information collected in a manner consistent 
 48.20  with subdivision 6b and other standard performance measurement 
 48.21  information, including but not limited to the financial and 
 48.22  utilization data classified as public data under chapter 13 that 
 48.23  are reported to the commissioner of health under chapter 62D and 
 48.24  to the commissioner of commerce under chapters 62A and 62C.  The 
 48.25  report shall be disseminated to consumers, purchasers, 
 48.26  policymakers, and other interested parties, consistent with the 
 48.27  data policies specified in section 62J.452.  
 48.28     Sec. 11.  Minnesota Statutes 1998, section 62J.451, 
 48.29  subdivision 6b, is amended to read: 
 48.30     Subd. 6b.  [CONSUMER SURVEYS.] (a) The health data 
 48.31  institute shall develop and implement a mechanism for collecting 
 48.32  comparative data on consumer perceptions of the health care 
 48.33  system, including consumer satisfaction, through adoption of a 
 48.34  standard consumer survey.  This survey surveys for health plan 
 48.35  companies, health care delivery systems, hospitals, clinics, and 
 48.36  other provider organizations.  These surveys shall include 
 49.1   enrollees in community integrated service networks, health 
 49.2   maintenance organizations, preferred provider organizations, 
 49.3   indemnity insurance plans, public programs, and other health 
 49.4   plan companies and consumers served by health care delivery 
 49.5   systems, hospitals, clinics and other provider organizations in 
 49.6   Minnesota.  The health data institute shall determine a 
 49.7   mechanism for the inclusion of the uninsured.  
 49.8      (b) The health data institute shall conduct a standard 
 49.9   consumer survey that measures consumer satisfaction with health 
 49.10  plan companies in Minnesota.  This consumer survey may be 
 49.11  conducted every two years.  A focused survey may be conducted on 
 49.12  the off years.  Health plan companies and group purchasers shall 
 49.13  provide to the health data institute roster data as defined in 
 49.14  subdivision 2, including the names, addresses, and telephone 
 49.15  numbers of enrollees and former enrollees and other data 
 49.16  necessary for the completion of this survey.  This roster data 
 49.17  provided by the health plan companies and group purchasers is 
 49.18  classified as provided under section 62J.452.  The health data 
 49.19  institute may analyze and prepare findings from the raw, 
 49.20  unaggregated data, and the findings from this survey may be 
 49.21  included in the health plan company performance reports 
 49.22  specified in subdivision 6a, and in other reports developed and 
 49.23  disseminated by the health data institute and the commissioner.  
 49.24  The raw, unaggregated data is classified as provided under 
 49.25  section 62J.452, and may be made available by the health data 
 49.26  institute to the extent permitted under section 62J.452.  The 
 49.27  health data institute shall provide raw, unaggregated data to 
 49.28  the commissioner.  The survey may include information on the 
 49.29  following subjects: 
 49.30     (1) enrollees' overall satisfaction with their health care 
 49.31  plan; 
 49.32     (2) consumers' perception of access to emergency, urgent, 
 49.33  routine, and preventive care, including locations, hours, 
 49.34  waiting times, and access to care when needed; 
 49.35     (3) premiums and costs; 
 49.36     (4) technical competence of providers; 
 50.1      (5) communication, courtesy, respect, reassurance, and 
 50.2   support; 
 50.3      (6) choice and continuity of providers; 
 50.4      (7) continuity of care; 
 50.5      (8) outcomes of care; 
 50.6      (9) services offered by the plan, including range of 
 50.7   services, coverage for preventive and routine services, and 
 50.8   coverage for illness and hospitalization; 
 50.9      (10) availability of information; and 
 50.10     (11) paperwork. 
 50.11     (b) The health data institute shall appoint a consumer 
 50.12  advisory group which shall consist of 13 individuals, 
 50.13  representing enrollees from public and private health plan 
 50.14  companies and programs and two uninsured consumers, to advise 
 50.15  the health data institute on issues of concern to consumers.  
 50.16  The advisory group must have at least one member from each 
 50.17  regional coordinating board region of the state.  The advisory 
 50.18  group expires June 30, 1996. 
 50.19     Sec. 12.  Minnesota Statutes 1998, section 62J.451, 
 50.20  subdivision 6c, is amended to read: 
 50.21     Subd. 6c.  [PROVIDER ORGANIZATION PERFORMANCE MEASUREMENT.] 
 50.22  (a) As part of the performance measurement plan specified in 
 50.23  subdivision 6, the health data institute shall develop a 
 50.24  mechanism to assess the performance of hospitals and other 
 50.25  provider organizations, and to disseminate this 
 50.26  information annually prepare a report assessing the performance 
 50.27  of health care delivery systems, hospitals, clinics, and other 
 50.28  provider organizations in Minnesota.  This report shall include 
 50.29  consumer survey information collected in a manner consistent 
 50.30  with subdivision 6b.  This report shall be disseminated to 
 50.31  consumers, purchasers, policymakers, and other interested 
 50.32  parties, consistent with the data policies specified in section 
 50.33  62J.452.  Data to be collected may also include structural 
 50.34  characteristics including staff-mix and nurse-patient ratios.  
 50.35  In selecting additional data for collection, the health data 
 50.36  institute may consider: 
 51.1      (1) feasibility and statistical validity of the indicator; 
 51.2      (2) purchaser and public demand for the indicator; 
 51.3      (3) estimated expense of collecting and reporting the 
 51.4   indicator; and 
 51.5      (4) usefulness of the indicator for internal improvement 
 51.6   purposes. 
 51.7      (b) The health data institute may shall conduct consumer 
 51.8   surveys that focus on health care provider organizations.  These 
 51.9   surveys shall include consumers served by health care delivery 
 51.10  systems, hospitals, clinics, and other provider organizations.  
 51.11  Health care provider organizations may shall provide roster 
 51.12  data, as defined in subdivision 2, including names, addresses, 
 51.13  and telephone numbers of their patients, to the health data 
 51.14  institute for purposes of conducting the surveys.  Roster data 
 51.15  provided by health care provider organizations under this 
 51.16  paragraph are private data on individuals as defined in section 
 51.17  13.02, subdivision 12.  Providing data under this paragraph does 
 51.18  not constitute a release of health records for purposes of 
 51.19  section 144.335, subdivision 3a. 
 51.20     Sec. 13.  [62J.535] [UNIFORM BILLING REQUIREMENTS.] 
 51.21     Subdivision 1.  [DEVELOPMENT OF UNIFORM BILLING 
 51.22  TRANSACTIONS.] The commissioners of commerce and health shall 
 51.23  adopt uniform billing standards that comply with Public Law 
 51.24  Number 104-91 enacted by Congress on August 21, 1996.  The 
 51.25  uniform billing standards shall apply to all paper and 
 51.26  electronic claim transactions and shall apply to all Minnesota 
 51.27  payers, including government programs.  
 51.28     Subd. 2.  [COMPLIANCE.] Concurrent with the effective dates 
 51.29  established under Public Law Number 104-91 for uniform 
 51.30  electronic billing standards, all health care providers must 
 51.31  conform to the uniform billing standards developed by the 
 51.32  commissioners of commerce and health. 
 51.33     Sec. 14.  Minnesota Statutes 1998, section 62J.69, is 
 51.34  amended by adding a subdivision to read:  
 51.35     Subd. 2a.  [MEDICAL RESEARCH.] Notwithstanding subdivision 
 51.36  2, paragraphs (c) and (d) and subdivision 4, money may be 
 52.1   distributed under this section as grants to support medical 
 52.2   research, including medical research activities that are 
 52.3   conducted in noneducational settings by Minnesota-based 
 52.4   nonprofit organizations. 
 52.5      Sec. 15.  Minnesota Statutes 1998, section 62J.69, is 
 52.6   amended by adding a subdivision to read: 
 52.7      Subd. 6.  [FEDERAL FINANCIAL PARTICIPATION.] The 
 52.8   commissioner of human services shall seek to maximize federal 
 52.9   financial participation in payments for medical education and 
 52.10  research costs.  If the commissioner of human services 
 52.11  determines that federal financial participation is available for 
 52.12  the medical education and research trust fund, the commissioner 
 52.13  of health shall transfer to the commissioner of human services 
 52.14  the amount of state funds necessary to maximize the federal 
 52.15  funds available.  The amount transferred to the commissioner of 
 52.16  human services, plus the amount of federal financial 
 52.17  participation, shall be distributed to medical assistance 
 52.18  providers according to the distribution methodology of the 
 52.19  medical education and research trust fund established under this 
 52.20  section. 
 52.21     Sec. 16.  Minnesota Statutes 1998, section 62J.77, is 
 52.22  amended to read: 
 52.23     62J.77 [DEFINITIONS.] 
 52.24     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
 52.25  62J.77 to section 62J.80, the terms defined in this section have 
 52.26  the meanings given them. 
 52.27     Subd. 2.  [ENROLLEE.] "Enrollee" means a natural person 
 52.28  covered by a health plan company, health insurance, or health 
 52.29  coverage plan and includes an insured, policyholder, subscriber, 
 52.30  contract holder, member, covered person, or certificate holder. 
 52.31     Subd. 3.  [PATIENT.] "Patient" means a former, current, or 
 52.32  prospective patient of a health care provider.  
 52.33     Subd. 4.  [COMMISSIONER.] "Commissioner" means the 
 52.34  commissioner of health. 
 52.35     Sec. 17.  Minnesota Statutes 1998, section 62Q.03, 
 52.36  subdivision 5a, is amended to read: 
 53.1      Subd. 5a.  [PUBLIC PROGRAMS.] (a) A separate risk 
 53.2   adjustment system must be developed for state-run public 
 53.3   programs, including medical assistance, general assistance 
 53.4   medical care, and MinnesotaCare.  The system must be developed 
 53.5   in accordance with the general risk adjustment methodologies 
 53.6   described in this section, must include factors in addition to 
 53.7   age and sex adjustment, and may include additional demographic 
 53.8   factors, different targeted conditions, and/or different payment 
 53.9   amounts for conditions.  The risk adjustment system for public 
 53.10  programs must attempt to reflect the special needs related to 
 53.11  poverty, cultural, or language barriers and other needs of the 
 53.12  public program population. 
 53.13     (b) The commissioners of health and human services shall 
 53.14  jointly convene a public programs risk adjustment work group 
 53.15  responsible for advising the commissioners in the design of the 
 53.16  public programs risk adjustment system.  The public programs 
 53.17  risk adjustment work group is governed by section 15.059 for 
 53.18  purposes of membership terms, expiration, and removal of members 
 53.19  and shall terminate on June 30, 1999.  The work group shall meet 
 53.20  at the discretion of the commissioners of health and human 
 53.21  services. The commissioner of health shall work with the risk 
 53.22  adjustment association to ensure coordination between the risk 
 53.23  adjustment systems for the public and private sectors.  The 
 53.24  commissioner of human services shall seek any needed federal 
 53.25  approvals necessary for the inclusion of the medical assistance 
 53.26  program in the public programs risk adjustment system.  
 53.27     (c) The public programs risk adjustment work group must be 
 53.28  representative of the persons served by publicly paid health 
 53.29  programs and providers and health plans that meet their needs.  
 53.30  To the greatest extent possible, the appointing authorities 
 53.31  shall attempt to select representatives that have historically 
 53.32  served a significant number of persons in publicly paid health 
 53.33  programs or the uninsured.  Membership of the work group shall 
 53.34  be as follows: 
 53.35     (1) one provider member appointed by the Minnesota Medical 
 53.36  Association; 
 54.1      (2) two provider members appointed by the Minnesota 
 54.2   Hospital Association, at least one of whom must represent a 
 54.3   major disproportionate share hospital; 
 54.4      (3) five members appointed by the Minnesota Council of 
 54.5   HMOs, one of whom must represent an HMO with fewer than 50,000 
 54.6   enrollees located outside the metropolitan area and one of whom 
 54.7   must represent an HMO with at least 50 percent of total 
 54.8   membership enrolled through a public program; 
 54.9      (4) two representatives of counties appointed by the 
 54.10  Association of Minnesota Counties; 
 54.11     (5) three representatives of organizations representing the 
 54.12  interests of families, children, childless adults, and elderly 
 54.13  persons served by the various publicly paid health programs 
 54.14  appointed by the governor; 
 54.15     (6) two representatives of persons with mental health, 
 54.16  developmental or physical disabilities, chemical dependency, or 
 54.17  chronic illness appointed by the governor; and 
 54.18     (7) three public members appointed by the governor, at 
 54.19  least one of whom must represent a community health board.  The 
 54.20  risk adjustment association may appoint a representative, if a 
 54.21  representative is not otherwise appointed by an appointing 
 54.22  authority. 
 54.23     (d) The commissioners of health and human services, with 
 54.24  the advice of the public programs risk adjustment work group, 
 54.25  shall develop a work plan and time frame and shall coordinate 
 54.26  their efforts with the private sector risk adjustment 
 54.27  association's activities and other state initiatives related to 
 54.28  public program managed care reimbursement. 
 54.29     (e) Before including risk adjustment in a contract for the 
 54.30  prepaid medical assistance program, the prepaid general 
 54.31  assistance medical care program, or the MinnesotaCare program, 
 54.32  the commissioner of human services shall provide to the 
 54.33  contractor an analysis of the expected impact on the contractor 
 54.34  of the implementation of risk adjustment.  This paragraph shall 
 54.35  not apply if the contractor has not supplied information to the 
 54.36  commissioner related to the risk adjustment analysis. 
 55.1      (f) The commissioner of human services shall report to the 
 55.2   public program risk adjustment work group on the methodology the 
 55.3   department will use for risk adjustment prior to implementation 
 55.4   of the risk adjustment payment methodology.  Upon completion of 
 55.5   the report to the work group, the commissioner shall phase in 
 55.6   risk adjustment according to the following schedule: 
 55.7      (1) for the first contract year, no more than ten percent 
 55.8   of reimbursements shall be risk adjusted; and 
 55.9      (2) for the second contract year, no more than 30 percent 
 55.10  of reimbursements shall be risk adjusted. 
 55.11     Sec. 18.  Minnesota Statutes 1998, section 62Q.075, is 
 55.12  amended to read: 
 55.13     62Q.075 [LOCAL PUBLIC ACCOUNTABILITY AND COLLABORATION 
 55.14  PLAN.] 
 55.15     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 55.16  "managed care organization" means a health maintenance 
 55.17  organization or community integrated service network. 
 55.18     Subd. 2.  [REQUIREMENT.] Beginning October 31, 1997, all 
 55.19  managed care organizations shall file biennially with the action 
 55.20  plans required under section 62Q.07 a plan describing the 
 55.21  actions the managed care organization has taken and those it 
 55.22  intends to take to contribute to achieving public health goals 
 55.23  for each service area in which an enrollee of the managed care 
 55.24  organization resides.  This plan must be jointly developed in 
 55.25  collaboration with the local public health units, appropriate 
 55.26  regional coordinating boards, and other community organizations 
 55.27  providing health services within the same service area as the 
 55.28  managed care organization.  Local government units with 
 55.29  responsibilities and authority defined under chapters 145A and 
 55.30  256E may designate individuals to participate in the 
 55.31  collaborative planning with the managed care organization to 
 55.32  provide expertise and represent community needs and goals as 
 55.33  identified under chapters 145A and 256E. 
 55.34     Subd. 3.  [CONTENTS.] The plan must address the following: 
 55.35     (a) specific measurement strategies and a description of 
 55.36  any activities which contribute to public health goals and needs 
 56.1   of high risk and special needs populations as defined and 
 56.2   developed under chapters 145A and 256E; 
 56.3      (b) description of the process by which the managed care 
 56.4   organization will coordinate its activities with the community 
 56.5   health boards, regional coordinating boards, and other relevant 
 56.6   community organizations servicing the same area; 
 56.7      (c) documentation indicating that local public health units 
 56.8   and local government unit designees were involved in the 
 56.9   development of the plan; 
 56.10     (d) documentation of compliance with the plan filed the 
 56.11  previous year, including data on the previously identified 
 56.12  progress measures. 
 56.13     Subd. 4.  [REVIEW.] Upon receipt of the plan, the 
 56.14  appropriate commissioner shall provide a copy to the regional 
 56.15  coordinating boards, local community health boards, and other 
 56.16  relevant community organizations within the managed care 
 56.17  organization's service area.  After reviewing the plan, these 
 56.18  community groups may submit written comments on the plan to 
 56.19  either the commissioner of health or commerce, as applicable, 
 56.20  and may advise the commissioner of the managed care 
 56.21  organization's effectiveness in assisting to achieve regional 
 56.22  public health goals.  The plan may be reviewed by the county 
 56.23  boards, or city councils acting as a local board of health in 
 56.24  accordance with chapter 145A, within the managed care 
 56.25  organization's service area to determine whether the plan is 
 56.26  consistent with the goals and objectives of the plans required 
 56.27  under chapters 145A and 256E and whether the plan meets the 
 56.28  needs of the community.  The county board, or applicable city 
 56.29  council, may also review and make recommendations on the 
 56.30  availability and accessibility of services provided by the 
 56.31  managed care organization.  The county board, or applicable city 
 56.32  council, may submit written comments to the appropriate 
 56.33  commissioner, and may advise the commissioner of the managed 
 56.34  care organization's effectiveness in assisting to meet the needs 
 56.35  and goals as defined under the responsibilities of chapters 145A 
 56.36  and 256E.  The commissioner of health shall develop 
 57.1   recommendations to utilize the written comments submitted as 
 57.2   part of the licensure process to ensure local public 
 57.3   accountability.  These recommendations shall be reported to the 
 57.4   legislative commission on health care access by January 15, 
 57.5   1996.  Copies of these written comments must be provided to the 
 57.6   managed care organization.  The plan and any comments submitted 
 57.7   must be filed with the information clearinghouse to be 
 57.8   distributed to the public. 
 57.9      Sec. 19.  Minnesota Statutes 1998, section 62Q.19, 
 57.10  subdivision 1, is amended to read: 
 57.11     Subdivision 1.  [DESIGNATION.] (a) The commissioner shall 
 57.12  designate essential community providers.  The criteria for 
 57.13  essential community provider designation shall be the following: 
 57.14     (1) a demonstrated ability to integrate applicable 
 57.15  supportive and stabilizing services with medical care for 
 57.16  uninsured persons and high-risk and special needs populations as 
 57.17  defined in section 62Q.07, subdivision 2, paragraph (e), 
 57.18  underserved, and other special needs populations; and 
 57.19     (2) a commitment to serve low-income and underserved 
 57.20  populations by meeting the following requirements: 
 57.21     (i) has nonprofit status in accordance with chapter 317A; 
 57.22     (ii) has tax exempt status in accordance with the Internal 
 57.23  Revenue Service Code, section 501(c)(3); 
 57.24     (iii) charges for services on a sliding fee schedule based 
 57.25  on current poverty income guidelines; and 
 57.26     (iv) does not restrict access or services because of a 
 57.27  client's financial limitation; 
 57.28     (3) status as a local government unit as defined in section 
 57.29  62D.02, subdivision 11, a hospital district created or 
 57.30  reorganized under sections 447.31 to 447.37, an Indian tribal 
 57.31  government, an Indian health service unit, or a community health 
 57.32  board as defined in chapter 145A; 
 57.33     (4) a former state hospital that specializes in the 
 57.34  treatment of cerebral palsy, spina bifida, epilepsy, closed head 
 57.35  injuries, specialized orthopedic problems, and other disabling 
 57.36  conditions; or 
 58.1      (5) a rural hospital that has qualified for a sole 
 58.2   community hospital financial assistance grant in the past three 
 58.3   years under section 144.1484, subdivision 1.  For these rural 
 58.4   hospitals, the essential community provider designation applies 
 58.5   to all health services provided, including both inpatient and 
 58.6   outpatient services. 
 58.7      (b) The commissioner shall not designate a provider, or 
 58.8   maintain an existing designation for a provider, as an essential 
 58.9   community provider if the provider is an organization or 
 58.10  affiliate of an organization which provides or promotes 
 58.11  abortions or directly refers for abortions, provided that 
 58.12  nondirective counseling relating to a pregnancy does not 
 58.13  disqualify a provider from being designated or maintaining a 
 58.14  designation as an essential community provider. 
 58.15     (c) Prior to designation, the commissioner shall publish 
 58.16  the names of all applicants in the State Register.  The public 
 58.17  shall have 30 days from the date of publication to submit 
 58.18  written comments to the commissioner on the application.  No 
 58.19  designation shall be made by the commissioner until the 30-day 
 58.20  period has expired. 
 58.21     (d) The commissioner may designate an eligible provider as 
 58.22  an essential community provider for all the services offered by 
 58.23  that provider or for specific services designated by the 
 58.24  commissioner. 
 58.25     (e) For the purpose of this subdivision, supportive and 
 58.26  stabilizing services include at a minimum, transportation, child 
 58.27  care, cultural, and linguistic services where appropriate. 
 58.28     Sec. 20.  Minnesota Statutes 1998, section 62Q.19, 
 58.29  subdivision 2, is amended to read: 
 58.30     Subd. 2.  [APPLICATION.] (a) Any provider may apply to the 
 58.31  commissioner for designation as an essential community provider 
 58.32  by submitting an application form developed by the 
 58.33  commissioner.  Applications must be accepted within two years 
 58.34  after the effective date of the rules adopted by the 
 58.35  commissioner to implement this section. 
 58.36     (b) Each application submitted must be accompanied by an 
 59.1   application fee in an amount determined by the commissioner of 
 59.2   $120. The fee shall be no more than what is needed to cover the 
 59.3   administrative costs of processing the application. 
 59.4      (c) The name, address, contact person, and the date by 
 59.5   which the commissioner's decision is expected to be made shall 
 59.6   be classified as public data under section 13.41.  All other 
 59.7   information contained in the application form shall be 
 59.8   classified as private data under section 13.41 until the 
 59.9   application has been approved, approved as modified, or denied 
 59.10  by the commissioner.  Once the decision has been made, all 
 59.11  information shall be classified as public data unless the 
 59.12  applicant designates and the commissioner determines that the 
 59.13  information contains trade secret information. 
 59.14     (Effective Date: Section 20 (62Q.19, subdivision 2) is 
 59.15  effective the day following final enactment.) 
 59.16     Sec. 21.  Minnesota Statutes 1998, section 62Q.19, 
 59.17  subdivision 6, is amended to read: 
 59.18     Subd. 6.  [TERMINATION OR RENEWAL OF DESIGNATION; 
 59.19  COMMISSIONER REVIEW.] The designation as an essential community 
 59.20  provider terminates shall be valid for a five-year period from 
 59.21  the date of designation.  Five years after it the designation of 
 59.22  essential community provider is granted, or when universal 
 59.23  coverage as defined under section 62Q.165 is achieved, whichever 
 59.24  is later to a provider, the commissioner shall review the need 
 59.25  for and appropriateness of continuing the designation for that 
 59.26  provider.  The commissioner may require a provider whose 
 59.27  designation is to be reviewed to submit an application to the 
 59.28  commissioner for renewal of the designation, and may require an 
 59.29  application fee of $120 to be submitted with the application to 
 59.30  cover the administrative costs of processing the application.  
 59.31  Based on that review, the commissioner may renew a provider's 
 59.32  essential community provider designation for an additional 
 59.33  five-year period or terminate the designation.  Once the 
 59.34  designation terminates, the former essential community provider 
 59.35  has no rights or privileges beyond those of any other health 
 59.36  care provider.  The commissioner shall make a recommendation to 
 60.1   the legislature on whether an essential community provider 
 60.2   designation should be longer than five years. 
 60.3      Sec. 22.  Minnesota Statutes 1998, section 62R.06, 
 60.4   subdivision 1, is amended to read: 
 60.5      Subdivision 1.  [PROVIDER CONTRACTS.] A health provider 
 60.6   cooperative and its licensed members may execute marketing and 
 60.7   service contracts requiring the provider members to provide some 
 60.8   or all of their health care services through the provider 
 60.9   cooperative to the enrollees, members, subscribers, or insureds, 
 60.10  of a health care network cooperative, community integrated 
 60.11  service network, nonprofit health service plan, health 
 60.12  maintenance organization, accident and health insurance company, 
 60.13  or any other purchaser, including the state of Minnesota and its 
 60.14  agencies, instruments, or units of local government.  Each 
 60.15  purchasing entity is authorized to execute contracts for the 
 60.16  purchase of health care services from a health provider 
 60.17  cooperative in accordance with this section.  Any A contract 
 60.18  between a provider cooperative and a purchaser must may provide 
 60.19  for payment by the purchaser to the health provider cooperative 
 60.20  on a substantially capitated or similar risk-sharing basis or by 
 60.21  other financial arrangements authorized under state law.  Each 
 60.22  contract between a provider cooperative and a purchaser shall be 
 60.23  filed by the provider network cooperative with the commissioner 
 60.24  of health and is subject to the provisions of section 62D.19. 
 60.25     Sec. 23.  [144.1201] [DEFINITIONS.] 
 60.26     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
 60.27  144.1201 to 144.1204, the terms defined in this section have the 
 60.28  meanings given to them. 
 60.29     Subd. 2.  [BY-PRODUCT NUCLEAR MATERIAL.] "By-product 
 60.30  nuclear material" means a radioactive material, other than 
 60.31  special nuclear material, yielded in or made radioactive by 
 60.32  exposure to radiation created incident to the process of 
 60.33  producing or utilizing special nuclear material. 
 60.34     Subd. 3.  [RADIATION.] "Radiation" means ionizing radiation 
 60.35  and includes alpha rays; beta rays; gamma rays; x-rays; high 
 60.36  energy neutrons, protons, or electrons; and other atomic 
 61.1   particles. 
 61.2      Subd. 4.  [RADIOACTIVE MATERIAL.] "Radioactive material" 
 61.3   means a matter that emits radiation.  Radioactive material 
 61.4   includes special nuclear material, source nuclear material, and 
 61.5   by-product nuclear material. 
 61.6      Subd. 5.  [SOURCE NUCLEAR MATERIAL.] "Source nuclear 
 61.7   material" means uranium or thorium, or a combination thereof, in 
 61.8   any physical or chemical form; or ores that contain by weight 
 61.9   1/20 of one percent (0.05 percent) or more of uranium, thorium, 
 61.10  or a combination thereof.  Source nuclear material does not 
 61.11  include special nuclear material. 
 61.12     Subd. 6.  [SPECIAL NUCLEAR MATERIAL.] "Special nuclear 
 61.13  material" means: 
 61.14     (1) plutonium, uranium enriched in the isotope 233 or in 
 61.15  the isotope 235, and any other material that the Nuclear 
 61.16  Regulatory Commission determines to be special nuclear material 
 61.17  according to United States Code, title 42, section 2071, except 
 61.18  that source nuclear material is not included; and 
 61.19     (2) a material artificially enriched by any of the 
 61.20  materials listed in clause (1), except that source nuclear 
 61.21  material is not included. 
 61.22     Sec. 24.  [144.1202] [UNITED STATES NUCLEAR REGULATORY 
 61.23  COMMISSION AGREEMENT.] 
 61.24     Subdivision 1.  [AGREEMENT AUTHORIZED.] In order to have a 
 61.25  comprehensive program to protect the public from radiation 
 61.26  hazards, the governor, on behalf of the state, is authorized to 
 61.27  enter into agreements with the United States Nuclear Regulatory 
 61.28  Commission under the Atomic Energy Act of 1954, section 274b, as 
 61.29  amended.  The agreement shall provide for the discontinuance of 
 61.30  portions of the Nuclear Regulatory Commission's licensing and 
 61.31  related regulatory authority over by-product, source, and 
 61.32  special nuclear materials, and the assumption of regulatory 
 61.33  authority over these materials by the state. 
 61.34     Subd. 2.  [HEALTH DEPARTMENT DESIGNATED LEAD.] The 
 61.35  department of health is designated as the lead agency to pursue 
 61.36  an agreement on behalf of the governor and for any assumption of 
 62.1   specified licensing and regulatory authority from the Nuclear 
 62.2   Regulatory Commission under an agreement with the commission.  
 62.3   The commissioner of health shall establish an advisory group to 
 62.4   assist in preparing the state to meet the requirements for 
 62.5   reaching an agreement.  The commissioner may adopt rules to 
 62.6   allow the state to assume regulatory authority under an 
 62.7   agreement under this section, including the licensing and 
 62.8   regulation of radioactive materials.  Any regulatory authority 
 62.9   assumed by the state includes the ability to set and collect 
 62.10  fees. 
 62.11     Subd. 3.  [TRANSITION.] A person who, on the effective date 
 62.12  of an agreement under this section, possesses a Nuclear 
 62.13  Regulatory Commission license that is subject to the agreement 
 62.14  is deemed to possess a similar license issued by the department 
 62.15  of health.  A department of health license obtained under this 
 62.16  subdivision expires on the expiration date specified in the 
 62.17  federal license. 
 62.18     Subd. 4.  [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 
 62.19  agreement entered into before August 2, 2002, must remain in 
 62.20  effect until terminated under the Atomic Energy Act of 1954, 
 62.21  United States Code, title 42, section 2021, paragraph (j).  The 
 62.22  governor may not enter into an initial agreement with the 
 62.23  Nuclear Regulatory Commission after August 1, 2002.  If an 
 62.24  agreement is not entered into by August 1, 2002, any rules 
 62.25  adopted under this section are repealed effective August 1, 2002.
 62.26     (b) An agreement authorized under subdivision 1 must be 
 62.27  approved by law before it may be implemented. 
 62.28     Sec. 25.  [144.1203] [TRAINING; RULEMAKING.] 
 62.29     The commissioner shall adopt rules to ensure that 
 62.30  individuals handling or utilizing radioactive materials under 
 62.31  the terms of a license issued by the commissioner under section 
 62.32  144.1202 have proper training and qualifications to do so.  The 
 62.33  rules adopted must be at least as stringent as federal 
 62.34  regulations on proper training and qualifications adopted by the 
 62.35  Nuclear Regulatory Commission.  Rules adopted under this section 
 62.36  may incorporate federal regulations by reference. 
 63.1      Sec. 26.  [144.1204] [SURETY REQUIREMENTS.] 
 63.2      Subdivision 1.  [FINANCIAL ASSURANCE REQUIRED.] The 
 63.3   commissioner may require an applicant for a license under 
 63.4   section 144.1202, or a person who was formerly licensed by the 
 63.5   Nuclear Regulatory Commission and is now subject to sections 
 63.6   144.1201 to 144.1204, to post financial assurances to ensure the 
 63.7   completion of all requirements established by the commissioner 
 63.8   for the decontamination, closure, decommissioning, and 
 63.9   reclamation of sites, structures, and equipment used in 
 63.10  conjunction with activities related to licensure.  The financial 
 63.11  assurances posted must be sufficient to restore the site to 
 63.12  unrestricted future use and must be sufficient to provide for 
 63.13  surveillance and care when radioactive materials remain at the 
 63.14  site after the licensed activities cease.  The commissioner may 
 63.15  establish financial assurance criteria by rule.  In establishing 
 63.16  such criteria, the commissioner may consider: 
 63.17     (1) the chemical and physical form of the licensed 
 63.18  radioactive material; 
 63.19     (2) the quantity of radioactive material authorized; 
 63.20     (3) the particular radioisotopes authorized and their 
 63.21  subsequent radiotoxicity; 
 63.22     (4) the method in which the radioactive material is held, 
 63.23  used, stored, processed, transferred, or disposed of; and 
 63.24     (5) the potential costs of decontamination, treatment, or 
 63.25  disposal of a licensee's equipment and facilities. 
 63.26     Subd. 2.  [ACCEPTABLE FINANCIAL ASSURANCES.] The 
 63.27  commissioner may, by rule, establish types of financial 
 63.28  assurances that meet the requirements of this section.  Such 
 63.29  financial assurances may include bank letters of credit, 
 63.30  deposits of cash, or deposits of government securities. 
 63.31     Subd. 3.  [TRUST AGREEMENTS.] Financial assurances must be 
 63.32  established together with trust agreements.  Both the financial 
 63.33  assurances and the trust agreements must be in a form and 
 63.34  substance that meet requirements established by the commissioner.
 63.35     Subd. 4.  [EXEMPTIONS.] The commissioner is authorized to 
 63.36  exempt from the requirements of this section, by rule, any 
 64.1   category of licensee upon a determination by the commissioner 
 64.2   that an exemption does not result in a significant risk to the 
 64.3   public health or safety or to the environment and does not pose 
 64.4   a financial risk to the state. 
 64.5      Subd. 5.  [OTHER REMEDIES UNAFFECTED.] Nothing in this 
 64.6   section relieves a licensee of a civil liability incurred, nor 
 64.7   may this section be construed to relieve the licensee of 
 64.8   obligations to prevent or mitigate the consequences of improper 
 64.9   handling or abandonment of radioactive materials. 
 64.10     Sec. 27.  Minnesota Statutes 1998, section 144.121, is 
 64.11  amended by adding a subdivision to read: 
 64.12     Subd. 8.  [EXEMPTION FROM EXAMINATION REQUIREMENTS; 
 64.13  OPERATORS OF CERTAIN BONE DENSITOMETERS.] (a) This subdivision 
 64.14  applies to a bone densitometer that is used on humans to 
 64.15  estimate bone mineral content and bone mineral density in a 
 64.16  region of a finger on a person's nondominant hand, gives an 
 64.17  x-ray dose equivalent of less than 0.001 microsieverts per scan, 
 64.18  and has an x-ray leakage exposure rate of less than two 
 64.19  milliroentgens per hour at a distance of one meter, provided 
 64.20  that the bone densitometer is operating in accordance with 
 64.21  manufacturer specifications. 
 64.22     (b) An individual who operates a bone densitometer that 
 64.23  satisfies the definition in paragraph (a) and the facility in 
 64.24  which an individual operates such a bone densitometer are exempt 
 64.25  from the requirements of subdivisions 5 and 6. 
 64.26     (Effective Date:  Section 27 (144.121, subdivision 8) is 
 64.27  effective the day following final enactment.) 
 64.28     Sec. 28.  Minnesota Statutes 1998, section 144.147, is 
 64.29  amended to read: 
 64.30     144.147 [RURAL HOSPITAL PLANNING AND TRANSITION IMPROVEMENT 
 64.31  GRANT PROGRAM.] 
 64.32     Subdivision 1.  [DEFINITION.] "Eligible rural hospital" 
 64.33  means any nonfederal, general acute care hospital that: 
 64.34     (1) is either located in a rural area, as defined in the 
 64.35  federal Medicare regulations, Code of Federal Regulations, title 
 64.36  42, section 405.1041, or located in a community with a 
 65.1   population of less than 5,000, according to United States Census 
 65.2   Bureau statistics, outside the seven-county metropolitan area; 
 65.3      (2) has 50 or fewer beds; and 
 65.4      (3) is not for profit. 
 65.5      Subd. 2.  [GRANTS AUTHORIZED.] The commissioner shall 
 65.6   establish a program of grants to assist eligible rural 
 65.7   hospitals.  The commissioner shall award grants to hospitals and 
 65.8   communities for the purposes set forth in paragraphs (a) and (b) 
 65.9   to (c). 
 65.10     (a) Grants may be used by hospitals and their communities 
 65.11  to develop strategic plans for preserving or enhancing access to 
 65.12  health services.  At a minimum, a strategic plan must consist of:
 65.13     (1) a needs assessment to determine what health services 
 65.14  are needed and desired by the community.  The assessment must 
 65.15  include interviews with or surveys of area health professionals, 
 65.16  local community leaders, and public hearings; 
 65.17     (2) an assessment of the feasibility of providing needed 
 65.18  health services that identifies priorities and timeliness for 
 65.19  potential changes; and 
 65.20     (3) an implementation plan.  
 65.21     The strategic plan must be developed by a committee that 
 65.22  includes representatives from the hospital, local public health 
 65.23  agencies, other health providers, and consumers from the 
 65.24  community.  
 65.25     (b) The Grants may also be used by eligible rural hospitals 
 65.26  that have developed strategic plans to implement transition 
 65.27  projects to modify the type and extent of services provided, in 
 65.28  order to reflect the needs of that plan.  Grants may be used by 
 65.29  hospitals under this paragraph to develop hospital-based 
 65.30  physician practices that integrate hospital and existing medical 
 65.31  practice facilities that agree to transfer their practices, 
 65.32  equipment, staffing, and administration to the hospital.  The 
 65.33  grants may also be used by the hospital to establish a health 
 65.34  provider cooperative, a telemedicine system, or a rural health 
 65.35  care system.  Not more than one-third of any grant shall be used 
 65.36  to offset losses incurred by physicians agreeing to transfer 
 66.1   their practices to hospitals. for implementation projects that 
 66.2   reflect the needs identified in a strategic plan or similar plan.
 66.3   Implementation projects may include development or enhancement 
 66.4   of telemedicine services, diversification of health services, 
 66.5   collaborative efforts to integrate health services, or critical 
 66.6   access hospital conversion activities. 
 66.7      (c) Grants may be used by hospitals for planning and 
 66.8   implementation of capital improvement projects.  A capital 
 66.9   improvement project is designed to update, remodel, or replace 
 66.10  aging hospital facilities and equipment necessary to maintain 
 66.11  the operations of a hospital.  
 66.12     Subd. 3.  [CONSIDERATION OF GRANTS.] In determining which 
 66.13  hospitals will receive grants under this section, the 
 66.14  commissioner shall take into account:  
 66.15     (1) improving community access to hospital or health 
 66.16  services; 
 66.17     (2) changes in service populations; 
 66.18     (3) demand for availability and upgrading ambulatory and 
 66.19  emergency services; 
 66.20     (4) the extent that the health needs of the community are 
 66.21  not currently being met by other providers in the service area; 
 66.22     (5) the need to recruit and retain health professionals; 
 66.23     (6) the extent of community support; 
 66.24     (7) the integration of health care services and the 
 66.25  coordination with local community organizations, such as 
 66.26  community development and public health agencies; and 
 66.27     (8) the financial condition of the hospital. 
 66.28     Subd. 4.  [ALLOCATION OF GRANTS.] (a) Eligible hospitals 
 66.29  must apply to the commissioner no later than September October 1 
 66.30  of each fiscal year for grants awarded for that fiscal year.  A 
 66.31  grant may be awarded upon signing of a grant contract. 
 66.32     (b) The commissioner must make a final decision on the 
 66.33  funding of each application within 60 days of the deadline for 
 66.34  receiving applications. 
 66.35     (c) Each relevant community health board has 30 days in 
 66.36  which to review and comment to the commissioner on grant 
 67.1   applications from hospitals in their community health service 
 67.2   area. 
 67.3      (d) In determining which hospitals will receive grants 
 67.4   under this section, the commissioner shall consider the 
 67.5   following factors: 
 67.6      (1) Description of the problem, description of the project, 
 67.7   and the likelihood of successful outcome of the project.  The 
 67.8   applicant must explain clearly the nature of the health services 
 67.9   problems in their service area, how the grant funds will be 
 67.10  used, what will be accomplished, and the results expected.  The 
 67.11  applicant should describe achievable objectives, a timetable, 
 67.12  and roles and capabilities of responsible individuals and 
 67.13  organizations. 
 67.14     (2) The extent of community support for the hospital and 
 67.15  this proposed project.  The applicant should demonstrate support 
 67.16  for the hospital and for the proposed project from other local 
 67.17  health service providers and from local community and government 
 67.18  leaders.  Evidence of such support may include past commitments 
 67.19  of financial support from local individuals, organizations, or 
 67.20  government entities; and commitment of financial support, 
 67.21  in-kind services or cash, for this project. 
 67.22     (3) The comments, if any, resulting from a review of the 
 67.23  application by the community health board in whose community 
 67.24  health service area the hospital is located. 
 67.25     (e) In evaluating applications, the commissioner shall 
 67.26  score each application on a 100 point scale, assigning the 
 67.27  maximum of 70 points for an applicant's understanding of the 
 67.28  problem, description of the project, and likelihood of 
 67.29  successful outcome of the project; and a maximum of 30 points 
 67.30  for the extent of community support for the hospital and this 
 67.31  project.  The commissioner may also take into account other 
 67.32  relevant factors. 
 67.33     (f) A grant to a hospital, including hospitals that submit 
 67.34  applications as consortia, may not exceed $50,000 a year and may 
 67.35  not exceed a term of two years.  Prior to the receipt of any 
 67.36  grant, the hospital must certify to the commissioner that at 
 68.1   least one-half of the amount, which may include in-kind 
 68.2   services, is available for the same purposes from nonstate 
 68.3   sources.  A hospital receiving a grant under this section may 
 68.4   use the grant for any expenses incurred in the development of 
 68.5   strategic plans or the implementation of transition projects 
 68.6   with respect to which the grant is made.  Project grants may not 
 68.7   be used to retire debt incurred with respect to any capital 
 68.8   expenditure made prior to the date on which the project is 
 68.9   initiated.  In determining the grant amount a hospital will 
 68.10  receive under this section, the commissioner shall consider the 
 68.11  following factors: 
 68.12     (1) grants to hospitals for planning and implementation 
 68.13  under subdivision 2, paragraphs (a) and (b), may not exceed 
 68.14  $100,000 a year and may not exceed a term of two years.  Prior 
 68.15  to the receipt of any grant, the hospital must certify to the 
 68.16  commissioner that at least one-half of the amount of the total 
 68.17  cost of the planning or implementation project, which may 
 68.18  include in-kind services, is available for the same purposes 
 68.19  from nonstate sources; and 
 68.20     (2) grants to hospitals for planning and implementation 
 68.21  projects under subdivision 2, paragraph (c), may not exceed 
 68.22  $300,000 a year and may not exceed a term of two years.  Prior 
 68.23  to the receipt of any grant, the hospital must certify to the 
 68.24  commissioner that at least one-quarter of the amount of the 
 68.25  total cost of the planning and implementation project, which may 
 68.26  include in-kind services, is available for the same purposes 
 68.27  from nonstate sources.  A hospital receiving a grant under this 
 68.28  section may use the grant for any expenses incurred in the 
 68.29  development of strategic plans or the implementation of 
 68.30  transition projects with respect to which the grant is made.  
 68.31  Project grants may not be used to retire debt incurred with 
 68.32  respect to any capital expenditure made prior to the date on 
 68.33  which the project is initiated.  Hospitals may apply to the 
 68.34  program each year they are eligible. 
 68.35     (g) The commissioner may adopt rules to implement this 
 68.36  section. 
 69.1      Subd. 5.  [EVALUATION.] The commissioner shall evaluate the 
 69.2   overall effectiveness of the grant program.  The commissioner 
 69.3   may collect, from the hospital, and communities receiving 
 69.4   grants, the information necessary quarterly progress reports to 
 69.5   evaluate the grant program.  Information related to the 
 69.6   financial condition of individual hospitals shall be classified 
 69.7   as nonpublic data. 
 69.8      Subd. 6.  [EXPIRATION.] This section expires June 30, 2001. 
 69.9      Sec. 29.  Minnesota Statutes 1998, section 144.1483, is 
 69.10  amended to read: 
 69.11     144.1483 [RURAL HEALTH INITIATIVES.] 
 69.12     The commissioner of health, through the office of rural 
 69.13  health, and consulting as necessary with the commissioner of 
 69.14  human services, the commissioner of commerce, the higher 
 69.15  education services office, and other state agencies, shall: 
 69.16     (1) develop a detailed plan regarding the feasibility of 
 69.17  coordinating rural health care services by organizing individual 
 69.18  medical providers and smaller hospitals and clinics into 
 69.19  referral networks with larger rural hospitals and clinics that 
 69.20  provide a broader array of services; 
 69.21     (2) develop and implement a program to assist rural 
 69.22  communities in establishing community health centers, as 
 69.23  required by section 144.1486; 
 69.24     (3) administer the program of financial assistance 
 69.25  established under section 144.1484 for rural hospitals in 
 69.26  isolated areas of the state that are in danger of closing 
 69.27  without financial assistance, and that have exhausted local 
 69.28  sources of support; 
 69.29     (4) develop recommendations regarding health education and 
 69.30  training programs in rural areas, including but not limited to a 
 69.31  physician assistants' training program, continuing education 
 69.32  programs for rural health care providers, and rural outreach 
 69.33  programs for nurse practitioners within existing training 
 69.34  programs; 
 69.35     (5) develop a statewide, coordinated recruitment strategy 
 69.36  for health care personnel and maintain a database on health care 
 70.1   personnel as required under section 144.1485; 
 70.2      (6) develop and administer technical assistance programs to 
 70.3   assist rural communities in:  (i) planning and coordinating the 
 70.4   delivery of local health care services; and (ii) hiring 
 70.5   physicians, nurse practitioners, public health nurses, physician 
 70.6   assistants, and other health personnel; 
 70.7      (7) study and recommend changes in the regulation of health 
 70.8   care personnel, such as nurse practitioners and physician 
 70.9   assistants, related to scope of practice, the amount of on-site 
 70.10  physician supervision, and dispensing of medication, to address 
 70.11  rural health personnel shortages; 
 70.12     (8) support efforts to ensure continued funding for medical 
 70.13  and nursing education programs that will increase the number of 
 70.14  health professionals serving in rural areas; 
 70.15     (9) support efforts to secure higher reimbursement for 
 70.16  rural health care providers from the Medicare and medical 
 70.17  assistance programs; 
 70.18     (10) coordinate the development of a statewide plan for 
 70.19  emergency medical services, in cooperation with the emergency 
 70.20  medical services advisory council; 
 70.21     (11) establish a Medicare rural hospital flexibility 
 70.22  program pursuant to section 1820 of the federal Social Security 
 70.23  Act, United States Code, title 42, section 1395i-4, by 
 70.24  developing a state rural health plan and designating, consistent 
 70.25  with the rural health plan, rural nonprofit or public hospitals 
 70.26  in the state as critical access hospitals.  Critical access 
 70.27  hospitals shall include facilities that are certified by the 
 70.28  state as necessary providers of health care services to 
 70.29  residents in the area.  Necessary providers of health care 
 70.30  services are designated as critical access hospitals on the 
 70.31  basis of being more than 20 miles, defined as official mileage 
 70.32  as reported by the Minnesota department of transportation, from 
 70.33  the next nearest hospital or being the sole hospital in the 
 70.34  county or being a hospital located in a designated medical 
 70.35  underserved area or health professional shortage area.  A 
 70.36  critical access hospital located in a designated medical 
 71.1   underserved area or a health professional shortage area shall 
 71.2   continue to be recognized as a critical access hospital in the 
 71.3   event the medical underserved area or health professional 
 71.4   shortage area designation is subsequently withdrawn; and 
 71.5      (12) carry out other activities necessary to address rural 
 71.6   health problems. 
 71.7      Sec. 30.  Minnesota Statutes 1998, section 144.1492, 
 71.8   subdivision 3, is amended to read: 
 71.9      Subd. 3.  [ELIGIBLE APPLICANTS AND CRITERIA FOR AWARDING OF 
 71.10  GRANTS TO RURAL COMMUNITIES.] (a) Funding which the department 
 71.11  receives to award grants to rural communities to establish 
 71.12  health care networks shall be awarded through a request for 
 71.13  proposals process.  Planning grant funds may be used for 
 71.14  community facilitation and initial network development 
 71.15  activities including incorporation as a nonprofit organization 
 71.16  or cooperative, assessment of network models, and determination 
 71.17  of the best fit for the community.  Implementation grant funds 
 71.18  can be used to enable incorporated nonprofit organizations and 
 71.19  cooperatives to purchase technical services needed for further 
 71.20  network development such as legal, actuarial, financial, 
 71.21  marketing, and administrative services. 
 71.22     (b) In order to be eligible to apply for a planning or 
 71.23  implementation grant under the federally funded health care 
 71.24  network reform program, an organization must be located in a 
 71.25  rural area of Minnesota excluding the seven-county Twin Cities 
 71.26  metropolitan area and the census-defined urbanized areas of 
 71.27  Duluth, Rochester, St. Cloud, and Moorhead.  The proposed 
 71.28  network organization must also meet or plan to meet the criteria 
 71.29  for a community integrated service network. 
 71.30     (c) In determining which organizations will receive grants, 
 71.31  the commissioner may consider the following factors: 
 71.32     (1) the applicant's description of their plans for health 
 71.33  care network development, their need for technical assistance, 
 71.34  and other technical assistance resources available to the 
 71.35  applicant.  The applicant must clearly describe the service area 
 71.36  to be served by the network, how the grant funds will be used, 
 72.1   what will be accomplished, and the expected results.  The 
 72.2   applicant should describe achievable objectives, a timetable, 
 72.3   and roles and capabilities of responsible individuals and 
 72.4   organizations; 
 72.5      (2) the extent of community support for the applicant and 
 72.6   the health care network.  The applicant should demonstrate 
 72.7   support from private and public health care providers in the 
 72.8   service area, and local community and government leaders, and 
 72.9   the regional coordinating board for the area.  Evidence of such 
 72.10  support may include a commitment of financial support, in-kind 
 72.11  services, or cash, for development of the network; 
 72.12     (3) the size and demographic characteristics of the 
 72.13  population in the service area for the proposed network and the 
 72.14  distance of the service area from the nearest metropolitan area; 
 72.15  and 
 72.16     (4) the technical assistance resources available to the 
 72.17  applicant from nonstate sources and the financial ability of the 
 72.18  applicant to purchase technical assistance services with 
 72.19  nonstate funds. 
 72.20     Sec. 31.  [144.1498] [LOAN FORGIVENESS FOR RURAL AND 
 72.21  UNDERSERVED URBAN AREA PHARMACISTS.] 
 72.22     Subdivision 1.  [DEFINITIONS.] (a) For purposes of sections 
 72.23  144.1498 and 144.1499, the terms defined in this subdivision 
 72.24  have the meanings given them, unless the context clearly 
 72.25  indicates otherwise. 
 72.26     (b) "Designated rural or underserved urban area" means a 
 72.27  geographic area given that designation by the commissioner of 
 72.28  health. 
 72.29     (c) "Eligible applicant" means a pharmacist licensed under 
 72.30  chapter 151 and practicing in Minnesota. 
 72.31     (d) "Qualified loan" means a government or commercial loan 
 72.32  for actual costs paid for tuition, reasonable education 
 72.33  expenses, and reasonable living expenses related to the graduate 
 72.34  or undergraduate education of a pharmacist. 
 72.35     Subd. 2.  [CREATION.] The commissioner shall establish a 
 72.36  loan forgiveness program for pharmacists agreeing to practice in 
 73.1   designated rural or underserved urban areas.  The commissioner 
 73.2   shall contract with a statewide pharmacist association 
 73.3   representing all pharmacy practice settings to administer the 
 73.4   program.  The program shall cover up to 25 participants per 
 73.5   year, and the total number of participants in the program at any 
 73.6   one time shall not exceed 50 participants. 
 73.7      Subd. 3.  [SELECTION CRITERIA; STARTING DATES.] The 
 73.8   commissioner shall determine selection criteria for applicants.  
 73.9   The commissioner shall also determine the participant's starting 
 73.10  date of service in a rural or underserved urban area.  
 73.11     Subd. 4.  [LOAN FORGIVENESS.] A pharmacist who is accepted 
 73.12  must sign a contract to serve at least five years in a 
 73.13  designated rural or underserved urban area.  For each year that 
 73.14  a participant serves as a pharmacist in a designated rural or 
 73.15  underserved urban area, the commissioner shall annually pay to 
 73.16  the program administrator an amount equal to one year of 
 73.17  qualified loans for all participants.  Participants who move 
 73.18  their practice from one designated rural or underserved urban 
 73.19  area to another remain eligible for loan repayment. 
 73.20     Subd. 5.  [PROCEDURE FOR LOAN REPAYMENT.] A program 
 73.21  participant, at the time of signing a contract, shall designate 
 73.22  the qualifying loan or loans up to a maximum of $10,000 per year 
 73.23  for not more than five years.  A participant must make payments 
 73.24  directly on the participant's loans.  The program administrator 
 73.25  is responsible for verifying the amount of debt, the 
 73.26  participant's timely repayment of debt, and the participant's 
 73.27  length and terms of service.  The program administrator shall 
 73.28  reimburse the participant on a quarterly basis for payments made 
 73.29  by the participant on qualifying loans in an amount not to 
 73.30  exceed $10,000 per year when annualized.  If the amount 
 73.31  reimbursed by the program administrator is less than $10,000 
 73.32  during a 12-month period, the program administrator shall pay 
 73.33  during the 12th month an additional amount toward a loan or 
 73.34  loans designated by the participant, to bring the total paid to 
 73.35  $10,000.  The total amount reimbursed by the program 
 73.36  administrator must not exceed the amount of principal and 
 74.1   accrued interest of the designated loans. 
 74.2      Subd. 6.  [TAX RESPONSIBILITY.] The participant is 
 74.3   responsible for reporting on federal income tax returns any 
 74.4   amount paid by the state on designated loans, if required to do 
 74.5   so by federal law. 
 74.6      Subd. 7.  [PENALTY FOR NONFULFILLMENT.] If a participant 
 74.7   does not fulfill the required five-year minimum commitment of 
 74.8   service in a designated rural or underserved urban area, the 
 74.9   program administrator shall recover from the participant the 
 74.10  amount paid under the loan forgiveness program.  A program 
 74.11  participant who fails to complete at least three years of 
 74.12  obligated service shall repay the amount paid, as well as a 
 74.13  financial penalty based upon the length of the service 
 74.14  obligation not fulfilled.  If the participant has served at 
 74.15  least two years, the financial penalty is the number of unserved 
 74.16  months multiplied by $1,000.  If the participant has served less 
 74.17  than two years, the financial penalty is the total number of 
 74.18  obligated months multiplied by $1,000.  The program 
 74.19  administrator has the authority to collect on all loan defaults. 
 74.20     Subd. 8.  [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 
 74.21  service obligations cancel in the event of a participant's 
 74.22  death.  The commissioner may waive or suspend payment or service 
 74.23  obligations in case of total and permanent disability or 
 74.24  long-term temporary disability lasting for more than two years.  
 74.25  The commissioner shall evaluate all other requests for 
 74.26  suspension or waivers on a case-by-case basis and may grant a 
 74.27  waiver of all or part of the money owed as a result of a 
 74.28  nonfulfillment penalty if emergency circumstances prevented 
 74.29  fulfillment of the required service commitment. 
 74.30     Sec. 32.  [144.1499] [RURAL AND UNDERSERVED URBAN AREA 
 74.31  PHARMACY FINANCIAL ASSISTANCE.] 
 74.32     Subdivision 1.  [ESTABLISHED.] The commissioner of health 
 74.33  shall award financial assistance grants to pharmacies in 
 74.34  designated rural or underserved urban areas that are designated 
 74.35  as sole community pharmacies.  
 74.36     Subd. 2.  [PROGRAM ADMINISTRATION.] The commissioner shall 
 75.1   contract with a statewide pharmacist association representing 
 75.2   all pharmacy practice settings to administer the program.  The 
 75.3   commissioner shall establish criteria for determining sole 
 75.4   community pharmacies in rural and underserved urban areas.  
 75.5      Subd. 3.  [EVIDENCE OF LOCAL SUPPORT.] In selecting 
 75.6   pharmacies to receive grants, the program administrator shall 
 75.7   take into account the extent of local support for the pharmacy.  
 75.8   Evidence of local support may include statements issued by a 
 75.9   local government entity, such as a city or county, and loans, 
 75.10  grants, or donations to the pharmacy from local government 
 75.11  entities, private organizations, or individuals. 
 75.12     Subd. 4.  [GRANT AWARDS.] The program administrator shall 
 75.13  determine the amount of the award to be given to each eligible 
 75.14  pharmacy based on the pharmacy's total operating losses as a 
 75.15  percentage of total operating revenue for two of the previous 
 75.16  three most recent consecutive fiscal years.  For purposes of 
 75.17  calculating a pharmacy's operating loss margin, total operating 
 75.18  revenue does not include grant funding provided under this 
 75.19  section.  The available funds shall be disbursed proportionately 
 75.20  based on the operating loss margins of all eligible pharmacies. 
 75.21     Sec. 33.  [144.3431] [ABORTION NOTIFICATION DATA.] 
 75.22     Subdivision 1.  [REPORTING FORM.] (a) Within 90 days of the 
 75.23  effective date of this section, the commissioner of health shall 
 75.24  prepare a reporting form for use by physicians and facilities 
 75.25  performing abortions. 
 75.26     (b) The form shall require the following information: 
 75.27     (1) the number of minors or women for whom a guardian or 
 75.28  conservator has been appointed under sections 525.54 to 525.551 
 75.29  because of a finding of incompetency for whom the physician or 
 75.30  an agent of the physician provided the notice described in 
 75.31  section 144.343, subdivision 2; of that number, the number of 
 75.32  notices provided personally as described in section 144.343, 
 75.33  subdivision 2, paragraph (a), and the number of notices provided 
 75.34  by mail as described in section 144.343, subdivision 2, 
 75.35  paragraph (b); and of each of those numbers, the number who, to 
 75.36  the best of the reporting physician's or reporting facility's 
 76.1   information and belief, went on to obtain the abortion from the 
 76.2   reporting physician or reporting physician's facility, or from 
 76.3   the reporting facility; 
 76.4      (2) the number of minors or women for whom a guardian or 
 76.5   conservator has been appointed under sections 525.54 to 525.551 
 76.6   because of a finding of incompetency upon whom the physician 
 76.7   performed an abortion without providing the notice described in 
 76.8   section 144.343, subdivision 2; and of that number, the number 
 76.9   who were emancipated minors, and the number for whom section 
 76.10  144.343, subdivision 4, was applicable, itemized by each of the 
 76.11  limitations identified in paragraphs (a), (b), and (c) of that 
 76.12  subdivision; 
 76.13     (3) the number of abortions performed by the physician for 
 76.14  which judicial authorization was received and for which the 
 76.15  notification described in section 144.343, subdivision 2, was 
 76.16  not provided; 
 76.17     (4) the county the female resides in; the county where the 
 76.18  abortion was performed, if different from the female's 
 76.19  residence; and, if a judicial bypass was obtained, the county it 
 76.20  was obtained in, if different from the female's residence; 
 76.21     (5) the age of the female; 
 76.22     (6) the race of the female; 
 76.23     (7) the process the physician or the physician's agent used 
 76.24  to inform the female of the judicial bypass; whether court forms 
 76.25  were provided to her; and whether the physician or the 
 76.26  physician's agent made the court arrangement for the female; and 
 76.27     (8) how soon after visiting the abortion facility the 
 76.28  female went to court to obtain a judicial bypass. 
 76.29     Subd. 2.  [FORMS TO PHYSICIANS AND FACILITIES.] Physicians 
 76.30  and facilities required to report under subdivision 3 shall 
 76.31  obtain reporting forms from the commissioner. 
 76.32     Subd. 3.  [SUBMISSION.] (a) The following physicians or 
 76.33  facilities must submit the forms to the commissioner no later 
 76.34  than April 1 for abortions performed in the previous calendar 
 76.35  year: 
 76.36     (1) a physician who provides, or whose agent provides, the 
 77.1   notice described in section 144.343, subdivision 2, or the 
 77.2   facility at which such notice is provided; and 
 77.3      (2) a physician who knowingly performs an abortion upon a 
 77.4   minor or a woman for whom a guardian or conservator has been 
 77.5   appointed according to sections 525.54 to 525.551 because of a 
 77.6   finding of incompetency, or a facility at which such an abortion 
 77.7   is performed. 
 77.8      (b) The commissioner shall maintain as confidential, data 
 77.9   which alone or in combination may constitute information that 
 77.10  would reasonably lead, using epidemiologic principles, to the 
 77.11  identification of: 
 77.12     (1) an individual who has had an abortion, who has received 
 77.13  judicial authorization for an abortion, or to whom the notice 
 77.14  described in section 144.343, subdivision 2, has been provided; 
 77.15  or 
 77.16     (2) a physician or facility required to report under 
 77.17  paragraph (a). 
 77.18     Subd. 4.  [FAILURE TO REPORT AS REQUIRED.] (a) Reports that 
 77.19  are not submitted more than 30 days following the due date shall 
 77.20  be subject to a late fee of $500 for each additional 30-day 
 77.21  period or portion of a 30-day period overdue.  If a physician or 
 77.22  facility required to report under this section has not submitted 
 77.23  a report, or has submitted only an incomplete report, more than 
 77.24  one year following the due date, the commissioner of health 
 77.25  shall bring an action in a court of competent jurisdiction for 
 77.26  an order directing the physician or facility to submit a 
 77.27  complete report within a period stated by court order or be 
 77.28  subject to sanctions.  If the commissioner brings such an action 
 77.29  for an order directing a physician or facility to submit a 
 77.30  complete report, the court may assess reasonable attorney fees 
 77.31  and costs against the noncomplying party. 
 77.32     (b) Notwithstanding section 13.39, data related to actions 
 77.33  taken by the commissioner to enforce any provision of this 
 77.34  section is private data if the data, alone or in combination, 
 77.35  may constitute information that would reasonably lead, using 
 77.36  epidemiologic principles, to the identification of: 
 78.1      (1) an individual who has had an abortion, who has received 
 78.2   judicial authorization for an abortion, or to whom the notice 
 78.3   described in section 144.343, subdivision 2, has been provided; 
 78.4   or 
 78.5      (2) a physician or facility required to report under 
 78.6   subdivision 3. 
 78.7      Subd. 5.  [PUBLIC RECORDS.] (a) By September 30 of each 
 78.8   year, the commissioner of health shall issue a public report 
 78.9   providing statistics for each item listed in subdivision 1 for 
 78.10  the previous calendar year compiled from reports submitted 
 78.11  according to this section.  The report shall also include 
 78.12  statistics, which shall be obtained from court administrators, 
 78.13  that include: 
 78.14     (1) the total number of petitions or motions filed under 
 78.15  section 144.343, subdivision 6, paragraph (c), clause (i); 
 78.16     (2) the number of cases in which the court appointed a 
 78.17  guardian ad litem; 
 78.18     (3) the number of cases in which the court appointed 
 78.19  counsel; 
 78.20     (4) the number of cases in which the judge issued an order 
 78.21  authorizing an abortion without notification, including: 
 78.22     (i) the number of petitions or motions granted by the court 
 78.23  because of a finding of maturity and the basis for that finding; 
 78.24  and 
 78.25     (ii) the number of petitions or motions granted because of 
 78.26  a finding that the abortion would be in the best interest of the 
 78.27  minor and the basis for that finding; 
 78.28     (5) the number of denials from which an appeal was filed; 
 78.29     (6) the number of appeals that resulted in a denial being 
 78.30  affirmed; and 
 78.31     (7) the number of appeals that resulted in reversal of a 
 78.32  denial. 
 78.33     (b) The report shall provide the statistics for all 
 78.34  previous calendar years for which a public report was required 
 78.35  to be issued, adjusted to reflect any additional information 
 78.36  from late or corrected reports. 
 79.1      (c) The commissioner shall ensure that all statistical 
 79.2   information included in the public reports are presented so that 
 79.3   the data cannot reasonably lead, using epidemiologic principles, 
 79.4   to the identification of: 
 79.5      (1) an individual who has had an abortion, who has received 
 79.6   judicial authorization for an abortion, or to whom the notice 
 79.7   described in section 144.343, subdivision 2, has been provided; 
 79.8   or 
 79.9      (2) a physician or facility who has submitted a form to the 
 79.10  commissioner under subdivision 3. 
 79.11     Subd. 6.  [MODIFICATION OF REQUIREMENTS.] The commissioner 
 79.12  of health may, by administrative rule, alter the dates 
 79.13  established in subdivisions 3 and 5, consolidate the forms 
 79.14  created according to subdivision 1 with the reporting form 
 79.15  created according to section 145.4131, or consolidate reports to 
 79.16  achieve administrative convenience or fiscal savings, to allow 
 79.17  physicians and facilities to submit all information collected by 
 79.18  the commissioner regarding abortions at one time, or to reduce 
 79.19  the burden of the data collection, so long as the report 
 79.20  described in subdivision 5 is issued at least once a year. 
 79.21     Subd. 7.  [SUIT TO COMPEL STATISTICAL REPORT.] If the 
 79.22  commissioner of health fails to issue the public report required 
 79.23  under subdivision 5, any group of ten or more citizens of the 
 79.24  state may seek an injunction in a court of competent 
 79.25  jurisdiction against the commissioner, requiring that a complete 
 79.26  report be issued within a period stated by court order.  Failure 
 79.27  to abide by the injunction shall subject the commissioner to 
 79.28  sanctions for civil contempt. 
 79.29     Subd. 8.  [ATTORNEY'S FEES.] If judgment is rendered in 
 79.30  favor of the plaintiff in any action described in this section, 
 79.31  the court shall also render judgment for a reasonable attorney's 
 79.32  fee in favor of the plaintiff against the defendant.  If the 
 79.33  judgment is rendered in favor of the defendant and the court 
 79.34  finds that plaintiff's suit was frivolous and brought in bad 
 79.35  faith, the court shall render judgment for a reasonable 
 79.36  attorney's fee in favor of the defendant against the plaintiff. 
 80.1      Subd. 9.  [SEVERABILITY.] If any one or more provision, 
 80.2   section, subdivision, sentence, clause, phrase, or word of this 
 80.3   section or the application thereof to any person or circumstance 
 80.4   is found to be unconstitutional, the same is hereby declared to 
 80.5   be severable and the balance of this section shall remain 
 80.6   effective notwithstanding such unconstitutionality.  The 
 80.7   legislature hereby declares that it would have passed this 
 80.8   section, and each provision, section, subdivision, sentence, 
 80.9   clause, phrase, or word thereof irrespective of the fact that 
 80.10  any one provision, section, subdivision, sentence, clause, 
 80.11  phrase, or word be declared unconstitutional. 
 80.12     Sec. 34.  Minnesota Statutes 1998, section 144.413, 
 80.13  subdivision 2, is amended to read: 
 80.14     Subd. 2.  [PUBLIC PLACE.] "Public place" means any 
 80.15  enclosed, indoor area used by the general public or serving as a 
 80.16  place of work, including, but not limited to, restaurants, 
 80.17  retail stores, offices and other commercial establishments, 
 80.18  public conveyances, educational facilities other than public 
 80.19  schools, as defined in section 120A.05, subdivision subdivisions 
 80.20  9, 11, and 13, hospitals, nursing homes, auditoriums, arenas, 
 80.21  meeting rooms, and common areas of rental apartment buildings, 
 80.22  but excluding private, enclosed offices occupied exclusively by 
 80.23  smokers even though such offices may be visited by nonsmokers. 
 80.24     (Effective Date: Section 34 (144.413, subdivision 2) is 
 80.25  effective the day following final enactment.) 
 80.26     Sec. 35.  Minnesota Statutes 1998, section 144.414, 
 80.27  subdivision 1, is amended to read: 
 80.28     Subdivision 1.  [PUBLIC PLACES.] No person shall smoke in a 
 80.29  public place or at a public meeting except in designated smoking 
 80.30  areas.  This prohibition does not apply in cases in which an 
 80.31  entire room or hall is used for a private social function and 
 80.32  seating arrangements are under the control of the sponsor of the 
 80.33  function and not of the proprietor or person in charge of the 
 80.34  place.  Furthermore, this prohibition shall not apply to 
 80.35  factories, warehouses, and similar places of work not usually 
 80.36  frequented by the general public, except that the state 
 81.1   commissioner of health shall establish rules to restrict or 
 81.2   prohibit smoking in those places of work where the close 
 81.3   proximity of workers or the inadequacy of ventilation causes 
 81.4   smoke pollution detrimental to the health and comfort of 
 81.5   nonsmoking employees.  
 81.6      (Effective Date:  Section 35 (144.414, subdivision 1) is 
 81.7   effective the day following final enactment.) 
 81.8      Sec. 36.  Minnesota Statutes 1998, section 144.4165, is 
 81.9   amended to read: 
 81.10     144.4165 [TOBACCO PRODUCTS PROHIBITED IN PUBLIC SCHOOLS.] 
 81.11     No person shall at any time smoke, chew, or otherwise 
 81.12  ingest tobacco or a tobacco product in a public school, as 
 81.13  defined in section 120A.05, subdivision subdivisions 9, 11, and 
 81.14  13.  This prohibition extends to all facilities, whether owned, 
 81.15  rented, or leased, and all vehicles that a school district owns, 
 81.16  leases, rents, contracts for, or controls.  Nothing in this 
 81.17  section shall prohibit the lighting of tobacco by an adult as a 
 81.18  part of a traditional Indian spiritual or cultural ceremony.  
 81.19  For purposes of this section, an Indian is a person who is a 
 81.20  member of an Indian tribe as defined in section 257.351, 
 81.21  subdivision 9. 
 81.22     (Effective Date:  Section 36 (144.4165) is effective the 
 81.23  day following final enactment.) 
 81.24     Sec. 37.  Minnesota Statutes 1998, section 144.56, 
 81.25  subdivision 2b, is amended to read: 
 81.26     Subd. 2b.  [BOARDING CARE HOMES.] The commissioner shall 
 81.27  not adopt or enforce any rule that limits: 
 81.28     (1) a certified boarding care home from providing nursing 
 81.29  services in accordance with the home's Medicaid certification; 
 81.30  or 
 81.31     (2) a noncertified boarding care home registered under 
 81.32  chapter 144D from providing home care services in accordance 
 81.33  with the home's registration. 
 81.34     Sec. 38.  Minnesota Statutes 1998, section 144.99, 
 81.35  subdivision 1, is amended to read: 
 81.36     Subdivision 1.  [REMEDIES AVAILABLE.] The provisions of 
 82.1   chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 
 82.2   subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 
 82.3   (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 
 82.4   144.3431; 144.35; 144.381 to 144.385; 144.411 to 144.417; 
 82.5   144.495; 144.71 to 144.74; 144.9501 to 144.9509; 
 82.6   144.992; 145.4131 to 145.4136; 326.37 to 326.45; 326.57 to 
 82.7   326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, 
 82.8   orders, stipulation agreements, settlements, compliance 
 82.9   agreements, licenses, registrations, certificates, and permits 
 82.10  adopted or issued by the department or under any other law now 
 82.11  in force or later enacted for the preservation of public health 
 82.12  may, in addition to provisions in other statutes, be enforced 
 82.13  under this section. 
 82.14     Sec. 39.  Minnesota Statutes 1998, section 144.99, is 
 82.15  amended by adding a subdivision to read: 
 82.16     Subd. 12.  [SECURING RADIOACTIVE MATERIALS.] (a) In the 
 82.17  event of an emergency that poses a danger to the public health, 
 82.18  the commissioner shall have the authority to impound radioactive 
 82.19  materials and the associated shielding in the possession of a 
 82.20  person who fails to abide by the provisions of the statutes, 
 82.21  rules, and any other item listed in subdivision 1.  If 
 82.22  impounding the source of these materials is impractical, the 
 82.23  commissioner shall have the authority to lock or otherwise 
 82.24  secure a facility that contains the source of such materials, 
 82.25  but only the portions of the facility as is necessary to protect 
 82.26  the public health.  An action taken under this paragraph is 
 82.27  effective for up to 72 hours.  The commissioner must seek an 
 82.28  injunction or take other administrative action to secure 
 82.29  radioactive materials beyond the initial 72-hour period. 
 82.30     (b) The commissioner may release impounded radioactive 
 82.31  materials and the associated shielding to the owner of the 
 82.32  radioactive materials and associated shielding, upon terms and 
 82.33  conditions that are in accordance with the provisions of 
 82.34  statutes, rules, and other items listed in subdivision 1.  In 
 82.35  the alternative, the commissioner may bring an action in a court 
 82.36  of competent jurisdiction for an order directing the disposal of 
 83.1   impounded radioactive materials and associated shielding or 
 83.2   directing other disposition as necessary to protect the public 
 83.3   health and safety and the environment.  The costs of 
 83.4   decontamination, transportation, burial, disposal, or other 
 83.5   disposition shall be borne by the owner or licensee of the 
 83.6   radioactive materials and shielding or by any other person who 
 83.7   has used the radioactive materials and shielding for business 
 83.8   purposes. 
 83.9      Sec. 40.  Minnesota Statutes 1998, section 144A.4605, 
 83.10  subdivision 2, is amended to read: 
 83.11     Subd. 2.  [ASSISTED LIVING HOME CARE LICENSE ESTABLISHED.] 
 83.12  A home care provider license category entitled assisted living 
 83.13  home care provider is hereby established.  A home care provider 
 83.14  may obtain an assisted living license if the program meets the 
 83.15  following requirements: 
 83.16     (a) nursing services, delegated nursing services, other 
 83.17  services performed by unlicensed personnel, or central storage 
 83.18  of medications under the assisted living license are provided 
 83.19  solely for residents of one or more housing with services 
 83.20  establishments registered under chapter 144D; 
 83.21     (b) unlicensed personnel perform home health aide and home 
 83.22  care aide tasks identified in Minnesota Rules, parts 4668.0100, 
 83.23  subparts 1 and 2, and 4668.0110, subpart 1.  Qualifications to 
 83.24  perform these tasks shall be established in accordance with 
 83.25  subdivision 3; 
 83.26     (c) periodic supervision of unlicensed personnel is 
 83.27  provided as required by rule; 
 83.28     (d) notwithstanding Minnesota Rules, part 4668.0160, 
 83.29  subpart 6, item D, client records shall include: 
 83.30     (1) daily records or a weekly summary of the client's 
 83.31  status and home care services provided; 
 83.32     (2) documentation each time medications are administered to 
 83.33  a client; and 
 83.34     (3) documentation on the day of occurrence of any 
 83.35  significant change in the client's status or any significant 
 83.36  incident, such as a fall or refusal to take medications. 
 84.1      All entries must be signed by the staff providing the 
 84.2   services and entered into the record no later than two weeks 
 84.3   after the end of the service day, except as specified in clauses 
 84.4   (2) and (3); 
 84.5      (e) medication and treatment orders, if any, are included 
 84.6   in the client record and are renewed at least every 12 months, 
 84.7   or more frequently when indicated by a clinical assessment; 
 84.8      (f) the central storage of medications in a housing with 
 84.9   services establishment registered under chapter 144D is managed 
 84.10  under a system that is established by a registered nurse and 
 84.11  addresses the control of medications, handling of medications, 
 84.12  medication containers, medication records, and disposition of 
 84.13  medications; and 
 84.14     (g) in other respects meets the requirements established by 
 84.15  rules adopted under sections 144A.45 to 144A.48. 
 84.16     Sec. 41.  Minnesota Statutes 1998, section 144D.01, 
 84.17  subdivision 4, is amended to read: 
 84.18     Subd. 4.  [HOUSING WITH SERVICES ESTABLISHMENT OR 
 84.19  ESTABLISHMENT.] "Housing with services establishment" or 
 84.20  "establishment" means an establishment providing sleeping 
 84.21  accommodations to one or more adult residents, at least 80 
 84.22  percent of which are 55 years of age or older, and offering or 
 84.23  providing, for a fee, one or more regularly scheduled 
 84.24  health-related services or two or more regularly scheduled 
 84.25  supportive services, whether offered or provided directly by the 
 84.26  establishment or by another entity arranged for by the 
 84.27  establishment. 
 84.28     Housing with services establishment does not include: 
 84.29     (1) a nursing home licensed under chapter 144A; 
 84.30     (2) a hospital, certified boarding care home, or supervised 
 84.31  living facility licensed under sections 144.50 to 144.56; 
 84.32     (3) a board and lodging establishment licensed under 
 84.33  chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 
 84.34  9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 
 84.35  9530.4450, or under chapter 245B; 
 84.36     (4) a board and lodging establishment which serves as a 
 85.1   shelter for battered women or other similar purpose; 
 85.2      (5) a family adult foster care home licensed by the 
 85.3   department of human services; 
 85.4      (6) private homes in which the residents are related by 
 85.5   kinship, law, or affinity with the providers of services; 
 85.6      (7) residential settings for persons with mental 
 85.7   retardation or related conditions in which the services are 
 85.8   licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 
 85.9   applicable successor rules or laws; 
 85.10     (8) a home-sharing arrangement such as when an elderly or 
 85.11  disabled person or single-parent family makes lodging in a 
 85.12  private residence available to another person in exchange for 
 85.13  services or rent, or both; 
 85.14     (9) a duly organized condominium, cooperative, common 
 85.15  interest community, or owners' association of the foregoing 
 85.16  where at least 80 percent of the units that comprise the 
 85.17  condominium, cooperative, or common interest community are 
 85.18  occupied by individuals who are the owners, members, or 
 85.19  shareholders of the units; or 
 85.20     (10) services for persons with developmental disabilities 
 85.21  that are provided under a license according to Minnesota Rules, 
 85.22  parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 
 85.23  under chapter 245B. 
 85.24     Sec. 42.  [145.4201] [PARTIAL-BIRTH ABORTION; DEFINITIONS.] 
 85.25     Subdivision 1.  [TERMS.] As used in sections 145.4201 to 
 85.26  145.4206, the terms defined in this section have the meanings 
 85.27  given them. 
 85.28     Subd. 2.  [ABORTION.] "Abortion" means the use of any means 
 85.29  to intentionally terminate the pregnancy of a female known to be 
 85.30  pregnant with knowledge that the termination with those means 
 85.31  will, with reasonable likelihood, cause the death of the fetus. 
 85.32     Subd. 3.  [FETUS.] "Fetus" is used to refer to the 
 85.33  biological offspring of human parents. 
 85.34     Subd. 4.  [PARTIAL-BIRTH ABORTION.] "Partial-birth abortion"
 85.35  means an abortion in which the person performing the abortion 
 85.36  partially vaginally delivers a living fetus before killing the 
 86.1   fetus and completing the delivery. 
 86.2      Subd. 5.  [PARTIALLY VAGINALLY DELIVERS A LIVING FETUS 
 86.3   BEFORE KILLING THE FETUS.] "Partially vaginally delivers a 
 86.4   living fetus before killing the fetus" means deliberately and 
 86.5   intentionally delivers into the vagina a living fetus, or a 
 86.6   substantial portion thereof, for the purpose of performing a 
 86.7   procedure the physician knows will kill the fetus, and kills the 
 86.8   fetus. 
 86.9      Sec. 43.  [145.4202] [PARTIAL-BIRTH ABORTIONS PROHIBITED.] 
 86.10     No person shall knowingly perform a partial-birth abortion. 
 86.11     Sec. 44.  [145.4203] [LIFE OF THE MOTHER EXCEPTION.] 
 86.12     The prohibition under section 145.4202 shall not apply to a 
 86.13  partial-birth abortion that is necessary to save the life of the 
 86.14  mother because her life is endangered by a physical disorder, 
 86.15  physical illness, or physical injury. 
 86.16     Sec. 45.  [145.4204] [CIVIL REMEDIES.] 
 86.17     Subdivision 1.  [STANDING.] The woman upon whom a 
 86.18  partial-birth abortion has been performed in violation of 
 86.19  sections 145.4201 to 145.4206, the father if married to the 
 86.20  mother at the time she receives a partial-birth abortion 
 86.21  procedure, and the maternal grandparents of the fetus if the 
 86.22  mother has not attained the age of 18 years at the time of the 
 86.23  abortion, may obtain appropriate relief in a civil action, 
 86.24  unless the pregnancy resulted from the plaintiff's criminal 
 86.25  conduct or the plaintiff consented to the abortion. 
 86.26     Subd. 2.  [TYPE OF RELIEF.] Relief shall include: 
 86.27     (1) money damages for all injuries, psychological and 
 86.28  physical, occasioned by the violation of sections 145.4201 to 
 86.29  145.4206; and 
 86.30     (2) statutory damages equal to three times the cost of the 
 86.31  partial-birth abortion. 
 86.32     Subd. 3.  [ATTORNEY'S FEE.] If judgment is rendered in 
 86.33  favor of the plaintiff in an action described in this section, 
 86.34  the court shall also render judgment for a reasonable attorney's 
 86.35  fee in favor of the plaintiff against the defendant.  If the 
 86.36  judgment is rendered in favor of the defendant and the court 
 87.1   finds that the plaintiff's suit was frivolous and brought in bad 
 87.2   faith, the court shall also render judgment for a reasonable 
 87.3   attorney's fee in favor of the defendant against the plaintiff. 
 87.4      Sec. 46.  [145.4205] [CRIMINAL PENALTY.] 
 87.5      Subdivision 1.  [FELONY.] A person who performs a 
 87.6   partial-birth abortion in knowing violation of sections 145.4201 
 87.7   to 145.4206 is guilty of a felony and may be sentenced to 
 87.8   imprisonment for not more than two years or to payment of a fine 
 87.9   of not more than $4,000, or both.  
 87.10     Subd. 2.  [ADMINISTRATIVE FINDING.] (a) A defendant accused 
 87.11  of an offense under this section may seek a hearing before the 
 87.12  state board of medical practice on whether the physician's 
 87.13  conduct was necessary to save the life of the mother whose life 
 87.14  was endangered by a physical disorder, illness, or injury. 
 87.15     (b) The findings of the state board of medical practice on 
 87.16  that issue are admissible at the trial of the defendant.  Upon 
 87.17  motion of the defendant, the court shall delay the beginning of 
 87.18  the trial for not more than 30 days to permit the hearing to 
 87.19  take place. 
 87.20     Subd. 3.  [PROSECUTION OF MOTHER PROHIBITED.] A woman upon 
 87.21  whom a partial-birth abortion is performed may not be prosecuted 
 87.22  under this section for violating sections 145.4201 to 145.4206, 
 87.23  or any provision thereof, or for conspiracy to violate sections 
 87.24  145.4201 to 145.4206, or any provision thereof. 
 87.25     (Effective Date: Section 46 (145.4205, subdivisions 1 to 3) 
 87.26  are effective July 1, 1999, and applies to crimes committed on 
 87.27  or after that date.) 
 87.28     Sec. 47.  [145.4206] [SEVERABILITY.] 
 87.29     (a) If any provision, word, phrase, or clause of section 
 87.30  145.4203, or the application thereof to any person or 
 87.31  circumstance is found to be unconstitutional, the same is hereby 
 87.32  declared to be inseverable. 
 87.33     (b) If any provision, section, paragraph, sentence, clause, 
 87.34  phrase, or word of section 145.4201, 145.4202, 145.4204, 
 87.35  145.4205, or 145.4206, or the application thereof to any person 
 87.36  or circumstance is found to be unconstitutional, the same is 
 88.1   hereby declared to be severable and the balance of sections 
 88.2   145.4201 to 145.4206 shall remain effective notwithstanding such 
 88.3   unconstitutionality.  The legislature hereby declares that it 
 88.4   would have passed sections 145.4201 to 145.4206, and each 
 88.5   provision, section, paragraph, sentence, clause, phrase, or word 
 88.6   thereto, with the exception of section 145.4203, irrespective of 
 88.7   the fact that a provision, section, paragraph, sentence, clause, 
 88.8   phrase, or word be declared unconstitutional. 
 88.9      Sec. 48.  [145.4241] [DEFINITIONS.] 
 88.10     Subdivision 1.  [APPLICABILITY.] As used in sections 
 88.11  145.4241 to 145.4246, the following terms have the meaning given 
 88.12  them. 
 88.13     Subd. 2.  [ABORTION.] "Abortion" means the use or 
 88.14  prescription of any instrument, medicine, drug, or any other 
 88.15  substance or device to intentionally terminate the pregnancy of 
 88.16  a female known to be pregnant, with an intention other than to 
 88.17  increase the probability of a live birth, to preserve the life 
 88.18  or health of the child after live birth, or to remove a dead 
 88.19  fetus.  
 88.20     Subd. 3.  [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to 
 88.21  perform an abortion" means an act, or an omission of a 
 88.22  statutorily required act, that, under the circumstances as the 
 88.23  actor believes them to be, constitutes a substantial step in a 
 88.24  course of conduct planned to culminate in the performance of an 
 88.25  abortion in Minnesota in violation of sections 145.4241 to 
 88.26  145.4246. 
 88.27     Subd. 4.  [MEDICAL EMERGENCY.] "Medical emergency" means 
 88.28  any condition that, on the basis of the physician's good faith 
 88.29  clinical judgment, complicates the medical condition of a 
 88.30  pregnant female to the extent that: 
 88.31     (1) an immediate abortion of her pregnancy is necessary to 
 88.32  avert her death; or 
 88.33     (2) a 24-hour delay in performing an abortion creates a 
 88.34  serious risk of substantial and irreversible impairment of a 
 88.35  major bodily function.  
 88.36     Subd. 5.  [PHYSICIAN.] "Physician" means a person licensed 
 89.1   under chapter 147. 
 89.2      Subd. 6.  [PROBABLE GESTATIONAL AGE OF THE UNBORN 
 89.3   CHILD.] "Probable gestational age of the unborn child" means 
 89.4   what will, in the judgment of the physician, with reasonable 
 89.5   probability, be the gestational age of the unborn child at the 
 89.6   time the abortion is planned to be performed. 
 89.7      Sec. 49.  [145.4242] [INFORMED CONSENT.] 
 89.8      No abortion shall be performed in this state except with 
 89.9   the voluntary and informed consent of the female upon whom the 
 89.10  abortion is to be performed.  Except in the case of a medical 
 89.11  emergency, consent to an abortion is voluntary and informed only 
 89.12  if: 
 89.13     (1) the female is told the following, by telephone or in 
 89.14  person, by the physician who is to perform the abortion or by a 
 89.15  referring physician, at least 24 hours before the abortion: 
 89.16     (i) the name of the physician who will perform the 
 89.17  abortion; 
 89.18     (ii) the particular medical risks associated with the 
 89.19  particular abortion procedure to be employed including, when 
 89.20  medically accurate, the risks of infection, hemorrhage, breast 
 89.21  cancer, danger to subsequent pregnancies, and infertility; 
 89.22     (iii) the probable gestational age of the unborn child at 
 89.23  the time the abortion is to be performed; and 
 89.24     (iv) the medical risks associated with carrying her child 
 89.25  to term. 
 89.26     The information required by this clause may be provided by 
 89.27  telephone without conducting a physical examination or tests of 
 89.28  the patient, in which case the information required to be 
 89.29  provided may be based on facts supplied the physician by the 
 89.30  female and whatever other relevant information is reasonably 
 89.31  available to the physician.  It may not be provided by a tape 
 89.32  recording, but must be provided during a consultation in which 
 89.33  the physician is able to ask questions of the female and the 
 89.34  female is able to ask questions of the physician.  If a physical 
 89.35  examination, tests, or the availability of other information to 
 89.36  the physician subsequently indicate, in the medical judgment of 
 90.1   the physician, a revision of the information previously supplied 
 90.2   to the patient, that revised information may be communicated to 
 90.3   the patient at any time prior to the performance of the 
 90.4   abortion.  Nothing in this section may be construed to preclude 
 90.5   provision of required information in a language understood by 
 90.6   the patient through a translator; 
 90.7      (2) the female is informed, by telephone or in person, by 
 90.8   the physician who is to perform the abortion, by a referring 
 90.9   physician, or by an agent of either physician at least 24 hours 
 90.10  before the abortion: 
 90.11     (i) that medical assistance benefits may be available for 
 90.12  prenatal care, childbirth, and neonatal care; 
 90.13     (ii) that the father is liable to assist in the support of 
 90.14  her child, even in instances when the father has offered to pay 
 90.15  for the abortion; and 
 90.16     (iii) that she has the right to review the printed 
 90.17  materials described in section 145.4243.  The physician or the 
 90.18  physician's agent shall orally inform the female that the 
 90.19  materials have been provided by the state of Minnesota and that 
 90.20  they describe the unborn child and list agencies that offer 
 90.21  alternatives to abortion.  If the female chooses to view the 
 90.22  materials, they shall either be given to her at least 24 hours 
 90.23  before the abortion or mailed to her at least 72 hours before 
 90.24  the abortion by certified mail, restricted delivery to 
 90.25  addressee, which means the postal employee can only deliver the 
 90.26  mail to the addressee.  
 90.27     The information required by this clause may be provided by 
 90.28  a tape recording if provision is made to record or otherwise 
 90.29  register specifically whether the female does or does not choose 
 90.30  to review the printed materials; 
 90.31     (3) the female certifies in writing, prior to the abortion, 
 90.32  that the information described in this section has been 
 90.33  furnished her, and that she has been informed of her opportunity 
 90.34  to review the information referred to in clause (2); and 
 90.35     (4) prior to the performance of the abortion, the physician 
 90.36  who is to perform the abortion or the physician's agent receives 
 91.1   a copy of the written certification prescribed by clause (3). 
 91.2      Sec. 50.  [145.4243] [PRINTED INFORMATION.] 
 91.3      (a) Within 90 days after the effective date of sections 
 91.4   145.4241 to 145.4246, the department of health shall cause to be 
 91.5   published, in English and in each language that is the primary 
 91.6   language of two percent or more of the state's population, the 
 91.7   following printed materials in such a way as to ensure that the 
 91.8   information is easily comprehensible: 
 91.9      (1) geographically indexed materials designed to inform the 
 91.10  female of public and private agencies and services available to 
 91.11  assist a female through pregnancy, upon childbirth, and while 
 91.12  the child is dependent, including adoption agencies, which shall 
 91.13  include a comprehensive list of the agencies available, a 
 91.14  description of the services they offer, and a description of the 
 91.15  manner, including telephone numbers, in which they might be 
 91.16  contacted or, at the option of the department of health, printed 
 91.17  materials including a toll-free, 24-hours-a-day telephone number 
 91.18  that may be called to obtain, orally, such a list and 
 91.19  description of agencies in the locality of the caller and of the 
 91.20  services they offer; and 
 91.21     (2) materials designed to inform the female of the probable 
 91.22  anatomical and physiological characteristics of the unborn child 
 91.23  at two-week gestational increments from the time when a female 
 91.24  can be known to be pregnant to full term, including any relevant 
 91.25  information on the possibility of the unborn child's survival 
 91.26  and pictures or drawings representing the development of unborn 
 91.27  children at two-week gestational increments, provided that any 
 91.28  such pictures or drawings must contain the dimensions of the 
 91.29  fetus and must be realistic and appropriate for the stage of 
 91.30  pregnancy depicted.  The materials shall be objective, 
 91.31  nonjudgmental, and designed to convey only accurate scientific 
 91.32  information about the unborn child at the various gestational 
 91.33  ages.  The material shall also contain objective information 
 91.34  describing the methods of abortion procedures commonly employed, 
 91.35  the medical risks commonly associated with each procedure, the 
 91.36  possible detrimental psychological effects of abortion, the 
 92.1   medical risks commonly associated with each procedure, and the 
 92.2   medical risks commonly associated with carrying a child to term. 
 92.3      (b) The materials referred to in this section must be 
 92.4   printed in a typeface large enough to be clearly legible.  The 
 92.5   materials required under this section must be available at no 
 92.6   cost from the department of health upon request and in 
 92.7   appropriate number to any person, facility, or hospital.  
 92.8      Sec. 51.  [145.4244] [PROCEDURE IN CASE OF MEDICAL 
 92.9   EMERGENCY.] 
 92.10     When a medical emergency compels the performance of an 
 92.11  abortion, the physician shall inform the female, prior to the 
 92.12  abortion if possible, of the medical indications supporting the 
 92.13  physician's judgment that an abortion is necessary to avert her 
 92.14  death or that a 24-hour delay in conformance with section 
 92.15  145.4242 creates a serious risk of substantial and irreversible 
 92.16  impairment of a major bodily function. 
 92.17     Sec. 52.  [145.4245] [REMEDIES.] 
 92.18     Subdivision 1.  [CIVIL REMEDIES.] Any person upon whom an 
 92.19  abortion has been performed or the parent of a minor upon whom 
 92.20  an abortion has been performed may maintain an action against 
 92.21  the person who performed the abortion in knowing or reckless 
 92.22  violation of sections 145.4241 to 145.4246 for actual and 
 92.23  punitive damages.  Any person upon whom an abortion has been 
 92.24  attempted without complying with sections 145.4241 to 145.4246 
 92.25  may maintain an action against the person who attempted to 
 92.26  perform the abortion in knowing or reckless violation of 
 92.27  sections 145.4241 to 145.4246 for actual and punitive damages. 
 92.28     Subd. 2.  [ATTORNEY FEES.] If judgment is rendered in favor 
 92.29  of the plaintiff in any action described in this section, the 
 92.30  court shall also render judgment for a reasonable attorney's fee 
 92.31  in favor of the plaintiff against the defendant.  If judgment is 
 92.32  rendered in favor of the defendant and the court finds that the 
 92.33  plaintiff's suit was frivolous and brought in bad faith, the 
 92.34  court shall also render judgment for a reasonable attorney's fee 
 92.35  in favor of the defendant against the plaintiff. 
 92.36     Subd. 3.  [PROTECTION OF PRIVACY IN COURT PROCEEDINGS.] In 
 93.1   every civil action brought under sections 145.4241 to 145.4246, 
 93.2   the court shall rule whether the anonymity of any female upon 
 93.3   whom an abortion has been performed or attempted shall be 
 93.4   preserved from public disclosure if she does not give her 
 93.5   consent to such disclosure.  The court, upon motion or sua 
 93.6   sponte, shall make such a ruling and, upon determining that her 
 93.7   anonymity should be preserved, shall issue orders to the 
 93.8   parties, witnesses, and counsel and shall direct the sealing of 
 93.9   the record and exclusion of individuals from courtrooms or 
 93.10  hearing rooms to the extent necessary to safeguard her identity 
 93.11  from public disclosure.  Each order must be accompanied by 
 93.12  specific written findings explaining why the anonymity of the 
 93.13  female should be preserved from public disclosure, why the order 
 93.14  is essential to that end, how the order is narrowly tailored to 
 93.15  serve that interest, and why no reasonable, less restrictive 
 93.16  alternative exists.  In the absence of written consent of the 
 93.17  female upon whom an abortion has been performed or attempted, 
 93.18  anyone, other than a public official, who brings an action under 
 93.19  subdivision 1, shall do so under a pseudonym.  This section may 
 93.20  not be construed to conceal the identity of the plaintiff or of 
 93.21  witnesses from the defendant. 
 93.22     Sec. 53.  [145.4246] [SEVERABILITY.] 
 93.23     If any one or more provision, section, paragraph, sentence, 
 93.24  clause, phrase, or word of sections 145.4241 to 145.4246 or the 
 93.25  application thereof to any person or circumstance is found to be 
 93.26  unconstitutional, the same is hereby declared to be severable 
 93.27  and the balance of sections 145.4241 to 145.4246 shall remain 
 93.28  effective notwithstanding such unconstitutionality.  The 
 93.29  legislature hereby declares that it would have passed sections 
 93.30  145.4241 to 145.4246, and each provision, section, paragraph, 
 93.31  sentence, clause, phrase, or word thereof, irrespective of the 
 93.32  fact that any one or more provision, section, paragraph, 
 93.33  sentence, clause, phrase, or word be declared unconstitutional. 
 93.34     Sec. 54.  Minnesota Statutes 1998, section 145.924, is 
 93.35  amended to read: 
 93.36     145.924 [AIDS PREVENTION GRANTS.] 
 94.1      (a) The commissioner may award grants to boards of health 
 94.2   as defined in section 145A.02, subdivision 2, state agencies, 
 94.3   state councils, or nonprofit corporations to provide evaluation 
 94.4   and counseling services to populations at risk for acquiring 
 94.5   human immunodeficiency virus infection, including, but not 
 94.6   limited to, minorities, adolescents, intravenous drug users, and 
 94.7   homosexual men. 
 94.8      (b) The commissioner may award grants to agencies 
 94.9   experienced in providing services to communities of color, for 
 94.10  the design of innovative outreach and education programs for 
 94.11  targeted groups within the community who may be at risk of 
 94.12  acquiring the human immunodeficiency virus infection, including 
 94.13  intravenous drug users and their partners, adolescents, gay and 
 94.14  bisexual individuals and women.  Grants shall be awarded on a 
 94.15  request for proposal basis and shall include funds for 
 94.16  administrative costs.  Priority for grants shall be given to 
 94.17  agencies or organizations that have experience in providing 
 94.18  service to the particular community which the grantee proposes 
 94.19  to serve; that have policymakers representative of the targeted 
 94.20  population; that have experience in dealing with issues relating 
 94.21  to HIV/AIDS; and that have the capacity to deal effectively with 
 94.22  persons of differing sexual orientations.  For purposes of this 
 94.23  paragraph, the "communities of color" are:  the American-Indian 
 94.24  community; the Hispanic community; the African-American 
 94.25  community; and the Asian-Pacific community. 
 94.26     (c) All state grants for programs targeted to children 
 94.27  shall be used exclusively to promote abstinence from sexual 
 94.28  activity outside of marriage. 
 94.29     Sec. 55.  [145.9253] [FAMILY PLANNING FUNDS RECIPIENTS 
 94.30  RESTRICTED.] 
 94.31     (a) The commissioner of health may not allocate state funds 
 94.32  that are appropriated for the provision of family planning 
 94.33  services, or for which the provision of family planning services 
 94.34  is a permitted use of the funds, to any entity that is an 
 94.35  organization or affiliate of an organization which provides 
 94.36  abortions, promotes abortions, or directly refers for abortions. 
 95.1      (b) Nondirective counseling relating to a pregnancy does 
 95.2   not disqualify an entity from receiving an allocation of funds 
 95.3   referenced in paragraph (a) from the commissioner. 
 95.4      Sec. 56.  Minnesota Statutes 1998, section 145.9255, 
 95.5   subdivision 1, is amended to read: 
 95.6      Subdivision 1.  [ESTABLISHMENT.] The commissioner of 
 95.7   health, in consultation with a representative from Minnesota 
 95.8   planning, the commissioner of human services, and the 
 95.9   commissioner of children, families, and learning, shall develop 
 95.10  and implement the Minnesota education now and babies later (MN 
 95.11  ENABL) program, targeted to adolescents ages 12 to 14, with the 
 95.12  goal of reducing the incidence of adolescent pregnancy in the 
 95.13  state and promoting abstinence until marriage.  The program must 
 95.14  provide a multifaceted, primary prevention, community health 
 95.15  promotion approach to educating and supporting adolescents in 
 95.16  the decision to postpone sexual involvement modeled after the 
 95.17  ENABL program in California.  The commissioner of health shall 
 95.18  consult with the chief of the health education section of the 
 95.19  California department of health services for general guidance in 
 95.20  developing and implementing the program. 
 95.21     Sec. 57.  Minnesota Statutes 1998, section 145.9255, 
 95.22  subdivision 4, is amended to read: 
 95.23     Subd. 4.  [PROGRAM COMPONENTS.] The program must include 
 95.24  the following four major components: 
 95.25     (a) A community organization component in which the 
 95.26  community-based local contractors shall include: 
 95.27     (1) use of a postponing sexual involvement education 
 95.28  curriculum targeted to boys and girls ages 12 to 14 in schools 
 95.29  and/or community settings; 
 95.30     (2) planning and implementing community organization 
 95.31  strategies to convey and reinforce the MN ENABL message of 
 95.32  postponing sexual involvement, including activities promoting 
 95.33  awareness and involvement of parents and other primary 
 95.34  caregivers/significant adults, schools, and community; and 
 95.35     (3) development of local media linkages.  
 95.36     (b) A statewide, comprehensive media and public relations 
 96.1   campaign to promote changes in sexual attitudes and behaviors, 
 96.2   and reinforce the message of postponing adolescent sexual 
 96.3   involvement promoting abstinence from sexual activity until 
 96.4   marriage. 
 96.5      The commissioner of health, in consultation with the 
 96.6   commissioner of children, families, and learning, shall contract 
 96.7   with the attorney general's office to develop and implement the 
 96.8   media and public relations campaign.  In developing the 
 96.9   campaign, the attorney general's office shall coordinate and 
 96.10  consult with representatives from ethnic and local communities 
 96.11  to maximize effectiveness of the social marketing approach to 
 96.12  health promotion among the culturally diverse population of the 
 96.13  state.  The development and implementation of the campaign is 
 96.14  subject to input and approval by the commissioner of health. 
 96.15     The local community-based contractors shall collaborate and 
 96.16  coordinate efforts with other community organizations and 
 96.17  interested persons to provide school and community-wide 
 96.18  promotional activities that support and reinforce the message of 
 96.19  the MN ENABL curriculum. 
 96.20     (c) An evaluation component which evaluates the process and 
 96.21  the impact of the program. 
 96.22     The "process evaluation" must provide information to the 
 96.23  state on the breadth and scope of the program.  The evaluation 
 96.24  must identify program areas that might need modification and 
 96.25  identify local MN ENABL contractor strategies and procedures 
 96.26  which are particularly effective.  Contractors must keep 
 96.27  complete records on the demographics of clients served, number 
 96.28  of direct education sessions delivered and other appropriate 
 96.29  statistics, and must document exactly how the program was 
 96.30  implemented.  The commissioner may select contractor sites for 
 96.31  more in-depth case studies. 
 96.32     The "impact evaluation" must provide information to the 
 96.33  state on the impact of the different components of the MN ENABL 
 96.34  program and an assessment of the impact of the program on 
 96.35  adolescents' related sexual knowledge, attitudes, and 
 96.36  risk-taking behavior. 
 97.1      The commissioner shall compare the MN ENABL evaluation 
 97.2   information and data with similar evaluation data from other 
 97.3   states pursuing a similar adolescent pregnancy prevention 
 97.4   program modeled after ENABL and use the information to improve 
 97.5   MN ENABL and build on aspects of the program that have 
 97.6   demonstrated a delay in adolescent sexual involvement. 
 97.7      (d) A training component requiring the commissioner of 
 97.8   health, in consultation with the commissioner of children, 
 97.9   families, and learning, to provide comprehensive uniform 
 97.10  training to the local MN ENABL community-based local contractors 
 97.11  and the direct education program staff.  
 97.12     The local community-based contractors may use adolescent 
 97.13  leaders slightly older than the adolescents in the program to 
 97.14  impart the message to postpone sexual involvement provided: 
 97.15     (1) the contractor follows a protocol for adult 
 97.16  mentors/leaders and older adolescent leaders established by the 
 97.17  commissioner of health; 
 97.18     (2) the older adolescent leader is accompanied by an adult 
 97.19  leader; and 
 97.20     (3) the contractor uses the curriculum as directed and 
 97.21  required by the commissioner of the department of health to 
 97.22  implement this part of the program.  The commissioner of health 
 97.23  shall provide technical assistance to community-based local 
 97.24  contractors. 
 97.25     Sec. 58.  [145A.135] [TOBACCO USE PREVENTION GRANTS FOR 
 97.26  YOUTH.] 
 97.27     Subdivision 1.  [COMPETITIVE GRANTS.] (a) The commissioner 
 97.28  of health, in consultation with the commissioner of children, 
 97.29  families, and learning, shall award grants to community health 
 97.30  boards for tobacco use prevention grants targeted at youth up to 
 97.31  age 18.  The commissioner shall issue a request for proposals by 
 97.32  September 1, 1999, require proposals to be submitted by November 
 97.33  1, 1999, and award grants by December 1, 1999.  The request for 
 97.34  proposals must describe the criteria for evaluation, outcome 
 97.35  measures, and evaluation methodology developed by the 
 97.36  commissioner under subdivision 4. 
 98.1      (b) The commissioner shall award grants only to community 
 98.2   health boards that: 
 98.3      (1) have developed, in collaboration with community action 
 98.4   agencies established under sections 119A.374 to 119A.376, a 
 98.5   four-year plan to reduce the rate of smoking and tobacco use 
 98.6   among youth up to age 18; and 
 98.7      (2) will implement the plan in collaboration with community 
 98.8   action agencies, schools, and other public or private entities 
 98.9   conducting similar or related initiatives, in a manner that does 
 98.10  not duplicate existing efforts. 
 98.11  Community health boards, in collaboration with their community 
 98.12  action agencies, may form partnerships and jointly apply for 
 98.13  grants. 
 98.14     (c) The commissioner shall award at least two but not more 
 98.15  than four competitive grants.  Grants awarded by the 
 98.16  commissioner must target different areas of the state.  At least 
 98.17  one grant must target a youth population at high risk of tobacco 
 98.18  use. 
 98.19     (d) Grants shall be awarded for two years and may be 
 98.20  renewed by the commissioner for an additional two years.  A 
 98.21  grant recipient may request renewal of a grant by submitting to 
 98.22  the commissioner a written request for renewal, a description of 
 98.23  initiatives funded by the initial grant, and information on 
 98.24  progress toward achieving the outcome measures developed by the 
 98.25  commissioner under subdivision 4.  The commissioner may renew a 
 98.26  grant only if the commissioner determines that the grant 
 98.27  recipient has made adequate progress toward implementing its 
 98.28  plan and achieving the outcome measures. 
 98.29     (e) A community health board may use grant funds received 
 98.30  under this subdivision for tobacco use prevention activities 
 98.31  targeted at youth only in those counties in the community health 
 98.32  board's community health service area that, as of the date on 
 98.33  which the community health board's application for a grant under 
 98.34  this subdivision is received by the commissioner, are in 
 98.35  compliance with section 461.12, subdivision 1. 
 98.36     Subd. 2.  [GRANTS TO COMMUNITY HEALTH BOARDS.] (a) The 
 99.1   commissioner shall award grants to each community health board 
 99.2   that submits a proposal to establish and implement, in 
 99.3   collaboration with community action agencies established under 
 99.4   sections 119A.374 to 119A.376, tobacco use prevention 
 99.5   initiatives targeted at youth up to age 18.  Proposals must be 
 99.6   developed in collaboration with the community action agencies.  
 99.7   The commissioner shall require community health boards to submit 
 99.8   proposals by November 1, 1999, and shall award grants by 
 99.9   December 15, 1999.  The commissioner shall establish grant 
 99.10  levels using the formula in section 145A.13. 
 99.11     (b) Grants shall be awarded for two years and may be 
 99.12  renewed by the commissioner for an additional two years.  A 
 99.13  community health board may request renewal of a grant by 
 99.14  submitting to the commissioner a written request for renewal, a 
 99.15  description of initiatives funded by the initial grant, and 
 99.16  information on progress toward achieving the outcome measures 
 99.17  developed by the commissioner under subdivision 4.  The 
 99.18  commissioner may renew a grant only if the commissioner 
 99.19  determines that the community health board has made adequate 
 99.20  progress toward implementing its plan and achieving the outcome 
 99.21  measures. 
 99.22     (c) A community health board may use grant funds received 
 99.23  under this subdivision for tobacco use prevention activities 
 99.24  targeted at youth only in those counties in the community health 
 99.25  board's community health service area that, as of the date on 
 99.26  which the community health board's proposal under this 
 99.27  subdivision is received by the commissioner, are in compliance 
 99.28  with section 461.12, subdivision 1. 
 99.29     Subd. 3.  [PROHIBITION ON MULTIPLE AWARDS.] A community 
 99.30  health board may apply for grants under both subdivisions 1 and 
 99.31  2, but may accept only one grant award.  If a community health 
 99.32  board is awarded a grant under both subdivisions 1 and 2, the 
 99.33  board must return one of the grant awards to the commissioner.  
 99.34  If a grant awarded under subdivision 1 is returned, the 
 99.35  commissioner shall award this money to another applicant.  If a 
 99.36  grant awarded under subdivision 2 is returned, the commissioner 
100.1   shall distribute this money on a pro rata basis to all other 
100.2   community health boards awarded that grant. 
100.3      Subd. 4.  [EVALUATION.] (a) The commissioner, in 
100.4   consultation with the commissioner of children, families, and 
100.5   learning, shall evaluate the effectiveness of the initiatives 
100.6   funded by the grants provided under this section.  Grant 
100.7   recipients shall cooperate with the commissioner in the 
100.8   evaluation and provide the commissioner with outcomes data and 
100.9   other information necessary to conduct the evaluation. 
100.10     (b) The commissioner, in consultation with the commissioner 
100.11  of children, families, and learning, shall develop criteria for 
100.12  evaluation, outcome measures, and an evaluation methodology by 
100.13  September 1, 2000, and shall provide this information to grant 
100.14  applicants.  The commissioner shall include evaluation results 
100.15  in the preliminary and final reports required under subdivision 
100.16  5. 
100.17     Subd. 5.  [REPORTS.] The commissioner shall present a 
100.18  preliminary report to the legislature by January 15, 2001, on 
100.19  the grant program established by this section.  The preliminary 
100.20  report must include information on grant recipients and grant 
100.21  awards, a summary of the evaluation criteria, outcome measures, 
100.22  and evaluation methodology, and preliminary evaluation results.  
100.23  The commissioner shall submit a final report to the legislature 
100.24  by January 15, 2003.  The final report must include information 
100.25  on grant renewals, final evaluation results, and recommendations 
100.26  for effective tobacco use prevention initiatives for youth. 
100.27     Sec. 59.  Minnesota Statutes 1998, section 148.5194, is 
100.28  amended to read: 
100.29     148.5194 [FEES.] 
100.30     Subdivision 1.  [FEE PRORATION.] The commissioner shall 
100.31  prorate the registration fee for first time registrants 
100.32  according to the number of months that have elapsed between the 
100.33  date registration is issued and the date registration must be 
100.34  renewed under section 148.5191, subdivision 4.  
100.35     Subd. 2.  [BIENNIAL REGISTRATION FEE.] The fee for initial 
100.36  registration and biennial registration, temporary registration, 
101.1   or renewal is $160 $200.  
101.2      Subd. 3.  [BIENNIAL REGISTRATION FEE FOR DUAL REGISTRATION 
101.3   AS A SPEECH-LANGUAGE PATHOLOGIST AND AUDIOLOGIST.] The fee for 
101.4   initial registration and biennial registration, temporary 
101.5   registration, or renewal is $160 $200.  
101.6      Subd. 3a.  [SURCHARGE FEE.] Notwithstanding section 
101.7   16A.1285, subdivision 2, for a period of four years following 
101.8   the effective date of this subdivision, an applicant for 
101.9   registration or registration renewal must pay a surcharge fee of 
101.10  $25 in addition to any other fees due upon registration or 
101.11  registration renewal. 
101.12     Subd. 4.  [PENALTY FEE FOR LATE RENEWALS.] The penalty fee 
101.13  for late submission of a renewal application is $15 $45.  
101.14     Subd. 5.  [NONREFUNDABLE FEES.] All fees are nonrefundable. 
101.15     Sec. 60.  [OUTREACH TO PHYSICIANS.] 
101.16     The commissioner of health shall plan and conduct outreach 
101.17  activities to educate physicians about the requirements of 
101.18  Minnesota Statutes, sections 145.4201 to 145.4206.  In 
101.19  conducting outreach, the commissioner shall disseminate at least 
101.20  two notices to physicians explaining the requirements of 
101.21  Minnesota Statutes, sections 145.4201 to 145.4206, and may 
101.22  conduct other outreach activities as the commissioner deems 
101.23  necessary.  The commissioner shall establish the timing and form 
101.24  of the outreach activities required under this section, except 
101.25  that outreach activities must be completed by July 1, 2000. 
101.26     Sec. 61.  [RULES REGULATING PUBLIC SWIMMING POOLS.] 
101.27     (a) The commissioner of health shall amend Minnesota Rules, 
101.28  part 4717.0250, subparts 7 and 8, to specify that the following 
101.29  portable wading pools are private residential pools, and not 
101.30  public pools, for purposes of public swimming pool regulation 
101.31  under Minnesota Rules, chapter 4717: 
101.32     (1) a portable wading pool operated at a family day care or 
101.33  group family day care home that is licensed under Minnesota 
101.34  Rules, chapter 9502; and 
101.35     (2) a portable wading pool operated at a home at which 
101.36  child care services are provided under Minnesota Statutes, 
102.1   section 245A.03, subdivision 2, clause (2), or under Laws 1997, 
102.2   chapter 248, section 46, including subsequent amendments. 
102.3      (b) The commissioner shall amend Minnesota Rules, part 
102.4   4717.0250, to define "portable wading pool" as a pool that is 
102.5   entirely aboveground, is readily movable, has a maximum depth of 
102.6   24 inches, and is used or designed to be used exclusively for 
102.7   wading. 
102.8      (c) The amendments required by this section may be done in 
102.9   the manner specified in Minnesota Statutes, section 14.388, 
102.10  under the authority of clause (3) of that section. 
102.11     (Effective Date: Section 61 (Rules regulating public 
102.12  swimming pools) is effective the day following final enactment.) 
102.13     Sec. 62.  [CASE STUDIES TO DEVELOP STANDARDS FOR AUTOPSY 
102.14  PRACTICE IN SPECIAL CASES.] 
102.15     Subdivision 1.  [CASE STUDIES.] (a) If a professional 
102.16  association representing coroners and medical examiners in 
102.17  Minnesota accepts a grant from the commissioner of health for 
102.18  purposes of this section, it must comply with the terms of this 
102.19  section.  A professional association representing coroners and 
102.20  medical examiners in Minnesota may conduct a series of case 
102.21  studies to examine cases in which performing autopsies are 
102.22  controversial or in which autopsies are opposed by a decedent's 
102.23  relative or friend based on the decedent's religious beliefs.  
102.24  The cases to be examined may be cases in which it is not 
102.25  immediately apparent that an autopsy is needed to determine the 
102.26  person's cause of death but that, upon further investigation, 
102.27  the coroner or medical examiner determines that an autopsy is 
102.28  necessary to determine the cause of death and that the cause of 
102.29  death must be determined.  Using these case studies, the 
102.30  professional association may develop: 
102.31     (1) guidelines for coroners and medical examiners regarding 
102.32  when to perform autopsies in controversial situations or in 
102.33  situations in which autopsies are opposed based on a decedent's 
102.34  religious beliefs; and 
102.35     (2) special autopsy methods and procedures, if appropriate, 
102.36  for autopsies in controversial situations or situations in which 
103.1   autopsies are opposed based on a decedent's religious beliefs. 
103.2      (b) The professional association may conduct 12 case 
103.3   studies or more for the purposes in paragraph (a).  Upon 
103.4   completion of the case studies, the professional association may 
103.5   disseminate the guidelines and procedures developed to all 
103.6   coroners and medical examiners conducting autopsies in Minnesota.
103.7      Subd. 2.  [REPORT TO LEGISLATURE.] The professional 
103.8   association may report to the legislature by January 15, 2000, 
103.9   on the results of the case studies, the guidelines developed for 
103.10  autopsy practice, the special autopsy methods and procedures 
103.11  developed, and efforts or plans to disseminate the guidelines 
103.12  and procedures developed to coroners and medical examiners 
103.13  conducting autopsies in Minnesota. 
103.14     Subd. 3.  [DATA PRIVACY.] All records held by the 
103.15  professional association for purposes of completing the case 
103.16  studies must be held in confidence.  The guidelines for 
103.17  autopsies and special autopsy methods and procedures that are 
103.18  disseminated to coroners and medical examiners shall contain no 
103.19  individually identifiable information. 
103.20     Sec. 63.  [ANNUAL FEE FOR SERVICE CONNECTIONS TO PUBLIC 
103.21  WATER SUPPLIES.] 
103.22     Notwithstanding Minnesota Statutes, section 144.3831, for 
103.23  the fiscal year ending June 30, 2000 the commissioner of health 
103.24  shall not assess an annual fee of $5.21 for every service 
103.25  connection to a public water supply that is owned or operated by 
103.26  a home rule charter city, a statutory city, a city of the first 
103.27  class, or a town. 
103.28     Sec. 64.  [PILOT PROGRAM FOR PHARMACIST DRUG THERAPY 
103.29  MANAGEMENT.] 
103.30     The commissioner of human services shall award grants to 
103.31  create and develop a pilot program to involve pharmacists in 
103.32  coordinating drug therapy management services.  Pharmacist drug 
103.33  therapy management (1) does not include the initiation of a 
103.34  prescription drug order by a pharmacist, and (2) does not permit 
103.35  a pharmacist to make any unauthorized decisions about modifying 
103.36  or substituting drug therapies under this pilot program.  A 
104.1   pharmacist participating in this pilot program must comply with 
104.2   Minnesota Statutes, section 151.21, subdivision 1.  The pilot 
104.3   program shall reimburse licensed Minnesota pharmacists for 
104.4   coordinating drug therapy management services to at-risk patient 
104.5   populations, including persons with asthma, hypertension, high 
104.6   cholesterol, diabetes, HIV, and tobacco addiction.  The program 
104.7   shall commence on February 1, 2000, and terminate on January 31, 
104.8   2001.  The commissioner of human services shall issue a request 
104.9   for information (RFI) on the pilot program from the public by 
104.10  August 1, 1999, and shall issue a request for proposal (RFP) to 
104.11  award a grant to the appropriate bidder to implement the pilot 
104.12  program by October 1, 1999.  A report to the Minnesota 
104.13  legislature is due by February 1, 2000.  The commissioner of 
104.14  human services shall issue a final report to the Minnesota 
104.15  legislature by March 15, 2001. 
104.16     Sec. 65.  [AMENDMENT TO RULES.] 
104.17     The commissioner of health shall amend Minnesota Rules, 
104.18  chapter 4730 to conform with Minnesota Statutes, section 
104.19  144.121, subdivision 8.  The amendments required by this section 
104.20  may be done in the manner specified in Minnesota Statutes, 
104.21  section 14.388, under the authority of clause (3) of that 
104.22  section.  Minnesota Statutes, section 14.386, paragraph (b), 
104.23  does not apply to amendments to rules made under this section. 
104.24     (Effective Date:  Section 65 (amendment to rules) is 
104.25  effective the day following final enactment.) 
104.26     Sec. 66.  [REPEALER.] 
104.27     (a) Minnesota Statutes 1998, sections 13.99, subdivision 
104.28  19m; 62J.78; and 62J.79, are repealed. 
104.29     (b) Minnesota Statutes 1998, sections 144.9507, subdivision 
104.30  4; 144.9511; and 145.46, are repealed. 
104.31     (c) Minnesota Statutes 1998, section 157.011, subdivision 
104.32  2, is repealed. 
104.33     (d) Minnesota Statutes 1998, sections 144.1475 and 144.148, 
104.34  are repealed. 
104.35     (e) Laws 1998, chapter 407, article 2, section 104, is 
104.36  repealed. 
105.1      (f) Minnesota Rules, part 4688.0030, is repealed. 
105.2      Sec. 67.  [EFFECTIVE DATE.] 
105.3      When preparing the health and human services conference 
105.4   committee report for adoption by the legislature, the revisor 
105.5   shall combine all the bracketed effective date notations into 
105.6   this effective date section. 
105.7                              ARTICLE 3 
105.8                            LONG-TERM CARE 
105.9      Section 1.  Minnesota Statutes 1998, section 144A.073, is 
105.10  amended to read: 
105.11     144A.073 [REVIEW OF PROPOSALS REQUIRING EXCEPTIONS TO THE 
105.12  MORATORIUM OR RATE ADJUSTMENTS.] 
105.13     Subdivision 1.  [DEFINITIONS.] For purposes of this 
105.14  section, the following terms have the meanings given them: 
105.15     (a) "Conversion" means the relocation of a nursing home bed 
105.16  from a nursing home to an attached hospital. 
105.17     (b) "Relocation" means the movement of licensed nursing 
105.18  home beds or certified boarding care beds as permitted under 
105.19  subdivision 4, clause (3), and subdivision 5. 
105.20     (c) "Renovation" means extensive remodeling of, or 
105.21  construction of an addition to, a facility on an existing site 
105.22  with a total cost exceeding ten percent of the appraised value 
105.23  of the facility or $200,000, whichever is less. 
105.24     (d) "Replacement" means the demolition, delicensure, 
105.25  reconstruction, or construction of an addition to all or part of 
105.26  an existing facility. 
105.27     (e) "Upgrading" means a change in the level of licensure of 
105.28  a bed from a boarding care bed to a nursing home bed in a 
105.29  certified boarding care facility. 
105.30     Subd. 2.  [REQUEST FOR PROPOSALS.] At the authorization by 
105.31  the legislature of additional medical assistance expenditures 
105.32  for exceptions to the moratorium on nursing homes or for rate 
105.33  adjustments, the interagency committee shall publish in the 
105.34  State Register a request for proposals for nursing home projects 
105.35  to be licensed or certified under section 144A.071, subdivision 
105.36  4a, clause (c), and for nursing facility rate adjustments.  The 
106.1   public notice of this funding and the request for proposals must 
106.2   specify how the approval criteria will be prioritized by the 
106.3   advisory review panel, the interagency long-term care planning 
106.4   committee, and the commissioner.  The notice must describe the 
106.5   information that must accompany a request and state that 
106.6   proposals must be submitted to the interagency committee within 
106.7   90 days of the date of publication.  The notice must include the 
106.8   amount of the legislative appropriation available for the 
106.9   additional costs to the medical assistance program of projects 
106.10  approved under this section.  If no money is appropriated for a 
106.11  year, the interagency committee shall publish a notice to that 
106.12  effect, and no proposals shall be requested.  If money is 
106.13  appropriated, the interagency committee shall initiate the 
106.14  application and review process described in this section at 
106.15  least twice each biennium and up to four times each biennium, 
106.16  according to dates established by rule.  Authorized funds shall 
106.17  be allocated proportionally to the number of processes.  Funds 
106.18  not encumbered by an earlier process within a biennium shall 
106.19  carry forward to subsequent iterations of the process.  
106.20  Authorization for expenditures does not carry forward into the 
106.21  following biennium.  To be considered for approval, a proposal 
106.22  must include the following information: 
106.23     (1) whether the request is for a rate adjustment, 
106.24  renovation, replacement, upgrading, conversion, or relocation; 
106.25     (2) a description of the problem the project is designed to 
106.26  address; 
106.27     (3) a description of the proposed project; 
106.28     (4) an analysis of projected costs of the nursing facility 
106.29  proposal, which are not required to exceed the cost threshold 
106.30  referred to in section 144A.071, subdivision 1, to be considered 
106.31  under this section, including costs of the rate adjustment; 
106.32  initial construction and remodeling costs; site preparation 
106.33  costs; financing costs, including the current estimated 
106.34  long-term financing costs of the proposal, which consists of 
106.35  estimates of the amount and sources of money, reserves if 
106.36  required under the proposed funding mechanism, annual payments 
107.1   schedule, interest rates, length of term, closing costs and 
107.2   fees, insurance costs, and any completed marketing study or 
107.3   underwriting review; and estimated operating costs during the 
107.4   first two years after completion of the project; 
107.5      (5) for proposals involving replacement of all or part of a 
107.6   facility, the proposed location of the replacement facility and 
107.7   an estimate of the cost of addressing the problem through 
107.8   renovation; 
107.9      (6) for proposals involving renovation, an estimate of the 
107.10  cost of addressing the problem through replacement; 
107.11     (7) the proposed timetable for commencing construction and 
107.12  completing the project; 
107.13     (8) a statement of any licensure or certification issues, 
107.14  such as certification survey deficiencies; 
107.15     (9) the proposed relocation plan for current residents if 
107.16  beds are to be closed so that the department of human services 
107.17  can estimate the total costs of a proposal; and 
107.18     (10) for proposals involving a rate adjustment, the 
107.19  historical circumstances leading the facility to request a rate 
107.20  adjustment, and supporting financial information demonstrating 
107.21  that the financial viability and continued operation of the 
107.22  facility would be threatened without the adjustment; and 
107.23     (11) other information required by permanent rule of the 
107.24  commissioner of health in accordance with subdivisions 4 and 8. 
107.25     Subd. 3.  [REVIEW AND APPROVAL OF PROPOSALS.] Within the 
107.26  limits of money specifically appropriated to the medical 
107.27  assistance program for this purpose, the interagency long-term 
107.28  care planning committee may recommend that the commissioner of 
107.29  health grant exceptions to the nursing home licensure or 
107.30  certification moratorium for proposals that satisfy the 
107.31  requirements of this section, or recommend that the commissioner 
107.32  of human services provide facility rate adjustments.  The 
107.33  interagency committee shall appoint an advisory review panel 
107.34  composed of representatives of consumers and providers to review 
107.35  proposals and provide comments and recommendations to the 
107.36  committee.  The commissioners of human services and health shall 
108.1   provide staff and technical assistance to the committee for the 
108.2   review and analysis of proposals.  The interagency committee 
108.3   shall hold a public hearing before submitting recommendations to 
108.4   the commissioner of health on project requests.  The committee 
108.5   shall submit recommendations within 150 days of the date of the 
108.6   publication of the notice.  The commissioner of health shall 
108.7   approve or disapprove a project within 30 days after receiving 
108.8   the committee's recommendations.  The advisory review panel, the 
108.9   committee, and the commissioner of health shall base their 
108.10  recommendations, approvals, or disapprovals on a comparison and 
108.11  ranking of proposals using only the criteria in subdivision 4 
108.12  and in rules adopted by the commissioner.  The cost to the 
108.13  medical assistance program of the proposals approved must be 
108.14  within the limits of the appropriations specifically made for 
108.15  this purpose.  Approval of a proposal expires 18 months after 
108.16  approval by the commissioner of health unless the facility has 
108.17  commenced construction as defined in section 144A.071, 
108.18  subdivision 1a, paragraph (d).  The committee's report to the 
108.19  legislature, as required under section 144A.31, must include the 
108.20  projects approved, the criteria used to recommend proposals for 
108.21  approval, and the estimated costs of the projects, including the 
108.22  costs of initial construction and remodeling and rate 
108.23  adjustments, and the estimated operating costs during the first 
108.24  two years after the project is completed. 
108.25     Subd. 3b.  [AMENDMENTS TO APPROVED PROJECTS.] (a) Nursing 
108.26  facilities that have received approval on or after July 1, 1993, 
108.27  for exceptions to the moratorium on nursing homes through the 
108.28  process described in this section may request amendments to the 
108.29  designs of the projects by writing the commissioner within 18 
108.30  months of receiving approval.  Applicants shall submit 
108.31  supporting materials that demonstrate how the amended projects 
108.32  meet the criteria described in paragraph (b). 
108.33     (b) The commissioner shall approve requests for amendments 
108.34  for projects approved on or after July 1, 1993, according to the 
108.35  following criteria: 
108.36     (1) the amended project designs must provide solutions to 
109.1   all of the problems addressed by the original application that 
109.2   are at least as effective as the original solutions; 
109.3      (2) the amended project designs may not reduce the space in 
109.4   each resident's living area or in the total amount of common 
109.5   space devoted to resident and family uses by more than five 
109.6   percent; 
109.7      (3) the costs recognized for reimbursement of amended 
109.8   project designs shall be the threshold amount of the original 
109.9   proposal as identified according to section 144A.071, 
109.10  subdivision 2, except under conditions described in clause (4); 
109.11  and 
109.12     (4) total costs up to ten percent greater than the cost 
109.13  identified in clause (3) may be recognized for reimbursement if 
109.14  the proposer can document that one of the following 
109.15  circumstances is true: 
109.16     (i) changes are needed due to a natural disaster; 
109.17     (ii) conditions that affect the safety or durability of the 
109.18  project that could not have reasonably been known prior to 
109.19  approval are discovered; 
109.20     (iii) state or federal law require changes in project 
109.21  design; or 
109.22     (iv) documentable circumstances occur that are beyond the 
109.23  control of the owner and require changes in the design. 
109.24     (c) Approval of a request for an amendment does not alter 
109.25  the expiration of approval of the project according to 
109.26  subdivision 3. 
109.27     Subd. 3c.  [COST NEUTRAL RELOCATION PROJECTS.] (a) 
109.28  Notwithstanding subdivision 3, the interagency committee may at 
109.29  any time accept proposals, or amendments to proposals previously 
109.30  approved under this section, for relocations that are cost 
109.31  neutral with respect to state costs as defined in section 
109.32  144A.071, subdivision 5a.  The committee shall review these 
109.33  applications and make recommendations to the commissioner within 
109.34  90 days.  The committee must evaluate proposals according to 
109.35  subdivision 4, clauses (1), (2), and (3), and other criteria 
109.36  established in rule.  The commissioner shall approve or 
110.1   disapprove a project within 30 days of receiving the committee's 
110.2   recommendation.  Proposals and amendments approved under this 
110.3   subdivision are not subject to the six-mile limit in subdivision 
110.4   5, paragraph (e). 
110.5      (b) For the purposes of paragraph (a), cost neutrality 
110.6   shall be measured over the first three 12-month periods of 
110.7   operation after completion of the project. 
110.8      Subd. 4.  [CRITERIA FOR REVIEW.] The following criteria 
110.9   shall be used in a consistent manner to compare, evaluate, and 
110.10  rank all proposals submitted.  Except for the criteria specified 
110.11  in clause clauses (3) and (9), the application of criteria 
110.12  listed under this subdivision shall not reflect any distinction 
110.13  based on the geographic location of the proposed project: 
110.14     (1) the extent to which the proposal furthers state 
110.15  long-term care goals, including the goals stated in section 
110.16  144A.31, and including the goal of enhancing the availability 
110.17  and use of alternative care services and the goal of reducing 
110.18  the number of long-term care resident rooms with more than two 
110.19  beds; 
110.20     (2) the proposal's long-term effects on state costs 
110.21  including the cost estimate of the project according to section 
110.22  144A.071, subdivision 5a; 
110.23     (3) the extent to which the proposal promotes equitable 
110.24  access to long-term care services in nursing homes through 
110.25  redistribution of the nursing home bed supply, as measured by 
110.26  the number of beds relative to the population 85 or older, 
110.27  projected to the year 2000 by the state demographer, and 
110.28  according to items (i) to (iv): 
110.29     (i) reduce beds in counties where the supply is high, 
110.30  relative to the statewide mean, and increase beds in counties 
110.31  where the supply is low, relative to the statewide mean; 
110.32     (ii) adjust the bed supply so as to create the greatest 
110.33  benefits in improving the distribution of beds; 
110.34     (iii) adjust the existing bed supply in counties so that 
110.35  the bed supply in a county moves toward the statewide mean; and 
110.36     (iv) adjust the existing bed supply so that the 
111.1   distribution of beds as projected for the year 2020 would be 
111.2   consistent with projected need, based on the methodology 
111.3   outlined in the interagency long-term care committee's 1993 
111.4   nursing home bed distribution study; 
111.5      (4) the extent to which the project improves conditions 
111.6   that affect the health or safety of residents, such as narrow 
111.7   corridors, narrow door frames, unenclosed fire exits, and wood 
111.8   frame construction, and similar provisions contained in fire and 
111.9   life safety codes and licensure and certification rules; 
111.10     (5) the extent to which the project improves conditions 
111.11  that affect the comfort or quality of life of residents in a 
111.12  facility or the ability of the facility to provide efficient 
111.13  care, such as a relatively high number of residents in a room; 
111.14  inadequate lighting or ventilation; poor access to bathing or 
111.15  toilet facilities; a lack of available ancillary space for 
111.16  dining rooms, day rooms, or rooms used for other activities; 
111.17  problems relating to heating, cooling, or energy efficiency; 
111.18  inefficient location of nursing stations; narrow corridors; or 
111.19  other provisions contained in the licensure and certification 
111.20  rules; 
111.21     (6) the extent to which the applicant demonstrates the 
111.22  delivery of quality care, as defined in state and federal 
111.23  statutes and rules, to residents as evidenced by the two most 
111.24  recent state agency certification surveys and the applicants' 
111.25  response to those surveys; 
111.26     (7) the extent to which the project removes the need for 
111.27  waivers or variances previously granted by either the licensing 
111.28  agency, certifying agency, fire marshal, or local government 
111.29  entity; and 
111.30     (8) other factors that may be developed in permanent rule 
111.31  by the commissioner of health that evaluate and assess how the 
111.32  proposed project will further promote or protect the health, 
111.33  safety, comfort, treatment, or well-being of the facility's 
111.34  residents; and 
111.35     (9) for rate adjustment proposals, the extent to which the 
111.36  financial viability and continued operation of the facility 
112.1   would be threatened without a rate adjustment. 
112.2      Subd. 5.  [REPLACEMENT RESTRICTIONS.] (a) Proposals 
112.3   submitted or approved under this section involving replacement 
112.4   must provide for replacement of the facility on the existing 
112.5   site except as allowed in this subdivision.  
112.6      (b) Facilities located in a metropolitan statistical area 
112.7   other than the Minneapolis-St. Paul seven-county metropolitan 
112.8   area may relocate to a site within the same census tract or a 
112.9   contiguous census tract.  
112.10     (c) Facilities located in the Minneapolis-St. Paul 
112.11  seven-county metropolitan area may relocate to a site within the 
112.12  same or contiguous health planning area as adopted in March 1982 
112.13  by the metropolitan council.  
112.14     (d) Facilities located outside a metropolitan statistical 
112.15  area may relocate to a site within the same city or township, or 
112.16  within a contiguous township.  
112.17     (e) A facility relocated to a different site under 
112.18  paragraph (b), (c), or (d) must not be relocated to a site more 
112.19  than six miles from the existing site. 
112.20     (f) The relocation of part of an existing first facility to 
112.21  a second location, under paragraphs (d) and (e), may include the 
112.22  relocation to the second location of up to four beds from part 
112.23  of an existing third facility located in a township contiguous 
112.24  to the location of the first facility.  The six-mile limit in 
112.25  paragraph (e) does not apply to this relocation from the third 
112.26  facility. 
112.27     (g) For proposals approved on January 13, 1994, under this 
112.28  section involving the replacement of 102 licensed and certified 
112.29  beds, the relocation of the existing first facility to the 
112.30  second and third locations under paragraphs (d) and (e) may 
112.31  include the relocation of up to 50 percent of the beds of the 
112.32  existing first facility to each of the locations.  The six-mile 
112.33  limit in paragraph (e) does not apply to this relocation to the 
112.34  third location.  Notwithstanding subdivision 3, construction of 
112.35  this project may be commenced any time prior to January 1, 1996. 
112.36     Subd. 6.  [CONVERSION RESTRICTIONS.] Proposals submitted or 
113.1   approved under this section involving conversion must satisfy 
113.2   the following conditions: 
113.3      (a) Conversion is limited to a total of five beds. 
113.4      (b) An equivalent number of hospital beds must be 
113.5   delicensed. 
113.6      (c) The average occupancy rate in the existing nursing home 
113.7   beds must be greater than 96 percent according to the most 
113.8   recent annual statistical report of the department of health. 
113.9      (d) The cost of remodeling the hospital rooms to meet 
113.10  current nursing home construction standards must not exceed ten 
113.11  percent of the appraised value of the nursing home or $200,000, 
113.12  whichever is less. 
113.13     (e) The conversion must not result in an increase in 
113.14  operating costs. 
113.15     Subd. 7.  [UPGRADING RESTRICTIONS.] Proposals submitted or 
113.16  approved under this section involving upgrading must satisfy the 
113.17  following conditions: 
113.18     (a) The facility must meet minimum nursing home care 
113.19  standards. 
113.20     (b) If beds are upgraded to nursing home beds, the number 
113.21  of boarding care beds in a facility must not increase in the 
113.22  future. 
113.23     (c) The average occupancy rate in the existing nursing home 
113.24  beds in an attached facility must be greater than 96 percent 
113.25  according to the most recent annual statistical report of the 
113.26  department of health. 
113.27     Subd. 8.  [RULEMAKING.] The commissioner of health shall 
113.28  adopt rules to implement this section.  The permanent rules must 
113.29  be in accordance with and implement only the criteria listed in 
113.30  this section.  The authority to adopt permanent rules continues 
113.31  until July 1, 1996.  
113.32     Subd. 9.  [BUDGET REQUEST.] The commissioner of human 
113.33  services, in consultation with the commissioner of finance, 
113.34  shall include in each biennial budget request a line item for 
113.35  the nursing home moratorium exception and rate adjustment 
113.36  process.  If the commissioner of human services does not request 
114.1   funding for this item, the commissioner of human services must 
114.2   justify the decision in the budget pages. 
114.3      Sec. 2.  Minnesota Statutes 1998, section 144A.10, is 
114.4   amended by adding a subdivision to read: 
114.5      Subd. 1a.  [TRAINING AND EDUCATION FOR NURSING FACILITY 
114.6   PROVIDERS.] The commissioner of health must establish and 
114.7   implement a prescribed process and program for providing 
114.8   training and education to providers licensed by the department 
114.9   of health, either by itself or in conjunction with the industry 
114.10  trade associations, before using any new regulatory guideline, 
114.11  regulation, interpretation, program letter or memorandum, or any 
114.12  other materials used in surveyor training to survey licensed 
114.13  providers.  The process should include but is not limited to the 
114.14  following key components: 
114.15     (1) facilitate the implementation of immediate revisions to 
114.16  any course curriculum for nursing assistants which reflect any 
114.17  new standard of care practice that has been adopted or 
114.18  referenced by the health department concerning the issue in 
114.19  question; 
114.20     (2) conduct training of long-term care providers and health 
114.21  department survey inspectors either jointly or during the same 
114.22  time frame on the department's new expectations; and 
114.23     (3) within available resources the commissioner shall 
114.24  cooperate in the development of clinical standards, work with 
114.25  vendors of supplies and services regarding hazards, and identify 
114.26  research of interest to the long-term care community. 
114.27     Sec. 3.  Minnesota Statutes 1998, section 144A.10, is 
114.28  amended by adding a subdivision to read: 
114.29     Subd. 11.  [DATA ON FOLLOW-UP SURVEYS.] (a) If requested 
114.30  and not prohibited by federal law, the commissioner shall make 
114.31  available to the nursing home associations and the public 
114.32  photocopies of statements of deficiencies and related letters 
114.33  from the department pertaining to federal certification 
114.34  surveys.  The commissioner may charge for the actual cost of 
114.35  reproduction of these documents. 
114.36     (b) The commissioner shall also make available on a 
115.1   quarterly basis aggregate data for all statements of 
115.2   deficiencies issued after federal certification follow-up 
115.3   surveys related to surveys that were conducted in the quarter 
115.4   prior to the immediately preceding quarter.  The data shall 
115.5   include the number of facilities with deficiencies, the total 
115.6   number of deficiencies, the number of facilities that did not 
115.7   have any deficiencies, the number of facilities for which a 
115.8   resurvey or follow-up survey was not performed, and the average 
115.9   number of days between the follow-up or resurvey and the exit 
115.10  date of the preceding survey. 
115.11     (Effective Date: Section 3 (144A.10, subdivision 11) is 
115.12  effective the day following final enactment.) 
115.13     Sec. 4.  Minnesota Statutes 1998, section 144A.10, is 
115.14  amended by adding a subdivision to read: 
115.15     Subd. 12.  [NURSE AIDE TRAINING WAIVERS.] Because any 
115.16  disruption or delay in the training and registration of nurses 
115.17  aides may reduce access to care in certified facilities, the 
115.18  commissioner shall grant all possible waivers for the 
115.19  continuation of an approved nurse aide training and competency 
115.20  evaluation program or nurse aide training program or competency 
115.21  evaluation program conducted by or on the site of any certified 
115.22  nursing facility or skilled nursing facility that would 
115.23  otherwise lose approval for the program or programs.  The 
115.24  commissioner shall take into consideration the distance to other 
115.25  training programs, the frequency of other training programs, and 
115.26  the impact that the loss of the onsite training will have on the 
115.27  nursing facility's ability to recruit and train nurse aides. 
115.28     (Effective Date: Section 4 (144A.10, subdivision 12) is 
115.29  effective the day following final enactment.) 
115.30     Sec. 5.  Minnesota Statutes 1998, section 144A.10, is 
115.31  amended by adding a subdivision to read: 
115.32     Subd. 13.  [IMMEDIATE JEOPARDY.] When conducting survey 
115.33  certification and enforcement activities related to regular, 
115.34  expanded, or extended surveys under Code of Federal Regulations, 
115.35  title 42, part 488, the commissioner may not issue a finding of 
115.36  immediate jeopardy unless the specific event or omission that 
116.1   constitutes the violation of the requirements of participation 
116.2   poses an imminent risk of life-threatening or serious injury to 
116.3   a resident.  The commissioner may not issue any findings of 
116.4   immediate jeopardy after the conclusion of a regular, expanded, 
116.5   or extended survey unless the survey team identified the 
116.6   deficient practice or practices that constitute immediate 
116.7   jeopardy and the residents at risk prior to the close of the 
116.8   exit conference. 
116.9      (Effective Date: Section 5 (144A.10, subdivision 13) is 
116.10  effective the day following final enactment.) 
116.11     Sec. 6.  Minnesota Statutes 1998, section 144A.10, is 
116.12  amended by adding a subdivision to read: 
116.13     Subd. 14.  [INFORMAL DISPUTE RESOLUTION.] The commissioner 
116.14  shall respond in writing to a request from a nursing facility 
116.15  certified under the federal Medicare and Medicaid programs for 
116.16  an informal dispute resolution, within 30 days of the exit date 
116.17  of the facility's survey.  The commissioner's response shall 
116.18  identify the commissioner's decision regarding the continuation 
116.19  of each deficiency citation challenged by the nursing facility, 
116.20  as well as a statement of any changes in findings, level of 
116.21  severity or scope, and proposed remedies or sanctions for each 
116.22  deficiency citation. 
116.23     (Effective Date: Section 6 (144A.10, subdivision 14) is 
116.24  effective the day following final enactment.) 
116.25     Sec. 7.  [144A.102] [USE OF CIVIL MONEY PENALTIES; WAIVER 
116.26  FROM STATE AND FEDERAL RULES AND REGULATIONS.] 
116.27     By January 2000, the commissioner of health shall work with 
116.28  providers to examine state and federal rules and regulations 
116.29  governing the provision of care in licensed nursing facilities 
116.30  and apply for federal waivers and identify necessary changes in 
116.31  state law to:  
116.32     (1) allow the use of civil money penalties imposed upon 
116.33  nursing facilities to abate any deficiencies identified in a 
116.34  nursing facility's plan of correction; and 
116.35     (2) stop the accrual of any fine imposed by the health 
116.36  department when a follow-up inspection survey is not conducted 
117.1   by the department within the regulatory deadline. 
117.2      (Effective Date: Section 7 (144A.102) is effective the day 
117.3   following final enactment.) 
117.4      Sec. 8.  Minnesota Statutes 1998, section 144D.01, 
117.5   subdivision 4, is amended to read: 
117.6      Subd. 4.  [HOUSING WITH SERVICES ESTABLISHMENT OR 
117.7   ESTABLISHMENT.] "Housing with services establishment" or 
117.8   "establishment" means an establishment providing sleeping 
117.9   accommodations to one or more adult residents, at least 80 
117.10  percent of which are 55 years of age or older, and offering or 
117.11  providing, for a fee, one or more regularly scheduled 
117.12  health-related services or two or more regularly scheduled 
117.13  supportive services, whether offered or provided directly by the 
117.14  establishment or by another entity arranged for by the 
117.15  establishment. 
117.16     Housing with services establishment does not include: 
117.17     (1) a nursing home licensed under chapter 144A; 
117.18     (2) a hospital, certified boarding care home, or supervised 
117.19  living facility licensed under sections 144.50 to 144.56; 
117.20     (3) a board and lodging establishment licensed under 
117.21  chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 
117.22  9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 
117.23  9530.4450, or under chapter 245B; 
117.24     (4) a board and lodging establishment which serves as a 
117.25  shelter for battered women or other similar purpose; 
117.26     (5) a family adult foster care home licensed by the 
117.27  department of human services; 
117.28     (6) private homes in which the residents are related by 
117.29  kinship, law, or affinity with the providers of services; 
117.30     (7) residential settings for persons with mental 
117.31  retardation or related conditions in which the services are 
117.32  licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 
117.33  applicable successor rules or laws; 
117.34     (8) a home-sharing arrangement such as when an elderly or 
117.35  disabled person or single-parent family makes lodging in a 
117.36  private residence available to another person in exchange for 
118.1   services or rent, or both; 
118.2      (9) a duly organized condominium, cooperative, common 
118.3   interest community, or owners' association of the foregoing 
118.4   where at least 80 percent of the units that comprise the 
118.5   condominium, cooperative, or common interest community are 
118.6   occupied by individuals who are the owners, members, or 
118.7   shareholders of the units; or 
118.8      (10) services for persons with developmental disabilities 
118.9   that are provided under a license according to Minnesota Rules, 
118.10  parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 
118.11  under chapter 245B. 
118.12     Sec. 9.  Minnesota Statutes 1998, section 252.28, 
118.13  subdivision 1, is amended to read: 
118.14     Subdivision 1.  [DETERMINATIONS; REDETERMINATIONS.] In 
118.15  conjunction with the appropriate county boards, the commissioner 
118.16  of human services shall determine, and shall redetermine at 
118.17  least every four years, the need, location, size, and program of 
118.18  public and private residential services and day training and 
118.19  habilitation services for persons with mental retardation or 
118.20  related conditions.  This subdivision does not apply to 
118.21  semi-independent living services and residential-based 
118.22  habilitation services provided to four or fewer persons at a 
118.23  single site funded as home and community-based services.  A 
118.24  determination of need shall not be required for a change in 
118.25  ownership.  
118.26     Sec. 10.  [252.282] [ICF/MR LOCAL SYSTEM NEEDS PLANNING.] 
118.27     Subdivision 1.  [HOST COUNTY RESPONSIBILITY.] (a) For 
118.28  purposes of this section, "local system needs planning" means 
118.29  the determination of need for ICF/MR services by program type, 
118.30  location, demographics, and size of licensed services for 
118.31  persons with developmental disabilities or related conditions. 
118.32     (b) This section does not apply to semi-independent living 
118.33  services and residential-based habilitation services funded as 
118.34  home and community-based services. 
118.35     (c) In collaboration with the commissioner and ICF/MR 
118.36  providers, counties shall complete a local system needs planning 
119.1   process for each ICF/MR facility.  Counties shall evaluate the 
119.2   preferences and needs of persons with developmental disabilities 
119.3   to determine resource demands through a systematic assessment 
119.4   and planning process by May 15, 2000, and by July 1 every two 
119.5   years thereafter beginning in 2001. 
119.6      (d) A local system needs planning process shall be 
119.7   undertaken more frequently when the needs or preferences of 
119.8   consumers change significantly to require reformation of the 
119.9   resources available to persons with developmental disabilities. 
119.10     (e) A local system needs plan shall be amended anytime 
119.11  recommendations for modifications to existing ICF/MR services 
119.12  are made to the host county, including recommendations for: 
119.13     (1) closure; 
119.14     (2) relocation of services; 
119.15     (3) downsizing; 
119.16     (4) rate adjustments exceeding 90 days duration to address 
119.17  access; or 
119.18     (5) modification of existing services for which a change in 
119.19  the framework of service delivery is advocated. 
119.20     Subd. 2.  [CONSUMER NEEDS AND PREFERENCES.] In conducting 
119.21  the local system needs planning process, the host county must 
119.22  use information from the individual service plans of persons for 
119.23  whom the county is financially responsible and of persons from 
119.24  other counties for whom the county has agreed to be the host 
119.25  county.  The determination of services and supports offered 
119.26  within the county shall be based on the preferences and needs of 
119.27  consumers.  The host county shall also consider the community 
119.28  social services plan, waiting lists, and other sources that 
119.29  identify unmet needs for services.  A review of ICF/MR facility 
119.30  licensing and certification surveys, substantiated maltreatment 
119.31  reports, and established service standards shall be employed to 
119.32  assess the performance of providers and shall be considered in 
119.33  the county's recommendations.  Consumer satisfaction surveys may 
119.34  also be considered in this process. 
119.35     Subd. 3.  [RECOMMENDATIONS.] (a) Upon completion of the 
119.36  local system needs planning assessment, the host county shall 
120.1   make recommendations by May 15, 2000, and by July 1 every two 
120.2   years thereafter beginning in 2001.  If no change is 
120.3   recommended, a copy of the assessment along with corresponding 
120.4   documentation shall be provided to the commissioner by July 1 
120.5   prior to the contract year. 
120.6      (b) Except as provided in section 252.292, subdivision 4, 
120.7   recommendations regarding closures, relocations, or downsizings 
120.8   that include a rate increase and recommendations regarding rate 
120.9   adjustments exceeding 90 days shall be submitted to the 
120.10  statewide advisory committee for review and determination, along 
120.11  with the assessment, plan, and corresponding budget. 
120.12     (c) Recommendations for closures, relocations, and 
120.13  downsizings that do not include a rate increase and for 
120.14  modification of existing services for which a change in the 
120.15  framework of service delivery is necessary shall be provided to 
120.16  the commissioner by July 1 prior to the contract year or at 
120.17  least 90 days prior to the anticipated change, along with the 
120.18  assessment and corresponding documentation. 
120.19     Subd. 4.  [THE STATEWIDE ADVISORY COMMITTEE.] (a) The 
120.20  commissioner shall appoint a five-member statewide advisory 
120.21  committee.  The advisory committee shall include representatives 
120.22  of providers and counties and the commissioner or the 
120.23  commissioner's designee. 
120.24     (b) The criteria for ranking proposals, already developed 
120.25  in 1997 by a task force authorized by the legislature, shall be 
120.26  adopted and incorporated into the decision-making process.  
120.27  Specific guidelines, including time frame for submission of 
120.28  requests, shall be established and announced through the State 
120.29  Register, and all requests shall be considered in comparison to 
120.30  each other and the ranking criteria.  The advisory committee 
120.31  shall review and recommend requests for facility rate 
120.32  adjustments to address closures, downsizing, relocation, or 
120.33  access needs within the county and shall forward recommendations 
120.34  and documentation to the commissioner.  The committee shall 
120.35  ensure that: 
120.36     (1) applications are in compliance with applicable state 
121.1   and federal law and with the state plan; and 
121.2      (2) cost projections for the proposed service are within 
121.3   fiscal limitations. 
121.4      (c) The advisory committee shall review proposals and 
121.5   submit recommendations to the commissioner within 60 days 
121.6   following the published deadline for submission under 
121.7   subdivision 5. 
121.8      Subd. 5.  [RESPONSIBILITIES OF THE COMMISSIONER.] (a) In 
121.9   collaboration with counties, providers, and the statewide 
121.10  advisory committee, the commissioner shall ensure that services 
121.11  recognize the preferences and needs of persons with 
121.12  developmental disabilities and related conditions through a 
121.13  recurring systemic review and assessment of ICF/MR facilities 
121.14  within the state. 
121.15     (b) The commissioner shall publish a notice in the state 
121.16  register twice each calendar year to announce the opportunity 
121.17  for counties or providers to submit requests for rate 
121.18  adjustments associated with plans for downsizing, relocation, 
121.19  and closure of ICF/MR facilities. 
121.20     (c) The commissioner shall designate funding parameters to 
121.21  counties and to the statewide advisory committee for the overall 
121.22  implementation of system needs within the fiscal resources 
121.23  allocated by the legislature. 
121.24     (d) The commissioner shall contract with ICF/MR providers.  
121.25  The initial contracts shall cover the period from October 1, 
121.26  2000, to December 31, 2001.  Subsequent contracts shall be for 
121.27  two-year periods beginning January 1, 2002. 
121.28     Sec. 11.  Minnesota Statutes 1998, section 256B.0911, 
121.29  subdivision 6, is amended to read: 
121.30     Subd. 6.  [PAYMENT FOR PREADMISSION SCREENING.] (a) The 
121.31  total screening payment for each county must be paid monthly by 
121.32  certified nursing facilities in the county.  The monthly amount 
121.33  to be paid by each nursing facility for each fiscal year must be 
121.34  determined by dividing the county's annual allocation for 
121.35  screenings by 12 to determine the monthly payment and allocating 
121.36  the monthly payment to each nursing facility based on the number 
122.1   of licensed beds in the nursing facility. 
122.2      (b) The commissioner shall include the total annual payment 
122.3   for screening for each nursing facility according to section 
122.4   256B.431, subdivision 2b, paragraph (g), or 256B.435. 
122.5      (c) Payments for screening activities are available to the 
122.6   county or counties to cover staff salaries and expenses to 
122.7   provide the screening function.  The lead agency shall employ, 
122.8   or contract with other agencies to employ, within the limits of 
122.9   available funding, sufficient personnel to conduct the 
122.10  preadmission screening activity while meeting the state's 
122.11  long-term care outcomes and objectives as defined in section 
122.12  256B.0917, subdivision 1.  The local agency shall be accountable 
122.13  for meeting local objectives as approved by the commissioner in 
122.14  the CSSA biennial plan. 
122.15     (c) (d) Notwithstanding section 256B.0641, overpayments 
122.16  attributable to payment of the screening costs under the medical 
122.17  assistance program may not be recovered from a facility.  
122.18     (d) (e) The commissioner of human services shall amend the 
122.19  Minnesota medical assistance plan to include reimbursement for 
122.20  the local screening teams. 
122.21     Sec. 12.  Minnesota Statutes 1998, section 256B.0913, 
122.22  subdivision 5, is amended to read: 
122.23     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
122.24  Alternative care funding may be used for payment of costs of: 
122.25     (1) adult foster care; 
122.26     (2) adult day care; 
122.27     (3) home health aide; 
122.28     (4) homemaker services; 
122.29     (5) personal care; 
122.30     (6) case management; 
122.31     (7) respite care; 
122.32     (8) assisted living; 
122.33     (9) residential care services; 
122.34     (10) care-related supplies and equipment; 
122.35     (11) meals delivered to the home; 
122.36     (12) transportation; 
123.1      (13) skilled nursing; 
123.2      (14) chore services; 
123.3      (15) companion services; 
123.4      (16) nutrition services; 
123.5      (17) training for direct informal caregivers; and 
123.6      (18) telemedicine devices to monitor recipients in their 
123.7   own homes as an alternative to hospital care, nursing home care, 
123.8   or home visits.; and 
123.9      (19) other services including direct cash payments to 
123.10  clients, approved by the county agency, subject to the 
123.11  provisions of paragraph (m).  Total annual payments for other 
123.12  services for all clients within a county may not exceed either 
123.13  ten percent of that county's annual alternative care program 
123.14  base allocation or $5,000, whichever is greater.  In no case 
123.15  shall this amount exceed the county's total annual alternative 
123.16  care program base allocation. 
123.17     (b) The county agency must ensure that the funds are used 
123.18  only to supplement and not supplant services available through 
123.19  other public assistance or services programs. 
123.20     (c) Unless specified in statute, the service standards for 
123.21  alternative care services shall be the same as the service 
123.22  standards defined in the elderly waiver.  Except for the county 
123.23  agencies' approval of direct cash payments to clients, persons 
123.24  or agencies must be employed by or under a contract with the 
123.25  county agency or the public health nursing agency of the local 
123.26  board of health in order to receive funding under the 
123.27  alternative care program. 
123.28     (d) The adult foster care rate shall be considered a 
123.29  difficulty of care payment and shall not include room and 
123.30  board.  The adult foster care daily rate shall be negotiated 
123.31  between the county agency and the foster care provider.  The 
123.32  rate established under this section shall not exceed 75 percent 
123.33  of the state average monthly nursing home payment for the case 
123.34  mix classification to which the individual receiving foster care 
123.35  is assigned, and it must allow for other alternative care 
123.36  services to be authorized by the case manager. 
124.1      (e) Personal care services may be provided by a personal 
124.2   care provider organization.  A county agency may contract with a 
124.3   relative of the client to provide personal care services, but 
124.4   must ensure nursing supervision.  Covered personal care services 
124.5   defined in section 256B.0627, subdivision 4, must meet 
124.6   applicable standards in Minnesota Rules, part 9505.0335. 
124.7      (f) A county may use alternative care funds to purchase 
124.8   medical supplies and equipment without prior approval from the 
124.9   commissioner when:  (1) there is no other funding source; (2) 
124.10  the supplies and equipment are specified in the individual's 
124.11  care plan as medically necessary to enable the individual to 
124.12  remain in the community according to the criteria in Minnesota 
124.13  Rules, part 9505.0210, item A; and (3) the supplies and 
124.14  equipment represent an effective and appropriate use of 
124.15  alternative care funds.  A county may use alternative care funds 
124.16  to purchase supplies and equipment from a non-Medicaid certified 
124.17  vendor if the cost for the items is less than that of a Medicaid 
124.18  vendor.  A county is not required to contract with a provider of 
124.19  supplies and equipment if the monthly cost of the supplies and 
124.20  equipment is less than $250.  
124.21     (g) For purposes of this section, residential care services 
124.22  are services which are provided to individuals living in 
124.23  residential care homes.  Residential care homes are currently 
124.24  licensed as board and lodging establishments and are registered 
124.25  with the department of health as providing special services.  
124.26  Residential care services are defined as "supportive services" 
124.27  and "health-related services."  "Supportive services" means the 
124.28  provision of up to 24-hour supervision and oversight.  
124.29  Supportive services includes:  (1) transportation, when provided 
124.30  by the residential care center only; (2) socialization, when 
124.31  socialization is part of the plan of care, has specific goals 
124.32  and outcomes established, and is not diversional or recreational 
124.33  in nature; (3) assisting clients in setting up meetings and 
124.34  appointments; (4) assisting clients in setting up medical and 
124.35  social services; (5) providing assistance with personal laundry, 
124.36  such as carrying the client's laundry to the laundry room.  
125.1   Assistance with personal laundry does not include any laundry, 
125.2   such as bed linen, that is included in the room and board rate.  
125.3   Health-related services are limited to minimal assistance with 
125.4   dressing, grooming, and bathing and providing reminders to 
125.5   residents to take medications that are self-administered or 
125.6   providing storage for medications, if requested.  Individuals 
125.7   receiving residential care services cannot receive both personal 
125.8   care services and residential care services.  
125.9      (h) For the purposes of this section, "assisted living" 
125.10  refers to supportive services provided by a single vendor to 
125.11  clients who reside in the same apartment building of three or 
125.12  more units which are not subject to registration under chapter 
125.13  144D.  Assisted living services are defined as up to 24-hour 
125.14  supervision, and oversight, supportive services as defined in 
125.15  clause (1), individualized home care aide tasks as defined in 
125.16  clause (2), and individualized home management tasks as defined 
125.17  in clause (3) provided to residents of a residential center 
125.18  living in their units or apartments with a full kitchen and 
125.19  bathroom.  A full kitchen includes a stove, oven, refrigerator, 
125.20  food preparation counter space, and a kitchen utensil storage 
125.21  compartment.  Assisted living services must be provided by the 
125.22  management of the residential center or by providers under 
125.23  contract with the management or with the county. 
125.24     (1) Supportive services include:  
125.25     (i) socialization, when socialization is part of the plan 
125.26  of care, has specific goals and outcomes established, and is not 
125.27  diversional or recreational in nature; 
125.28     (ii) assisting clients in setting up meetings and 
125.29  appointments; and 
125.30     (iii) providing transportation, when provided by the 
125.31  residential center only.  
125.32     Individuals receiving assisted living services will not 
125.33  receive both assisted living services and homemaking or personal 
125.34  care services.  Individualized means services are chosen and 
125.35  designed specifically for each resident's needs, rather than 
125.36  provided or offered to all residents regardless of their 
126.1   illnesses, disabilities, or physical conditions.  
126.2      (2) Home care aide tasks means:  
126.3      (i) preparing modified diets, such as diabetic or low 
126.4   sodium diets; 
126.5      (ii) reminding residents to take regularly scheduled 
126.6   medications or to perform exercises; 
126.7      (iii) household chores in the presence of technically 
126.8   sophisticated medical equipment or episodes of acute illness or 
126.9   infectious disease; 
126.10     (iv) household chores when the resident's care requires the 
126.11  prevention of exposure to infectious disease or containment of 
126.12  infectious disease; and 
126.13     (v) assisting with dressing, oral hygiene, hair care, 
126.14  grooming, and bathing, if the resident is ambulatory, and if the 
126.15  resident has no serious acute illness or infectious disease.  
126.16  Oral hygiene means care of teeth, gums, and oral prosthetic 
126.17  devices.  
126.18     (3) Home management tasks means:  
126.19     (i) housekeeping; 
126.20     (ii) laundry; 
126.21     (iii) preparation of regular snacks and meals; and 
126.22     (iv) shopping.  
126.23     Assisted living services as defined in this section shall 
126.24  not be authorized in boarding and lodging establishments 
126.25  licensed according to sections 157.011 and 157.15 to 157.22. 
126.26     (i) For establishments registered under chapter 144D, 
126.27  assisted living services under this section means the services 
126.28  described and licensed under section 144A.4605. 
126.29     (j) For the purposes of this section, reimbursement for 
126.30  assisted living services and residential care services shall be 
126.31  a monthly rate negotiated and authorized by the county agency 
126.32  based on an individualized service plan for each resident. The 
126.33  rate shall not exceed the nonfederal share of the greater of 
126.34  either the statewide or any of the geographic groups' weighted 
126.35  average monthly medical assistance nursing facility payment rate 
126.36  of the case mix resident class to which the 180-day eligible 
127.1   client would be assigned under Minnesota Rules, parts 9549.0050 
127.2   to 9549.0059, unless the services are provided by a home care 
127.3   provider licensed by the department of health and are provided 
127.4   in a building that is registered as a housing with services 
127.5   establishment under chapter 144D and that provides 24-hour 
127.6   supervision. 
127.7      (k) For purposes of this section, companion services are 
127.8   defined as nonmedical care, supervision and oversight, provided 
127.9   to a functionally impaired adult.  Companions may assist the 
127.10  individual with such tasks as meal preparation, laundry and 
127.11  shopping, but do not perform these activities as discrete 
127.12  services.  The provision of companion services does not entail 
127.13  hands-on medical care.  Providers may also perform light 
127.14  housekeeping tasks which are incidental to the care and 
127.15  supervision of the recipient.  This service must be approved by 
127.16  the case manager as part of the care plan.  Companion services 
127.17  must be provided by individuals or nonprofit organizations who 
127.18  are under contract with the local agency to provide the 
127.19  service.  Any person related to the waiver recipient by blood, 
127.20  marriage or adoption cannot be reimbursed under this service.  
127.21  Persons providing companion services will be monitored by the 
127.22  case manager. 
127.23     (l) For purposes of this section, training for direct 
127.24  informal caregivers is defined as a classroom or home course of 
127.25  instruction which may include:  transfer and lifting skills, 
127.26  nutrition, personal and physical cares, home safety in a home 
127.27  environment, stress reduction and management, behavioral 
127.28  management, long-term care decision making, care coordination 
127.29  and family dynamics.  The training is provided to an informal 
127.30  unpaid caregiver of a 180-day eligible client which enables the 
127.31  caregiver to deliver care in a home setting with high levels of 
127.32  quality.  The training must be approved by the case manager as 
127.33  part of the individual care plan.  Individuals, agencies, and 
127.34  educational facilities which provide caregiver training and 
127.35  education will be monitored by the case manager. 
127.36     (m) A county agency may make payment from their alternative 
128.1   care program allocation for other services provided to an 
128.2   alternative care program recipient if those services prevent, 
128.3   shorten, or delay institutionalization.  These services may 
128.4   include direct cash payments to the recipient for the purpose of 
128.5   purchasing the recipient's services.  The following provisions 
128.6   apply to payments under this paragraph: 
128.7      (1) a cash payment to a client under this provision cannot 
128.8   exceed 80 percent of the monthly payment limit for that client 
128.9   as specified in subdivision 4, paragraph (a), clause (7); 
128.10     (2) a county may not approve any cash payment for a client 
128.11  who has been assessed as having a dependency in orientation, 
128.12  unless the client has an authorized representative under section 
128.13  256.476, subdivision 2, paragraph (g), or for a client who is 
128.14  concurrently receiving adult foster care, residential care, or 
128.15  assisted living services; 
128.16     (3) any service approved under this section must be a 
128.17  service which meets the purpose and goals of the program as 
128.18  listed in subdivision 1; 
128.19     (4) cash payments must also meet the criteria in section 
128.20  256.476, subdivision 4, paragraph (b), and recipients of cash 
128.21  grants must meet the requirements in section 256.476, 
128.22  subdivision 10; and 
128.23     (5) the county shall report client outcomes, services, and 
128.24  costs under this paragraph in a manner prescribed by the 
128.25  commissioner. 
128.26  Upon implementation of direct cash payments to clients under 
128.27  this section, any person determined eligible for the alternative 
128.28  care program who chooses a cash payment approved by the county 
128.29  agency shall receive the cash payment under this section and not 
128.30  under section 256.476 unless the person was receiving a consumer 
128.31  support grant under section 256.476 before implementation of 
128.32  direct cash payments under this section. 
128.33     Sec. 13.  Minnesota Statutes 1998, section 256B.0913, 
128.34  subdivision 10, is amended to read: 
128.35     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
128.36  appropriation for fiscal years 1992 and beyond shall cover only 
129.1   180-day eligible clients. 
129.2      (b) Prior to July 1 of each year, the commissioner shall 
129.3   allocate to county agencies the state funds available for 
129.4   alternative care for persons eligible under subdivision 2.  The 
129.5   allocation for fiscal year 1992 shall be calculated using a base 
129.6   that is adjusted to exclude the medical assistance share of 
129.7   alternative care expenditures.  The adjusted base is calculated 
129.8   by multiplying each county's allocation for fiscal year 1991 by 
129.9   the percentage of county alternative care expenditures for 
129.10  180-day eligible clients.  The percentage is determined based on 
129.11  expenditures for services rendered in fiscal year 1989 or 
129.12  calendar year 1989, whichever is greater. 
129.13     (c) If the county expenditures for 180-day eligible clients 
129.14  are 95 percent or more of its adjusted base allocation, the 
129.15  allocation for the next fiscal year is 100 percent of the 
129.16  adjusted base, plus inflation to the extent that inflation is 
129.17  included in the state budget. 
129.18     (d) If the county expenditures for 180-day eligible clients 
129.19  are less than 95 percent of its adjusted base allocation, the 
129.20  allocation for the next fiscal year is the adjusted base 
129.21  allocation less the amount of unspent funds below the 95 percent 
129.22  level. 
129.23     (e) For fiscal year 1992 only, a county may receive an 
129.24  increased allocation if annualized service costs for the month 
129.25  of May 1991 for 180-day eligible clients are greater than the 
129.26  allocation otherwise determined.  A county may apply for this 
129.27  increase by reporting projected expenditures for May to the 
129.28  commissioner by June 1, 1991.  The amount of the allocation may 
129.29  exceed the amount calculated in paragraph (b).  The projected 
129.30  expenditures for May must be based on actual 180-day eligible 
129.31  client caseload and the individual cost of clients' care plans.  
129.32  If a county does not report its expenditures for May, the amount 
129.33  in paragraph (c) or (d) shall be used. 
129.34     (f) Calculations for paragraphs (c) and (d) are to be made 
129.35  as follows:  for each county, the determination of expenditures 
129.36  shall be based on payments for services rendered from April 1 
130.1   through March 31 in the base year, to the extent that claims 
130.2   have been submitted by June 1 of that year.  Calculations for 
130.3   paragraphs (c) and (d) must also include the funds transferred 
130.4   to the consumer support grant program for clients who have 
130.5   transferred to that program from April 1 through March 31 in the 
130.6   base year.  
130.7      (g) For the biennium ending June 30, 2001, the allocation 
130.8   of state funds to county agencies shall be calculated as 
130.9   described in paragraphs (c) and (d).  If the annual legislative 
130.10  appropriation for the alternative care program is inadequate to 
130.11  fund the combined county allocations for fiscal year 2000 or 
130.12  2001, the commissioner shall distribute to each county the 
130.13  entire annual appropriation as that county's percentage of the 
130.14  computed base as calculated in paragraph (f). 
130.15     Sec. 14.  Minnesota Statutes 1998, section 256B.0913, 
130.16  subdivision 12, is amended to read: 
130.17     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
130.18  all 180-day eligible clients to help pay for the cost of 
130.19  participating in the program.  The amount of the premium for the 
130.20  alternative care client shall be determined as follows: 
130.21     (1) when the alternative care client's income less 
130.22  recurring and predictable medical expenses is greater than the 
130.23  medical assistance income standard but less than 150 percent of 
130.24  the federal poverty guideline, and total assets are less than 
130.25  $6,000 $10,000, the fee is zero; 
130.26     (2) when the alternative care client's income less 
130.27  recurring and predictable medical expenses is greater than 150 
130.28  percent of the federal poverty guideline, and total assets are 
130.29  less than $6,000 $10,000, the fee is 25 percent of the cost of 
130.30  alternative care services or the difference between 150 percent 
130.31  of the federal poverty guideline and the client's income less 
130.32  recurring and predictable medical expenses, whichever is less; 
130.33  and 
130.34     (3) when the alternative care client's total assets are 
130.35  greater than $6,000 $10,000, the fee is 25 percent of the cost 
130.36  of alternative care services.  
131.1      For married persons, total assets are defined as the total 
131.2   marital assets less the estimated community spouse asset 
131.3   allowance, under section 256B.059, if applicable.  For married 
131.4   persons, total income is defined as the client's income less the 
131.5   monthly spousal allotment, under section 256B.058. 
131.6      All alternative care services except case management shall 
131.7   be included in the estimated costs for the purpose of 
131.8   determining 25 percent of the costs. 
131.9      The monthly premium shall be calculated based on the cost 
131.10  of the first full month of alternative care services and shall 
131.11  continue unaltered until the next reassessment is completed or 
131.12  at the end of 12 months, whichever comes first.  Premiums are 
131.13  due and payable each month alternative care services are 
131.14  received unless the actual cost of the services is less than the 
131.15  premium. 
131.16     (b) The fee shall be waived by the commissioner when: 
131.17     (1) a person who is residing in a nursing facility is 
131.18  receiving case management only; 
131.19     (2) a person is applying for medical assistance; 
131.20     (3) a married couple is requesting an asset assessment 
131.21  under the spousal impoverishment provisions; 
131.22     (4) a person is a medical assistance recipient, but has 
131.23  been approved for alternative care-funded assisted living 
131.24  services; 
131.25     (5) a person is found eligible for alternative care, but is 
131.26  not yet receiving alternative care services; or 
131.27     (6) a person's fee under paragraph (a) is less than $25. 
131.28     (c) The county agency must collect the premium from the 
131.29  client and forward the amounts collected to the commissioner in 
131.30  the manner and at the times prescribed by the commissioner.  
131.31  Money collected must be deposited in the general fund and is 
131.32  appropriated to the commissioner for the alternative care 
131.33  program.  The client must supply the county with the client's 
131.34  social security number at the time of application.  If a client 
131.35  fails or refuses to pay the premium due, the county shall supply 
131.36  the commissioner with the client's social security number and 
132.1   other information the commissioner requires to collect the 
132.2   premium from the client.  The commissioner shall collect unpaid 
132.3   premiums using the Revenue Recapture Act in chapter 270A and 
132.4   other methods available to the commissioner.  The commissioner 
132.5   may require counties to inform clients of the collection 
132.6   procedures that may be used by the state if a premium is not 
132.7   paid.  
132.8      (d) The commissioner shall begin to adopt emergency or 
132.9   permanent rules governing client premiums within 30 days after 
132.10  July 1, 1991, including criteria for determining when services 
132.11  to a client must be terminated due to failure to pay a premium.  
132.12     Sec. 15.  [256B.0918] [OLDER ADULT SERVICES PLANNING AND 
132.13  TRANSITION GRANTS AND LOANS.] 
132.14     Subdivision 1.  [DEFINITION.] "Eligible provider of older 
132.15  adult services" means a nursing home licensed under sections 
132.16  144A.01 to 144A.16 and certified by an appropriate authority 
132.17  under United States Code, title 42, sections 1396-1396p, to 
132.18  participate as a vendor in the medical assistance program 
132.19  established under chapter 256B; a housing with services 
132.20  establishment registered under chapter 144D; a home care 
132.21  provider licensed under sections 144A.43 to 144A.48; or a 
132.22  housing project where 80 percent or more of the tenants are 55 
132.23  or older. 
132.24     Subd. 2.  [GRANTS AND LOAN ELIGIBILITY.] (a) An eligible 
132.25  provider of older adult services may apply for a planning or 
132.26  transition grant under section 256B.0917 and loans under chapter 
132.27  462A.  Seniors agenda for independent living (SAIL) shall assist 
132.28  with planning and assessment at the request of the provider of 
132.29  older adult services. 
132.30     (b) Planning grants may be used by an eligible provider of 
132.31  older adult services to develop a strategic plan that identifies 
132.32  the appropriate institutional and noninstitutional settings 
132.33  necessary to meet the long-term care needs of the community.  
132.34  Strategic plans may be developed in cooperation with the county 
132.35  public health and social services departments in which the 
132.36  project will be undertaken.  At a minimum, a strategic plan must 
133.1   consist of: 
133.2      (1) a needs assessment to determine what long-term care 
133.3   services are needed and desired by the community; 
133.4      (2) an assessment of the appropriate settings in which to 
133.5   provide needed long-term care services; 
133.6      (3) an assessment identifying currently available services 
133.7   and their settings in the community; and 
133.8      (4) a transition plan to achieve the needed outcome 
133.9   identified by the assessments. 
133.10     (c) Transition grants may be used by an eligible provider 
133.11  of older adult services to implement transition projects 
133.12  identified in a strategic plan.  The eligible provider of older 
133.13  adult services, the community, or a combined contribution from 
133.14  both, must provide 20 percent of the total cost of the 
133.15  transition project when funded by grants. 
133.16     (d) Eligible providers of older adult services may apply to 
133.17  the Minnesota Housing Finance Agency for financing to implement 
133.18  transition projects subject to the requirements of chapter 462A. 
133.19     (e) Transition projects include, but are not limited to: 
133.20     (1) converting nursing homes, or portions thereof, into 
133.21  housing with services establishments; 
133.22     (2) adding on-site therapy services including converting a 
133.23  portion of the nursing home or housing with services 
133.24  establishment for that purpose; 
133.25     (3) adding or expanding health-related or supportive 
133.26  services to an existing building serving seniors; 
133.27     (4) preserving or renovating affordable senior housing, 
133.28  which may include necessary renovations or equipment upgrades; 
133.29     (5) adding or expanding transportation services to a 
133.30  community to assist seniors in maintaining their independence; 
133.31  and 
133.32     (6) offering a meals-on-wheels program in the community. 
133.33     Sec. 16.  Minnesota Statutes 1998, section 256B.431, 
133.34  subdivision 17, is amended to read: 
133.35     Subd. 17.  [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 
133.36  (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 
134.1   for rate periods beginning on October 1, 1992, and for rate 
134.2   years beginning after June 30, 1993, a nursing facility that (1) 
134.3   has completed a construction project approved under section 
134.4   144A.071, subdivision 4a, clause (m); (2) has completed a 
134.5   construction project approved under section 144A.071, 
134.6   subdivision 4a, and effective after June 30, 1995; or (3) has 
134.7   completed a renovation, replacement, or upgrading project 
134.8   approved under the moratorium exception process in section 
134.9   144A.073 shall be reimbursed for costs directly identified to 
134.10  that project as provided in subdivision 16 and this subdivision. 
134.11     (b) Notwithstanding Minnesota Rules, part 9549.0060, 
134.12  subparts 5, item A, subitems (1) and (3), and 7, item D, 
134.13  allowable interest expense on debt shall include: 
134.14     (1) interest expense on debt related to the cost of 
134.15  purchasing or replacing depreciable equipment, excluding 
134.16  vehicles, not to exceed six percent of the total historical cost 
134.17  of the project; and 
134.18     (2) interest expense on debt related to financing or 
134.19  refinancing costs, including costs related to points, loan 
134.20  origination fees, financing charges, legal fees, and title 
134.21  searches; and issuance costs including bond discounts, bond 
134.22  counsel, underwriter's counsel, corporate counsel, printing, and 
134.23  financial forecasts.  Allowable debt related to items in this 
134.24  clause shall not exceed seven percent of the total historical 
134.25  cost of the project.  To the extent these costs are financed, 
134.26  the straight-line amortization of the costs in this clause is 
134.27  not an allowable cost; and 
134.28     (3) interest on debt incurred for the establishment of a 
134.29  debt reserve fund, net of the interest earned on the debt 
134.30  reserve fund. 
134.31     (c) Debt incurred for costs under paragraph (b) is not 
134.32  subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 
134.33  subitem (5) or (6). 
134.34     (d) The incremental increase in a nursing facility's rental 
134.35  rate, determined under Minnesota Rules, parts 9549.0010 to 
134.36  9549.0080, and this section, resulting from the acquisition of 
135.1   allowable capital assets, and allowable debt and interest 
135.2   expense under this subdivision shall be added to its 
135.3   property-related payment rate and shall be effective on the 
135.4   first day of the month following the month in which the 
135.5   moratorium project was completed. 
135.6      (e) Notwithstanding subdivision 3f, paragraph (a), for rate 
135.7   periods beginning on October 1, 1992, and for rate years 
135.8   beginning after June 30, 1993, the replacement-costs-new per bed 
135.9   limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 
135.10  item B, for a nursing facility that has completed a renovation, 
135.11  replacement, or upgrading project that has been approved under 
135.12  the moratorium exception process in section 144A.073, or that 
135.13  has completed an addition to or replacement of buildings, 
135.14  attached fixtures, or land improvements for which the total 
135.15  historical cost exceeds the lesser of $150,000 or ten percent of 
135.16  the most recent appraised value, must be $47,500 per licensed 
135.17  bed in multiple-bed rooms and $71,250 per licensed bed in a 
135.18  single-bed room.  These amounts must be adjusted annually as 
135.19  specified in subdivision 3f, paragraph (a), beginning January 1, 
135.20  1993. 
135.21     (f) A nursing facility that completes a project identified 
135.22  in this subdivision and, as of April 17, 1992, has not been 
135.23  mailed a rate notice with a special appraisal for a completed 
135.24  project, or completes a project after April 17, 1992, but before 
135.25  September 1, 1992, may elect either to request a special 
135.26  reappraisal with the corresponding adjustment to the 
135.27  property-related payment rate under the laws in effect on June 
135.28  30, 1992, or to submit their capital asset and debt information 
135.29  after that date and obtain the property-related payment rate 
135.30  adjustment under this section, but not both. 
135.31     (g) For purposes of this paragraph, a total replacement 
135.32  means the complete replacement of the nursing facility's 
135.33  physical plant through the construction of a new physical plant 
135.34  or the transfer of the nursing facility's license from one 
135.35  physical plant location to another.  For total replacement 
135.36  projects completed on or after July 1, 1992, the commissioner 
136.1   shall compute the incremental change in the nursing facility's 
136.2   rental per diem, for rate years beginning on or after July 1, 
136.3   1995, by replacing its appraised value, including the historical 
136.4   capital asset costs, and the capital debt and interest costs 
136.5   with the new nursing facility's allowable capital asset costs 
136.6   and the related allowable capital debt and interest costs.  If 
136.7   the new nursing facility has decreased its licensed capacity, 
136.8   the aggregate investment per bed limit in subdivision 3a, 
136.9   paragraph (d), shall apply.  If the new nursing facility has 
136.10  retained a portion of the original physical plant for nursing 
136.11  facility usage, then a portion of the appraised value prior to 
136.12  the replacement must be retained and included in the calculation 
136.13  of the incremental change in the nursing facility's rental per 
136.14  diem.  For purposes of this part, the original nursing facility 
136.15  means the nursing facility prior to the total replacement 
136.16  project.  The portion of the appraised value to be retained 
136.17  shall be calculated according to clauses (1) to (3): 
136.18     (1) The numerator of the allocation ratio shall be the 
136.19  square footage of the area in the original physical plant which 
136.20  is being retained for nursing facility usage. 
136.21     (2) The denominator of the allocation ratio shall be the 
136.22  total square footage of the original nursing facility physical 
136.23  plant. 
136.24     (3) Each component of the nursing facility's allowable 
136.25  appraised value prior to the total replacement project shall be 
136.26  multiplied by the allocation ratio developed by dividing clause 
136.27  (1) by clause (2). 
136.28     In the case of either type of total replacement as 
136.29  authorized under section 144A.071 or 144A.073, the provisions of 
136.30  this subdivision shall also apply.  For purposes of the 
136.31  moratorium exception authorized under section 144A.071, 
136.32  subdivision 4a, paragraph (s), if the total replacement involves 
136.33  the renovation and use of an existing health care facility 
136.34  physical plant, the new allowable capital asset costs and 
136.35  related debt and interest costs shall include first the 
136.36  allowable capital asset costs and related debt and interest 
137.1   costs of the renovation, to which shall be added the allowable 
137.2   capital asset costs of the existing physical plant prior to the 
137.3   renovation, and if reported by the facility, the related 
137.4   allowable capital debt and interest costs. 
137.5      (h) Notwithstanding Minnesota Rules, part 9549.0060, 
137.6   subpart 11, item C, subitem (2), for a total replacement, as 
137.7   defined in paragraph (g), authorized under section 144A.071 or 
137.8   section 144A.073 after July 1, 1999, the replacement-costs-new 
137.9   per bed limit shall be $74,280 per licensed bed in 
137.10  multiple-bed-rooms, $92,850 per licensed bed in semi-private 
137.11  rooms with a fixed partition separating the resident beds, and 
137.12  $111,420 per licensed bed in single rooms.  Minnesota Rules, 
137.13  part 9549.0060, subpart 11, item C, subitem (2), does not 
137.14  apply.  These amounts must be adjusted annually as specified in 
137.15  subdivision 3f, paragraph (a), beginning January 1, 2000.  
137.16     Sec. 17.  Minnesota Statutes 1998, section 256B.431, is 
137.17  amended by adding a subdivision to read: 
137.18     Subd. 28.  [CHANGES TO NURSING FACILITY REIMBURSEMENT 
137.19  BEGINNING JULY 1, 1999.] (a) For the rate years beginning July 
137.20  1, 1999, and July 1, 2000, the commissioner shall increase the 
137.21  total payment rates as of June 30 of the same calendar year for 
137.22  nursing facilities reimbursed under this section by 4.75 percent 
137.23  for facilities located in geographic group one, 3.50 percent for 
137.24  facilities located in geographic group two, and 2.75 percent for 
137.25  facilities located in geographic group three.  For those rate 
137.26  years, the commissioner shall not index the allowable operating 
137.27  cost per diems of these facilities by the inflation factor 
137.28  provided for in subdivision 26, paragraph (d), clause (1). 
137.29     (b) For the rate year beginning July 1, 1999, nursing 
137.30  facilities with rates set according to section 256B.434 shall 
137.31  not receive increases according to this subdivision but shall 
137.32  receive inflation increases according to section 256B.434.  For 
137.33  the rate year beginning July 1, 2000, the commissioner shall 
137.34  increase the total payment rates of nursing facilities with 
137.35  rates set according to section 256B.434 by 4.75 percent for 
137.36  facilities located in geographic group one, 3.50 percent for 
138.1   facilities located in geographic group two, and 2.75 percent for 
138.2   facilities located in geographic group three, and shall not 
138.3   provide these facilities with inflation increases according to 
138.4   section 256B.434. 
138.5      (c) It is the intention of the legislature that the rate 
138.6   increases provided in this subdivision be used to increase the 
138.7   compensation packages of direct-care staff in nursing 
138.8   facilities, by the percentage specified in paragraph (a) or (b) 
138.9   that applies to the nursing facility. 
138.10     Sec. 18.  Minnesota Statutes 1998, section 256B.434, 
138.11  subdivision 3, is amended to read: 
138.12     Subd. 3.  [DURATION AND TERMINATION OF CONTRACTS.] (a) 
138.13  Subject to available resources, the commissioner may begin to 
138.14  execute contracts with nursing facilities November 1, 1995. 
138.15     (b) All contracts entered into under this section are for a 
138.16  term of one year.  Either party may terminate a contract at any 
138.17  time without cause by providing 30 90 calendar days advance 
138.18  written notice to the other party.  The decision to terminate a 
138.19  contract is not appealable.  If neither party provides written 
138.20  notice of termination the contract shall be renegotiated for 
138.21  additional one-year terms, for up to a total of four consecutive 
138.22  one-year terms Notwithstanding section 16C.05, subdivision 2, 
138.23  paragraph (a), clause (5), the contract shall be renegotiated 
138.24  for additional one-year terms, unless either party provides 
138.25  written notice of termination.  The provisions of the contract 
138.26  shall be renegotiated annually by the parties prior to the 
138.27  expiration date of the contract.  The parties may voluntarily 
138.28  renegotiate the terms of the contract at any time by mutual 
138.29  agreement. 
138.30     (c) If a nursing facility fails to comply with the terms of 
138.31  a contract, the commissioner shall provide reasonable notice 
138.32  regarding the breach of contract and a reasonable opportunity 
138.33  for the facility to come into compliance.  If the facility fails 
138.34  to come into compliance or to remain in compliance, the 
138.35  commissioner may terminate the contract.  If a contract is 
138.36  terminated, the contract payment remains in effect for the 
139.1   remainder of the rate year in which the contract was terminated, 
139.2   but in all other respects the provisions of this section do not 
139.3   apply to that facility effective the date the contract is 
139.4   terminated.  The contract shall contain a provision governing 
139.5   the transition back to the cost-based reimbursement system 
139.6   established under section 256B.431, subdivision 25, and 
139.7   Minnesota Rules, parts 9549.0010 to 9549.0080.  A contract 
139.8   entered into under this section may be amended by mutual 
139.9   agreement of the parties. 
139.10     Sec. 19.  Minnesota Statutes 1998, section 256B.434, 
139.11  subdivision 13, is amended to read: 
139.12     Subd. 13.  [PAYMENT SYSTEM REFORM ADVISORY COMMITTEE.] (a) 
139.13  The commissioner, in consultation with an advisory committee, 
139.14  shall study options for reforming the regulatory and 
139.15  reimbursement system for nursing facilities to reduce the level 
139.16  of regulation, reporting, and procedural requirements, and to 
139.17  provide greater flexibility and incentives to stimulate 
139.18  competition and innovation.  The advisory committee shall 
139.19  include, at a minimum, representatives from the long-term care 
139.20  provider community, the department of health, and consumers of 
139.21  long-term care services.  The advisory committee sunsets on June 
139.22  30, 1997.  Among other things, the commissioner shall consider 
139.23  the feasibility and desirability of changing from a 
139.24  certification requirement to an accreditation requirement for 
139.25  participation in the medical assistance program, options to 
139.26  encourage early discharge of short-term residents through the 
139.27  provision of intensive therapy, and further modifications needed 
139.28  in rate equalization.  The commissioner shall also include 
139.29  detailed recommendations for a permanent managed care payment 
139.30  system to replace the contractual alternative payment 
139.31  demonstration project authorized under this section.  The 
139.32  commissioner shall submit a report with findings and 
139.33  recommendations to the legislature by January 15, 1997. 
139.34     (b) If a permanent managed care payment system has not been 
139.35  enacted into law by July 1, 1997, the commissioner shall develop 
139.36  and implement a transition plan to enable nursing facilities 
140.1   under contract with the commissioner under this section to 
140.2   revert to the cost-based payment system at the expiration of the 
140.3   alternative payment demonstration project.  The commissioner 
140.4   shall include in the alternative payment demonstration project 
140.5   contracts entered into under this section a provision to permit 
140.6   an amendment to the contract to be made after July 1, 1997, 
140.7   governing the transition back to the cost-based payment system.  
140.8   The transition plan and contract amendments are not subject to 
140.9   rulemaking requirements.  
140.10     Sec. 20.  Minnesota Statutes 1998, section 256B.435, is 
140.11  amended to read: 
140.12     256B.435 [NURSING FACILITY REIMBURSEMENT SYSTEM EFFECTIVE 
140.13  JULY 1, 2000 2001.] 
140.14     Subdivision 1.  [IN GENERAL.] Effective July 1, 2000 2001, 
140.15  the commissioner shall implement a performance-based contracting 
140.16  system to replace the current method of setting operating cost 
140.17  payment rates under sections 256B.431 and 256B.434 and Minnesota 
140.18  Rules, parts 9549.0010 to 9549.0080.  Operating cost payment 
140.19  rates for newly established facilities under Minnesota Rules, 
140.20  part 9549.0057, shall be established using section 256B.431 and 
140.21  Minnesota Rules, parts 9549.0010 to 9549.0070.  A nursing 
140.22  facility in operation on May 1, 1998, with payment rates not 
140.23  established under section 256B.431 or 256B.434 on that date, is 
140.24  ineligible for this performance-based contracting system.  In 
140.25  determining prospective payment rates of nursing facility 
140.26  services, the commissioner shall distinguish between operating 
140.27  costs and property-related costs.  The commissioner of finance 
140.28  shall include an annual inflationary adjustment in operating 
140.29  costs for nursing facilities using the inflation factor 
140.30  specified in subdivision 3 and funding for incentive-based 
140.31  payments as a budget change request in each biennial detailed 
140.32  expenditure budget submitted to the legislature under section 
140.33  16A.11.  Property related payment rates, including real estate 
140.34  taxes and special assessments, shall be determined under section 
140.35  256B.431 or 256B.434 or under a new property-related 
140.36  reimbursement system, if one is implemented by the commissioner 
141.1   under subdivision 3.  The commissioner shall present additional 
141.2   recommendations for performance-based contracting for nursing 
141.3   facilities to the legislature by February 15, 2000, in the 
141.4   following specific areas: 
141.5      (a) development of an interim default payment mechanism for 
141.6   nursing facilities that do not respond to the state's request 
141.7   for proposal but wish to continue participation in the medical 
141.8   assistance program; nursing facilities the state does not select 
141.9   in the request for proposal process; and nursing facilities 
141.10  whose contract has been canceled; 
141.11     (b) development of criteria for facilities to earn 
141.12  performance-based incentive payments based on relevant outcomes 
141.13  negotiated by nursing facilities and the commissioner and that 
141.14  recognize both continuous quality efforts and quality 
141.15  improvement; 
141.16     (c) development of criteria and a process under which 
141.17  nursing facilities can request rate adjustments for low base 
141.18  rates, geographic disparities, or other reasons; 
141.19     (d) development of a dispute resolution mechanism for 
141.20  nursing facilities that are denied a contract, denied incentive 
141.21  payments, or denied a rate adjustment; 
141.22     (e) development of a property payment system to address the 
141.23  capital needs of nursing facilities that will be funded with 
141.24  additional appropriations; 
141.25     (f) establishment of a transitional plan to move from dual 
141.26  assessment instruments to the federally mandated resident 
141.27  assessment system, whereby the financial impact for each 
141.28  facility would be budget neutral; 
141.29     (g) identification of net cost implications for facilities 
141.30  and to the department of preparing for and implementing 
141.31  performance-based contracting or any proposed alternative 
141.32  system; 
141.33     (h) identification of facility financial and statistical 
141.34  reporting requirements; and 
141.35     (i) identification of exemptions from current regulations 
141.36  and statutes applicable under performance-based contracting.  
142.1      Subd. 1a.  [REQUESTS FOR PROPOSALS.] (a) For nursing 
142.2   facilities with rates established under section 256B.434 on 
142.3   January 1, 2001, the commissioner shall renegotiate contracts 
142.4   without requiring a response to a request for proposal, 
142.5   notwithstanding the solicitation process described in chapter 
142.6   16C. 
142.7      (b) Prior to July 1, 2001, the commissioner shall publish 
142.8   in the State Register a request for proposals to provide nursing 
142.9   facility services according to this section.  The commissioner 
142.10  will consider proposals from all nursing facilities that have 
142.11  payment rates established under section 256B.431.  The 
142.12  commissioner must respond to all proposals in a timely manner. 
142.13     (c) In issuing a request for proposals, the commissioner 
142.14  may develop reasonable requirements which, in the judgment of 
142.15  the commissioner, are necessary to protect residents or ensure 
142.16  that the performance-based contracting system furthers the 
142.17  interests of the state of Minnesota.  The request for proposals 
142.18  may include, but need not be limited to: 
142.19     (1) a requirement that nursing facility make reasonable 
142.20  efforts to maximize Medicare payments on behalf of eligible 
142.21  residents; 
142.22     (2) requirements designed to prevent inappropriate or 
142.23  illegal discrimination against residents enrolled in the medical 
142.24  assistance program as compared to private paying residents; 
142.25     (3) requirements designed to ensure that admissions to a 
142.26  nursing facility are appropriate and that reasonable efforts are 
142.27  made to place residents in home and community-based settings 
142.28  when appropriate; 
142.29     (4) a requirement to agree to participate in the 
142.30  development of data collection systems and outcome-based 
142.31  standards.  Among other requirements specified by the 
142.32  commissioner, each facility entering into a contract may be 
142.33  required to pay an annual fee not to exceed $1,000.  The 
142.34  commissioner must use revenue generated from the fees to 
142.35  contract with a qualified consultant or contractor to develop 
142.36  data collection systems and outcome-based contracting standards; 
143.1      (5) a requirement that Medicare-certified contractors agree 
143.2   to maintain Medicare cost reports and to submit them to the 
143.3   commissioner upon request, or at times specified by the 
143.4   commissioner; and that contractors that are not 
143.5   Medicare-certified agree to maintain a uniform cost report in a 
143.6   format established by the commissioner and to submit the report 
143.7   to the commissioner upon request, or at times specified by the 
143.8   commissioner; 
143.9      (6) a requirement that demonstrates willingness and ability 
143.10  to develop and maintain data collection and retrieval systems to 
143.11  measure outcomes; and 
143.12     (7) a requirement to provide all information and assurances 
143.13  required by the terms and conditions of the federal waiver or 
143.14  federal approval. 
143.15     (d) In addition to the information and assurances contained 
143.16  in the submitted proposals, the commissioner may consider the 
143.17  following criteria in developing the terms of the contract: 
143.18     (1) the facility's history of compliance with federal and 
143.19  state laws and rules.  A facility deemed to be in substantial 
143.20  compliance with federal and state laws and rules is eligible to 
143.21  respond to a request for proposals.  A facility's compliance 
143.22  history shall not be the sole determining factor in situations 
143.23  where the facility has been sold and the new owners have 
143.24  submitted a proposal; 
143.25     (2) whether the facility has a record of excessive 
143.26  licensure fines or sanctions or fraudulent cost reports; 
143.27     (3) the facility's financial history and solvency; and 
143.28     (4) other factors identified by the commissioner deemed 
143.29  relevant to developing the terms of the contract, including a 
143.30  determination that a contract with a particular facility is not 
143.31  in the best interests of the residents of the facility or the 
143.32  state of Minnesota. 
143.33     (e) Notwithstanding the requirements of the solicitation 
143.34  process described in chapter 16C, the commissioner may contract 
143.35  with nursing facilities established according to section 
143.36  144A.073 without issuing a request for proposals. 
144.1      (f) Notwithstanding subdivision 1, after July 1, 2001, the 
144.2   commissioner may contract with additional nursing facilities, 
144.3   according to requests for proposals. 
144.4      Subd. 2.  [CONTRACT PROVISIONS.] (a) The performance-based 
144.5   contract with each nursing facility must include provisions that:
144.6      (1) apply the resident case mix assessment provisions of 
144.7   Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 
144.8   another assessment system, with the goal of moving to a single 
144.9   assessment system; 
144.10     (2) monitor resident outcomes through various methods, such 
144.11  as quality indicators based on the minimum data set and other 
144.12  utilization and performance measures; 
144.13     (3) require the establishment and use of a continuous 
144.14  quality improvement process that integrates information from 
144.15  quality indicators and regular resident and family satisfaction 
144.16  interviews; 
144.17     (4) require annual reporting of facility statistical 
144.18  information, including resident days by case mix category, 
144.19  productive nursing hours, wages and benefits, and raw food costs 
144.20  for use by the commissioner in the development of facility 
144.21  profiles that include trends in payment and service utilization; 
144.22     (5) require from each nursing facility an annual certified 
144.23  audited financial statement consisting of a balance sheet, 
144.24  income and expense statements, and an opinion from either a 
144.25  licensed or certified public accountant, if a certified audit 
144.26  was prepared, or unaudited financial statements if no certified 
144.27  audit was prepared; and 
144.28     (6) specify the method for resolving disputes; 
144.29     (7) establish additional requirements and penalties for 
144.30  nursing facilities not meeting the standards set forth in the 
144.31  performance-based contract. 
144.32     (b) The commissioner may develop additional incentive-based 
144.33  payments for achieving specified outcomes specified in each 
144.34  contract.  The specified facility-specific outcomes must be 
144.35  measurable and approved by the commissioner.  
144.36     (c) The commissioner may also contract with nursing 
145.1   facilities in other ways through requests for proposals, 
145.2   including contracts on a risk or nonrisk basis, with nursing 
145.3   facilities or consortia of nursing facilities, to provide 
145.4   comprehensive long-term care coverage on a premium or capitated 
145.5   basis. 
145.6      (d) The commissioner may negotiate different contract terms 
145.7   for different nursing facilities. 
145.8      Subd. 2a.  [DURATION AND TERMINATION OF CONTRACTS.] (a) All 
145.9   contracts entered into under this section are for a term of one 
145.10  year.  Either party may terminate this contract at any time 
145.11  without cause by providing 90 calendar days' advance written 
145.12  notice to the other party.  Notwithstanding section 16C.05, 
145.13  subdivisions 2, paragraph (a), and 5, if neither party provides 
145.14  written notice of termination, the contract shall be 
145.15  renegotiated for additional one-year terms or the terms of the 
145.16  existing contract will be extended for one year.  The provisions 
145.17  of the contract shall be renegotiated annually by the parties 
145.18  prior to the expiration date of the contract.  The parties may 
145.19  voluntarily renegotiate the terms of the contract at any time by 
145.20  mutual agreement. 
145.21     (b) If a nursing facility fails to comply with the terms of 
145.22  a contract, the commissioner shall provide reasonable notice 
145.23  regarding the breach of contract and a reasonable opportunity 
145.24  for the facility to come into compliance.  If the facility fails 
145.25  to come into compliance or to remain in compliance, the 
145.26  commissioner may terminate the contract.  If a contract is 
145.27  terminated, provisions of section 256B.48, subdivision 1a, shall 
145.28  apply. 
145.29     Subd. 3.  [PAYMENT RATE PROVISIONS.] (a) For rate years 
145.30  beginning on or after July 1, 2000 2001, within the limits of 
145.31  appropriations specifically for this purpose, the commissioner 
145.32  shall determine operating cost payment rates for each licensed 
145.33  and certified nursing facility by indexing its operating cost 
145.34  payment rates in effect on June 30, 2000 2001, for inflation.  
145.35  The inflation factor to be used must be based on the change in 
145.36  the Consumer Price Index-All Items, United States city average 
146.1   (CPI-U) as forecasted by Data Resources, Inc. in the fourth 
146.2   quarter preceding the rate year.  The CPI-U forecasted index for 
146.3   operating cost payment rates shall be based on the 12-month 
146.4   period from the midpoint of the nursing facility's prior rate 
146.5   year to the midpoint of the rate year for which the operating 
146.6   payment rate is being determined.  The operating cost payment 
146.7   rate to be inflated shall be the total payment rate in effect on 
146.8   June 30, 2001, minus the portion determined to be the 
146.9   property-related payment rate, minus the per diem amount of the 
146.10  preadmission screening cost included in the nursing facility's 
146.11  last payment rate established under section 256B.431. 
146.12     (b) Beginning July 1, 2000, each nursing facility subject 
146.13  to a performance-based contract under this section shall choose 
146.14  one of two methods of payment for property-related costs: 
146.15     (1) the method established in section 256B.434; or 
146.16     (2) the method established in section 256B.431. 
146.17     Once the nursing facility has made the election in this 
146.18  paragraph, that election shall remain in effect for at least 
146.19  four years or until an alternative property payment system is 
146.20  developed.  A per diem amount for preadmission screening will be 
146.21  added onto the contract payment rates according to the method of 
146.22  distribution of county allocation described in section 
146.23  256B.0911, subdivision 6, paragraph (a). 
146.24     (c) For rate years beginning on or after July 1, 2000 2001, 
146.25  the commissioner may implement a new method of payment for 
146.26  property-related costs that addresses the capital needs of 
146.27  nursing facilities.  Notwithstanding paragraph (b), The new 
146.28  property payment system or systems, if implemented, shall 
146.29  replace the current method methods of setting property payment 
146.30  rates under sections 256B.431 and 256B.434. 
146.31     Subd. 4.  [CONTRACT PAYMENT RATES; APPEALS.] If an appeal 
146.32  is pending concerning the cost-based payment rates that are the 
146.33  basis for the calculation of the payment rate under this 
146.34  section, the commissioner and the nursing facility may agree on 
146.35  an interim contract rate to be used until the appeal is 
146.36  resolved.  When the appeal is resolved, the contract rate must 
147.1   be adjusted retroactively according to the appeal decision. 
147.2      Subd. 5.  [CONSUMER PROTECTION.] In addition to complying 
147.3   with all applicable laws regarding consumer protection, as a 
147.4   condition of entering into a contract under this section, a 
147.5   nursing facility must agree to: 
147.6      (1) establish resident grievance procedures; 
147.7      (2) establish expedited grievance procedures to resolve 
147.8   complaints made by short-stay residents; and 
147.9      (3) make available to residents and families a copy of the 
147.10  performance-based contract and outcomes to be achieved. 
147.11     Subd. 6.  [CONTRACTS ARE VOLUNTARY.] Participation of 
147.12  nursing facilities in the medical assistance program is 
147.13  voluntary.  The terms and procedures governing the 
147.14  performance-based contract are determined under this section and 
147.15  through negotiations between the commissioner and nursing 
147.16  facilities.  
147.17     Subd. 7.  [FEDERAL REQUIREMENTS.] The commissioner shall 
147.18  implement the performance-based contracting system subject to 
147.19  any required federal waivers or approval and in a manner that is 
147.20  consistent with federal requirements.  If a provision of this 
147.21  section is inconsistent with a federal requirement, the federal 
147.22  requirement supersedes the inconsistent provision.  The 
147.23  commissioner shall seek federal approval and request waivers as 
147.24  necessary to implement this section. 
147.25     Sec. 21.  Minnesota Statutes 1998, section 256B.48, 
147.26  subdivision 1, is amended to read: 
147.27     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
147.28  is not eligible to receive medical assistance payments unless it 
147.29  refrains from all of the following: 
147.30     (a) Charging private paying residents rates for similar 
147.31  services which exceed those which are approved by the state 
147.32  agency for medical assistance recipients as determined by the 
147.33  prospective desk audit rate, except under the following 
147.34  circumstances:  the nursing facility may (1) charge private 
147.35  paying residents a higher rate for a private room, and (2) 
147.36  charge for special services which are not included in the daily 
148.1   rate if medical assistance residents are charged separately at 
148.2   the same rate for the same services in addition to the daily 
148.3   rate paid by the commissioner.  Services covered by the payment 
148.4   rate must be the same regardless of payment source.  Special 
148.5   services, if offered, must be available to all residents in all 
148.6   areas of the nursing facility and charged separately at the same 
148.7   rate.  Residents are free to select or decline special 
148.8   services.  Special services must not include services which must 
148.9   be provided by the nursing facility in order to comply with 
148.10  licensure or certification standards and that if not provided 
148.11  would result in a deficiency or violation by the nursing 
148.12  facility.  Services beyond those required to comply with 
148.13  licensure or certification standards must not be charged 
148.14  separately as a special service if they were included in the 
148.15  payment rate for the previous reporting year.  A nursing 
148.16  facility that charges a private paying resident a rate in 
148.17  violation of this clause is subject to an action by the state of 
148.18  Minnesota or any of its subdivisions or agencies for civil 
148.19  damages.  A private paying resident or the resident's legal 
148.20  representative has a cause of action for civil damages against a 
148.21  nursing facility that charges the resident rates in violation of 
148.22  this clause.  The damages awarded shall include three times the 
148.23  payments that result from the violation, together with costs and 
148.24  disbursements, including reasonable attorneys' fees or their 
148.25  equivalent.  A private paying resident or the resident's legal 
148.26  representative, the state, subdivision or agency, or a nursing 
148.27  facility may request a hearing to determine the allowed rate or 
148.28  rates at issue in the cause of action.  Within 15 calendar days 
148.29  after receiving a request for such a hearing, the commissioner 
148.30  shall request assignment of an administrative law judge under 
148.31  sections 14.48 to 14.56 to conduct the hearing as soon as 
148.32  possible or according to agreement by the parties.  The 
148.33  administrative law judge shall issue a report within 15 calendar 
148.34  days following the close of the hearing.  The prohibition set 
148.35  forth in this clause shall not apply to facilities licensed as 
148.36  boarding care facilities which are not certified as skilled or 
149.1   intermediate care facilities level I or II for reimbursement 
149.2   through medical assistance. 
149.3      (b) Requiring (1) Charging, soliciting, accepting, or 
149.4   receiving from an applicant for admission to the facility, 
149.5   or the guardian or conservator from anyone acting in behalf of 
149.6   the applicant, as a condition of admission, to pay expediting 
149.7   the admission, or as a requirement for the individual's 
149.8   continued stay, any fee or, deposit in excess of $100, gift, 
149.9   money, donation, or other consideration not otherwise required 
149.10  as payment under the state plan.  Nothing in this clause would 
149.11  prohibit discharge for nonpayment of services in accordance with 
149.12  state and federal regulations; 
149.13     (2) requiring an individual, or anyone acting in behalf of 
149.14  the individual, to loan any money to the nursing facility, or; 
149.15     (3) requiring an individual, or anyone acting in behalf of 
149.16  the individual, to promise to leave all or part of 
149.17  the applicant's individual's estate to the facility; or (4) 
149.18  requiring a third-party guarantee of payment to the facility as 
149.19  a condition of admission, expedited admission, or continued stay 
149.20  in the facility.  
149.21     (c) Requiring any resident of the nursing facility to 
149.22  utilize a vendor of health care services chosen by the nursing 
149.23  facility. 
149.24     (d) Providing differential treatment on the basis of status 
149.25  with regard to public assistance.  
149.26     (e) Discriminating in admissions, services offered, or room 
149.27  assignment on the basis of status with regard to public 
149.28  assistance or refusal to purchase special services.  Admissions 
149.29  discrimination shall include, but is not limited to:  
149.30     (1) basing admissions decisions upon assurance by the 
149.31  applicant to the nursing facility, or the applicant's guardian 
149.32  or conservator, that the applicant is neither eligible for nor 
149.33  will seek public assistance for payment of nursing facility care 
149.34  costs; and 
149.35     (2) engaging in preferential selection from waiting lists 
149.36  based on an applicant's ability to pay privately or an 
150.1   applicant's refusal to pay for a special service. 
150.2      The collection and use by a nursing facility of financial 
150.3   information of any applicant pursuant to a preadmission 
150.4   screening program established by law shall not raise an 
150.5   inference that the nursing facility is utilizing that 
150.6   information for any purpose prohibited by this paragraph.  
150.7      (f) Requiring any vendor of medical care as defined by 
150.8   section 256B.02, subdivision 7, who is reimbursed by medical 
150.9   assistance under a separate fee schedule, to pay any amount 
150.10  based on utilization or service levels or any portion of the 
150.11  vendor's fee to the nursing facility except as payment for 
150.12  renting or leasing space or equipment or purchasing support 
150.13  services from the nursing facility as limited by section 
150.14  256B.433.  All agreements must be disclosed to the commissioner 
150.15  upon request of the commissioner.  Nursing facilities and 
150.16  vendors of ancillary services that are found to be in violation 
150.17  of this provision shall each be subject to an action by the 
150.18  state of Minnesota or any of its subdivisions or agencies for 
150.19  treble civil damages on the portion of the fee in excess of that 
150.20  allowed by this provision and section 256B.433.  Damages awarded 
150.21  must include three times the excess payments together with costs 
150.22  and disbursements including reasonable attorney's fees or their 
150.23  equivalent.  
150.24     (g) Refusing, for more than 24 hours, to accept a resident 
150.25  returning to the same bed or a bed certified for the same level 
150.26  of care, in accordance with a physician's order authorizing 
150.27  transfer, after receiving inpatient hospital services. 
150.28     The prohibitions set forth in clause (b) shall not apply to 
150.29  a retirement facility with more than 325 beds including at least 
150.30  150 licensed nursing facility beds and which:  
150.31     (1) is owned and operated by an organization tax-exempt 
150.32  under section 290.05, subdivision 1, clause (i); and 
150.33     (2) accounts for all of the applicant's assets which are 
150.34  required to be assigned to the facility so that only expenses 
150.35  for the cost of care of the applicant may be charged against the 
150.36  account; and 
151.1      (3) agrees in writing at the time of admission to the 
151.2   facility to permit the applicant, or the applicant's guardian, 
151.3   or conservator, to examine the records relating to the 
151.4   applicant's account upon request, and to receive an audited 
151.5   statement of the expenditures charged against the applicant's 
151.6   individual account upon request; and 
151.7      (4) agrees in writing at the time of admission to the 
151.8   facility to permit the applicant to withdraw from the facility 
151.9   at any time and to receive, upon withdrawal, the balance of the 
151.10  applicant's individual account. 
151.11     For a period not to exceed 180 days, the commissioner may 
151.12  continue to make medical assistance payments to a nursing 
151.13  facility or boarding care home which is in violation of this 
151.14  section if extreme hardship to the residents would result.  In 
151.15  these cases the commissioner shall issue an order requiring the 
151.16  nursing facility to correct the violation.  The nursing facility 
151.17  shall have 20 days from its receipt of the order to correct the 
151.18  violation.  If the violation is not corrected within the 20-day 
151.19  period the commissioner may reduce the payment rate to the 
151.20  nursing facility by up to 20 percent.  The amount of the payment 
151.21  rate reduction shall be related to the severity of the violation 
151.22  and shall remain in effect until the violation is corrected.  
151.23  The nursing facility or boarding care home may appeal the 
151.24  commissioner's action pursuant to the provisions of chapter 14 
151.25  pertaining to contested cases.  An appeal shall be considered 
151.26  timely if written notice of appeal is received by the 
151.27  commissioner within 20 days of notice of the commissioner's 
151.28  proposed action.  
151.29     In the event that the commissioner determines that a 
151.30  nursing facility is not eligible for reimbursement for a 
151.31  resident who is eligible for medical assistance, the 
151.32  commissioner may authorize the nursing facility to receive 
151.33  reimbursement on a temporary basis until the resident can be 
151.34  relocated to a participating nursing facility.  
151.35     Certified beds in facilities which do not allow medical 
151.36  assistance intake on July 1, 1984, or after shall be deemed to 
152.1   be decertified for purposes of section 144A.071 only.  
152.2      Sec. 22.  Minnesota Statutes 1998, section 256B.48, 
152.3   subdivision 1a, is amended to read: 
152.4      Subd. 1a.  [TERMINATION.] If a nursing facility terminates 
152.5   its participation in the medical assistance program, whether 
152.6   voluntarily or involuntarily, the commissioner may authorize the 
152.7   nursing facility to receive continued medical assistance 
152.8   reimbursement only on a temporary basis until medical assistance 
152.9   residents can be relocated to nursing facilities participating 
152.10  in the medical assistance program. 
152.11     Sec. 23.  Minnesota Statutes 1998, section 256B.48, 
152.12  subdivision 1b, is amended to read: 
152.13     Subd. 1b.  [EXCEPTION.] Notwithstanding any agreement 
152.14  between a nursing facility and the department of human services 
152.15  or the provisions of this section or section 256B.411, other 
152.16  than subdivision 1a, the commissioner may authorize continued 
152.17  medical assistance payments to a nursing facility which ceased 
152.18  intake of medical assistance recipients prior to July 1, 1983, 
152.19  and which charges private paying residents rates that exceed 
152.20  those permitted by subdivision 1, paragraph (a), for (i) 
152.21  residents who resided in the nursing facility before July 1, 
152.22  1983, or (ii)  residents for whom the commissioner or any 
152.23  predecessors of the commissioner granted a permanent individual 
152.24  waiver prior to October 1, 1983.  Nursing facilities seeking 
152.25  continued medical assistance payments under this subdivision 
152.26  shall make the reports required under subdivision 2, except that 
152.27  on or after December 31, 1985, the financial statements required 
152.28  need not be audited by or contain the opinion of a certified 
152.29  public accountant or licensed public accountant, but need only 
152.30  be reviewed by a certified public accountant or licensed public 
152.31  accountant.  In the event that the state is determined by the 
152.32  federal government to be no longer eligible for the federal 
152.33  share of medical assistance payments made to a nursing facility 
152.34  under this subdivision, the commissioner may cease medical 
152.35  assistance payments, under this subdivision, to that nursing 
152.36  facility.  Between October 1, 1992, and July 1, 1993, a facility 
153.1   governed by this subdivision may elect to resume full 
153.2   participation in the medical assistance program by agreeing to 
153.3   comply with all of the requirements of the medical assistance 
153.4   program, including the rate equalization law in subdivision 1, 
153.5   paragraph (a), and all other requirements established in law or 
153.6   rule, and to resume intake of new medical assistance recipients. 
153.7      Sec. 24.  Minnesota Statutes 1998, section 256B.48, 
153.8   subdivision 6, is amended to read: 
153.9      Subd. 6.  [MEDICARE CERTIFICATION.] (a) [DEFINITION.] For 
153.10  purposes of this subdivision, "nursing facility" means a nursing 
153.11  facility that is certified as a skilled nursing facility or, 
153.12  after September 30, 1990, a nursing facility licensed under 
153.13  chapter 144A that is certified as a nursing facility.  
153.14     (b) [MEDICARE PARTICIPATION REQUIRED.] All nursing 
153.15  facilities shall participate in Medicare part A and part B 
153.16  unless, after submitting an application, Medicare certification 
153.17  is denied by the federal health care financing administration.  
153.18  Medicare review shall be conducted at the time of the annual 
153.19  medical assistance review.  Charges for Medicare-covered 
153.20  services provided to residents who are simultaneously eligible 
153.21  for medical assistance and Medicare must be billed to Medicare 
153.22  part A or part B before billing medical assistance.  Medical 
153.23  assistance may be billed only for charges not reimbursed by 
153.24  Medicare.  Within the limits of available appropriations, the 
153.25  commissioner shall approve a request for an exemption from 
153.26  Medicare certification if a nursing facility meets the following 
153.27  criteria: 
153.28     (1) the facility has had at least six months' experience 
153.29  under the Medicare prospective payment system; and 
153.30     (2) the facility can demonstrate losses under the Medicare 
153.31  prospective payment system that threaten the financial viability 
153.32  of the facility. 
153.33     Facilities requesting an exemption from Medicare 
153.34  certification may request that they not be certified for 
153.35  Medicare for up to three years.  The commissioner must respond 
153.36  within 30 days to a request for an exemption under this section. 
154.1      (c) [UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, a 
154.2   nursing facility satisfies the requirements of paragraph (b) 
154.3   if:  (1) at least 50 percent of the facility's beds that are 
154.4   licensed under section 144A and certified as skilled nursing 
154.5   beds under the medical assistance program are Medicare 
154.6   certified; or (2) if a nursing facility's beds are licensed 
154.7   under section 144A, and some are medical assistance certified as 
154.8   skilled nursing beds and others are medical assistance certified 
154.9   as intermediate care facility I beds, at least 50 percent of the 
154.10  facility's total skilled nursing beds and intermediate care 
154.11  facility I beds or 100 percent of its skilled nursing beds, 
154.12  whichever is less, are Medicare certified. 
154.13     (d) [AFTER SEPTEMBER 30, 1990.] After September 30, 1990, a 
154.14  nursing facility satisfies the requirements of paragraph (b) if 
154.15  at least 50 percent of the facility's beds certified as nursing 
154.16  facility beds under the medical assistance program are Medicare 
154.17  certified. 
154.18     (e) (d) [CONFLICT WITH MEDICARE DISTINCT PART 
154.19  REQUIREMENTS.] At the request of a facility, the commissioner of 
154.20  human services may reduce the 50 percent Medicare participation 
154.21  requirement in paragraphs (c) and (d) to no less than 20 percent 
154.22  if the commissioner of health determines that, due to the 
154.23  facility's physical plant configuration, the facility cannot 
154.24  satisfy Medicare distinct part requirements at the 50 percent 
154.25  certification level.  To receive a reduction in the 
154.26  participation requirement, a facility must demonstrate that the 
154.27  reduction will not adversely affect access of Medicare-eligible 
154.28  residents to Medicare-certified beds. 
154.29     (f) (e) [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner 
154.30  may grant exceptions to the requirements of paragraph (b) for 
154.31  nursing facilities that are designated as institutions for 
154.32  mental disease. 
154.33     (g) (f) [NOTICE OF RIGHTS.] The commissioner shall inform 
154.34  recipients of their rights under this subdivision and section 
154.35  144.651, subdivision 29. 
154.36     Sec. 25.  Minnesota Statutes 1998, section 256B.50, 
155.1   subdivision 1e, is amended to read: 
155.2      Subd. 1e.  [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding 
155.3   section 15.472, paragraph (a), for an issue appealed under 
155.4   subdivision 1, the prevailing party in a contested case 
155.5   proceeding or, if appealed, in subsequent judicial review, must 
155.6   be awarded reasonable attorney's fees and costs incurred in 
155.7   litigating the appeal, if the prevailing party shows that the 
155.8   position of the opposing party was not substantially justified.  
155.9   The procedures for awarding fees and costs set forth in section 
155.10  15.474 must be followed in determining the prevailing party's 
155.11  fees and costs except as otherwise provided in this 
155.12  subdivision.  For purposes of this subdivision, "costs" means 
155.13  subpoena fees and mileage, transcript costs, court reporter 
155.14  fees, witness fees, postage and delivery costs, photocopying and 
155.15  printing costs, amounts charged the commissioner by the office 
155.16  of administrative hearings, and direct administrative costs of 
155.17  the department; and "substantially justified" means that a 
155.18  position had a reasonable basis in law and fact, based on the 
155.19  totality of the circumstances prior to and during the contested 
155.20  case proceeding and subsequent review. 
155.21     (b) When an award is made to the department under this 
155.22  subdivision, attorney fees must be calculated at the cost to the 
155.23  department.  When an award is made to a provider under this 
155.24  subdivision, attorney fees must be calculated at the rate 
155.25  charged to the provider except that attorney fees awarded must 
155.26  be the lesser of the attorney's normal hourly fee or $100 per 
155.27  hour. 
155.28     (c) In contested case proceedings involving more than one 
155.29  issue, the administrative law judge shall determine what portion 
155.30  of each party's attorney fees and costs is related to the issue 
155.31  or issues on which it prevailed and for which it is entitled to 
155.32  an award.  In making that determination, the administrative law 
155.33  judge shall consider the amount of time spent on each issue, the 
155.34  precedential value of the issue, the complexity of the issue, 
155.35  and other factors deemed appropriate by the administrative law 
155.36  judge.  
156.1      (d) When the department prevails on an issue involving more 
156.2   than one provider, the administrative law judge shall allocate 
156.3   the total amount of any award for attorney fees and costs among 
156.4   the providers.  In determining the allocation, the 
156.5   administrative law judge shall consider each provider's monetary 
156.6   interest in the issue and other factors deemed appropriate by 
156.7   the administrative law judge.  
156.8      (e) Attorney fees and costs awarded to the department for 
156.9   proceedings under this subdivision must not be reported or 
156.10  treated as allowable costs on the provider's cost report.  
156.11     (f) Fees and costs awarded to a provider for proceedings 
156.12  under this subdivision must be reimbursed to them by reporting 
156.13  the amount of fees and costs awarded as allowable costs on the 
156.14  provider's cost report for the reporting year in which they were 
156.15  awarded.  Fees and costs reported pursuant to this subdivision 
156.16  must be included in the general and administrative cost category 
156.17  but are not subject to categorical or overall cost limitations 
156.18  established in rule or statute within 120 days of the final 
156.19  decision on the award of attorney fees and costs. 
156.20     (g) If the provider fails to pay the awarded attorney fees 
156.21  and costs within 120 days of the final decision on the award of 
156.22  attorney fees and costs, the department may collect the amount 
156.23  due through any method available to it for the collection of 
156.24  medical assistance overpayments to providers.  Interest charges 
156.25  must be assessed on balances outstanding after 120 days of the 
156.26  final decision on the award of attorney fees and costs.  The 
156.27  annual interest rate charged must be the rate charged by the 
156.28  commissioner of revenue for late payment of taxes that is in 
156.29  effect on the 121st day after the final decision on the award of 
156.30  attorney fees and costs.  
156.31     (h) Amounts collected by the commissioner pursuant to this 
156.32  subdivision must be deemed to be recoveries pursuant to section 
156.33  256.01, subdivision 2, clause (15). 
156.34     (i) This subdivision applies to all contested case 
156.35  proceedings set on for hearing by the commissioner on or after 
156.36  April 29, 1988, regardless of the date the appeal was filed. 
157.1      Sec. 26.  Minnesota Statutes 1998, section 256B.501, is 
157.2   amended by adding a subdivision to read: 
157.3      Subd. 13.  [CHANGES TO ICF/MR REIMBURSEMENT BEGINNING 
157.4   OCTOBER 1, 1999.] (a) For the rate years beginning October 1, 
157.5   1999, and October 1, 2000, the commissioner shall increase the 
157.6   allowable operating cost per diems of ICFs/MR subject to 
157.7   reimbursement under this section or Laws 1993, First Special 
157.8   Session chapter 1, article 4, section 11, by three percent, and 
157.9   shall not provide these facilities with inflation increases 
157.10  under subdivision 3c, clause (1), Laws 1993, First Special 
157.11  Session chapter 1, article 4, section 11, or section 256B.5012. 
157.12     (b) It is the intention of the legislature that the 
157.13  compensation packages of direct-care staff in ICFs/MR be 
157.14  increased by three percent for each rate year. 
157.15     Sec. 27.  Minnesota Statutes 1998, section 256B.5011, 
157.16  subdivision 1, is amended to read: 
157.17     Subdivision 1.  [IN GENERAL.] Effective October 1, 2000, 
157.18  the commissioner shall implement a performance-based contracting 
157.19  system to replace the current method of setting total cost 
157.20  payment rates under section 256B.501 and Minnesota Rules, parts 
157.21  9553.0010 to 9553.0080.  In determining prospective payment 
157.22  rates of intermediate care facilities for persons with mental 
157.23  retardation or related conditions, the commissioner shall index 
157.24  each facility's total operating payment rate by an inflation 
157.25  factor as described in subdivision 3 section 256B.5012.  The 
157.26  commissioner of finance shall include annual inflation 
157.27  adjustments in operating costs for intermediate care facilities 
157.28  for persons with mental retardation and related conditions as a 
157.29  budget change request in each biennial detailed expenditure 
157.30  budget submitted to the legislature under section 16A.11. 
157.31     Sec. 28.  Minnesota Statutes 1998, section 256B.5011, 
157.32  subdivision 2, is amended to read: 
157.33     Subd. 2.  [CONTRACT PROVISIONS.] (a) The 
157.34  performance-based service contract with each intermediate care 
157.35  facility must include provisions for: 
157.36     (1) modifying payments when significant changes occur in 
158.1   the needs of the consumers; 
158.2      (2) monitoring service quality using performance indicators 
158.3   that measure consumer outcomes; 
158.4      (3) the establishment and use of continuous quality 
158.5   improvement processes using the results attained through service 
158.6   quality monitoring; 
158.7      (4) the annual reporting of facility statistical 
158.8   information on all supervisory personnel, direct care personnel, 
158.9   specialized support personnel, hours, wages and benefits, 
158.10  staff-to-consumer ratios, and staffing patterns 
158.11     (3) appropriate and necessary statistical information 
158.12  required by the commissioner; 
158.13     (5) (4) annual aggregate facility financial information or 
158.14  an annual certified audited financial statement, including a 
158.15  balance sheet and income and expense statements for each 
158.16  facility, if a certified audit was prepared; and 
158.17     (6) (5) additional requirements and penalties for 
158.18  intermediate care facilities not meeting the standards set forth 
158.19  in the performance-based service contract. 
158.20     (b) The commissioner shall recommend to the legislature by 
158.21  January 15, 2000, whether the contract should include service 
158.22  quality monitoring that may utilize performance indicators that 
158.23  measure consumer and program outcomes.  Performance measurement 
158.24  shall not increase or duplicate regulatory requirements. 
158.25     Sec. 29.  [256B.5012] [ICF/MR PAYMENT SYSTEM 
158.26  IMPLEMENTATION.] 
158.27     Subdivision 1.  [TOTAL PAYMENT RATE.] The total payment 
158.28  rate effective October 1, 2000, for existing ICF/MR facilities 
158.29  is the total of the operating payment rate and the property 
158.30  payment rate plus inflation factors as defined in this section.  
158.31  The initial rate year shall run from October 1, 2000, through 
158.32  December 31, 2001.  Subsequent rate years shall run from January 
158.33  1 through December 31 beginning in the year 2002. 
158.34     Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
158.35  payment rate equals the facility's total payment rate in effect 
158.36  on September 30, 2000, minus the property rate.  The operating 
159.1   payment rate includes the special operating rate and the 
159.2   efficiency incentive in effect as of September 30, 2000.  The 
159.3   operating payment shall be increased for each rate year by the 
159.4   annual percentage change in the Consumer Price Index-All Items 
159.5   (United States City Average) (CPI-U), as forecasted by Data 
159.6   Resources, Inc., in the second quarter of the calendar year 
159.7   preceding the start of each rate year.  In the case of the 
159.8   initial rate year beginning October 1, 2000, and continuing 
159.9   through December 31, 2001, the percentage change shall be based 
159.10  on the percentage change in the CPI-U for the 15-month period 
159.11  beginning October 1, 2000, as forecast by Data Resources, Inc., 
159.12  in the first quarter of 2000. 
159.13     (b) Effective October 1, 2000, the operating payment rate 
159.14  shall be adjusted to reflect an occupancy rate equal to 100 
159.15  percent of the facility's capacity days as of September 30, 2000.
159.16     Subd. 3.  [PROPERTY PAYMENT RATE.] (a) The property payment 
159.17  rate effective October 1, 2000, is based on the facility's 
159.18  property payment rate in effect on September 30, 2000.  
159.19  Effective October 1, 2000, a facility minimum property rate of 
159.20  $8.13 shall be applied to all existing ICF/MR facilities.  
159.21  Facilities with a property payment rate effective September 30, 
159.22  2000, which is below the minimum property rate shall receive an 
159.23  increase effective October 1, 2000, equal to the difference 
159.24  between the minimum property payment rate and the property 
159.25  payment rate in effect as of September 30, 2000.  Facilities 
159.26  with a property payment rate at or above the minimum property 
159.27  payment rate effective September 30, 2000, shall have no change 
159.28  in their property payment rate effective October 1, 2000. 
159.29     (b) Facility property payment rates shall be increased 
159.30  annually for inflation, effective January 1, 2002.  The increase 
159.31  shall be based on each facility's property payment rate in 
159.32  effect on September 30, 2000.  Property payment rates effective 
159.33  September 30, 2000, shall be arrayed from highest to lowest 
159.34  before applying the minimum property payment rate in paragraph 
159.35  (a).  For property payment rates at the 90th percentile or 
159.36  above, the annual inflation increase shall be zero.  For 
160.1   property payment rates below the 90th percentile but equal to or 
160.2   above the 75th percentile, the annual inflation increase shall 
160.3   be one percent.  For property payment rates below the 75th 
160.4   percentile, the annual inflation increase shall be two percent.  
160.5      Sec. 30.  [256B.5013] [PAYMENT RATE ADJUSTMENTS.] 
160.6      Subdivision 1.  [VARIABLE RATE ADJUSTMENTS.] When there is 
160.7   a documented increase in the resource needs of a current ICF/MR 
160.8   recipient or recipients, or a person is admitted to a facility 
160.9   who requires additional resources, the county of financial 
160.10  responsibility may approve an enhanced rate for one or more 
160.11  persons in the facility.  Resource needs directly attributable 
160.12  to an individual that may be considered under the variable rate 
160.13  adjustment include increased direct staff hours and other 
160.14  specialized services, equipment, and human resources.  The 
160.15  guidelines in paragraphs (a) to (d) apply for the payment rate 
160.16  adjustments under this section. 
160.17     (a) All persons must be screened according to section 
160.18  256B.092, subdivisions 7 and 8, prior to implementation of the 
160.19  new payment system and annually thereafter.  Screening data 
160.20  shall be analyzed to develop broad profiles of the functional 
160.21  characteristics of recipients.  Three components shall be used 
160.22  to distinguish recipients based on the following broad profiles: 
160.23     (1) functional ability to care for and maintain one's own 
160.24  basic needs; 
160.25     (2) the intensity of any aggressive or destructive 
160.26  behavior; and 
160.27     (3) any history of obstructive behavior in combination with 
160.28  a diagnosis of psychosis or neurosis.  
160.29     The profile groups shall be used to link resource needs to 
160.30  funding.  The resource profile shall determine the level of 
160.31  funding that may be authorized by the county.  The county of 
160.32  financial responsibility may approve a rate adjustment for an 
160.33  individual.  The commissioner shall recommend to the legislature 
160.34  by January 15, 2000, a methodology using the profile groups to 
160.35  determine variable rates.  The variable rate must be applied to 
160.36  expenses related to increased direct staff hours and other 
161.1   specialized services, equipment, and human resources.  This 
161.2   variable rate component plus the facility's current operating 
161.3   payment rate equals the individual's total operating payment 
161.4   rate. 
161.5      (b) A recipient must be screened by the county of financial 
161.6   responsibility using the developmental disabilities screening 
161.7   document completed immediately prior to approval of a variable 
161.8   rate by the county.  A comparison of the updated screening and 
161.9   the previous screening must demonstrate an increase in resource 
161.10  needs. 
161.11     (c) Rate adjustments projected to exceed the authorized 
161.12  funding level associated with the person's profile must be 
161.13  submitted to the commissioner. 
161.14     (d) The new rate approved through this process shall not be 
161.15  averaged across all persons living at a facility but shall be an 
161.16  individual rate.  The county of financial responsibility must 
161.17  indicate the projected length of time that the additional 
161.18  funding may be needed by the individual.  The need to continue 
161.19  an individual variable rate must be reviewed at the end of the 
161.20  anticipated duration of need but at least annually through the 
161.21  completion of the developmental disabilities screening document. 
161.22     Subd. 2.  [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 
161.23  payment rates may be adjusted by the host county, with 
161.24  authorization from a statewide advisory committee, if, through 
161.25  the local system needs planning process, it is determined that a 
161.26  need exists to amend the package of purchased services with a 
161.27  resulting increase or decrease in costs.  Except as provided in 
161.28  section 252.292, subdivision 4, if a provider demonstrates that 
161.29  the loss of revenues caused by the downsizing or closure of a 
161.30  facility cannot be absorbed by the facility based on current 
161.31  operations, the host county or the provider may submit a request 
161.32  to the statewide advisory committee for a facility base rate 
161.33  adjustment. 
161.34     Subd. 3.  [RELOCATION.] (a) Property rates for all 
161.35  facilities relocated after December 31, 1997, and up to and 
161.36  including October 1, 2000, shall have the full annual costs of 
162.1   relocation included in their October 1, 2000, property rate.  
162.2   The property rate for the relocated home is subject to the costs 
162.3   that were allowable under Minnesota Rules, chapter 9553, and the 
162.4   investment per bed limitation for newly constructed or newly 
162.5   established class B facilities.  
162.6      (b) In ensuing years, all relocated homes shall be subject 
162.7   to the investment per bed limit for newly constructed or newly 
162.8   established class B facilities under section 256B.501, 
162.9   subdivision 11.  The limits shall be adjusted on January 1 of 
162.10  each year by the percentage increase in the construction index 
162.11  published by the Bureau of Economic Analysis of the United 
162.12  States Department of Commerce in the Survey of Current Business 
162.13  Statistics in October of the previous two years.  Facilities 
162.14  that are relocated within the investment per bed limit may be 
162.15  approved by the statewide advisory committee.  Costs for 
162.16  relocation of a facility that exceed the investment per bed 
162.17  limit must be absorbed by the facility. 
162.18     (c) The payment rate shall take effect when the new 
162.19  facility is licensed and certified by the commissioner of 
162.20  health.  Rates for facilities that are relocated after December 
162.21  31, 1997, through October 1, 2000, shall be adjusted to reflect 
162.22  the full inclusion of the relocation costs, subject to the 
162.23  investment per bed limit in paragraph (b).  The investment per 
162.24  bed limit calculated rate for the year in which the facility was 
162.25  relocated shall be the investment per bed limit used. 
162.26     Subd. 4.  [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 
162.27  AND ACCESS.] If a facility is operating at less than 100 percent 
162.28  occupancy on September 30, 2000, or if a recipient is discharged 
162.29  from a facility, the commissioner shall adjust the total payment 
162.30  rate for up to 90 days for the remaining recipients.  This 
162.31  mechanism shall not be used to pay for hospital or therapeutic 
162.32  leave days beyond the maximums allowed.  Facility payment 
162.33  adjustments exceeding 90 days to address a demonstrated need for 
162.34  access must be submitted to the statewide advisory committee 
162.35  with a local system needs assessment, plan, and budget for 
162.36  review and recommendation. 
163.1      Sec. 31.  [256B.5014] [FINANCIAL REPORTING.] 
163.2      All facilities shall maintain financial records and shall 
163.3   provide annual income and expense reports to the commissioner of 
163.4   human services on a form prescribed by the commissioner no later 
163.5   than April 30 of each year in order to receive medical 
163.6   assistance payments.  The reports for the reporting year ending 
163.7   December 31 must include: 
163.8      (1) salaries and related expenses, including program 
163.9   salaries, administrative salaries, other salaries, payroll 
163.10  taxes, and fringe benefits; 
163.11     (2) general operating expenses, including supplies, 
163.12  training, repairs, purchased services and consultants, 
163.13  utilities, food, licenses and fees, real estate taxes, 
163.14  insurance, and working capital interest; 
163.15     (3) property related costs, including depreciation, capital 
163.16  debt interest, rent, and leases; and 
163.17     (4) total annual resident days. 
163.18     Sec. 32.  [256B.5015] [PASS-THROUGH OF TRAINING AND 
163.19  HABILITATION SERVICES COSTS.] 
163.20     Training and habilitation services costs shall be paid as a 
163.21  pass-through payment at the lowest rate paid for the comparable 
163.22  services at that site under sections 252.40 to 252.46.  The 
163.23  pass-through payments for training and habilitation services 
163.24  shall be paid separately by the commissioner and shall not be 
163.25  included in the computation of the total payment rate. 
163.26     Sec. 33.  Minnesota Statutes 1998, section 256B.69, 
163.27  subdivision 6a, is amended to read: 
163.28     Subd. 6a.  [NURSING HOME SERVICES.] (a) Notwithstanding 
163.29  Minnesota Rules, part 9500.1457, subpart 1, item B, up to 90 
163.30  days of nursing facility services as defined in section 
163.31  256B.0625, subdivision 2, which are provided in a nursing 
163.32  facility certified by the Minnesota department of health for 
163.33  services provided and eligible for payment under Medicaid, shall 
163.34  be covered under the prepaid medical assistance program for 
163.35  individuals who are not residing in a nursing facility at the 
163.36  time of enrollment in the prepaid medical assistance 
164.1   program.  Liability for coverage of nursing facility services by 
164.2   a participating health plan is limited to 365 days for any 
164.3   person enrolled under the prepaid medical assistance program. 
164.4      (b) For individuals enrolled in the Minnesota senior health 
164.5   options project authorized under subdivision 23, nursing 
164.6   facility services shall be covered according to the terms and 
164.7   conditions of the federal waiver governing that demonstration 
164.8   project. 
164.9      Sec. 34.  Minnesota Statutes 1998, section 256B.69, 
164.10  subdivision 6b, is amended to read: 
164.11     Subd. 6b.  [ELDERLY WAIVER SERVICES.] Notwithstanding 
164.12  Minnesota Rules, part 9500.1457, subpart 1, item C, elderly 
164.13  waiver services shall be covered under the prepaid medical 
164.14  assistance program for all individuals who are eligible 
164.15  according to section 256B.0915.  For individuals enrolled in the 
164.16  Minnesota senior health options project authorized under 
164.17  subdivision 23, elderly waiver services shall be covered 
164.18  according to the terms and conditions of the federal waiver 
164.19  governing that demonstration project. 
164.20     Sec. 35.  Minnesota Statutes 1998, section 256I.04, 
164.21  subdivision 3, is amended to read: 
164.22     Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
164.23  RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
164.24  into agreements for new group residential housing beds with 
164.25  total rates in excess of the MSA equivalent rate except:  (1) 
164.26  for group residential housing establishments meeting the 
164.27  requirements of subdivision 2a, clause (2) with department 
164.28  approval; (2) for group residential housing establishments 
164.29  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
164.30  provided the facility is needed to meet the census reduction 
164.31  targets for persons with mental retardation or related 
164.32  conditions at regional treatment centers; (3) to ensure 
164.33  compliance with the federal Omnibus Budget Reconciliation Act 
164.34  alternative disposition plan requirements for inappropriately 
164.35  placed persons with mental retardation or related conditions or 
164.36  mental illness; (4) up to 80 beds in a single, specialized 
165.1   facility located in Hennepin county that will provide housing 
165.2   for chronic inebriates who are repetitive users of 
165.3   detoxification centers and are refused placement in emergency 
165.4   shelters because of their state of intoxication, and planning 
165.5   for the specialized facility must have been initiated before 
165.6   July 1, 1991, in anticipation of receiving a grant from the 
165.7   housing finance agency under section 462A.05, subdivision 20a, 
165.8   paragraph (b); or (5) notwithstanding the provisions of 
165.9   subdivision 2a, for up to 190 supportive housing units in Anoka, 
165.10  Dakota, Hennepin, or Ramsey county for homeless adults with a 
165.11  mental illness, a history of substance abuse, or human 
165.12  immunodeficiency virus or acquired immunodeficiency syndrome.  
165.13  For purposes of this section, "homeless adult" means a person 
165.14  who is living on the street or in a shelter or discharged from a 
165.15  regional treatment center, community hospital, or residential 
165.16  treatment program and has no appropriate housing available and 
165.17  lacks the resources and support necessary to access appropriate 
165.18  housing.  At least 70 percent of the supportive housing units 
165.19  must serve homeless adults with mental illness, substance abuse 
165.20  problems, or human immunodeficiency virus or acquired 
165.21  immunodeficiency syndrome who are about to be or, within the 
165.22  previous six months, has been discharged from a regional 
165.23  treatment center, or a state-contracted psychiatric bed in a 
165.24  community hospital, or a residential mental health or chemical 
165.25  dependency treatment program.  If a person meets the 
165.26  requirements of subdivision 1, paragraph (a), and receives a 
165.27  federal or state housing subsidy, the group residential housing 
165.28  rate for that person is limited to the supplementary rate under 
165.29  section 256I.05, subdivision 1a, and is determined by 
165.30  subtracting the amount of the person's countable income that 
165.31  exceeds the MSA equivalent rate from the group residential 
165.32  housing supplementary rate.  A resident in a demonstration 
165.33  project site who no longer participates in the demonstration 
165.34  program shall retain eligibility for a group residential housing 
165.35  payment in an amount determined under section 256I.06, 
165.36  subdivision 8, using the MSA equivalent rate.  Service funding 
166.1   under section 256I.05, subdivision 1a, will end June 30, 1997, 
166.2   if federal matching funds are available and the services can be 
166.3   provided through a managed care entity.  If federal matching 
166.4   funds are not available, then service funding will continue 
166.5   under section 256I.05, subdivision 1a.; or (6) for group 
166.6   residential housing beds in settings meeting the requirements of 
166.7   subdivision 2, paragraph (a), clause (3), which are used 
166.8   exclusively for recipients receiving home and community-based 
166.9   waiver services under sections 256B.0915, 256B.092, subdivision 
166.10  5, 256B.093, and 256B.49, and who resided in a nursing facility 
166.11  for the six months immediately prior to the month of entry into 
166.12  the group residential housing setting.  The group residential 
166.13  housing rate for these beds must be set so that the monthly 
166.14  group residential housing payment for an individual occupying 
166.15  the bed when combined with the nonfederal share of services 
166.16  delivered under the waiver for that person does not exceed the 
166.17  nonfederal share of the monthly medical assistance payment made 
166.18  for the person to the nursing facility in which the person 
166.19  resided prior to entry into the group residential housing 
166.20  establishment.  The rate may not exceed the MSA equivalent rate 
166.21  plus $426.37 for any case. 
166.22     (b) A county agency may enter into a group residential 
166.23  housing agreement for beds with rates in excess of the MSA 
166.24  equivalent rate in addition to those currently covered under a 
166.25  group residential housing agreement if the additional beds are 
166.26  only a replacement of beds with rates in excess of the MSA 
166.27  equivalent rate which have been made available due to closure of 
166.28  a setting, a change of licensure or certification which removes 
166.29  the beds from group residential housing payment, or as a result 
166.30  of the downsizing of a group residential housing setting.  The 
166.31  transfer of available beds from one county to another can only 
166.32  occur by the agreement of both counties. 
166.33     Sec. 36.  Minnesota Statutes 1998, section 256I.05, 
166.34  subdivision 1, is amended to read: 
166.35     Subdivision 1.  [MAXIMUM RATES.] Monthly room and board 
166.36  rates negotiated by a county agency for a recipient living in 
167.1   group residential housing must not exceed the MSA equivalent 
167.2   rate specified under section 256I.03, subdivision 5, with the 
167.3   exception that a county agency may negotiate a supplementary 
167.4   room and board rate that exceeds the MSA equivalent rate by up 
167.5   to $426.37 for recipients of waiver services under title XIX of 
167.6   the Social Security Act.  This exception is subject to the 
167.7   following conditions: 
167.8      (1) that the Secretary of Health and Human Services has not 
167.9   approved a state request to include room and board costs which 
167.10  exceed the MSA equivalent rate in an individual's set of waiver 
167.11  services under title XIX of the Social Security Act; or 
167.12     (2) that the Secretary of Health and Human Services has 
167.13  approved the inclusion of room and board costs which exceed the 
167.14  MSA equivalent rate, but in an amount that is insufficient to 
167.15  cover costs which are included in a group residential housing 
167.16  agreement in effect on June 30, 1994; and 
167.17     (3) the amount of the rate that is above the MSA equivalent 
167.18  rate has been approved by the commissioner the setting is 
167.19  licensed by the commissioner of human services under Minnesota 
167.20  Rules, parts 9555.5050 to 9555.6265; 
167.21     (2) the setting is not the primary residence of the license 
167.22  holder and in which the license holder is not the primary 
167.23  caregiver; and 
167.24     (3) the average supplementary room and board rate in a 
167.25  county for a calendar year may not exceed the average 
167.26  supplementary room and board rate for that county in effect on 
167.27  January 1, 2000.  If a county has not negotiated supplementary 
167.28  room and board rates for any facilities located in the county as 
167.29  of January 1, 2000, or has an average supplemental room and 
167.30  board rate under $100 per person as of January 1, 2000, it may 
167.31  submit a supplementary room and board rate request with budget 
167.32  information for a facility to the commissioner for approval. 
167.33  The county agency may at any time negotiate a higher or lower 
167.34  room and board rate than the average supplementary room and 
167.35  board rate that would otherwise be paid under this subdivision. 
167.36     Sec. 37.  Minnesota Statutes 1998, section 256I.05, 
168.1   subdivision 1a, is amended to read: 
168.2      Subd. 1a.  [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 
168.3   the provisions of section 256I.04, subdivision 3, in addition to 
168.4   the room and board rate specified in subdivision 1, the county 
168.5   agency may negotiate a payment not to exceed $426.37 for other 
168.6   services necessary to provide room and board provided by the 
168.7   group residence if the residence is licensed by or registered by 
168.8   the department of health, or licensed by the department of human 
168.9   services to provide services in addition to room and board, and 
168.10  if the provider of services is not also concurrently receiving 
168.11  funding for services for a recipient under a home and 
168.12  community-based waiver under title XIX of the Social Security 
168.13  Act; or funding from the medical assistance program under 
168.14  section 256B.0627, subdivision 4, for personal care services for 
168.15  residents in the setting; or residing in a setting which 
168.16  receives funding under Minnesota Rules, parts 9535.2000 to 
168.17  9535.3000.  If funding is available for other necessary services 
168.18  through a home and community-based waiver, or personal care 
168.19  services under section 256B.0627, subdivision 4, then the GRH 
168.20  rate is limited to the rate set in subdivision 1.  Unless 
168.21  otherwise provided in law, in no case may the supplementary 
168.22  service rate plus the supplementary room and board rate exceed 
168.23  $426.37.  The registration and licensure requirement does not 
168.24  apply to establishments which are exempt from state licensure 
168.25  because they are located on Indian reservations and for which 
168.26  the tribe has prescribed health and safety requirements.  
168.27  Service payments under this section may be prohibited under 
168.28  rules to prevent the supplanting of federal funds with state 
168.29  funds.  The commissioner shall pursue the feasibility of 
168.30  obtaining the approval of the Secretary of Health and Human 
168.31  Services to provide home and community-based waiver services 
168.32  under title XIX of the Social Security Act for residents who are 
168.33  not eligible for an existing home and community-based waiver due 
168.34  to a primary diagnosis of mental illness or chemical dependency 
168.35  and shall apply for a waiver if it is determined to be 
168.36  cost-effective.  
169.1      (b) The commissioner is authorized to make cost-neutral 
169.2   transfers from the GRH fund for beds under this section to other 
169.3   funding programs administered by the department after 
169.4   consultation with the county or counties in which the affected 
169.5   beds are located.  The commissioner may also make cost-neutral 
169.6   transfers from the GRH fund to county human service agencies for 
169.7   beds permanently removed from the GRH census under a plan 
169.8   submitted by the county agency and approved by the 
169.9   commissioner.  The commissioner shall report the amount of any 
169.10  transfers under this provision annually to the legislature. 
169.11     (c) The provisions of paragraph (b) do not apply to a 
169.12  facility that has its reimbursement rate established under 
169.13  section 256B.431, subdivision 4, paragraph (c). 
169.14     Sec. 38.  Minnesota Statutes 1998, section 256I.05, is 
169.15  amended by adding a subdivision to read: 
169.16     Subd. 1e.  [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 
169.17  Notwithstanding the provisions of subdivisions 1a and 1c, 
169.18  beginning July 1, 1999, a county agency shall negotiate a 
169.19  supplementary rate in addition to the rate specified in 
169.20  subdivision 1, up to the amount specified in subdivision 1a, for 
169.21  a group residential housing provider that: 
169.22     (1) is located in Hennepin county and has had a group 
169.23  residential housing contract with the county since June 1996; 
169.24     (2) operates in three separate locations a 56-bed facility, 
169.25  a 40-bed facility, and a 30-bed facility; and 
169.26     (3) serves a chemically dependent clientele, providing 24 
169.27  hours per day supervision and limiting a resident's maximum 
169.28  length of stay to 13 months out of a consecutive 24-month period.
169.29     Sec. 39.  Laws 1995, chapter 207, article 3, section 21, is 
169.30  amended to read: 
169.31     Sec. 21.  [FACILITY CERTIFICATION.] 
169.32     Notwithstanding Minnesota Statutes, section 252.291, 
169.33  subdivisions 1 and 2, the commissioner of health shall inspect 
169.34  to certify a large community-based facility currently licensed 
169.35  under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 
169.36  than 16 beds and located in Northfield.  The facility may be 
170.1   certified for up to 44 beds.  The commissioner of health must 
170.2   inspect to certify the facility as soon as possible after the 
170.3   effective date of this section.  The commissioner of human 
170.4   services shall work with the facility and affected counties to 
170.5   relocate any current residents of the facility who do not meet 
170.6   the admission criteria for an ICF/MR.  Until January 1, 1999, in 
170.7   order to fund the ICF/MR services and relocations of current 
170.8   residents authorized, the commissioner of human services may 
170.9   transfer on a quarterly basis to the medical assistance account 
170.10  from each affected county's community social service allocation, 
170.11  an amount equal to the state share of medical assistance 
170.12  reimbursement for the residential and day habilitation services 
170.13  funded by medical assistance and provided to clients for whom 
170.14  the county is financially responsible.  After January 1, 1999, 
170.15  the commissioner of human services shall fund the services under 
170.16  the state medical assistance program and may transfer on a 
170.17  quarterly basis to the medical assistance account from each 
170.18  affected county's community social service allocation, an amount 
170.19  equal to one-half of the state share of medical assistance 
170.20  reimbursement for the residential and day habilitation services 
170.21  funded by medical assistance and provided to clients for whom 
170.22  the county is financially responsible.  For nonresidents of 
170.23  Minnesota seeking admission to the facility, Rice county shall 
170.24  be notified in order to assure that appropriate funding is 
170.25  guaranteed from their state or country of residence. 
170.26     Sec. 40.  [DEADLINE EXTENSION.] 
170.27     Notwithstanding Minnesota Statutes, section 144A.073, 
170.28  subdivision 3, the commissioner of health shall extend approval 
170.29  to May 31, 2000, for a total replacement of a 96-bed nursing 
170.30  home located in Carlton county previously approved under 
170.31  Minnesota Statutes, section 144A.073. 
170.32     Sec. 41.  [ICF/MR REIMBURSEMENT EFFECTIVE OCTOBER 1, 1999.] 
170.33     (a) For the rate year beginning October 1, 1999, the 
170.34  commissioner of human services shall exempt an intermediate care 
170.35  facility for persons with mental retardation from reductions to 
170.36  the payment rates under Minnesota Statutes, section 256B.501, 
171.1   subdivision 5b, paragraph (d), clause (6), if the facility: 
171.2      (1) has had a settle-up payment rate established in the 
171.3   reporting year preceding the rate year for the one-time rate 
171.4   adjustment; 
171.5      (2) is a newly established facility; 
171.6      (3) is an A to B conversion that has been converted under 
171.7   Minnesota Statutes, section 252.292, since rate year 1990; 
171.8      (4) has a payment rate subject to a community conversion 
171.9   project under Minnesota Statutes, section 252.292; 
171.10     (5) has a payment rate established under Minnesota 
171.11  Statutes, section 245A.12 or 245A.13; or 
171.12     (6) is a facility created by the relocation of more than 25 
171.13  percent of the capacity of a related facility during the 
171.14  reporting year. 
171.15     (b) Notwithstanding any contrary provision in Minnesota 
171.16  Statutes, section 256B.501, for the rate year beginning October 
171.17  1, 1999, the commissioner of human services shall, for purposes 
171.18  of the spend-up limit, array facilities within each grouping 
171.19  established under Minnesota Statutes, section 256B.501, 
171.20  subdivision 5b, paragraph (d), clause (4), by each facility's 
171.21  cost per resident day.  A facility's cost per resident day shall 
171.22  be determined by dividing its allowable historical general 
171.23  operating cost for the reporting year by the facility's resident 
171.24  days for the reporting year.  Facilities with a cost per 
171.25  resident day at or above the median shall be limited to the 
171.26  lesser of: 
171.27     (1) the current reporting year's cost per resident day; or 
171.28     (2) the prior report year's cost per resident day plus the 
171.29  inflation factor established under Minnesota Statutes, section 
171.30  256B.501, subdivision 3c, clause (2), increased by three 
171.31  percentage points.  In no case shall the amount of this 
171.32  reduction exceed:  (i) three percent for a facility with a 
171.33  licensed capacity greater than 16 beds; (ii) two percent for a 
171.34  facility with a licensed capacity of nine to 16 beds; and (iii) 
171.35  one percent for a facility with a licensed capacity of eight or 
171.36  fewer beds. 
172.1      (c) The commissioner shall not apply the limits established 
172.2   under Minnesota Statutes, section 256B.501, subdivision 5b, 
172.3   paragraph (d), clause (8), for the rate year beginning October 
172.4   1, 1999. 
172.5      (d) Notwithstanding paragraphs (b) and (c), the 
172.6   commissioner must utilize facility payment rates based on the 
172.7   laws in effect for October 1, 1998, payment rates and use the 
172.8   resulting allowable operating cost per diems as the basis for 
172.9   the spend-up limits for the rate year beginning October 1, 1999. 
172.10     Sec. 42.  [IMMEDIATE JEOPARDY FINES.] 
172.11     (a) The commissioner of health shall implement this section 
172.12  using existing budget resources of the Minnesota department of 
172.13  health. 
172.14     (b) The commissioner of health shall reimburse the 
172.15  following nursing facilities for fines paid by the facility as a 
172.16  result of immediate jeopardy citations issued by the 
172.17  commissioner from April 1, 1998, through February 3, 1999: Burr 
172.18  Oak Manor in Austin, MN for $70,525; Fairview Nursing Home in 
172.19  Dodge Center, MN for $21,550; Madison Lutheran Home in Madison, 
172.20  MN for $13,650; Maplewood Care Center in Maplewood, MN for 
172.21  $29,770; and St. Francis Home in Breckenridge, MN for $7,442.50. 
172.22     (c) The commissioner of health shall pay the Health Care 
172.23  Financing Administration (HCFA) directly for fines resulting 
172.24  from immediate jeopardy citations issued by the commissioner 
172.25  from April 1, 1998, through February 3, 1999 to the following 
172.26  facilities:  Arnold Memorial Health Care in Adrian, MN for 
172.27  $26,650; Colonial Manor in Balatin, MN for $10,790; the Lutheran 
172.28  Home in Caledonia, MN for $127,450; Nopeming Nursing Home in 
172.29  Duluth, MN for $28,250; Samaritan Bethany on 8th in Rochester, 
172.30  MN for $43,350; Shakopee Friendship Village in Shakopee, MN for 
172.31  $22,250; Stillwater Good Samaritan in Stillwater, MN for 
172.32  $22,500; Trevilla of Golden Valley in Golden Valley, MN for 
172.33  $15,665; and Walker Methodist Health Care in Minneapolis, MN for 
172.34  $39,000.  If a facility listed in this paragraph pays the 
172.35  immediate jeopardy fine to the HCFA prior to the effective date 
172.36  of this provision, the commissioner of health shall directly 
173.1   reimburse the facility for the amount of the fine paid.  A 
173.2   facility listed in this paragraph that has appealed their fine 
173.3   may request that the commissioner of health delay payment to the 
173.4   HCFA, until the appeal is decided. 
173.5      (d) The commissioner of health shall reimburse Stewartville 
173.6   Care Center in Stewartville, MN for any loss of revenue 
173.7   resulting from a denial of payment for new admissions, if this 
173.8   remedy is imposed by the HCFA as a result of findings from the 
173.9   surveys by the Minnesota department of health on January 11 and 
173.10  12, 1999. 
173.11     (e) If the fine amounts listed in paragraphs (b) or (c) are 
173.12  adjusted by the HCFA, the commissioner shall reimburse the 
173.13  facility or pay the HCFA the adjusted fine amount. 
173.14     (Effective Date:  Section 42 (immediate jeopardy fines) is 
173.15  effective the day following final enactment.) 
173.16     Sec. 43.  [ICF/MR SERVICE RECONFIGURATION PROJECT.] 
173.17     (a) The commissioner of human services may authorize a 
173.18  project to reconfigure two existing intermediate care facilities 
173.19  for persons with mental retardation or related conditions 
173.20  (ICFs/MR) located on the same campus in Carver county and 
173.21  totaling 60 licensed beds in one 46-bed facility and one 14-bed 
173.22  facility.  The reconfiguration project will involve the 
173.23  relocation of up to six beds to a six-bed ICF/MR.  The remaining 
173.24  two ICFs/MR shall consist of one 34-bed ICF/MR and one ten-bed 
173.25  ICF/MR. 
173.26     (b) The project shall include the development of 
173.27  alternative home and community-based services for individuals 
173.28  relocated from the existing facilities.  In conjunction with 
173.29  this project, two beds in the 34-bed facility shall be reserved 
173.30  for temporary care services for individuals receiving 
173.31  alternative home and community-based services.  The ICF/MR may 
173.32  seek county approval to modify its need determinations in order 
173.33  to serve fewer clients, or to provide additional beds for 
173.34  temporary care services. 
173.35     (c) The project must be approved by the commissioner under 
173.36  Minnesota Statutes, section 252.28, and must include criteria 
174.1   for determining how individuals are selected for alternative 
174.2   services and the use of a request for proposal process in 
174.3   selecting vendors for the alternative services.  The 
174.4   commissioner is authorized to develop the two additional beds 
174.5   required, and set aside waivered service slots as needed for 
174.6   individuals choosing alternative home and community-based 
174.7   services. 
174.8      (d) Upon approval of the project, the following additional 
174.9   conditions shall apply to rate setting: 
174.10     (1) the two existing facilities' aggregate 
174.11  investment-per-bed limits in effect before the downsizing shall 
174.12  be the investment-per-bed limit after the downsizing; 
174.13     (2) the ten-bed and the 34-bed facilities shall be eligible 
174.14  for a one-time rate adjustment to be negotiated with the 
174.15  commissioner taking into consideration estimated excess revenues 
174.16  available from the six-bed facility; 
174.17     (3) the relocated six-bed facility shall receive the 
174.18  payment rates established for the former 46-bed facility until 
174.19  each facility files a cost report for a period of five months or 
174.20  longer ending on December 31 following their opening and those 
174.21  reports are desk audited by the commissioner.  The two remaining 
174.22  facilities shall file their regularly scheduled annual cost 
174.23  reports; 
174.24     (4) all facilities are exempt from the spend-up and high 
174.25  cost limits in Minnesota Statutes, section 256B.501, subdivision 
174.26  5b, for the rate year following the first cost report submitted 
174.27  under clause (3); and 
174.28     (5) the maintenance limit for the 34-bed facility shall be 
174.29  established using the methodology in Minnesota Statutes, section 
174.30  256B.501, subdivision 5d.  The maintenance limit for the ten-bed 
174.31  facility shall be adjusted by the same ratio used to adjust the 
174.32  34-bed facility's maintenance limit. 
174.33     Sec. 44.  [GROUP RESIDENTIAL HOUSING STUDY.] 
174.34     The commissioner of human services shall submit to the 
174.35  legislature by November 1, 2000, a study of the cost of 
174.36  providing housing for individuals eligible for group residential 
175.1   housing payments and an analysis of the relationship of the 
175.2   costs to market rate housing costs in a representative number of 
175.3   regions in the state. 
175.4      Sec. 45.  [STATE LICENSURE CONFLICTS WITH FEDERAL 
175.5   REGULATIONS.] 
175.6      Notwithstanding the provisions of Minnesota Rules, part 
175.7   4658.0520, an incontinent resident must be checked according to 
175.8   a specific time interval written in the resident's care plan.  
175.9      (Effective Date: Section 45 (state licensure conflicts with 
175.10  federal regulations) is effective the day following final 
175.11  enactment.) 
175.12     Sec. 46.  [REPEALER.] 
175.13     (a) Minnesota Statutes 1998, sections 144.0723; and 
175.14  256B.5011, subdivision 3, are repealed. 
175.15     (b) Minnesota Statutes 1998, section 256B.501, subdivision 
175.16  3g, is repealed effective October 1, 2000. 
175.17     (c) Minnesota Statutes 1998, section 256B.434, subdivision 
175.18  17, is repealed effective July 1, 1999.  
175.19     (d) Minnesota Statutes 1998, section 144A.33, is repealed 
175.20  effective July 1, 2000. 
175.21     Sec. 47.  [EFFECTIVE DATE.] 
175.22     When preparing the health and human services conference 
175.23  committee report for adoption by the legislature, the revisor 
175.24  shall combine all the bracketed effective date notations into 
175.25  this effective date section. 
175.26                             ARTICLE 4 
175.27                        HEALTH CARE PROGRAMS
175.28     Section 1.  Minnesota Statutes 1998, section 122A.09, 
175.29  subdivision 4, is amended to read: 
175.30     Subd. 4.  [LICENSE AND RULES.] (a) The board must adopt 
175.31  rules to license public school teachers and interns subject to 
175.32  chapter 14. 
175.33     (b) The board must adopt rules requiring a person to 
175.34  successfully complete a skills examination in reading, writing, 
175.35  and mathematics as a requirement for initial teacher licensure.  
175.36  Such rules must require college and universities offering a 
176.1   board approved teacher preparation program to provide remedial 
176.2   assistance to persons who did not achieve a qualifying score on 
176.3   the skills examination, including those for whom English is a 
176.4   second language. 
176.5      (c) The board must adopt rules to approve teacher 
176.6   preparation programs. 
176.7      (d) The board must provide the leadership and shall adopt 
176.8   rules for the redesign of teacher education programs to 
176.9   implement a research based, results-oriented curriculum that 
176.10  focuses on the skills teachers need in order to be effective.  
176.11  The board shall implement new systems of teacher preparation 
176.12  program evaluation to assure program effectiveness based on 
176.13  proficiency of graduates in demonstrating attainment of program 
176.14  outcomes. 
176.15     (e) The board must adopt rules requiring successful 
176.16  completion of an examination of general pedagogical knowledge 
176.17  and examinations of licensure-specific teaching skills.  The 
176.18  rules shall be effective on the dates determined by the board, 
176.19  but not later than July 1, 1999. 
176.20     (f) The board must adopt rules requiring teacher educators 
176.21  to work directly with elementary or secondary school teachers in 
176.22  elementary or secondary schools to obtain periodic exposure to 
176.23  the elementary or secondary teaching environment. 
176.24     (g) The board must grant licenses to interns and to 
176.25  candidates for initial licenses. 
176.26     (h) The board must design and implement an assessment 
176.27  system which requires a candidate for an initial license and 
176.28  first continuing license to demonstrate the abilities necessary 
176.29  to perform selected, representative teaching tasks at 
176.30  appropriate levels. 
176.31     (i) The board must receive recommendations from local 
176.32  committees as established by the board for the renewal of 
176.33  teaching licenses. 
176.34     (j) The board must grant life licenses to those who qualify 
176.35  according to requirements established by the board, and suspend 
176.36  or revoke licenses pursuant to sections 122A.20 and 214.10.  The 
177.1   board must not establish any expiration date for application for 
177.2   life licenses.  
177.3      (k) In adopting rules to license public school teachers who 
177.4   provide health-related services for disabled children, the board 
177.5   shall adopt rules consistent with license or registration 
177.6   requirements of the commissioner of health and the 
177.7   health-related boards who license personnel who perform similar 
177.8   services outside of the school. 
177.9      Sec. 2.  Minnesota Statutes 1998, section 125A.08, is 
177.10  amended to read: 
177.11     125A.08 [SCHOOL DISTRICT OBLIGATIONS.] 
177.12     (a) As defined in this section, to the extent required by 
177.13  federal law as of July 1, 1999 2000, every district must ensure 
177.14  the following: 
177.15     (1) all students with disabilities are provided the special 
177.16  instruction and services which are appropriate to their needs.  
177.17  Where the individual education plan team has determined 
177.18  appropriate goals and objectives based on the student's needs, 
177.19  including the extent to which the student can be included in the 
177.20  least restrictive environment, and where there are essentially 
177.21  equivalent and effective instruction, related services, or 
177.22  assistive technology devices available to meet the student's 
177.23  needs, cost to the district may be among the factors considered 
177.24  by the team in choosing how to provide the appropriate services, 
177.25  instruction, or devices that are to be made part of the 
177.26  student's individual education plan.  The individual education 
177.27  plan team shall consider and may authorize services covered by 
177.28  medical assistance according to section 256B.0625, subdivision 
177.29  26.  The student's needs and the special education instruction 
177.30  and services to be provided must be agreed upon through the 
177.31  development of an individual education plan.  The plan must 
177.32  address the student's need to develop skills to live and work as 
177.33  independently as possible within the community.  By grade 9 or 
177.34  age 14, the plan must address the student's needs for transition 
177.35  from secondary services to post-secondary education and 
177.36  training, employment, community participation, recreation, and 
178.1   leisure and home living.  In developing the plan, districts must 
178.2   inform parents of the full range of transitional goals and 
178.3   related services that should be considered.  The plan must 
178.4   include a statement of the needed transition services, including 
178.5   a statement of the interagency responsibilities or linkages or 
178.6   both before secondary services are concluded; 
178.7      (2) children with a disability under age five and their 
178.8   families are provided special instruction and services 
178.9   appropriate to the child's level of functioning and needs; 
178.10     (3) children with a disability and their parents or 
178.11  guardians are guaranteed procedural safeguards and the right to 
178.12  participate in decisions involving identification, assessment 
178.13  including assistive technology assessment, and educational 
178.14  placement of children with a disability; 
178.15     (4) eligibility and needs of children with a disability are 
178.16  determined by an initial assessment or reassessment, which may 
178.17  be completed using existing data under United States Code, title 
178.18  20, section 33, et seq.; 
178.19     (5) to the maximum extent appropriate, children with a 
178.20  disability, including those in public or private institutions or 
178.21  other care facilities, are educated with children who are not 
178.22  disabled, and that special classes, separate schooling, or other 
178.23  removal of children with a disability from the regular 
178.24  educational environment occurs only when and to the extent that 
178.25  the nature or severity of the disability is such that education 
178.26  in regular classes with the use of supplementary services cannot 
178.27  be achieved satisfactorily; 
178.28     (6) in accordance with recognized professional standards, 
178.29  testing and evaluation materials, and procedures used for the 
178.30  purposes of classification and placement of children with a 
178.31  disability are selected and administered so as not to be 
178.32  racially or culturally discriminatory; and 
178.33     (7) the rights of the child are protected when the parents 
178.34  or guardians are not known or not available, or the child is a 
178.35  ward of the state. 
178.36     (b) For paraprofessionals employed to work in programs for 
179.1   students with disabilities, the school board in each district 
179.2   shall ensure that: 
179.3      (1) before or immediately upon employment, each 
179.4   paraprofessional develops sufficient knowledge and skills in 
179.5   emergency procedures, building orientation, roles and 
179.6   responsibilities, confidentiality, vulnerability, and 
179.7   reportability, among other things, to begin meeting the needs of 
179.8   the students with whom the paraprofessional works; 
179.9      (2) annual training opportunities are available to enable 
179.10  the paraprofessional to continue to further develop the 
179.11  knowledge and skills that are specific to the students with whom 
179.12  the paraprofessional works, including understanding 
179.13  disabilities, following lesson plans, and implementing follow-up 
179.14  instructional procedures and activities; and 
179.15     (3) a districtwide process obligates each paraprofessional 
179.16  to work under the ongoing direction of a licensed teacher and, 
179.17  where appropriate and possible, the supervision of a school 
179.18  nurse. 
179.19     (Effective Date: Section 2 (125A.08) is effective July 1, 
179.20  2000.) 
179.21     Sec. 3.  Minnesota Statutes 1998, section 125A.21, 
179.22  subdivision 1, is amended to read: 
179.23     Subdivision 1.  [OBLIGATION TO PAY.] Nothing in sections 
179.24  125A.03 to 125A.24 and 125A.65 relieves an insurer or similar 
179.25  third party from an otherwise valid obligation to pay, or 
179.26  changes the validity of an obligation to pay, for services 
179.27  rendered to a child with a disability, and the child's family.  
179.28  A school district shall pay the nonfederal share of medical 
179.29  assistance services provided according to section 256B.0625, 
179.30  subdivision 26.  Eligible expenditures must not be made from 
179.31  federal funds or funds used to match other federal funds.  Any 
179.32  federal disallowances are the responsibility of the school 
179.33  district.  A school district may pay or reimburse copayments, 
179.34  coinsurance, deductibles, and other enrollee cost-sharing 
179.35  amounts, on behalf of the student or family, in connection with 
179.36  health and related services provided under an individual 
180.1   educational plan.  
180.2      (Effective Date: Section 3 (125A.21, subdivision 1) is 
180.3   effective July 1, 2000.) 
180.4      Sec. 4.  Minnesota Statutes 1998, section 125A.74, 
180.5   subdivision 1, is amended to read: 
180.6      Subdivision 1.  [ELIGIBILITY.] A district may enroll as a 
180.7   provider in the medical assistance program and receive medical 
180.8   assistance payments for covered special education services 
180.9   provided to persons eligible for medical assistance under 
180.10  chapter 256B.  To receive medical assistance payments, the 
180.11  district must pay the nonfederal share of medical assistance 
180.12  services provided according to section 256B.0625, subdivision 
180.13  26, and comply with relevant provisions of state and federal 
180.14  statutes and regulations governing the medical assistance 
180.15  program. 
180.16     (Effective Date: Section 4 (125A.74, subdivision 1) is 
180.17  effective July 1, 2000.) 
180.18     Sec. 5.  Minnesota Statutes 1998, section 125A.74, 
180.19  subdivision 2, is amended to read: 
180.20     Subd. 2.  [FUNDING.] A district that provides a covered 
180.21  service to an eligible person and complies with relevant 
180.22  requirements of the medical assistance program is entitled to 
180.23  receive payment for the service provided, including that portion 
180.24  of the payment services that will subsequently be reimbursed by 
180.25  the federal government, in the same manner as other medical 
180.26  assistance providers.  The school district is not required to 
180.27  provide matching funds or pay part of the costs of the service, 
180.28  as long as the rate charged for the service does not exceed 
180.29  medical assistance limits that apply to all medical assistance 
180.30  providers. 
180.31     (Effective Date: Section 5 (125A.74, subdivision 2) is 
180.32  effective July 1, 2000.) 
180.33     Sec. 6.  Minnesota Statutes 1998, section 125A.744, 
180.34  subdivision 3, is amended to read: 
180.35     Subd. 3.  [IMPLEMENTATION.] Consistent with section 
180.36  256B.0625, subdivision 26, school districts may enroll as 
181.1   medical assistance providers or subcontractors and bill the 
181.2   department of human services under the medical assistance fee 
181.3   for service claims processing system for special education 
181.4   services which are covered services under chapter 256B, which 
181.5   are provided in the school setting for a medical assistance 
181.6   recipient, and for whom the district has secured informed 
181.7   consent consistent with section 13.05, subdivision 4, paragraph 
181.8   (d), and section 256B.77, subdivision 2, paragraph (p), to bill 
181.9   for each type of covered service.  School districts shall be 
181.10  reimbursed by the commissioner of human services for the federal 
181.11  share of individual education plan health-related services that 
181.12  qualify for reimbursement by medical assistance, minus five 
181.13  percent retained by the commissioner of human services for 
181.14  administrative costs.  A school district is not eligible to 
181.15  enroll as a home care provider or a personal care provider 
181.16  organization for purposes of billing home care services under 
181.17  section 256B.0627 until the commissioner of human services 
181.18  issues a bulletin instructing county public health nurses on how 
181.19  to assess for the needs of eligible recipients during school 
181.20  hours.  To use private duty nursing services or personal care 
181.21  services at school, the recipient or responsible party must 
181.22  provide written authorization in the care plan identifying the 
181.23  chosen provider and the daily amount of services to be used at 
181.24  school.  Medical assistance services for those enrolled in a 
181.25  prepaid health plan shall remain the responsibility of the 
181.26  contracted health plan subject to their network, credentialing, 
181.27  prior authorization, and determination of medical necessity 
181.28  criteria.  The commissioner of human services shall adjust 
181.29  payments to health plans to reflect increased costs incurred by 
181.30  health plans due to increased payments made to school districts 
181.31  or new payment or delivery arrangements developed by health 
181.32  plans in cooperation with school districts. 
181.33     (Effective Date: Section 6 (125A.744, subdivision 3) is 
181.34  effective July 1, 2000.) 
181.35     Sec. 7.  Minnesota Statutes 1998, section 125A.76, 
181.36  subdivision 2, is amended to read: 
182.1      Subd. 2.  [SPECIAL EDUCATION BASE REVENUE.] (a) The special 
182.2   education base revenue equals the sum of the following amounts 
182.3   computed using base year data: 
182.4      (1) 68 percent of the salary of each essential person 
182.5   employed in the district's program for children with a 
182.6   disability during the fiscal year, not including the share of 
182.7   salaries for personnel providing health-related services counted 
182.8   in clause (8), whether the person is employed by one or more 
182.9   districts or a Minnesota correctional facility operating on a 
182.10  fee-for-service basis; 
182.11     (2) for the Minnesota state academy for the deaf or the 
182.12  Minnesota state academy for the blind, 68 percent of the salary 
182.13  of each instructional aide assigned to a child attending the 
182.14  academy, if that aide is required by the child's individual 
182.15  education plan; 
182.16     (3) for special instruction and services provided to any 
182.17  pupil by contracting with public, private, or voluntary agencies 
182.18  other than school districts, in place of special instruction and 
182.19  services provided by the district, 52 percent of the difference 
182.20  between the amount of the contract and the basic revenue of the 
182.21  district for that pupil for the fraction of the school day the 
182.22  pupil receives services under the contract; 
182.23     (4) for special instruction and services provided to any 
182.24  pupil by contracting for services with public, private, or 
182.25  voluntary agencies other than school districts, that are 
182.26  supplementary to a full educational program provided by the 
182.27  school district, 52 percent of the amount of the contract for 
182.28  that pupil; 
182.29     (5) for supplies and equipment purchased or rented for use 
182.30  in the instruction of children with a disability, not including 
182.31  the portion of the expenses for supplies and equipment used to 
182.32  provide health-related services counted in clause (8), an amount 
182.33  equal to 47 percent of the sum actually expended by the 
182.34  district, or a Minnesota correctional facility operating on a 
182.35  fee-for-service basis, but not to exceed an average of $47 in 
182.36  any one school year for each child with a disability receiving 
183.1   instruction; 
183.2      (6) for fiscal years 1997 and later, special education base 
183.3   revenue shall include amounts under clauses (1) to (5) for 
183.4   special education summer programs provided during the base year 
183.5   for that fiscal year; and 
183.6      (7) for fiscal years 1999 and later, the cost of providing 
183.7   transportation services for children with disabilities under 
183.8   section 123B.92, subdivision 1, paragraph (b), clause (4); and 
183.9      (8) for fiscal years 2001 and later, the cost of salaries, 
183.10  supplies and equipment, and other related costs actually 
183.11  expended by the district for the nonfederal share of medical 
183.12  assistance services according to section 256B.0625, subdivision 
183.13  26. 
183.14     (b) If requested by a school district operating a special 
183.15  education program during the base year for less than the full 
183.16  fiscal year, or a school district in which is located a 
183.17  Minnesota correctional facility operating on a fee-for-service 
183.18  basis for less than the full fiscal year, the commissioner may 
183.19  adjust the base revenue to reflect the expenditures that would 
183.20  have occurred during the base year had the program been operated 
183.21  for the full fiscal year. 
183.22     (c) Notwithstanding paragraphs (a) and (b), the portion of 
183.23  a school district's base revenue attributable to a Minnesota 
183.24  correctional facility operating on a fee-for-service basis 
183.25  during the facility's first year of operating on a 
183.26  fee-for-service basis shall be computed using current year data. 
183.27     (Effective Date: Section 7 (125A.76, subdivision 2) is 
183.28  effective July 1, 2000.) 
183.29     Sec. 8.  [127A.11] [MONITOR MEDICAL ASSISTANCE SERVICES FOR 
183.30  DISABLED STUDENTS.] 
183.31     The commissioner of children, families, and learning, in 
183.32  cooperation with the commissioner of human services, shall 
183.33  monitor the costs of health-related, special education services 
183.34  provided by public schools. 
183.35     Sec. 9.  [214.045] [COORDINATION WITH BOARD OF TEACHING.] 
183.36     The commissioner of health and the health-related licensing 
184.1   boards must coordinate with the board of teaching when modifying 
184.2   licensure requirements for regulated persons in order to have 
184.3   consistent regulatory requirements for personnel who perform 
184.4   services in schools. 
184.5      Sec. 10.  Minnesota Statutes 1998, section 245B.05, 
184.6   subdivision 7, is amended to read: 
184.7      Subd. 7.  [REPORTING INCIDENTS AND EMERGENCIES.] The 
184.8   license holder must report the following incidents to the 
184.9   consumer's legal representative, caregiver, and case manager 
184.10  within 24 hours of the occurrence, or within 24 hours of receipt 
184.11  of the information: 
184.12     (1) the death of a consumer; 
184.13     (2) any medical emergencies, unexpected serious illnesses, 
184.14  or accidents that require physician treatment or 
184.15  hospitalization; 
184.16     (3) a consumer's unauthorized absence; or 
184.17     (4) any fires and incidents involving a law enforcement 
184.18  agency. 
184.19     Death or serious injury of the consumer must also be 
184.20  reported to the commissioner department of human services 
184.21  licensing division and the ombudsman, as required under sections 
184.22  245.91 and 245.94, subdivision 2a. 
184.23     Sec. 11.  Minnesota Statutes 1998, section 245B.07, 
184.24  subdivision 5, is amended to read: 
184.25     Subd. 5.  [STAFF ORIENTATION.] (a) Within 60 days of hiring 
184.26  staff who provide direct service, the license holder must 
184.27  provide 30 hours of staff orientation.  Direct care staff must 
184.28  complete 15 of the 30 hours orientation before providing any 
184.29  unsupervised direct service to a consumer.  If the staff person 
184.30  has received orientation training from a license holder licensed 
184.31  under this chapter, or provides semi-independent living services 
184.32  only, the 15-hour requirement may be reduced to eight hours.  
184.33  The total orientation of 30 hours may be reduced to 15 hours if 
184.34  the staff person has previously received orientation training 
184.35  from a license holder licensed under this chapter. 
184.36     (b) The 30 hours of orientation must combine supervised 
185.1   on-the-job training with coverage of the following material: 
185.2      (1) review of the consumer's service plans and risk 
185.3   management plan to achieve an understanding of the consumer as a 
185.4   unique individual; 
185.5      (2) review and instruction on the license holder's policies 
185.6   and procedures, including their location and access; 
185.7      (3) emergency procedures; 
185.8      (4) explanation of specific job functions, including 
185.9   implementing objectives from the consumer's individual service 
185.10  plan; 
185.11     (5) explanation of responsibilities related to section 
185.12  245A.65; sections 626.556 and 626.557, governing maltreatment 
185.13  reporting and service planning for children and vulnerable 
185.14  adults; and section 245.825, governing use of aversive and 
185.15  deprivation procedures; 
185.16     (6) medication administration as it applies to the 
185.17  individual consumer, from a training curriculum developed by a 
185.18  health services professional described in section 245B.05, 
185.19  subdivision 5, and when the consumer meets the criteria of 
185.20  having overriding health care needs, then medication 
185.21  administration taught by a health services professional.  Staff 
185.22  may administer medications only after they demonstrate the 
185.23  ability, as defined in the license holder's medication 
185.24  administration policy and procedures.  Once a consumer with 
185.25  overriding health care needs is admitted, staff will be provided 
185.26  with remedial training as deemed necessary by the license holder 
185.27  and the health professional to meet the needs of that consumer. 
185.28     For purposes of this section, overriding health care needs 
185.29  means a health care condition that affects the service options 
185.30  available to the consumer because the condition requires: 
185.31     (i) specialized or intensive medical or nursing 
185.32  supervision; and 
185.33     (ii) nonmedical service providers to adapt their services 
185.34  to accommodate the health and safety needs of the consumer; 
185.35     (7) consumer rights; and 
185.36     (8) other topics necessary as determined by the consumer's 
186.1   individual service plan or other areas identified by the license 
186.2   holder. 
186.3      (c) The license holder must document each employee's 
186.4   orientation received. 
186.5      Sec. 12.  Minnesota Statutes 1998, section 245B.07, 
186.6   subdivision 8, is amended to read: 
186.7      Subd. 8.  [POLICIES AND PROCEDURES.] The license holder 
186.8   must develop and implement the policies and procedures in 
186.9   paragraphs (1) to (3). 
186.10     (1) policies and procedures that promote consumer health 
186.11  and safety by ensuring: 
186.12     (i) consumer safety in emergency situations as identified 
186.13  in section 245B.05, subdivision 7; 
186.14     (ii) consumer health through sanitary practices; 
186.15     (iii) safe transportation, when the license holder is 
186.16  responsible for transportation of consumers, with provisions for 
186.17  handling emergency situations; 
186.18     (iv) a system of recordkeeping for both individuals and the 
186.19  organization, for review of incidents and emergencies, and 
186.20  corrective action if needed; 
186.21     (v) a plan for responding to and reporting all emergencies, 
186.22  including deaths, medical emergencies, illnesses, accidents, 
186.23  missing consumers, fires, severe weather and natural disasters, 
186.24  bomb threats, and other threats; 
186.25     (vi) safe medication administration as identified in 
186.26  section 245B.05, subdivision 5, incorporating an observed skill 
186.27  assessment to ensure that staff demonstrate the ability to 
186.28  administer medications consistent with the license holder's 
186.29  policy and procedures; 
186.30     (vii) psychotropic medication monitoring when the consumer 
186.31  is prescribed a psychotropic medication, including the use of 
186.32  the psychotropic medication use checklist.  If the 
186.33  responsibility for implementing the psychotropic medication use 
186.34  checklist has not been assigned in the individual service plan 
186.35  and the consumer lives in a licensed site, the residential 
186.36  license holder shall be designated; and 
187.1      (viii) criteria for admission or service initiation 
187.2   developed by the license holder; 
187.3      (2) policies and procedures that protect consumer rights 
187.4   and privacy by ensuring: 
187.5      (i) consumer data privacy, in compliance with the Minnesota 
187.6   Data Practices Act, chapter 13; and 
187.7      (ii) that complaint procedures provide consumers with a 
187.8   simple process to bring grievances and consumers receive a 
187.9   response to the grievance within a reasonable time period.  The 
187.10  license holder must provide a copy of the program's grievance 
187.11  procedure and time lines for addressing grievances.  The 
187.12  program's grievance procedure must permit consumers served by 
187.13  the program and the authorized representatives to bring a 
187.14  grievance to the highest level of authority in the program; and 
187.15     (3) policies and procedures that promote continuity and 
187.16  quality of consumer supports by ensuring: 
187.17     (i) continuity of care and service coordination, including 
187.18  provisions for service termination, temporary service 
187.19  suspension, and efforts made by the license holder to coordinate 
187.20  services with other vendors who also provide support to the 
187.21  consumer.  The policy must include the following requirements: 
187.22     (A) the license holder must notify the consumer or 
187.23  consumer's legal representative and the consumer's case manager 
187.24  in writing of the intended termination or temporary service 
187.25  suspension and the consumer's right to seek a temporary order 
187.26  staying the termination or suspension of service according to 
187.27  the procedures in section 256.045, subdivision 4a or subdivision 
187.28  6, paragraph (c); 
187.29     (B) notice of the proposed termination of services, 
187.30  including those situations that began with a temporary service 
187.31  suspension, must be given at least 60 days before the proposed 
187.32  termination is to become effective, unless services are 
187.33  temporarily suspended according to the license holder's written 
187.34  temporary service suspension procedures, in which case notice 
187.35  must be given as soon as possible; 
187.36     (C) the license holder must provide information requested 
188.1   by the consumer or consumer's legal representative or case 
188.2   manager when services are temporarily suspended or upon notice 
188.3   of termination; 
188.4      (D) use of temporary service suspension procedures are 
188.5   restricted to situations in which the consumer's behavior causes 
188.6   immediate and serious danger to the health and safety of the 
188.7   individual or others; 
188.8      (E) prior to giving notice of service termination or 
188.9   temporary service suspension, the license holder must document 
188.10  actions taken to minimize or eliminate the need for service 
188.11  termination or temporary service suspension; and 
188.12     (F) during the period of temporary service suspension, the 
188.13  license holder will work with the appropriate county agency to 
188.14  develop reasonable alternatives to protect the individual and 
188.15  others; and 
188.16     (ii) quality services measured through a program evaluation 
188.17  process including regular evaluations of consumer satisfaction 
188.18  and sharing the results of the evaluations with the consumers 
188.19  and legal representatives. 
188.20     Sec. 13.  Minnesota Statutes 1998, section 245B.07, 
188.21  subdivision 10, is amended to read: 
188.22     Subd. 10.  [CONSUMER FUNDS.] (a) The license holder must 
188.23  ensure that consumers retain the use and availability of 
188.24  personal funds or property unless restrictions are justified in 
188.25  the consumer's individual service plan. 
188.26     (b) The license holder must ensure separation of resident 
188.27  consumer funds from funds of the license holder, the residential 
188.28  program, or program staff. 
188.29     (c) Whenever the license holder assists a consumer with the 
188.30  safekeeping of funds or other property, the license holder 
188.31  must have written authorization to do so by the consumer or the 
188.32  consumer's legal representative, and the case manager.  In 
188.33  addition, the license holder must: 
188.34     (1) document receipt and disbursement of the consumer's 
188.35  funds or the property, and include the signature of the 
188.36  consumer, conservator, or payee; 
189.1      (2) provide a statement at least quarterly itemizing 
189.2   annually survey, document, and implement the preferences of the 
189.3   consumer, consumer's legal representative, and the case manager 
189.4   for frequency of receiving a statement that itemizes receipts 
189.5   and disbursements of resident consumer funds or other property; 
189.6   and 
189.7      (3) return to the consumer upon the consumer's request, 
189.8   funds and property in the license holder's possession subject to 
189.9   restrictions in the consumer's individual service plan, as soon 
189.10  as possible, but no later than three working days after the date 
189.11  of the request. 
189.12     (d) License holders and program staff must not: 
189.13     (1) borrow money from a consumer; 
189.14     (2) purchase personal items from a consumer; 
189.15     (3) sell merchandise or personal services to a consumer; 
189.16     (4) require a resident consumer to purchase items for which 
189.17  the license holder is eligible for reimbursement; or 
189.18     (5) use resident consumer funds in a manner that would 
189.19  violate section 256B.04, or any rules promulgated under that 
189.20  section. 
189.21     Sec. 14.  Minnesota Statutes 1998, section 252.32, 
189.22  subdivision 3a, is amended to read: 
189.23     Subd. 3a.  [REPORTS AND ALLOCATIONS.] (a) The commissioner 
189.24  shall specify requirements for quarterly fiscal and annual 
189.25  program reports according to section 256.01, subdivision 2, 
189.26  paragraph (17).  Program reports shall include data which will 
189.27  enable the commissioner to evaluate program effectiveness and to 
189.28  audit compliance.  The commissioner shall reimburse county costs 
189.29  on a quarterly basis. 
189.30     (b) Beginning January 1, 1998, The commissioner shall 
189.31  allocate state funds made available under this section to county 
189.32  social service agencies on a calendar year basis.  The 
189.33  commissioner shall allocate to each county first in amounts 
189.34  equal to each county's guaranteed floor as described in clause 
189.35  (1), and second, any remaining funds, after the allocation of 
189.36  funds to the newly participating counties as provided for in 
190.1   clause (3), shall be allocated in proportion to each county's 
190.2   total number of families receiving a grant on July 1 of the most 
190.3   recent calendar year will be allocated to county agencies to 
190.4   support children in their family homes.  
190.5      (1) Each county's guaranteed floor shall be calculated as 
190.6   follows:  
190.7      (i) 95 percent of the county's allocation received in the 
190.8   preceding calendar year.  For the calendar year 1998 allocation, 
190.9   the preceding calendar year shall be considered to be double the 
190.10  six-month allocation as provided in clause (2); 
190.11     (ii) when the amount of funds available for allocation is 
190.12  less than the amount available in the preceding year, each 
190.13  county's previous year allocation shall be reduced in proportion 
190.14  to the reduction in statewide funding, for the purpose of 
190.15  establishing the guaranteed floor.  
190.16     (2) For the period July 1, 1997, to December 31, 1997, the 
190.17  commissioner shall allocate to each county an amount equal to 
190.18  the actual, state approved grants issued to the families for the 
190.19  month of January 1997, multiplied by six.  This six-month 
190.20  allocation shall be combined with the calendar year 1998 
190.21  allocation and be administered as an 18-month allocation.  
190.22     (3) At the commissioner's discretion, funds may be 
190.23  allocated to any nonparticipating county that requests an 
190.24  allocation under this section.  Allocations to newly 
190.25  participating counties are dependent upon the availability of 
190.26  funds, as determined by the actual expenditure amount of the 
190.27  participating counties for the most recently completed calendar 
190.28  year.  
190.29     (4) The commissioner shall regularly review the use of 
190.30  family support fund allocations by county.  The commissioner may 
190.31  reallocate unexpended or unencumbered money at any time to those 
190.32  counties that have a demonstrated need for additional funding.  
190.33     (c) County allocations under this section will be adjusted 
190.34  for transfers that occur according to section 256.476 or when 
190.35  the county of financial responsibility changes according to 
190.36  chapter 256G for eligible recipients. 
191.1      Sec. 15.  Minnesota Statutes 1998, section 252.46, 
191.2   subdivision 6, is amended to read: 
191.3      Subd. 6.  [VARIANCES.] (a) A variance from the minimum or 
191.4   maximum payment rates in subdivisions 2 and 3 may be granted by 
191.5   the commissioner when the vendor requests and the county board 
191.6   submits to the commissioner a written variance request on forms 
191.7   supplied by the commissioner with the recommended payment rates. 
191.8      (b) A variance to the rate maximum may be utilized for 
191.9   costs associated with compliance with state administrative 
191.10  rules, compliance with court orders, capital costs required for 
191.11  continued licensure, increased insurance costs, start-up and 
191.12  conversion costs for supported employment, direct service staff 
191.13  salaries and benefits, transportation, and other program related 
191.14  costs when any of the criteria in clauses (1) to (4) is also met:
191.15     (1) change is necessary to comply with licensing citations; 
191.16     (2) a licensed vendor currently serving fewer than 70 
191.17  persons with payment rates of 80 percent or less of the 
191.18  statewide average rates and with clients meeting the behavioral 
191.19  or medical criteria under clause (3) approved by the 
191.20  commissioner as a significant program change under section 
191.21  252.28; 
191.22     (3) (1) A determination of need under section 252.28 is 
191.23  approved for a significant program change is approved by the 
191.24  commissioner under section 252.28 that is necessary for a vendor 
191.25  to provide authorized services to a new client or clients with 
191.26  very severe self-injurious or assaultive behavior, or medical 
191.27  conditions requiring delivery of physician-prescribed medical 
191.28  interventions requiring one-to-one staffing for at least 15 
191.29  minutes each time they are performed, or to a new client or 
191.30  clients directly discharged to the vendor's program from a 
191.31  regional treatment center; or 
191.32     (4) there is a need to maintain required staffing levels in 
191.33  order to provide authorized services approved by the 
191.34  commissioner under section 252.28, that is necessitated by a 
191.35  significant and permanent decrease in licensed capacity or 
191.36  clientele. 
192.1      The county shall review the adequacy of services provided 
192.2   by vendors whose payment rates are 80 percent or more of the 
192.3   statewide average rates and 50 percent or more of the vendor's 
192.4   clients meet the behavioral or medical criteria in clause (3). 
192.5      A variance under this paragraph may be approved only if the 
192.6   costs to the medical assistance program do not exceed the 
192.7   medical assistance costs for all clients served by the 
192.8   alternatives and all clients remaining in the existing services. 
192.9   one or more clients who meet one or more of the following 
192.10  criteria: 
192.11     (a) the client is a new client and: 
192.12     (i) exhibits severe behavior as indicated on the screening 
192.13  document; 
192.14     (ii) periodically requires one-to-one staff time for at 
192.15  least 15 minutes at a time to deliver physician prescribed 
192.16  medical interventions; or 
192.17     (iii) has been discharged directly to the vendor's program 
192.18  from a regional treatment center or the Minnesota extended 
192.19  treatment option. 
192.20     (b) the client is an existing client who has developed one 
192.21  of the following changed circumstances which increases costs 
192.22  that are not covered by the vendor's current rate, and for whom 
192.23  a significant program change is necessary to ensure the 
192.24  continued provision of authorized services to that client: 
192.25     (i) severe behavior as indicated on the screening document; 
192.26     (ii) a medical condition periodically requiring one-to-one 
192.27  staff time for at least 15 minutes at a time to deliver 
192.28  physician prescribed medical interventions; or 
192.29     (iii) a permanent decrease in skill functioning, as 
192.30  verified by medical reports or assessments. 
192.31     (2) A licensing determination requires a program change 
192.32  that the vendor cannot comply with due to funding restraints. 
192.33     (3) A determination of need under section 252.28 is 
192.34  approved for a significant and permanent decrease in licensed 
192.35  capacity and the vendor demonstrates the need to retain certain 
192.36  staffing levels to serve the remaining clients. 
193.1      (4) In cases where conditions in clauses (1) to (3) do not 
193.2   apply, but a determination of need under section 252.28 is 
193.3   approved for an unusual circumstance which exists that 
193.4   significantly impacts the type or amount of services delivered, 
193.5   as evidenced by documentation presented by the vendor and with 
193.6   the concurrence of the commissioner.  
193.7      (b) (c) A variance to the rate minimum may be granted when: 
193.8      (1) the county board contracts for increased services from 
193.9   a vendor and for some or all individuals receiving services from 
193.10  the vendor lower per unit fixed costs result; or 
193.11     (2) when the actual costs of delivering authorized service 
193.12  over a 12-month contract period have decreased. 
193.13     (c) (d) The written variance request under this subdivision 
193.14  must include documentation that all the following criteria have 
193.15  been met: 
193.16     (1) The commissioner and the county board have both 
193.17  conducted a review and have identified a need for a change in 
193.18  the payment rates and recommended an effective date for the 
193.19  change in the rate. 
193.20     (2) The vendor documents efforts to reallocate current 
193.21  staff and any additional staffing needs cannot be met by using 
193.22  temporary special needs rate exceptions under Minnesota Rules, 
193.23  parts 9510.1020 to 9510.1140. 
193.24     (3) The vendor documents that financial resources have been 
193.25  reallocated before applying for a variance.  No variance may be 
193.26  granted for equipment, supplies, or other capital expenditures 
193.27  when depreciation expense for repair and replacement of such 
193.28  items is part of the current rate. 
193.29     (4) For variances related to loss of clientele, the vendor 
193.30  documents the other program and administrative expenses, if any, 
193.31  that have been reduced. 
193.32     (5) The county board submits verification of the conditions 
193.33  for which the variance is requested, a description of the nature 
193.34  and cost of the proposed changes, and how the county will 
193.35  monitor the use of money by the vendor to make necessary changes 
193.36  in services.  
194.1      (6) The county board's recommended payment rates do not 
194.2   exceed 95 percent of the greater of 125 percent of the current 
194.3   statewide median or 125 percent of the regional average payment 
194.4   rates, whichever is higher, for each of the regional commission 
194.5   districts under sections 462.381 to 462.396 in which the vendor 
194.6   is located except for the following:  when a variance is 
194.7   recommended to allow authorized service delivery to new clients 
194.8   with severe self-injurious or assaultive behaviors or with 
194.9   medical conditions requiring delivery of physician prescribed 
194.10  medical interventions, or to persons being directly discharged 
194.11  from a regional treatment center or Minnesota extended treatment 
194.12  options to the vendor's program, those persons must be assigned 
194.13  a payment rate of 200 percent of the current statewide average 
194.14  rates.  All other clients receiving services from the vendor 
194.15  must be assigned a payment rate equal to the vendor's current 
194.16  rate unless the vendor's current rate exceeds 95 percent of 125 
194.17  percent of the statewide median or 125 percent of the regional 
194.18  average payment rates, whichever is higher.  When the vendor's 
194.19  rates exceed 95 percent of 125 percent of the statewide median 
194.20  or 125 percent of the regional average rates, the maximum rates 
194.21  assigned to all other clients must be equal to the greater of 95 
194.22  percent of 125 percent of the statewide median or 125 percent of 
194.23  the regional average rates.  The maximum payment rate that may 
194.24  be recommended for the vendor under these conditions is 
194.25  determined by multiplying the number of clients at each limit by 
194.26  the rate corresponding to that limit and then dividing the sum 
194.27  by the total number of clients. 
194.28     (d) (e) The commissioner shall have 60 calendar days from 
194.29  the date of the receipt of the complete request to accept or 
194.30  reject it, or the request shall be deemed to have been granted.  
194.31  If the commissioner rejects the request, the commissioner shall 
194.32  state in writing the specific objections to the request and the 
194.33  reasons for its rejection. 
194.34     Sec. 16.  Minnesota Statutes 1998, section 256.955, 
194.35  subdivision 2, is amended to read: 
194.36     Subd. 2.  [DEFINITIONS.] (a) For purposes of this section, 
195.1   the following definitions apply. 
195.2      (b) "Health plan" has the meaning provided in section 
195.3   62Q.01, subdivision 3. 
195.4      (c) "Health plan company" has the meaning provided in 
195.5   section 62Q.01, subdivision 4. 
195.6      (d) "Qualified senior citizen" means a Medicare enrollee, 
195.7   or an individual age 65 or older who is not a Medicare enrollee, 
195.8   who: 
195.9      (1) is eligible as a qualified Medicare beneficiary 
195.10  according to section 256B.057, subdivision 3 or 3a, or is 
195.11  eligible under section 256B.057, subdivision 3 or 3a, and is 
195.12  also eligible for medical assistance or general assistance 
195.13  medical care with a spenddown as defined in section 256B.056, 
195.14  subdivision 5.  Persons who are determined eligible for medical 
195.15  assistance according to section 256B.0575, who are eligible for 
195.16  medical assistance or general assistance medical care without a 
195.17  spenddown, or who are enrolled in MinnesotaCare, are not 
195.18  eligible for this program; 
195.19     (2) is not enrolled in prescription drug coverage under a 
195.20  health plan; 
195.21     (3) is not enrolled in prescription drug coverage under a 
195.22  Medicare supplement plan, as defined in sections 62A.31 to 
195.23  62A.44, or policies, contracts, or certificates that supplement 
195.24  Medicare issued by health maintenance organizations or those 
195.25  policies, contracts, or certificates governed by section 1833 or 
195.26  1876 of the federal Social Security Act, United States Code, 
195.27  title 42, section 1395, et seq., as amended; 
195.28     (4) has not had coverage described in clauses (2) and (3) 
195.29  for at least four months prior to application for the program; 
195.30  and 
195.31     (5) is a permanent resident of Minnesota as defined in 
195.32  section 256L.09. 
195.33     Sec. 17.  Minnesota Statutes 1998, section 256.955, 
195.34  subdivision 3, is amended to read: 
195.35     Subd. 3.  [PRESCRIPTION DRUG COVERAGE.] Coverage under the 
195.36  program is limited to prescription drugs covered under the 
196.1   medical assistance program as described in section 256B.0625, 
196.2   subdivision 13, subject to a maximum deductible of $300 
196.3   annually, except drugs cleared by the FDA shall be available to 
196.4   qualified senior citizens enrolled in the program without 
196.5   restriction when prescribed for medically accepted indication as 
196.6   defined in the federal rebate program under section 1927 of 
196.7   title XIX of the federal Social Security Act.  Coverage under 
196.8   the program shall be limited to those prescription drugs that: 
196.9      (1) are covered under the medical assistance program as 
196.10  described in section 256B.0625, subdivision 13; and 
196.11     (2) are provided by manufacturers that have fully executed 
196.12  senior drug rebate agreements with the commissioner and comply 
196.13  with such agreements. 
196.14     Sec. 18.  Minnesota Statutes 1998, section 256.955, 
196.15  subdivision 4, is amended to read: 
196.16     Subd. 4.  [APPLICATION PROCEDURES AND COORDINATION WITH 
196.17  MEDICAL ASSISTANCE.] Applications and information on the program 
196.18  must be made available at county social service agencies, health 
196.19  care provider offices, and agencies and organizations serving 
196.20  senior citizens.  Senior citizens shall submit applications and 
196.21  any information specified by the commissioner as being necessary 
196.22  to verify eligibility directly to the county social service 
196.23  agencies:  
196.24     (1) beginning January 1, 1999, the county social service 
196.25  agency shall determine medical assistance spenddown eligibility 
196.26  of individuals who qualify for the senior citizen drug program 
196.27  of individuals; and 
196.28     (2) program payments will be used to reduce the spenddown 
196.29  obligations of individuals who are determined to be eligible for 
196.30  medical assistance with a spenddown as defined in section 
196.31  256B.056, subdivision 5. 
196.32  Seniors who are eligible for medical assistance with a spenddown 
196.33  shall be financially responsible for the deductible amount up to 
196.34  the satisfaction of the spenddown.  No deductible applies once 
196.35  the spenddown has been met.  Payments to providers for 
196.36  prescription drugs for persons eligible under this subdivision 
197.1   shall be reduced by the deductible.  
197.2      County social service agencies shall determine an 
197.3   applicant's eligibility for the program within 30 days from the 
197.4   date the application is received.  Eligibility begins the month 
197.5   after approval. 
197.6      Sec. 19.  Minnesota Statutes 1998, section 256.955, 
197.7   subdivision 7, is amended to read: 
197.8      Subd. 7.  [COST SHARING.] (a) Enrollees shall pay an annual 
197.9   premium of $120. 
197.10     (b) Program enrollees must satisfy a $300 $420 annual 
197.11  deductible, based upon expenditures for prescription drugs, to 
197.12  be paid as follows: 
197.13     (1) $25 monthly deductible for persons with a monthly 
197.14  spenddown; or 
197.15     (2) $150 biannual deductible for persons with a six-month 
197.16  spenddown in $35 monthly increments. 
197.17     Sec. 20.  Minnesota Statutes 1998, section 256.955, 
197.18  subdivision 9, is amended to read: 
197.19     Subd. 9.  [PROGRAM LIMITATION.] This section shall be 
197.20  repealed upon federal approval of the waiver to allow the 
197.21  commissioner to provide prescription drug coverage for qualified 
197.22  Medicare beneficiaries whose income is less than 150 percent of 
197.23  the federal poverty guidelines The commissioner shall administer 
197.24  the senior drug program so that the costs total no more than 
197.25  funds appropriated plus the drug rebate proceeds.  Senior drug 
197.26  program rebate revenues are appropriated to the commissioner and 
197.27  shall be expended to augment funding of the senior drug 
197.28  program.  New enrollment shall cease if the commissioner 
197.29  determines that, given current enrollment, costs of the program 
197.30  will exceed appropriated funds and rebate proceeds.  
197.31     Sec. 21.  Minnesota Statutes 1998, section 256.9685, 
197.32  subdivision 1a, is amended to read: 
197.33     Subd. 1a.  [ADMINISTRATIVE RECONSIDERATION.] 
197.34  Notwithstanding sections 256B.04, subdivision 15, and 256D.03, 
197.35  subdivision 7, the commissioner shall establish an 
197.36  administrative reconsideration process for appeals of inpatient 
198.1   hospital services determined to be medically unnecessary.  A 
198.2   physician or hospital may request a reconsideration of the 
198.3   decision that inpatient hospital services are not medically 
198.4   necessary by submitting a written request for review to the 
198.5   commissioner within 30 days after receiving notice of the 
198.6   decision.  The reconsideration process shall take place prior to 
198.7   the procedures of subdivision 1b and shall be conducted by 
198.8   physicians that are independent of the case under 
198.9   reconsideration.  A majority decision by the physicians is 
198.10  necessary to make a determination that the services were not 
198.11  medically necessary.  
198.12     Sec. 22.  Minnesota Statutes 1998, section 256.969, 
198.13  subdivision 1, is amended to read: 
198.14     Subdivision 1.  [HOSPITAL COST INDEX.] (a) The hospital 
198.15  cost index shall be the change in the Consumer Price Index-All 
198.16  Items (United States city average) (CPI-U) forecasted by Data 
198.17  Resources, Inc.  The commissioner shall use the indices as 
198.18  forecasted in the third quarter of the calendar year prior to 
198.19  the rate year.  The hospital cost index may be used to adjust 
198.20  the base year operating payment rate through the rate year on an 
198.21  annually compounded basis.  
198.22     (b) For fiscal years beginning on or after July 1, 1993, 
198.23  the commissioner of human services shall not provide automatic 
198.24  annual inflation adjustments for hospital payment rates under 
198.25  medical assistance, nor under general assistance medical care, 
198.26  except that the inflation adjustments under paragraph (a) for 
198.27  medical assistance, excluding general assistance medical care, 
198.28  shall apply through calendar year 1999 2001.  The index for 
198.29  calendar year 2000 shall be reduced 2.5 percentage points to 
198.30  recover overprojections of the index from 1994 to 1996.  The 
198.31  commissioner of finance shall include as a budget change request 
198.32  in each biennial detailed expenditure budget submitted to the 
198.33  legislature under section 16A.11 annual adjustments in hospital 
198.34  payment rates under medical assistance and general assistance 
198.35  medical care, based upon the hospital cost index. 
198.36     Sec. 23.  Minnesota Statutes 1998, section 256B.04, 
199.1   subdivision 16, is amended to read: 
199.2      Subd. 16.  [PERSONAL CARE SERVICES.] (a) Notwithstanding 
199.3   any contrary language in this paragraph, the commissioner of 
199.4   human services and the commissioner of health shall jointly 
199.5   promulgate rules to be applied to the licensure of personal care 
199.6   services provided under the medical assistance program.  The 
199.7   rules shall consider standards for personal care services that 
199.8   are based on the World Institute on Disability's recommendations 
199.9   regarding personal care services.  These rules shall at a 
199.10  minimum consider the standards and requirements adopted by the 
199.11  commissioner of health under section 144A.45, which the 
199.12  commissioner of human services determines are applicable to the 
199.13  provision of personal care services, in addition to other 
199.14  standards or modifications which the commissioner of human 
199.15  services determines are appropriate. 
199.16     The commissioner of human services shall establish an 
199.17  advisory group including personal care consumers and providers 
199.18  to provide advice regarding which standards or modifications 
199.19  should be adopted.  The advisory group membership must include 
199.20  not less than 15 members, of which at least 60 percent must be 
199.21  consumers of personal care services and representatives of 
199.22  recipients with various disabilities and diagnoses and ages.  At 
199.23  least 51 percent of the members of the advisory group must be 
199.24  recipients of personal care. 
199.25     The commissioner of human services may contract with the 
199.26  commissioner of health to enforce the jointly promulgated 
199.27  licensure rules for personal care service providers. 
199.28     Prior to final promulgation of the joint rule the 
199.29  commissioner of human services shall report preliminary findings 
199.30  along with any comments of the advisory group and a plan for 
199.31  monitoring and enforcement by the department of health to the 
199.32  legislature by February 15, 1992. 
199.33     Limits on the extent of personal care services that may be 
199.34  provided to an individual must be based on the 
199.35  cost-effectiveness of the services in relation to the costs of 
199.36  inpatient hospital care, nursing home care, and other available 
200.1   types of care.  The rules must provide, at a minimum:  
200.2      (1) that agencies be selected to contract with or employ 
200.3   and train staff to provide and supervise the provision of 
200.4   personal care services; 
200.5      (2) that agencies employ or contract with a qualified 
200.6   applicant that a qualified recipient proposes to the agency as 
200.7   the recipient's choice of assistant; 
200.8      (3) that agencies bill the medical assistance program for a 
200.9   personal care service by a personal care assistant and 
200.10  supervision by the registered nurse a qualified professional 
200.11  supervising the personal care assistant unless the recipient 
200.12  selects the fiscal agent option under section 256B.0627, 
200.13  subdivision 10; 
200.14     (4) that agencies establish a grievance mechanism; and 
200.15     (5) that agencies have a quality assurance program.  
200.16     (b) The commissioner may waive the requirement for the 
200.17  provision of personal care services through an agency in a 
200.18  particular county, when there are less than two agencies 
200.19  providing services in that county and shall waive the 
200.20  requirement for personal care assistants required to join an 
200.21  agency for the first time during 1993 when personal care 
200.22  services are provided under a relative hardship waiver under 
200.23  section 256B.0627, subdivision 4, paragraph (b), clause (7), and 
200.24  at least two agencies providing personal care services have 
200.25  refused to employ or contract with the independent personal care 
200.26  assistant. 
200.27     Sec. 24.  Minnesota Statutes 1998, section 256B.04, is 
200.28  amended by adding a subdivision to read: 
200.29     Subd. 19.  [PERFORMANCE DATA REPORTING UNIT.] The 
200.30  commissioner of human services shall establish a performance 
200.31  data reporting unit that serves counties and the state.  The 
200.32  department shall support this unit and provide technical 
200.33  assistance and access to the data warehouse.  The performance 
200.34  data reporting unit, which will operate within the department's 
200.35  central office and consist of both county and department staff, 
200.36  shall provide performance data reports to individual counties, 
201.1   share expertise from counties and the department perspective, 
201.2   and participate in joint planning to link with county databases 
201.3   and other county data sources in order to provide information on 
201.4   services provided to public clients from state, federal, and 
201.5   county funding sources.  The unit shall provide counties both 
201.6   individual and group summary level standard or unique reports on 
201.7   health care eligibility and services provided to clients for 
201.8   whom they have financial responsibility.  
201.9      Sec. 25.  Minnesota Statutes 1998, section 256B.055, 
201.10  subdivision 3a, is amended to read: 
201.11     Subd. 3a.  [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 
201.12  AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 
201.13  MFIP-S is implemented in counties, medical assistance may be 
201.14  paid for a person receiving public assistance under the MFIP-S 
201.15  program. 
201.16     (b) Beginning January 1, 1998, medical assistance may be 
201.17  paid for a person who would have been eligible for public 
201.18  assistance under the income and resource standards and 
201.19  deprivation requirements, or who would have been eligible but 
201.20  for excess income or assets, under the state's AFDC plan in 
201.21  effect as of July 16, 1996, as required by the Personal 
201.22  Responsibility and Work Opportunity Reconciliation Act of 1996 
201.23  (PRWORA), Public Law Number 104-193. 
201.24     Sec. 26.  Minnesota Statutes 1998, section 256B.056, 
201.25  subdivision 4, is amended to read: 
201.26     Subd. 4.  [INCOME.] To be eligible for medical assistance, 
201.27  a person eligible under section 256B.055, subdivision 7, not 
201.28  receiving supplemental security income program payments, and 
201.29  families and children may have an income up to 133-1/3 percent 
201.30  of the AFDC income standard in effect under the July 16, 1996, 
201.31  AFDC state plan.  For rate years beginning on or after July 1, 
201.32  1999, the commissioner shall consider increasing the base AFDC 
201.33  standard in effect July 16, 1996, by an amount equal to the 
201.34  percent change in the Consumer Price Index for All Urban 
201.35  Consumers for the previous October compared to one year 
201.36  earlier.  Effective July 1, 1999, the base AFDC standard in 
202.1   effect on July 16, 1996, shall be increased by an amount equal 
202.2   to the percentage increase in the Consumer Price Index for all 
202.3   urban consumers for July 1996 through April 1999.  Effective 
202.4   January 1, 2000, and each successive January, recipients of 
202.5   supplemental security income may have an income up to the 
202.6   supplemental security income standard in effect on that date.  
202.7   In computing income to determine eligibility of persons who are 
202.8   not residents of long-term care facilities, the commissioner 
202.9   shall disregard increases in income as required by Public Law 
202.10  Numbers 94-566, section 503; 99-272; and 99-509.  Veterans aid 
202.11  and attendance benefits and Veterans Administration unusual 
202.12  medical expense payments are considered income to the recipient. 
202.13     Sec. 27.  Minnesota Statutes 1998, section 256B.057, is 
202.14  amended by adding a subdivision to read: 
202.15     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
202.16  assistance may be paid for a person who is employed; who, except 
202.17  for income or assets, would be eligible for the supplemental 
202.18  security income program; whose assets do not exceed $20,000, 
202.19  excluding retirement accounts, medical savings accounts, and all 
202.20  assets excluded under the supplemental security income program; 
202.21  and who pays a premium, if required.  Any spousal income or 
202.22  assets shall be disregarded for purposes of eligibility and 
202.23  premium determinations. 
202.24     (b) A person whose earned and unearned income is equal to 
202.25  or greater than 200 percent of federal poverty guidelines for 
202.26  the applicable family size must pay a premium to be eligible for 
202.27  medical assistance.  The premium shall be equal to ten percent 
202.28  of the person's gross earned and unearned income above 200 
202.29  percent of federal poverty guidelines for the applicable family 
202.30  size up to the cost of coverage. 
202.31     (c) A person's eligibility and premium shall be determined 
202.32  by the local county agency.  Premiums must be paid to the 
202.33  commissioner.  All premiums are dedicated to the commissioner. 
202.34     (d) Any required premium shall be determined at application 
202.35  and redetermined annually at recertification or when a change in 
202.36  income occurs. 
203.1      (e) The first premium payment is due upon notification from 
203.2   the commissioner of the premium amount required.  Premiums may 
203.3   be paid in installments at the discretion of the commissioner. 
203.4      (f) Nonpayment of the premium shall result in denial or 
203.5   termination of medical assistance unless the person demonstrates 
203.6   good cause for nonpayment.  Nonpayment shall include payment 
203.7   with a dishonored instrument.  If payment is made with a 
203.8   dishonored instrument, the commissioner may demand a guaranteed 
203.9   form of payment. 
203.10     Sec. 28.  Minnesota Statutes 1998, section 256B.0575, is 
203.11  amended to read: 
203.12     256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 
203.13  PERSONS.] 
203.14     When an institutionalized person is determined eligible for 
203.15  medical assistance, the income that exceeds the deductions in 
203.16  paragraphs (a) and (b) must be applied to the cost of 
203.17  institutional care.  
203.18     (a) The following amounts must be deducted from the 
203.19  institutionalized person's income in the following order: 
203.20     (1) the personal needs allowance under section 256B.35 or, 
203.21  for a veteran who does not have a spouse or child, or a 
203.22  surviving spouse of a veteran having no child, the amount of an 
203.23  improved pension received from the veteran's administration not 
203.24  exceeding $90 per month; 
203.25     (2) the personal allowance for disabled individuals under 
203.26  section 256B.36; 
203.27     (3) if the institutionalized person has a legally appointed 
203.28  guardian or conservator, five percent of the recipient's gross 
203.29  monthly income up to $100 as reimbursement for guardianship or 
203.30  conservatorship services; 
203.31     (4) a monthly income allowance determined under section 
203.32  256B.058, subdivision 2, but only to the extent income of the 
203.33  institutionalized spouse is made available to the community 
203.34  spouse; 
203.35     (5) a monthly allowance for children under age 18 which, 
203.36  together with the net income of the children, would provide 
204.1   income equal to the medical assistance standard for families and 
204.2   children according to section 256B.056, subdivision 4, for a 
204.3   family size that includes only the minor children.  This 
204.4   deduction applies only if the children do not live with the 
204.5   community spouse and only to the extent that the deduction is 
204.6   not included in the personal needs allowance under section 
204.7   256B.35, subdivision 1, as child support garnished under a court 
204.8   order; 
204.9      (6) a monthly family allowance for other family members, 
204.10  equal to one-third of the difference between 122 percent of the 
204.11  federal poverty guidelines and the monthly income for that 
204.12  family member; 
204.13     (7) reparations payments made by the Federal Republic of 
204.14  Germany and reparations payments made by the Netherlands for 
204.15  victims of Nazi persecution between 1940 and 1945; and 
204.16     (8) all other exclusions from income for institutionalized 
204.17  persons as mandated by federal law; and 
204.18     (8) (9) amounts for reasonable expenses incurred for 
204.19  necessary medical or remedial care for the institutionalized 
204.20  spouse that are not medical assistance covered expenses and that 
204.21  are not subject to payment by a third party.  
204.22     For purposes of clause (6), "other family member" means a 
204.23  person who resides with the community spouse and who is a minor 
204.24  or dependent child, dependent parent, or dependent sibling of 
204.25  either spouse.  "Dependent" means a person who could be claimed 
204.26  as a dependent for federal income tax purposes under the 
204.27  Internal Revenue Code. 
204.28     (b) Income shall be allocated to an institutionalized 
204.29  person for a period of up to three calendar months, in an amount 
204.30  equal to the medical assistance standard for a family size of 
204.31  one if:  
204.32     (1) a physician certifies that the person is expected to 
204.33  reside in the long-term care facility for three calendar months 
204.34  or less; 
204.35     (2) if the person has expenses of maintaining a residence 
204.36  in the community; and 
205.1      (3) if one of the following circumstances apply:  
205.2      (i) the person was not living together with a spouse or a 
205.3   family member as defined in paragraph (a) when the person 
205.4   entered a long-term care facility; or 
205.5      (ii) the person and the person's spouse become 
205.6   institutionalized on the same date, in which case the allocation 
205.7   shall be applied to the income of one of the spouses.  
205.8   For purposes of this paragraph, a person is determined to be 
205.9   residing in a licensed nursing home, regional treatment center, 
205.10  or medical institution if the person is expected to remain for a 
205.11  period of one full calendar month or more. 
205.12     Sec. 29.  Minnesota Statutes 1998, section 256B.0625, is 
205.13  amended by adding a subdivision to read: 
205.14     Subd. 3b.  [TELEMEDICINE CONSULTATIONS.] (a) Medical 
205.15  assistance covers telemedicine consultations.  Telemedicine 
205.16  consultations may be made via two-way, interactive video or 
205.17  store-and-forward technology.  Store-and-forward technology 
205.18  includes telemedicine consultations that do not occur in real 
205.19  time via synchronous transmissions, and that do not require a 
205.20  face-to-face encounter with the patient for all or any part of 
205.21  any such telemedicine consultation.  The patient record must 
205.22  include a written opinion from the consulting physician 
205.23  providing the telemedicine consultation.  A communication 
205.24  between two physicians that consists solely of a telephone 
205.25  conversation is not a telemedicine consultation.  Coverage is 
205.26  limited to three telemedicine consultations per recipient per 
205.27  calendar week.  Telemedicine consultations will be paid at the 
205.28  full allowable. 
205.29     (b) This subdivision expires July 1, 2001.  
205.30     Sec. 30.  Minnesota Statutes 1998, section 256B.0625, is 
205.31  amended by adding a subdivision to read: 
205.32     Subd. 3c.  [CONSULTATION SERVICES BY PHYSICIANS 
205.33  SPECIALIZING IN CHILD ABUSE AND NEGLECT.] (a) Medical assistance 
205.34  covers consultation services by physicians specializing in child 
205.35  abuse and neglect.  Alternative media formats may be used when 
205.36  the patient is a child being examined for potential abuse or 
206.1   neglect, the consulting physician is a specialist in child abuse 
206.2   and neglect, and the use of two-way, interactive video or the 
206.3   occurrence of a second exam would be medically counter indicated 
206.4   for the child. 
206.5      (b) This subdivision expires July 1, 2001.  
206.6      Sec. 31.  Minnesota Statutes 1998, section 256B.0625, 
206.7   subdivision 6a, is amended to read: 
206.8      Subd. 6a.  [HOME HEALTH SERVICES.] Home health services are 
206.9   those services specified in Minnesota Rules, part 9505.0290. 
206.10  Medical assistance covers home health services at a recipient's 
206.11  home residence.  Medical assistance does not cover home health 
206.12  services for residents of a hospital, nursing facility, or 
206.13  intermediate care facility, or a health care facility licensed 
206.14  by the commissioner of health, unless the program is funded 
206.15  under a home and community-based services waiver or unless the 
206.16  commissioner of human services has prior authorized skilled 
206.17  nurse visits for less than 90 days for a resident at an 
206.18  intermediate care facility for persons with mental retardation, 
206.19  to prevent an admission to a hospital or nursing facility or 
206.20  unless a resident who is otherwise eligible is on leave from the 
206.21  facility and the facility either pays for the home health 
206.22  services or forgoes the facility per diem for the leave days 
206.23  that home health services are used.  Home health services must 
206.24  be provided by a Medicare certified home health agency.  All 
206.25  nursing and home health aide services must be provided according 
206.26  to section 256B.0627. 
206.27     Sec. 32.  Minnesota Statutes 1998, section 256B.0625, 
206.28  subdivision 8, is amended to read: 
206.29     Subd. 8.  [PHYSICAL THERAPY.] Medical assistance covers 
206.30  physical therapy and related services, including specialized 
206.31  maintenance therapy.  Services provided by a physical therapy 
206.32  assistant shall be reimbursed at the same rate as services 
206.33  performed by a physical therapist when the services of the 
206.34  physical therapy assistant are provided under the direction of a 
206.35  physical therapist who is on the premises.  Services provided by 
206.36  a physical therapy assistant that are provided under the 
207.1   direction of a physical therapist who is not on the premises 
207.2   shall be reimbursed at 65 percent of the physical therapist rate.
207.3      Sec. 33.  Minnesota Statutes 1998, section 256B.0625, 
207.4   subdivision 8a, is amended to read: 
207.5      Subd. 8a.  [OCCUPATIONAL THERAPY.] Medical assistance 
207.6   covers occupational therapy and related services, including 
207.7   specialized maintenance therapy.  Services provided by an 
207.8   occupational therapy assistant shall be reimbursed at the same 
207.9   rate as services performed by an occupational therapist when the 
207.10  services of the occupational therapy assistant are provided 
207.11  under the direction of the occupational therapist who is on the 
207.12  premises.  Services provided by an occupational therapy 
207.13  assistant that are provided under the direction of an 
207.14  occupational therapist who is not on the premises shall be 
207.15  reimbursed at 65 percent of the occupational therapist rate. 
207.16     Sec. 34.  Minnesota Statutes 1998, section 256B.0625, is 
207.17  amended by adding a subdivision to read: 
207.18     Subd. 8b.  [SPEECH LANGUAGE PATHOLOGY SERVICES.] Medical 
207.19  assistance covers speech language pathology and related 
207.20  services, including specialized maintenance therapy. 
207.21     Sec. 35.  Minnesota Statutes 1998, section 256B.0625, is 
207.22  amended by adding a subdivision to read: 
207.23     Subd. 8c.  [REHABILITATION SERVICES.] Effective July 1, 
207.24  1999, annual thresholds for provision of rehabilitation services 
207.25  described in subdivisions 8, 8a, and 8b will be the same in 
207.26  amount and description as the thresholds prescribed by the 
207.27  department of human services health care programs provider 
207.28  manual for calendar year 1997, and they will include sensory 
207.29  skills and cognitive training skills. 
207.30     Sec. 36.  Minnesota Statutes 1998, section 256B.0625, 
207.31  subdivision 13, is amended to read: 
207.32     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
207.33  except for fertility drugs when specifically used to enhance 
207.34  fertility, if prescribed by a licensed practitioner and 
207.35  dispensed by a licensed pharmacist, by a physician enrolled in 
207.36  the medical assistance program as a dispensing physician, or by 
208.1   a physician or a nurse practitioner employed by or under 
208.2   contract with a community health board as defined in section 
208.3   145A.02, subdivision 5, for the purposes of communicable disease 
208.4   control.  The commissioner, after receiving recommendations from 
208.5   professional medical associations and professional pharmacist 
208.6   associations, shall designate a formulary committee to advise 
208.7   the commissioner on the names of drugs for which payment is 
208.8   made, recommend a system for reimbursing providers on a set fee 
208.9   or charge basis rather than the present system, and develop 
208.10  methods encouraging use of generic drugs when they are less 
208.11  expensive and equally effective as trademark drugs.  The 
208.12  formulary committee shall consist of nine members, four of whom 
208.13  shall be physicians who are not employed by the department of 
208.14  human services, and a majority of whose practice is for persons 
208.15  paying privately or through health insurance, three of whom 
208.16  shall be pharmacists who are not employed by the department of 
208.17  human services, and a majority of whose practice is for persons 
208.18  paying privately or through health insurance, a consumer 
208.19  representative, and a nursing home representative.  Committee 
208.20  members shall serve three-year terms and shall serve without 
208.21  compensation.  Members may be reappointed once.  
208.22     (b) The commissioner shall establish a drug formulary.  Its 
208.23  establishment and publication shall not be subject to the 
208.24  requirements of the Administrative Procedure Act, but the 
208.25  formulary committee shall review and comment on the formulary 
208.26  contents.  The formulary committee shall review and recommend 
208.27  drugs which require prior authorization.  The formulary 
208.28  committee may recommend drugs for prior authorization directly 
208.29  to the commissioner, as long as opportunity for public input is 
208.30  provided.  Prior authorization may be requested by the 
208.31  commissioner based on medical and clinical criteria before 
208.32  certain drugs are eligible for payment.  Before a drug may be 
208.33  considered for prior authorization at the request of the 
208.34  commissioner:  
208.35     (1) the drug formulary committee must develop criteria to 
208.36  be used for identifying drugs; the development of these criteria 
209.1   is not subject to the requirements of chapter 14, but the 
209.2   formulary committee shall provide opportunity for public input 
209.3   in developing criteria; 
209.4      (2) the drug formulary committee must hold a public forum 
209.5   and receive public comment for an additional 15 days; and 
209.6      (3) the commissioner must provide information to the 
209.7   formulary committee on the impact that placing the drug on prior 
209.8   authorization will have on the quality of patient care and 
209.9   information regarding whether the drug is subject to clinical 
209.10  abuse or misuse.  Prior authorization may be required by the 
209.11  commissioner before certain formulary drugs are eligible for 
209.12  payment.  The formulary shall not include:  
209.13     (i) drugs or products for which there is no federal 
209.14  funding; 
209.15     (ii) over-the-counter drugs, except for antacids, 
209.16  acetaminophen, family planning products, aspirin, insulin, 
209.17  products for the treatment of lice, vitamins for adults with 
209.18  documented vitamin deficiencies, vitamins for children under the 
209.19  age of seven and pregnant or nursing women, and any other 
209.20  over-the-counter drug identified by the commissioner, in 
209.21  consultation with the drug formulary committee, as necessary, 
209.22  appropriate, and cost-effective for the treatment of certain 
209.23  specified chronic diseases, conditions or disorders, and this 
209.24  determination shall not be subject to the requirements of 
209.25  chapter 14; 
209.26     (iii) anorectics; 
209.27     (iv) drugs for which medical value has not been 
209.28  established; and 
209.29     (v) drugs from manufacturers who have not signed a rebate 
209.30  agreement with the Department of Health and Human Services 
209.31  pursuant to section 1927 of title XIX of the Social Security Act 
209.32  and who have not signed an agreement with the state for drugs 
209.33  purchased pursuant to the senior citizen drug program 
209.34  established under section 256.955. 
209.35     The commissioner shall publish conditions for prohibiting 
209.36  payment for specific drugs after considering the formulary 
210.1   committee's recommendations.  
210.2      (c) The basis for determining the amount of payment shall 
210.3   be the lower of the actual acquisition costs of the drugs plus a 
210.4   fixed dispensing fee; the maximum allowable cost set by the 
210.5   federal government or by the commissioner plus the fixed 
210.6   dispensing fee; or the usual and customary price charged to the 
210.7   public.  The pharmacy dispensing fee shall be $3.65.  Actual 
210.8   acquisition cost includes quantity and other special discounts 
210.9   except time and cash discounts.  The actual acquisition cost of 
210.10  a drug shall be estimated by the commissioner, at average 
210.11  wholesale price minus nine percent.  The maximum allowable cost 
210.12  of a multisource drug may be set by the commissioner and it 
210.13  shall be comparable to, but no higher than, the maximum amount 
210.14  paid by other third-party payors in this state who have maximum 
210.15  allowable cost programs.  Establishment of the amount of payment 
210.16  for drugs shall not be subject to the requirements of the 
210.17  Administrative Procedure Act.  An additional dispensing fee of 
210.18  $.30 may be added to the dispensing fee paid to pharmacists for 
210.19  legend drug prescriptions dispensed to residents of long-term 
210.20  care facilities when a unit dose blister card system, approved 
210.21  by the department, is used.  Under this type of dispensing 
210.22  system, the pharmacist must dispense a 30-day supply of drug.  
210.23  The National Drug Code (NDC) from the drug container used to 
210.24  fill the blister card must be identified on the claim to the 
210.25  department.  The unit dose blister card containing the drug must 
210.26  meet the packaging standards set forth in Minnesota Rules, part 
210.27  6800.2700, that govern the return of unused drugs to the 
210.28  pharmacy for reuse.  The pharmacy provider will be required to 
210.29  credit the department for the actual acquisition cost of all 
210.30  unused drugs that are eligible for reuse.  Over-the-counter 
210.31  medications must be dispensed in the manufacturer's unopened 
210.32  package.  The commissioner may permit the drug clozapine to be 
210.33  dispensed in a quantity that is less than a 30-day supply.  
210.34  Whenever a generically equivalent product is available, payment 
210.35  shall be on the basis of the actual acquisition cost of the 
210.36  generic drug, unless the prescriber specifically indicates 
211.1   "dispense as written - brand necessary" on the prescription as 
211.2   required by section 151.21, subdivision 2. 
211.3      (d) For purposes of this subdivision, "multisource drugs" 
211.4   means covered outpatient drugs, excluding innovator multisource 
211.5   drugs, for which there are two or more drug products which: 
211.6      (i) are related as therapeutically equivalent under the 
211.7   Food and Drug Administration's most recent publication of 
211.8   "Approved Drug Products with Therapeutic Equivalence 
211.9   Evaluations"; 
211.10     (ii) are pharmaceutically equivalent and bioequivalent as 
211.11  determined by the Food and Drug Administration; and 
211.12     (iii) are sold or marketed in Minnesota. 
211.13  "Innovator multisource drug" means a multisource drug that was 
211.14  originally marketed under an original new drug application 
211.15  approved by the Food and Drug Administration. 
211.16     Sec. 37.  Minnesota Statutes 1998, section 256B.0625, 
211.17  subdivision 17, is amended to read: 
211.18     Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
211.19  covers transportation costs incurred solely for obtaining 
211.20  emergency medical care or transportation costs incurred by 
211.21  nonambulatory persons in obtaining emergency or nonemergency 
211.22  medical care when paid directly to an ambulance company, common 
211.23  carrier, or other recognized providers of transportation 
211.24  services.  For the purpose of this subdivision, a person who is 
211.25  incapable of transport by taxicab or bus shall be considered to 
211.26  be nonambulatory. 
211.27     (b) Medical assistance covers special transportation, as 
211.28  defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
211.29  if the provider receives and maintains a current physician's 
211.30  order by the recipient's attending physician certifying that the 
211.31  recipient has a physical or mental impairment that would 
211.32  prohibit the recipient from safely accessing and using a bus, 
211.33  taxi, other commercial transportation, or private automobile.  
211.34  Special transportation includes driver-assisted service to 
211.35  eligible individuals.  Driver-assisted service includes 
211.36  passenger pickup at and return to the individual's residence or 
212.1   place of business, assistance with admittance of the individual 
212.2   to the medical facility, and assistance in passenger securement 
212.3   or in securing of wheelchairs or stretchers in the vehicle.  The 
212.4   commissioner shall establish maximum medical assistance 
212.5   reimbursement rates for special transportation services for 
212.6   persons who need a wheelchair lift van or stretcher-equipped 
212.7   vehicle and for those who do not need a wheelchair lift van or 
212.8   stretcher-equipped vehicle.  The average of these two rates per 
212.9   trip must not exceed $15 $15.50 for the base rate and 
212.10  $1.20 $1.25 per mile.  Special transportation provided to 
212.11  nonambulatory persons who do not need a wheelchair lift van or 
212.12  stretcher-equipped vehicle, may be reimbursed at a lower rate 
212.13  than special transportation provided to persons who need a 
212.14  wheelchair lift van or stretcher-equipped vehicle. 
212.15     Sec. 38.  Minnesota Statutes 1998, section 256B.0625, 
212.16  subdivision 19c, is amended to read: 
212.17     Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
212.18  personal care services provided by an individual who is 
212.19  qualified to provide the services according to subdivision 19a 
212.20  and section 256B.0627, where the services are prescribed by a 
212.21  physician in accordance with a plan of treatment and are 
212.22  supervised by a registered nurse the recipient under the fiscal 
212.23  agent option according to section 256B.0627, subdivision 10, or 
212.24  a qualified professional.  "Qualified professional" means a 
212.25  mental health professional as defined in section 245.462, 
212.26  subdivision 18, or 245.4871, subdivision 26; or a registered 
212.27  nurse as defined in sections 148.171 to 148.285.  As part of the 
212.28  assessment, the county public health nurse will consult with the 
212.29  recipient or responsible party and identify the most appropriate 
212.30  person to provide supervision of the personal care assistant.  
212.31  The qualified professional shall perform the duties described in 
212.32  Minnesota Rules, part 9505.0335, subpart 4.  
212.33     Sec. 39.  Minnesota Statutes 1998, section 256B.0625, 
212.34  subdivision 26, is amended to read: 
212.35     Subd. 26.  [SPECIAL EDUCATION SERVICES.] (a) Medical 
212.36  assistance covers medical services identified in a recipient's 
213.1   individualized education plan and covered under the medical 
213.2   assistance state plan.  Covered services include occupational 
213.3   therapy, physical therapy, speech-language therapy, clinical 
213.4   psychological services, nursing services, school psychological 
213.5   services, school social work services, personal care assistants 
213.6   serving as management aides, assistive technology devices, 
213.7   transportation services, and other services covered under the 
213.8   medical assistance state plan.  The services may be provided by 
213.9   a Minnesota school district that is enrolled as a medical 
213.10  assistance provider or its subcontractor, and only if the 
213.11  services meet all the requirements otherwise applicable if the 
213.12  service had been provided by a provider other than a school 
213.13  district, in the following areas:  medical necessity, 
213.14  physician's orders, documentation, personnel qualifications, and 
213.15  prior authorization requirements.  The nonfederal share of costs 
213.16  for services provided under this subdivision is the 
213.17  responsibility of the local school district as provided in 
213.18  section 125A.74.  Services listed in a child's individual 
213.19  education plan are eligible for medical assistance reimbursement 
213.20  only if those services meet criteria for federal financial 
213.21  participation under the Medicaid program.  
213.22     (b) Approval of health-related services for inclusion in 
213.23  the individual education plan does not require prior 
213.24  authorization for purposes of reimbursement under this chapter.  
213.25  The commissioner may require physician review and approval of 
213.26  the plan not more than once annually or upon any modification of 
213.27  the individual education plan that reflects a change in 
213.28  health-related services. 
213.29     (c) Services of a speech-language pathologist provided 
213.30  under this section are covered notwithstanding Minnesota Rules, 
213.31  part 9505.0390, subpart 1, item L, if the person: 
213.32     (1) holds a masters degree in speech-language pathology; 
213.33     (2) is licensed by the Minnesota board of teaching as an 
213.34  educational speech-language pathologist; and 
213.35     (3) either has a certificate of clinical competence from 
213.36  the American Speech and Hearing Association, has completed the 
214.1   equivalent educational requirements and work experience 
214.2   necessary for the certificate or has completed the academic 
214.3   program and is acquiring supervised work experience to qualify 
214.4   for the certificate. 
214.5      (d) Medical assistance coverage for medically necessary 
214.6   services provided under other subdivisions in this section may 
214.7   not be denied solely on the basis that the same or similar 
214.8   services are covered under this subdivision. 
214.9      (e) The commissioner shall develop and implement package 
214.10  rates, bundled rates, or per diem rates for special education 
214.11  services under which separately covered services are grouped 
214.12  together and billed as a unit in order to reduce administrative 
214.13  complexity.  
214.14     (f) The commissioner shall develop a cost-based payment 
214.15  structure for payment of these services.  
214.16     (g) Effective July 1, 2000, medical assistance services 
214.17  provided under an individual education plan or an individual 
214.18  family service plan by local school districts shall not count 
214.19  against medical assistance authorization thresholds for that 
214.20  child. 
214.21     (Effective Date: Section 39 (256B.0625, subdivision 26) is 
214.22  effective July 1, 2000.) 
214.23     Sec. 40.  Minnesota Statutes 1998, section 256B.0625, 
214.24  subdivision 28, is amended to read: 
214.25     Subd. 28.  [CERTIFIED NURSE PRACTITIONER SERVICES.] Medical 
214.26  assistance covers services performed by a certified pediatric 
214.27  nurse practitioner, a certified family nurse practitioner, a 
214.28  certified adult nurse practitioner, a certified 
214.29  obstetric/gynecological nurse practitioner, a certified neonatal 
214.30  nurse practitioner, or a certified geriatric nurse practitioner 
214.31  in independent practice, if services provided on an inpatient 
214.32  basis are not included as part of the cost for inpatient 
214.33  services included in the operating payment rate, if the services 
214.34  are otherwise covered under this chapter as a physician service, 
214.35  and if the service is within the scope of practice of the nurse 
214.36  practitioner's license as a registered nurse, as defined in 
215.1   section 148.171. 
215.2      Sec. 41.  Minnesota Statutes 1998, section 256B.0625, 
215.3   subdivision 30, is amended to read: 
215.4      Subd. 30.  [OTHER CLINIC SERVICES.] (a) Medical assistance 
215.5   covers rural health clinic services, federally qualified health 
215.6   center services, nonprofit community health clinic services, 
215.7   public health clinic services, and the services of a clinic 
215.8   meeting the criteria established in rule by the commissioner.  
215.9   Rural health clinic services and federally qualified health 
215.10  center services mean services defined in United States Code, 
215.11  title 42, section 1396d(a)(2)(B) and (C).  Payment for rural 
215.12  health clinic and federally qualified health center services 
215.13  shall be made according to applicable federal law and regulation.
215.14     (b) A federally qualified health center that is beginning 
215.15  initial operation shall submit an estimate of budgeted costs and 
215.16  visits for the initial reporting period in the form and detail 
215.17  required by the commissioner.  A federally qualified health 
215.18  center that is already in operation shall submit an initial 
215.19  report using actual costs and visits for the initial reporting 
215.20  period.  Within 90 days of the end of its reporting period, a 
215.21  federally qualified health center shall submit, in the form and 
215.22  detail required by the commissioner, a report of its operations, 
215.23  including allowable costs actually incurred for the period and 
215.24  the actual number of visits for services furnished during the 
215.25  period, and other information required by the commissioner.  
215.26  Federally qualified health centers that file Medicare cost 
215.27  reports shall provide the commissioner with a copy of the most 
215.28  recent Medicare cost report filed with the Medicare program 
215.29  intermediary for the reporting year which support the costs 
215.30  claimed on their cost report to the state. 
215.31     (c) In order to continue cost-based payment under the 
215.32  medical assistance program according to paragraphs (a) and (b), 
215.33  a federally qualified health center or rural health clinic must 
215.34  apply for designation as an essential community provider within 
215.35  six months of final adoption of rules by the department of 
215.36  health according to section 62Q.19, subdivision 7.  For those 
216.1   federally qualified health centers and rural health clinics that 
216.2   have applied for essential community provider status within the 
216.3   six-month time prescribed, medical assistance payments will 
216.4   continue to be made according to paragraphs (a) and (b) for the 
216.5   first three years after application.  For federally qualified 
216.6   health centers and rural health clinics that either do not apply 
216.7   within the time specified above or who have had essential 
216.8   community provider status for three years, medical assistance 
216.9   payments for health services provided by these entities shall be 
216.10  according to the same rates and conditions applicable to the 
216.11  same service provided by health care providers that are not 
216.12  federally qualified health centers or rural health clinics.  
216.13  This paragraph takes effect only if the Minnesota health care 
216.14  reform waiver is approved by the federal government, and remains 
216.15  in effect for as long as the Minnesota health care reform waiver 
216.16  remains in effect.  When the waiver expires, this paragraph 
216.17  expires, and the commissioner of human services shall publish a 
216.18  notice in the State Register and notify the revisor of statutes. 
216.19     (d) Effective July 1, 1999, the provisions of paragraph (c) 
216.20  requiring a federally qualified health center or a rural health 
216.21  clinic to make application for an essential community provider 
216.22  designation in order to have cost-based payments made according 
216.23  to paragraphs (a) and (b) no longer apply. 
216.24     (e) Effective January 1, 2000, payments made according to 
216.25  paragraphs (a) and (b) shall be limited to the cost phase-out 
216.26  schedule of the Balanced Budget Act of 1997. 
216.27     Sec. 42.  Minnesota Statutes 1998, section 256B.0625, 
216.28  subdivision 32, is amended to read: 
216.29     Subd. 32.  [NUTRITIONAL PRODUCTS.] (a) Medical assistance 
216.30  covers nutritional products needed for nutritional 
216.31  supplementation because solid food or nutrients thereof cannot 
216.32  be properly absorbed by the body or needed for treatment of 
216.33  phenylketonuria, hyperlysinemia, maple syrup urine disease, a 
216.34  combined allergy to human milk, cow's milk, and soy formula, or 
216.35  any other childhood or adult diseases, conditions, or disorders 
216.36  identified by the commissioner as requiring a similarly 
217.1   necessary nutritional product.  Nutritional products needed for 
217.2   the treatment of a combined allergy to human milk, cow's milk, 
217.3   and soy formula require prior authorization.  Separate payment 
217.4   shall not be made for nutritional products for residents of 
217.5   long-term care facilities.  Payment for dietary requirements is 
217.6   a component of the per diem rate paid to these facilities. 
217.7      (b) The commissioner shall designate a nutritional 
217.8   supplementation products advisory committee to advise the 
217.9   commissioner on nutritional supplementation products for which 
217.10  payment is made.  The committee shall consist of nine members, 
217.11  one of whom shall be a physician, one of whom shall be a 
217.12  pharmacist, two of whom shall be registered dietitians, one of 
217.13  whom shall be a public health nurse, one of whom shall be a 
217.14  representative of a home health care agency, one of whom shall 
217.15  be a provider of long-term care services, and two of whom shall 
217.16  be consumers of nutritional supplementation products.  Committee 
217.17  members shall serve two-year terms and shall serve without 
217.18  compensation. 
217.19     (c) The advisory committee shall review and recommend 
217.20  nutritional supplementation products which require prior 
217.21  authorization.  The commissioner shall develop procedures for 
217.22  the operation of the advisory committee so that the advisory 
217.23  committee operates in a manner parallel to the drug formulary 
217.24  committee. 
217.25     Sec. 43.  Minnesota Statutes 1998, section 256B.0625, 
217.26  subdivision 35, is amended to read: 
217.27     Subd. 35.  [FAMILY COMMUNITY SUPPORT SERVICES.] Medical 
217.28  assistance covers family community support services as defined 
217.29  in section 245.4871, subdivision 17.  In addition to the 
217.30  provisions of section 245.4871, and to the extent authorized by 
217.31  rules promulgated by the state agency, medical assistance covers 
217.32  the following services as family community support services: 
217.33     (1) services identified in an individual treatment plan 
217.34  when provided by a trained mental health behavioral aide under 
217.35  the direction of a mental health practitioner or mental health 
217.36  professional; 
218.1      (2) mental health crisis intervention and crisis 
218.2   stabilization services provided outside of hospital inpatient 
218.3   settings; and 
218.4      (3) the therapeutic components of preschool and therapeutic 
218.5   camp programs. 
218.6      Sec. 44.  Minnesota Statutes 1998, section 256B.0627, 
218.7   subdivision 1, is amended to read: 
218.8      Subdivision 1.  [DEFINITION.] (a) "Assessment" means a 
218.9   review and evaluation of a recipient's need for home care 
218.10  services conducted in person.  Assessments for private duty 
218.11  nursing shall be conducted by a registered private duty nurse.  
218.12  Assessments for home health agency services shall be conducted 
218.13  by a home health agency nurse.  Assessments for personal 
218.14  care assistant services shall be conducted by the county public 
218.15  health nurse or a certified public health nurse under contract 
218.16  with the county.  An initial assessment for personal care 
218.17  services is conducted on individuals who are requesting personal 
218.18  care services or for those consumers who have never had a public 
218.19  health nurse assessment.  The initial A face-to-face assessment 
218.20  must include:  a face-to-face health status assessment and 
218.21  determination of baseline need, evaluation of service outcomes, 
218.22  collection of initial case data, identification of appropriate 
218.23  services and service plan development or modification, 
218.24  coordination of initial services, referrals and follow-up to 
218.25  appropriate payers and community resources, completion of 
218.26  required reports, obtaining service authorization, and consumer 
218.27  education.  A reassessment visit face-to-face assessment for 
218.28  personal care services is conducted on those recipients who have 
218.29  never had a county public health nurse assessment.  A 
218.30  face-to-face assessment must occur at least annually or when 
218.31  there is a significant change in consumer recipient condition 
218.32  and or when there is a change in the need for personal care 
218.33  assistant services.  The reassessment visit A service update may 
218.34  substitute for the annual face-to-face assessment when there is 
218.35  not a significant change in recipient condition or a change in 
218.36  the need for personal care assistant service.  A service update 
219.1   or review for temporary increase includes a review of initial 
219.2   baseline data, evaluation of service outcomes, redetermination 
219.3   of service need, modification of service plan and appropriate 
219.4   referrals, update of initial forms, obtaining service 
219.5   authorization, and on going consumer education.  Assessments for 
219.6   medical assistance home care services for mental retardation or 
219.7   related conditions and alternative care services for 
219.8   developmentally disabled home and community-based waivered 
219.9   recipients may be conducted by the county public health nurse to 
219.10  ensure coordination and avoid duplication.  Assessments must be 
219.11  completed on forms provided by the commissioner within 30 days 
219.12  of a request for home care services by a recipient or 
219.13  responsible party. 
219.14     (b) "Care plan" means a written description of personal 
219.15  care assistant services developed by the agency nurse qualified 
219.16  professional with the recipient or responsible party to be used 
219.17  by the personal care assistant with a copy provided to the 
219.18  recipient or responsible party. 
219.19     (c) "Home care services" means a health service, determined 
219.20  by the commissioner as medically necessary, that is ordered by a 
219.21  physician and documented in a service plan that is reviewed by 
219.22  the physician at least once every 60 62 days for the provision 
219.23  of home health services, or private duty nursing, or at least 
219.24  once every 365 days for personal care.  Home care services are 
219.25  provided to the recipient at the recipient's residence that is a 
219.26  place other than a hospital or long-term care facility or as 
219.27  specified in section 256B.0625.  
219.28     (d) "Medically necessary" has the meaning given in 
219.29  Minnesota Rules, parts 9505.0170 to 9505.0475.  
219.30     (e) "Personal care assistant" means a person who:  (1) is 
219.31  at least 18 years old, except for persons 16 to 18 years of age 
219.32  who participated in a related school-based job training program 
219.33  or have completed a certified home health aide competency 
219.34  evaluation; (2) is able to effectively communicate with the 
219.35  recipient and personal care provider organization; (3) effective 
219.36  July 1, 1996, has completed one of the training requirements as 
220.1   specified in Minnesota Rules, part 9505.0335, subpart 3, items A 
220.2   to D; (4) has the ability to, and provides covered personal care 
220.3   services according to the recipient's care plan, responds 
220.4   appropriately to recipient needs, and reports changes in the 
220.5   recipient's condition to the supervising registered nurse 
220.6   qualified professional; 
220.7      (5) is not a consumer of personal care services; and (6) is 
220.8   subject to criminal background checks and procedures specified 
220.9   in section 245A.04.  An individual who has been convicted of a 
220.10  crime specified in Minnesota Rules, part 4668.0020, subpart 14, 
220.11  or a comparable crime in another jurisdiction is disqualified 
220.12  from being a personal care assistant, unless the individual 
220.13  meets the rehabilitation criteria specified in Minnesota Rules, 
220.14  part 4668.0020, subpart 15. 
220.15     (f) "Personal care provider organization" means an 
220.16  organization enrolled to provide personal care services under 
220.17  the medical assistance program that complies with the 
220.18  following:  (1) owners who have a five percent interest or more, 
220.19  and managerial officials are subject to a background study as 
220.20  provided in section 245A.04.  This applies to currently enrolled 
220.21  personal care provider organizations and those agencies seeking 
220.22  enrollment as a personal care provider organization.  An 
220.23  organization will be barred from enrollment if an owner or 
220.24  managerial official of the organization has been convicted of a 
220.25  crime specified in section 245A.04, or a comparable crime in 
220.26  another jurisdiction, unless the owner or managerial official 
220.27  meets the reconsideration criteria specified in section 245A.04; 
220.28  (2) the organization must maintain a surety bond and liability 
220.29  insurance throughout the duration of enrollment and provides 
220.30  proof thereof.  The insurer must notify the department of human 
220.31  services of the cancellation or lapse of policy; and (3) the 
220.32  organization must maintain documentation of services as 
220.33  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
220.34  as evidence of compliance with personal care assistant training 
220.35  requirements. 
220.36     (g) "Responsible party" means an individual residing with a 
221.1   recipient of personal care services who is capable of providing 
221.2   the supportive care necessary to assist the recipient to live in 
221.3   the community, is at least 18 years old, and is not a personal 
221.4   care assistant.  Responsible parties who are parents of minors 
221.5   or guardians of minors or incapacitated persons may delegate the 
221.6   responsibility to another adult during a temporary absence of at 
221.7   least 24 hours but not more than six months.  The person 
221.8   delegated as a responsible party must be able to meet the 
221.9   definition of responsible party, except that the delegated 
221.10  responsible party is required to reside with the recipient only 
221.11  while serving as the responsible party.  Foster care license 
221.12  holders may be designated the responsible party for residents of 
221.13  the foster care home if case management is provided as required 
221.14  in section 256B.0625, subdivision 19a.  For persons who, as of 
221.15  April 1, 1992, are sharing personal care services in order to 
221.16  obtain the availability of 24-hour coverage, an employee of the 
221.17  personal care provider organization may be designated as the 
221.18  responsible party if case management is provided as required in 
221.19  section 256B.0625, subdivision 19a. 
221.20     (h) "Service plan" means a written description of the 
221.21  services needed based on the assessment developed by the nurse 
221.22  who conducts the assessment together with the recipient or 
221.23  responsible party.  The service plan shall include a description 
221.24  of the covered home care services, frequency and duration of 
221.25  services, and expected outcomes and goals.  The recipient and 
221.26  the provider chosen by the recipient or responsible party must 
221.27  be given a copy of the completed service plan within 30 calendar 
221.28  days of the request for home care services by the recipient or 
221.29  responsible party. 
221.30     (i) "Skilled nurse visits" are provided in a recipient's 
221.31  residence under a plan of care or service plan that specifies a 
221.32  level of care which the nurse is qualified to provide.  These 
221.33  services are: 
221.34     (1) nursing services according to the written plan of care 
221.35  or service plan and accepted standards of medical and nursing 
221.36  practice in accordance with chapter 148; 
222.1      (2) services which due to the recipient's medical condition 
222.2   may only be safely and effectively provided by a registered 
222.3   nurse or a licensed practical nurse; 
222.4      (3) assessments performed only by a registered nurse; and 
222.5      (4) teaching and training the recipient, the recipient's 
222.6   family, or other caregivers requiring the skills of a registered 
222.7   nurse or licensed practical nurse.  
222.8      Sec. 45.  Minnesota Statutes 1998, section 256B.0627, 
222.9   subdivision 2, is amended to read: 
222.10     Subd. 2.  [SERVICES COVERED.] Home care services covered 
222.11  under this section include:  
222.12     (1) nursing services under section 256B.0625, subdivision 
222.13  6a; 
222.14     (2) private duty nursing services under section 256B.0625, 
222.15  subdivision 7; 
222.16     (3) home health aide services under section 256B.0625, 
222.17  subdivision 6a; 
222.18     (4) personal care services under section 256B.0625, 
222.19  subdivision 19a; 
222.20     (5) nursing supervision of personal care assistant services 
222.21  provided by a qualified professional under section 256B.0625, 
222.22  subdivision 19a; and 
222.23     (6) consulting professional of personal care assistant 
222.24  services under the fiscal agent option as specified in 
222.25  subdivision 10; 
222.26     (7) face-to-face assessments by county public health nurses 
222.27  for services under section 256B.0625, subdivision 19a; and 
222.28     (8) service updates and review of temporary increases for 
222.29  personal care assistant services by the county public health 
222.30  nurse for services under section 256B.0625, subdivision 19a. 
222.31     Sec. 46.  Minnesota Statutes 1998, section 256B.0627, 
222.32  subdivision 4, is amended to read: 
222.33     Subd. 4.  [PERSONAL CARE SERVICES.] (a) The personal care 
222.34  services that are eligible for payment are the following:  
222.35     (1) bowel and bladder care; 
222.36     (2) skin care to maintain the health of the skin; 
223.1      (3) repetitive maintenance range of motion, muscle 
223.2   strengthening exercises, and other tasks specific to maintaining 
223.3   a recipient's optimal level of function; 
223.4      (4) respiratory assistance; 
223.5      (5) transfers and ambulation; 
223.6      (6) bathing, grooming, and hairwashing necessary for 
223.7   personal hygiene; 
223.8      (7) turning and positioning; 
223.9      (8) assistance with furnishing medication that is 
223.10  self-administered; 
223.11     (9) application and maintenance of prosthetics and 
223.12  orthotics; 
223.13     (10) cleaning medical equipment; 
223.14     (11) dressing or undressing; 
223.15     (12) assistance with eating and meal preparation and 
223.16  necessary grocery shopping; 
223.17     (13) accompanying a recipient to obtain medical diagnosis 
223.18  or treatment; 
223.19     (14) assisting, monitoring, or prompting the recipient to 
223.20  complete the services in clauses (1) to (13); 
223.21     (15) redirection, monitoring, and observation that are 
223.22  medically necessary and an integral part of completing the 
223.23  personal care services described in clauses (1) to (14); 
223.24     (16) redirection and intervention for behavior, including 
223.25  observation and monitoring; 
223.26     (17) interventions for seizure disorders, including 
223.27  monitoring and observation if the recipient has had a seizure 
223.28  that requires intervention within the past three months; 
223.29     (18) tracheostomy suctioning using a clean procedure if the 
223.30  procedure is properly delegated by a registered nurse.  Before 
223.31  this procedure can be delegated to a personal care assistant, a 
223.32  registered nurse must determine that the tracheostomy suctioning 
223.33  can be accomplished utilizing a clean rather than a sterile 
223.34  procedure and must ensure that the personal care assistant has 
223.35  been taught the proper procedure; and 
223.36     (19) incidental household services that are an integral 
224.1   part of a personal care service described in clauses (1) to (18).
224.2   For purposes of this subdivision, monitoring and observation 
224.3   means watching for outward visible signs that are likely to 
224.4   occur and for which there is a covered personal care service or 
224.5   an appropriate personal care intervention.  For purposes of this 
224.6   subdivision, a clean procedure refers to a procedure that 
224.7   reduces the numbers of microorganisms or prevents or reduces the 
224.8   transmission of microorganisms from one person or place to 
224.9   another.  A clean procedure may be used beginning 14 days after 
224.10  insertion. 
224.11     (b) The personal care services that are not eligible for 
224.12  payment are the following:  
224.13     (1) services not ordered by the physician; 
224.14     (2) assessments by personal care provider organizations or 
224.15  by independently enrolled registered nurses; 
224.16     (3) services that are not in the service plan; 
224.17     (4) services provided by the recipient's spouse, legal 
224.18  guardian for an adult or child recipient, or parent of a 
224.19  recipient under age 18; 
224.20     (5) services provided by a foster care provider of a 
224.21  recipient who cannot direct the recipient's own care, unless 
224.22  monitored by a county or state case manager under section 
224.23  256B.0625, subdivision 19a; 
224.24     (6) services provided by the residential or program license 
224.25  holder in a residence for more than four persons; 
224.26     (7) services that are the responsibility of a residential 
224.27  or program license holder under the terms of a service agreement 
224.28  and administrative rules; 
224.29     (8) sterile procedures; 
224.30     (9) injections of fluids into veins, muscles, or skin; 
224.31     (10) services provided by parents of adult recipients, 
224.32  adult children, or adult siblings of the recipient, unless these 
224.33  relatives meet one of the following hardship criteria and the 
224.34  commissioner waives this requirement: 
224.35     (i) the relative resigns from a part-time or full-time job 
224.36  to provide personal care for the recipient; 
225.1      (ii) the relative goes from a full-time to a part-time job 
225.2   with less compensation to provide personal care for the 
225.3   recipient; 
225.4      (iii) the relative takes a leave of absence without pay to 
225.5   provide personal care for the recipient; 
225.6      (iv) the relative incurs substantial expenses by providing 
225.7   personal care for the recipient; or 
225.8      (v) because of labor conditions, special language needs, or 
225.9   intermittent hours of care needed, the relative is needed in 
225.10  order to provide an adequate number of qualified personal care 
225.11  assistants to meet the medical needs of the recipient; 
225.12     (11) homemaker services that are not an integral part of a 
225.13  personal care services; 
225.14     (12) home maintenance, or chore services; 
225.15     (13) services not specified under paragraph (a); and 
225.16     (14) services not authorized by the commissioner or the 
225.17  commissioner's designee. 
225.18     Sec. 47.  Minnesota Statutes 1998, section 256B.0627, 
225.19  subdivision 5, is amended to read: 
225.20     Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
225.21  payments for home care services shall be limited according to 
225.22  this subdivision.  
225.23     (a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 
225.24  recipient may receive the following home care services during a 
225.25  calendar year: 
225.26     (1) any initial assessment up to two face-to-face 
225.27  assessments to determine a recipient's need for personal care 
225.28  assistant services; 
225.29     (2) up to two reassessments per year one service update 
225.30  done to determine a recipient's need for personal care services; 
225.31  and 
225.32     (3) up to five skilled nurse visits.  
225.33     (b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
225.34  services above the limits in paragraph (a) must receive the 
225.35  commissioner's prior authorization, except when: 
225.36     (1) the home care services were required to treat an 
226.1   emergency medical condition that if not immediately treated 
226.2   could cause a recipient serious physical or mental disability, 
226.3   continuation of severe pain, or death.  The provider must 
226.4   request retroactive authorization no later than five working 
226.5   days after giving the initial service.  The provider must be 
226.6   able to substantiate the emergency by documentation such as 
226.7   reports, notes, and admission or discharge histories; 
226.8      (2) the home care services were provided on or after the 
226.9   date on which the recipient's eligibility began, but before the 
226.10  date on which the recipient was notified that the case was 
226.11  opened.  Authorization will be considered if the request is 
226.12  submitted by the provider within 20 working days of the date the 
226.13  recipient was notified that the case was opened; 
226.14     (3) a third-party payor for home care services has denied 
226.15  or adjusted a payment.  Authorization requests must be submitted 
226.16  by the provider within 20 working days of the notice of denial 
226.17  or adjustment.  A copy of the notice must be included with the 
226.18  request; 
226.19     (4) the commissioner has determined that a county or state 
226.20  human services agency has made an error; or 
226.21     (5) the professional nurse determines an immediate need for 
226.22  up to 40 skilled nursing or home health aide visits per calendar 
226.23  year and submits a request for authorization within 20 working 
226.24  days of the initial service date, and medical assistance is 
226.25  determined to be the appropriate payer. 
226.26     (c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive 
226.27  authorization will be evaluated according to the same criteria 
226.28  applied to prior authorization requests.  
226.29     (d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under 
226.30  section 256B.0627, subdivision 1, paragraph (a), shall be 
226.31  conducted initially, and at least annually thereafter, in person 
226.32  with the recipient and result in a completed service plan using 
226.33  forms specified by the commissioner.  Within 30 days of 
226.34  recipient or responsible party request for home care services, 
226.35  the assessment, the service plan, and other information 
226.36  necessary to determine medical necessity such as diagnostic or 
227.1   testing information, social or medical histories, and hospital 
227.2   or facility discharge summaries shall be submitted to the 
227.3   commissioner.  For personal care services: 
227.4      (1) The amount and type of service authorized based upon 
227.5   the assessment and service plan will follow the recipient if the 
227.6   recipient chooses to change providers.  
227.7      (2) If the recipient's medical need changes, the 
227.8   recipient's provider may assess the need for a change in service 
227.9   authorization and request the change from the county public 
227.10  health nurse.  Within 30 days of the request, the public health 
227.11  nurse will determine whether to request the change in services 
227.12  based upon the provider assessment, or conduct a home visit to 
227.13  assess the need and determine whether the change is appropriate. 
227.14     (3) To continue to receive personal care services after the 
227.15  first year, the recipient or the responsible party, in 
227.16  conjunction with the public health nurse, may complete a service 
227.17  update on forms developed by the commissioner according to 
227.18  criteria and procedures in subdivision 1.  The service update 
227.19  may substitute for the annual reassessment described in 
227.20  subdivision 1. 
227.21     (e)  [PRIOR AUTHORIZATION.] The commissioner, or the 
227.22  commissioner's designee, shall review the assessment, the 
227.23  service update, request for temporary services, service plan, 
227.24  and any additional information that is submitted.  The 
227.25  commissioner shall, within 30 days after receiving a complete 
227.26  request, assessment, and service plan, authorize home care 
227.27  services as follows:  
227.28     (1)  [HOME HEALTH SERVICES.] All home health services 
227.29  provided by a licensed nurse or a home health aide must be prior 
227.30  authorized by the commissioner or the commissioner's designee.  
227.31  Prior authorization must be based on medical necessity and 
227.32  cost-effectiveness when compared with other care options.  When 
227.33  home health services are used in combination with personal care 
227.34  and private duty nursing, the cost of all home care services 
227.35  shall be considered for cost-effectiveness.  The commissioner 
227.36  shall limit nurse and home health aide visits to no more than 
228.1   one visit each per day. 
228.2      (2)  [PERSONAL CARE SERVICES.] (i) All personal care 
228.3   services and registered nurse supervision by a qualified 
228.4   professional must be prior authorized by the commissioner or the 
228.5   commissioner's designee except for the assessments established 
228.6   in paragraph (a).  The amount of personal care services 
228.7   authorized must be based on the recipient's home care rating.  A 
228.8   child may not be found to be dependent in an activity of daily 
228.9   living if because of the child's age an adult would either 
228.10  perform the activity for the child or assist the child with the 
228.11  activity and the amount of assistance needed is similar to the 
228.12  assistance appropriate for a typical child of the same age.  
228.13  Based on medical necessity, the commissioner may authorize: 
228.14     (A) up to two times the average number of direct care hours 
228.15  provided in nursing facilities for the recipient's comparable 
228.16  case mix level; or 
228.17     (B) up to three times the average number of direct care 
228.18  hours provided in nursing facilities for recipients who have 
228.19  complex medical needs or are dependent in at least seven 
228.20  activities of daily living and need physical assistance with 
228.21  eating or have a neurological diagnosis; or 
228.22     (C) up to 60 percent of the average reimbursement rate, as 
228.23  of July 1, 1991, for care provided in a regional treatment 
228.24  center for recipients who have Level I behavior, plus any 
228.25  inflation adjustment as provided by the legislature for personal 
228.26  care service; or 
228.27     (D) up to the amount the commissioner would pay, as of July 
228.28  1, 1991, plus any inflation adjustment provided for home care 
228.29  services, for care provided in a regional treatment center for 
228.30  recipients referred to the commissioner by a regional treatment 
228.31  center preadmission evaluation team.  For purposes of this 
228.32  clause, home care services means all services provided in the 
228.33  home or community that would be included in the payment to a 
228.34  regional treatment center; or 
228.35     (E) up to the amount medical assistance would reimburse for 
228.36  facility care for recipients referred to the commissioner by a 
229.1   preadmission screening team established under section 256B.0911 
229.2   or 256B.092; and 
229.3      (F) a reasonable amount of time for the provision of 
229.4   nursing supervision by a qualified professional of personal care 
229.5   services.  
229.6      (ii) The number of direct care hours shall be determined 
229.7   according to the annual cost report submitted to the department 
229.8   by nursing facilities.  The average number of direct care hours, 
229.9   as established by May 1, 1992, shall be calculated and 
229.10  incorporated into the home care limits on July 1, 1992.  These 
229.11  limits shall be calculated to the nearest quarter hour. 
229.12     (iii) The home care rating shall be determined by the 
229.13  commissioner or the commissioner's designee based on information 
229.14  submitted to the commissioner by the county public health nurse 
229.15  on forms specified by the commissioner.  The home care rating 
229.16  shall be a combination of current assessment tools developed 
229.17  under sections 256B.0911 and 256B.501 with an addition for 
229.18  seizure activity that will assess the frequency and severity of 
229.19  seizure activity and with adjustments, additions, and 
229.20  clarifications that are necessary to reflect the needs and 
229.21  conditions of recipients who need home care including children 
229.22  and adults under 65 years of age.  The commissioner shall 
229.23  establish these forms and protocols under this section and shall 
229.24  use an advisory group, including representatives of recipients, 
229.25  providers, and counties, for consultation in establishing and 
229.26  revising the forms and protocols. 
229.27     (iv) A recipient shall qualify as having complex medical 
229.28  needs if the care required is difficult to perform and because 
229.29  of recipient's medical condition requires more time than 
229.30  community-based standards allow or requires more skill than 
229.31  would ordinarily be required and the recipient needs or has one 
229.32  or more of the following: 
229.33     (A) daily tube feedings; 
229.34     (B) daily parenteral therapy; 
229.35     (C) wound or decubiti care; 
229.36     (D) postural drainage, percussion, nebulizer treatments, 
230.1   suctioning, tracheotomy care, oxygen, mechanical ventilation; 
230.2      (E) catheterization; 
230.3      (F) ostomy care; 
230.4      (G) quadriplegia; or 
230.5      (H) other comparable medical conditions or treatments the 
230.6   commissioner determines would otherwise require institutional 
230.7   care.  
230.8      (v) A recipient shall qualify as having Level I behavior if 
230.9   there is reasonable supporting evidence that the recipient 
230.10  exhibits, or that without supervision, observation, or 
230.11  redirection would exhibit, one or more of the following 
230.12  behaviors that cause, or have the potential to cause: 
230.13     (A) injury to the recipient's own body; 
230.14     (B) physical injury to other people; or 
230.15     (C) destruction of property. 
230.16     (vi) Time authorized for personal care relating to Level I 
230.17  behavior in subclause (v), items (A) to (C), shall be based on 
230.18  the predictability, frequency, and amount of intervention 
230.19  required. 
230.20     (vii) A recipient shall qualify as having Level II behavior 
230.21  if the recipient exhibits on a daily basis one or more of the 
230.22  following behaviors that interfere with the completion of 
230.23  personal care services under subdivision 4, paragraph (a): 
230.24     (A) unusual or repetitive habits; 
230.25     (B) withdrawn behavior; or 
230.26     (C) offensive behavior. 
230.27     (viii) A recipient with a home care rating of Level II 
230.28  behavior in subclause (vii), items (A) to (C), shall be rated as 
230.29  comparable to a recipient with complex medical needs under 
230.30  subclause (iv).  If a recipient has both complex medical needs 
230.31  and Level II behavior, the home care rating shall be the next 
230.32  complex category up to the maximum rating under subclause (i), 
230.33  item (B). 
230.34     (3)  [PRIVATE DUTY NURSING SERVICES.] All private duty 
230.35  nursing services shall be prior authorized by the commissioner 
230.36  or the commissioner's designee.  Prior authorization for private 
231.1   duty nursing services shall be based on medical necessity and 
231.2   cost-effectiveness when compared with alternative care options.  
231.3   The commissioner may authorize medically necessary private duty 
231.4   nursing services in quarter-hour units when: 
231.5      (i) the recipient requires more individual and continuous 
231.6   care than can be provided during a nurse visit; or 
231.7      (ii) the cares are outside of the scope of services that 
231.8   can be provided by a home health aide or personal care assistant.
231.9      The commissioner may authorize: 
231.10     (A) up to two times the average amount of direct care hours 
231.11  provided in nursing facilities statewide for case mix 
231.12  classification "K" as established by the annual cost report 
231.13  submitted to the department by nursing facilities in May 1992; 
231.14     (B) private duty nursing in combination with other home 
231.15  care services up to the total cost allowed under clause (2); 
231.16     (C) up to 16 hours per day if the recipient requires more 
231.17  nursing than the maximum number of direct care hours as 
231.18  established in item (A) and the recipient meets the hospital 
231.19  admission criteria established under Minnesota Rules, parts 
231.20  9505.0500 to 9505.0540.  
231.21     The commissioner may authorize up to 16 hours per day of 
231.22  medically necessary private duty nursing services or up to 24 
231.23  hours per day of medically necessary private duty nursing 
231.24  services until such time as the commissioner is able to make a 
231.25  determination of eligibility for recipients who are 
231.26  cooperatively applying for home care services under the 
231.27  community alternative care program developed under section 
231.28  256B.49, or until it is determined by the appropriate regulatory 
231.29  agency that a health benefit plan is or is not required to pay 
231.30  for appropriate medically necessary health care services.  
231.31  Recipients or their representatives must cooperatively assist 
231.32  the commissioner in obtaining this determination.  Recipients 
231.33  who are eligible for the community alternative care program may 
231.34  not receive more hours of nursing under this section than would 
231.35  otherwise be authorized under section 256B.49. 
231.36     (4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 
232.1   ventilator-dependent, the monthly medical assistance 
232.2   authorization for home care services shall not exceed what the 
232.3   commissioner would pay for care at the highest cost hospital 
232.4   designated as a long-term hospital under the Medicare program.  
232.5   For purposes of this clause, home care services means all 
232.6   services provided in the home that would be included in the 
232.7   payment for care at the long-term hospital.  
232.8   "Ventilator-dependent" means an individual who receives 
232.9   mechanical ventilation for life support at least six hours per 
232.10  day and is expected to be or has been dependent for at least 30 
232.11  consecutive days.  
232.12     (f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 
232.13  or the commissioner's designee shall determine the time period 
232.14  for which a prior authorization shall be effective.  If the 
232.15  recipient continues to require home care services beyond the 
232.16  duration of the prior authorization, the home care provider must 
232.17  request a new prior authorization.  Under no circumstances, 
232.18  other than the exceptions in paragraph (b), shall a prior 
232.19  authorization be valid prior to the date the commissioner 
232.20  receives the request or for more than 12 months.  A recipient 
232.21  who appeals a reduction in previously authorized home care 
232.22  services may continue previously authorized services, other than 
232.23  temporary services under paragraph (h), pending an appeal under 
232.24  section 256.045.  The commissioner must provide a detailed 
232.25  explanation of why the authorized services are reduced in amount 
232.26  from those requested by the home care provider.  
232.27     (g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or 
232.28  the commissioner's designee shall determine the medical 
232.29  necessity of home care services, the level of caregiver 
232.30  according to subdivision 2, and the institutional comparison 
232.31  according to this subdivision, the cost-effectiveness of 
232.32  services, and the amount, scope, and duration of home care 
232.33  services reimbursable by medical assistance, based on the 
232.34  assessment, primary payer coverage determination information as 
232.35  required, the service plan, the recipient's age, the cost of 
232.36  services, the recipient's medical condition, and diagnosis or 
233.1   disability.  The commissioner may publish additional criteria 
233.2   for determining medical necessity according to section 256B.04. 
233.3      (h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 
233.4   The agency nurse, the independently enrolled private duty nurse, 
233.5   or county public health nurse may request a temporary 
233.6   authorization for home care services by telephone.  The 
233.7   commissioner may approve a temporary level of home care services 
233.8   based on the assessment, and service or care plan information, 
233.9   and primary payer coverage determination information as required.
233.10  Authorization for a temporary level of home care services 
233.11  including nurse supervision is limited to the time specified by 
233.12  the commissioner, but shall not exceed 45 days, unless extended 
233.13  because the county public health nurse has not completed the 
233.14  required assessment and service plan, or the commissioner's 
233.15  determination has not been made.  The level of services 
233.16  authorized under this provision shall have no bearing on a 
233.17  future prior authorization. 
233.18     (i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 
233.19  Home care services provided in an adult or child foster care 
233.20  setting must receive prior authorization by the department 
233.21  according to the limits established in paragraph (a). 
233.22     The commissioner may not authorize: 
233.23     (1) home care services that are the responsibility of the 
233.24  foster care provider under the terms of the foster care 
233.25  placement agreement and administrative rules.  Requests for home 
233.26  care services for recipients residing in a foster care setting 
233.27  must include the foster care placement agreement and 
233.28  determination of difficulty of care; 
233.29     (2) personal care services when the foster care license 
233.30  holder is also the personal care provider or personal care 
233.31  assistant unless the recipient can direct the recipient's own 
233.32  care, or case management is provided as required in section 
233.33  256B.0625, subdivision 19a; 
233.34     (3) personal care services when the responsible party is an 
233.35  employee of, or under contract with, or has any direct or 
233.36  indirect financial relationship with the personal care provider 
234.1   or personal care assistant, unless case management is provided 
234.2   as required in section 256B.0625, subdivision 19a; 
234.3      (4) home care services when the number of foster care 
234.4   residents is greater than four unless the county responsible for 
234.5   the recipient's foster placement made the placement prior to 
234.6   April 1, 1992, requests that home care services be provided, and 
234.7   case management is provided as required in section 256B.0625, 
234.8   subdivision 19a; or 
234.9      (5) home care services when combined with foster care 
234.10  payments, other than room and board payments that exceed the 
234.11  total amount that public funds would pay for the recipient's 
234.12  care in a medical institution. 
234.13     Sec. 48.  Minnesota Statutes 1998, section 256B.0627, 
234.14  subdivision 8, is amended to read: 
234.15     Subd. 8.  [SHARED PERSONAL CARE ASSISTANT SERVICES; SHARED 
234.16  CARE.] (a) Medical assistance payments for shared personal care 
234.17  assistance shared care services shall be limited according to 
234.18  this subdivision. 
234.19     (b) Recipients of personal care assistant services may 
234.20  share staff and the commissioner shall provide a rate system for 
234.21  shared personal care assistant services.  For two persons 
234.22  sharing care services, the rate paid to a provider shall not 
234.23  exceed 1-1/2 times the rate paid for serving a single 
234.24  individual, and for three persons sharing care services, the 
234.25  rate paid to a provider shall not exceed twice the rate paid for 
234.26  serving a single individual.  These rates apply only to 
234.27  situations in which all recipients were present and received 
234.28  shared care services on the date for which the service is 
234.29  billed.  No more than three persons may receive shared care 
234.30  services from a personal care assistant in a single setting. 
234.31     (c) Shared care service is the provision of personal care 
234.32  services by a personal care assistant to two or three recipients 
234.33  at the same time and in the same setting.  For the purposes of 
234.34  this subdivision, "setting" means: 
234.35     (1) the home or foster care home of one of the individual 
234.36  recipients; or 
235.1      (2) a child care program in which all recipients served by 
235.2   one personal care assistant are participating, which is licensed 
235.3   under chapter 245A or operated by a local school district or 
235.4   private school.  
235.5      The provisions of this subdivision do not apply when a 
235.6   personal care assistant is caring for multiple recipients in 
235.7   more than one setting. 
235.8      (d) The recipient or the recipient's responsible party, in 
235.9   conjunction with the county public health nurse, shall determine:
235.10     (1) whether shared care personal care assistant services is 
235.11  an appropriate option based on the individual needs and 
235.12  preferences of the recipient; and 
235.13     (2) the amount of shared care services allocated as part of 
235.14  the overall authorization of personal care services. 
235.15     The recipient or the responsible party, in conjunction with 
235.16  the supervising registered nurse qualified professional, shall 
235.17  approve arrange the setting, and grouping, and arrangement of 
235.18  shared care services based on the individual needs and 
235.19  preferences of the recipients.  Decisions on the selection of 
235.20  recipients to share care services must be based on the ages of 
235.21  the recipients, compatibility, and coordination of their care 
235.22  needs. 
235.23     (e) The following items must be considered by the recipient 
235.24  or the responsible party and the supervising nurse qualified 
235.25  professional, and documented in the recipient's care plan health 
235.26  service record: 
235.27     (1) the additional qualifications needed by the personal 
235.28  care assistant to provide care to several recipients in the same 
235.29  setting; 
235.30     (2) the additional training and supervision needed by the 
235.31  personal care assistant to ensure that the needs of the 
235.32  recipient are met appropriately and safely.  The provider must 
235.33  provide on-site supervision by a registered nurse qualified 
235.34  professional within the first 14 days of shared care services, 
235.35  and monthly thereafter; 
235.36     (3) the setting in which the shared care services will be 
236.1   provided; 
236.2      (4) the ongoing monitoring and evaluation of the 
236.3   effectiveness and appropriateness of the service and process 
236.4   used to make changes in service or setting; and 
236.5      (5) a contingency plan which accounts for absence of the 
236.6   recipient in a shared care services setting due to illness or 
236.7   other circumstances and staffing contingencies. 
236.8      (f) The provider must offer the recipient or the 
236.9   responsible party the option of shared or individual one-on-one 
236.10  personal care assistant care services.  The recipient or the 
236.11  responsible party can withdraw from participating in a shared 
236.12  care services arrangement at any time. 
236.13     (g) In addition to documentation requirements under 
236.14  Minnesota Rules, part 9505.2175, a personal care provider must 
236.15  meet documentation requirements for shared personal 
236.16  care assistant services and must document the following in the 
236.17  health service record for each individual recipient sharing care 
236.18  services: 
236.19     (1) authorization permission by the recipient or the 
236.20  recipient's responsible party, if any, for the maximum number of 
236.21  shared care services hours per week chosen by the recipient; 
236.22     (2) authorization permission by the recipient or the 
236.23  recipient's responsible party, if any, for personal 
236.24  care assistant services provided outside the recipient's 
236.25  residence; 
236.26     (3) authorization permission by the recipient or the 
236.27  recipient's responsible party, if any, for others to receive 
236.28  shared care services in the recipient's residence; 
236.29     (4) revocation by the recipient or the recipient's 
236.30  responsible party, if any, of the shared care service 
236.31  authorization, or the shared care service to be provided to 
236.32  others in the recipient's residence, or the shared care service 
236.33  to be provided outside the recipient's residence; 
236.34     (5) supervision of the shared care personal care assistant 
236.35  services by the supervisory nurse qualified professional, 
236.36  including the date, time of day, number of hours spent 
237.1   supervising the provision of shared care services, whether the 
237.2   supervision was face-to-face or another method of supervision, 
237.3   changes in the recipient's condition, shared care services 
237.4   scheduling issues and recommendations; 
237.5      (6) documentation by the personal care assistant qualified 
237.6   professional of telephone calls or other discussions with 
237.7   the supervisory nurse personal care assistant regarding services 
237.8   being provided to the recipient; and 
237.9      (7) daily documentation of the shared care services 
237.10  provided by each identified personal care assistant including: 
237.11     (i) the names of each recipient receiving shared care 
237.12  services together; 
237.13     (ii) the setting for the day's care shared services, 
237.14  including the starting and ending times that the recipient 
237.15  received shared care services; and 
237.16     (iii) notes by the personal care assistant regarding 
237.17  changes in the recipient's condition, problems that may arise 
237.18  from the sharing of care services, scheduling issues, care 
237.19  issues, and other notes as required by the supervising nurse 
237.20  qualified professional. 
237.21     (h) Unless otherwise provided in this subdivision, all 
237.22  other statutory and regulatory provisions relating to personal 
237.23  care services apply to shared care services. 
237.24     Nothing in this subdivision shall be construed to reduce 
237.25  the total number of hours authorized for an individual recipient.
237.26     Sec. 49.  Minnesota Statutes 1998, section 256B.0627, is 
237.27  amended by adding a subdivision to read: 
237.28     Subd. 9.  [FLEXIBLE USE OF PERSONAL CARE ASSISTANT 
237.29  HOURS.] (a) The commissioner may allow for the flexible use of 
237.30  personal care assistant hours.  "Flexible use" means the 
237.31  scheduled use of authorized hours of personal care assistant 
237.32  services which vary within the length of the service 
237.33  authorization in order to more effectively meet the needs and 
237.34  schedule of the recipient.  Recipients may use their approved 
237.35  hours flexibly within the service authorization period for 
237.36  medically necessary covered services specified in the assessment 
238.1   required in subdivision 1.  The flexible use of authorized hours 
238.2   does not increase the total amount of authorized hours available 
238.3   to a recipient as determined under subdivision 5.  The 
238.4   commissioner shall not authorize additional personal care 
238.5   assistant services to supplement a service authorization that is 
238.6   exhausted before the end date under a flexible service use plan, 
238.7   unless the county public health nurse determines a change in 
238.8   condition and a need for increased services is established. 
238.9      (b) The recipient or responsible party, together with the 
238.10  county public health nurse, shall determine whether flexible use 
238.11  is an appropriate option based on the needs and preferences of 
238.12  the recipient or responsible party, and, if appropriate, must 
238.13  ensure that the allocation of hours covers the ongoing needs of 
238.14  the recipient over the entire service authorization period.  As 
238.15  part of the assessment and service planning process, the 
238.16  recipient or responsible party works with the county public 
238.17  health nurse to develop a written month-to-month plan of the 
238.18  projected use of personal care assistant services that is part 
238.19  of the service plan and assures that: 
238.20     (1) health and safety needs of the recipient will be met; 
238.21     (2) total annual authorization will not exceed before the 
238.22  end date; and 
238.23     (3) actual use of hours will be monitored. 
238.24     (c) If the actual use of personal care assistant service 
238.25  varies significantly from the use projected in the plan, the 
238.26  written plan must be promptly updated by the recipient or 
238.27  responsible party and the county public health nurse. 
238.28     (d) The recipient or responsible party, together with the 
238.29  provider, must work to monitor and document the use of 
238.30  authorized hours and ensure that a recipient is able to manage 
238.31  services effectively throughout the authorized period.  The 
238.32  provider must assure that the month to month plan is 
238.33  incorporated into the care plan.  Upon request of the recipient 
238.34  or responsible party, the provider must furnish regular updates 
238.35  to the recipient or responsible party on the amount of personal 
238.36  care assistant services used. 
239.1      (e) The recipient or responsible party may revoke the 
239.2   authorization for flexible use of hours by notifying the 
239.3   provider and the county public health nurse in writing. 
239.4      (f) If the requirements in paragraphs (a) to (e) have not 
239.5   substantially been met, the commissioner shall deny, revoke, or 
239.6   suspend the authorization to use authorized hours flexibly.  The 
239.7   recipient or responsible party may appeal the commissioner's 
239.8   action according to section 256.045.  The denial, revocation, or 
239.9   suspension to use the flexible hours option shall not affect the 
239.10  recipient's authorized level of personal care assistant services 
239.11  as determined under subdivision 5. 
239.12     Sec. 50.  Minnesota Statutes 1998, section 256B.0627, is 
239.13  amended by adding a subdivision to read: 
239.14     Subd. 10.  [FISCAL AGENT OPTION AVAILABLE FOR PERSONAL CARE 
239.15  ASSISTANT SERVICES.] (a) "Fiscal agent option" is an option that 
239.16  allows the recipient to: 
239.17     (1) use a fiscal agent instead of a personal care provider 
239.18  organization; 
239.19     (2) supervise the personal care assistant; and 
239.20     (3) use a consulting professional.  The commissioner may 
239.21  allow a recipient of personal care assistant services to use a 
239.22  fiscal agent to assist the recipient in paying and accounting 
239.23  for medically necessary covered personal care assistant services 
239.24  authorized in subdivision 4 and within the payment parameters of 
239.25  subdivision 5.  Unless otherwise provided in this subdivision, 
239.26  all other statutory and regulatory provisions relating to 
239.27  personal care services apply to a recipient using the fiscal 
239.28  agent option. 
239.29     (b) The recipient or responsible party shall: 
239.30     (1) hire, and terminate the personal care assistant and 
239.31  consulting professional, with the fiscal agent; 
239.32     (2) recruit the personal care assistant and consulting 
239.33  professional and orient and train the personal care assistant in 
239.34  areas that do not require professional delegation as determined 
239.35  by the county public health nurse; 
239.36     (3) supervise and evaluate the personal care assistant in 
240.1   areas that do not require professional delegation as determined 
240.2   in the assessment; 
240.3      (4) cooperate with a consulting professional and implement 
240.4   recommendations pertaining to the health and safety of the 
240.5   recipient; 
240.6      (5) hire a qualified professional to train and supervise 
240.7   the performance of delegated tasks done by the personal care 
240.8   assistant; 
240.9      (6) monitor services and verify in writing the hours worked 
240.10  by the personal care assistant and the consulting professional; 
240.11     (7) develop and revise a care plan with assistance from a 
240.12  consulting professional; 
240.13     (8) verify and document the credentials of the consulting 
240.14  professional; and 
240.15     (9) enter into a written agreement, as specified in 
240.16  paragraph (f). 
240.17     (c) The duties of the fiscal agent shall be to: 
240.18     (1) bill the medical assistance program for personal care 
240.19  assistant and consulting professional services; 
240.20     (2) request and secure background checks on personal care 
240.21  assistants and consulting professionals according to section 
240.22  245A.04; 
240.23     (3) pay the personal care assistant and consulting 
240.24  professional based on actual hours of services provided; 
240.25     (4) withhold and pay all applicable federal and state 
240.26  taxes; 
240.27     (5) verify and document hours worked by the personal care 
240.28  assistant and consulting professional; 
240.29     (6) make the arrangements and pay unemployment insurance, 
240.30  taxes, workers' compensation, liability insurance, and other 
240.31  benefits, if any; 
240.32     (7) enroll in the medical assistance program as a fiscal 
240.33  agent; and 
240.34     (8) enter into a written agreement as specified in 
240.35  paragraph (f) before services are provided. 
240.36     (d) The fiscal agent: 
241.1      (1) may not be related to the recipient, consulting 
241.2   professional, or the personal care assistant; 
241.3      (2) must ensure arm's length transactions with the 
241.4   recipient and personal care assistant; and 
241.5      (3) shall be considered a joint employer of the personal 
241.6   care assistant and consulting professional to the extent 
241.7   specified in this section. 
241.8      The fiscal agent or owners of the entity that provides 
241.9   fiscal agent services under this subdivision must pass a 
241.10  criminal background check as required in section 256B.0627, 
241.11  subdivision 1, paragraph (e). 
241.12     (e) The consulting professional providing assistance to the 
241.13  recipient shall meet the qualifications specified in section 
241.14  256B.0625, subdivision 19c.  The professional shall assist the 
241.15  recipient in developing and revising a plan to meet the 
241.16  recipient's assessed needs, and supervise the performance of 
241.17  delegated tasks, as determined by the public health nurse.  In 
241.18  performing this function, the professional must visit the 
241.19  recipient in the recipient's home at least once annually.  The 
241.20  professional must report to the local county public health nurse 
241.21  concerns relating to the health and safety of the recipient, and 
241.22  any suspected abuse, neglect, or financial exploitation of the 
241.23  recipient to the appropriate authorities.  
241.24     (f) The fiscal agent, recipient or responsible party, 
241.25  personal care assistant, and consulting professional shall enter 
241.26  into a written agreement before services are started.  The 
241.27  agreement shall include: 
241.28     (1) the duties of the recipient, professional, personal 
241.29  care assistant, and fiscal agent based on paragraphs (a) to (e); 
241.30     (2) the salary and benefits for the personal care assistant 
241.31  and those providing professional consultation; 
241.32     (3) the administrative fee of the fiscal agent and services 
241.33  paid for with that fee, including background check fees; 
241.34     (4) procedures to respond to billing or payment complaints; 
241.35  and 
241.36     (5) procedures for hiring and terminating the personal care 
242.1   assistant and those providing professional consultation. 
242.2      (g) The rates paid for personal care services, professional 
242.3   assistance, and fiscal agency services under this subdivision 
242.4   shall be the same rates paid for personal care services and 
242.5   qualified professional services under subdivision 2 
242.6   respectively.  Except for the administrative fee of the fiscal 
242.7   agent specified in paragraph (f), the remainder of the rates 
242.8   paid to the fiscal agent must be used to pay for the salary and 
242.9   benefits for the personal care assistant or those providing 
242.10  professional consultation. 
242.11     (h) As part of the assessment defined in subdivision 1, the 
242.12  following conditions must be met to use or continue use of a 
242.13  fiscal agent: 
242.14     (1) the recipient must be able to direct the recipient's 
242.15  own care, or the responsible party for the recipient must be 
242.16  readily available to direct the care of the personal care 
242.17  assistant; 
242.18     (2) the recipient or responsible party must be 
242.19  knowledgeable of the health care needs of the recipient and be 
242.20  able to effectively communicate those needs; 
242.21     (3) a face-to-face assessment must be conducted by the 
242.22  local county public health nurse at least annually, or when 
242.23  there is a significant change in the recipient's condition or 
242.24  change in the need for personal care assistant services.  The 
242.25  county public health nurse shall determine the services that 
242.26  require professional delegation, if any, and the amount and 
242.27  frequency of related supervision; 
242.28     (4) the recipient cannot select the shared services option 
242.29  as specified in subdivision 8; and 
242.30     (5) parties must be in compliance with the written 
242.31  agreement specified in paragraph (f). 
242.32     (i) The commissioner shall deny, revoke, or suspend the 
242.33  authorization to use the fiscal agent option if: 
242.34     (1) it has been determined by the consulting professional 
242.35  or local county public health nurse that the use of this option 
242.36  jeopardizes the recipient's health and safety; 
243.1      (2) the parties have failed to comply with the written 
243.2   agreement specified in paragraph (f); or 
243.3      (3) the use of the option has led to abusive or fraudulent 
243.4   billing for personal care assistant services.  
243.5      The recipient or responsible party may appeal the 
243.6   commissioner's action according to section 256.045.  The denial, 
243.7   revocation, or suspension to use the fiscal agent option shall 
243.8   not affect the recipient's authorized level of personal care 
243.9   assistant services as determined in subdivision 5.  The 
243.10  effective date of this subdivision is the date of federal 
243.11  approval.  
243.12     Sec. 51.  Minnesota Statutes 1998, section 256B.0627, is 
243.13  amended by adding a subdivision to read: 
243.14     Subd. 11.  [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 
243.15  Medical assistance payments for shared private duty nursing 
243.16  services by a private duty nurse shall be limited according to 
243.17  this subdivision.  For the purposes of this section, "private 
243.18  duty nursing agency" means an agency licensed under chapter 144A 
243.19  to provide private duty nursing services. 
243.20     (b) Recipients of private duty nursing services may share 
243.21  nursing staff and the commissioner shall provide a rate 
243.22  methodology for shared private duty nursing.  For two persons 
243.23  sharing nursing care, the rate paid to a provider shall not 
243.24  exceed 1.5 times the nonwaivered private duty nursing rates paid 
243.25  for serving a single individual who is not ventilator-dependent, 
243.26  by a registered nurse or licensed practical nurse.  These rates 
243.27  apply only to situations in which both recipients are present 
243.28  and receive shared private duty nursing care on the date for 
243.29  which the service is billed.  No more than two persons may 
243.30  receive shared private duty nursing services from a private duty 
243.31  nurse in a single setting. 
243.32     (c) Shared private duty nursing care is the provision of 
243.33  nursing services by a private duty nurse to two recipients at 
243.34  the same time and in the same setting.  For the purposes of this 
243.35  subdivision, "setting" means: 
243.36     (1) the home or foster care home of one of the individual 
244.1   recipients; or 
244.2      (2) a child care program licensed under chapter 245A or 
244.3   operated by a local school district or private school; or 
244.4      (3) an adult day care service licensed under chapter 245A. 
244.5      This subdivision does not apply when a private duty nurse 
244.6   is caring for multiple recipients in more than one setting. 
244.7      (d) The recipient or the recipient's legal representative, 
244.8   and the recipient's physician, in conjunction with the home 
244.9   health care agency, shall determine: 
244.10     (1) whether shared private duty nursing care is an 
244.11  appropriate option based on the individual needs and preferences 
244.12  of the recipient; and 
244.13     (2) the amount of shared private duty nursing services 
244.14  authorized as part of the overall authorization of nursing 
244.15  services. 
244.16     (e) The recipient or the recipient's legal representative, 
244.17  in conjunction with the private duty nursing agency, shall 
244.18  approve the setting, grouping, and arrangement of shared private 
244.19  duty nursing care based on the individual needs and preferences 
244.20  of the recipients.  Decisions on the selection of recipients to 
244.21  share services must be based on the ages of the recipients, 
244.22  compatibility, and coordination of their care needs. 
244.23     (f) The following items must be considered by the recipient 
244.24  or the recipient's legal representative and the private duty 
244.25  nursing agency, and documented in the recipient's health service 
244.26  record: 
244.27     (1) the additional training needed by the private duty 
244.28  nurse to provide care to several recipients in the same setting 
244.29  and to ensure that the needs of the recipients are met 
244.30  appropriately and safely; 
244.31     (2) the setting in which the shared private duty nursing 
244.32  care will be provided; 
244.33     (3) the ongoing monitoring and evaluation of the 
244.34  effectiveness and appropriateness of the service and process 
244.35  used to make changes in service or setting; 
244.36     (4) a contingency plan which accounts for absence of the 
245.1   recipient in a shared private duty nursing setting due to 
245.2   illness or other circumstances; 
245.3      (5) staffing backup contingencies in the event of employee 
245.4   illness or absence; and 
245.5      (6) arrangements for additional assistance to respond to 
245.6   urgent or emergency care needs of the recipients. 
245.7      (g) The provider must offer the recipient or responsible 
245.8   party the option of shared or one-on-one private duty nursing 
245.9   services.  The recipient or responsible party can withdraw from 
245.10  participating in a shared service arrangement at any time. 
245.11     (h) The private duty nursing agency must document the 
245.12  following in the health service record for each individual 
245.13  recipient sharing private duty nursing care: 
245.14     (1) permission by the recipient or the recipient's legal 
245.15  representative for the maximum number of shared nursing care 
245.16  hours per week chosen by the recipient; 
245.17     (2) permission by the recipient or the recipient's legal 
245.18  representative for shared private duty nursing services provided 
245.19  outside the recipient's residence; 
245.20     (3) permission by the recipient or the recipient's legal 
245.21  representative for others to receive shared private duty nursing 
245.22  services in the recipient's residence; 
245.23     (4) revocation by the recipient or the recipient's legal 
245.24  representative of the shared private duty nursing care 
245.25  authorization, or the shared care to be provided to others in 
245.26  the recipient's residence, or the shared private duty nursing 
245.27  services to be provided outside the recipient's residence; and 
245.28     (5) daily documentation of the shared private duty nursing 
245.29  services provided by each identified private duty nurse, 
245.30  including: 
245.31     (i) the names of each recipient receiving shared private 
245.32  duty nursing services together; 
245.33     (ii) the setting for the shared services, including the 
245.34  starting and ending times that the recipient received shared 
245.35  private duty nursing care; and 
245.36     (iii) notes by the private duty nurse regarding changes in 
246.1   the recipient's condition, problems that may arise from the 
246.2   sharing of private duty nursing services, and scheduling and 
246.3   care issues. 
246.4      (i) Unless otherwise provided in this subdivision, all 
246.5   other statutory and regulatory provisions relating to private 
246.6   duty nursing services apply to shared private duty nursing 
246.7   services. 
246.8      Nothing in this subdivision shall be construed to reduce 
246.9   the total number of private duty nursing hours authorized for an 
246.10  individual recipient under subdivision 5. 
246.11     Sec. 52.  Minnesota Statutes 1998, section 256B.0635, 
246.12  subdivision 3, is amended to read: 
246.13     Subd. 3.  [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO 
246.14  OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.] Upon federal 
246.15  approval, Medical assistance is available to persons who 
246.16  received MFIP-S in at least three of the six months preceding 
246.17  the month in which the person opted opt to discontinue receiving 
246.18  MFIP-S cash assistance under section 256J.31, subdivision 12.  A 
246.19  person who is eligible for medical assistance under this section 
246.20  may receive medical assistance without reapplication as long as 
246.21  the person meets MFIP-S eligibility requirements, unless the 
246.22  assistance unit does not include a dependent child.  Medical 
246.23  assistance may be paid pursuant to subdivisions 1 and 2 for 
246.24  persons who are no longer eligible for MFIP-S due to increased 
246.25  employment or child support.  A person may be eligible for 
246.26  MinnesotaCare due to increased employment or child support, and 
246.27  as such must be informed of the option to transition onto 
246.28  MinnesotaCare. 
246.29     Sec. 53.  [256B.0914] [CONFLICTS OF INTEREST RELATED TO 
246.30  MEDICAID EXPENDITURES.] 
246.31     Subdivision 1.  [DEFINITIONS.] (a) "Contract" means a 
246.32  written, fully executed agreement for the purchase of goods and 
246.33  services involving a substantial expenditure of Medicaid 
246.34  funding.  A contract under a renewal period shall be considered 
246.35  a separate contract. 
246.36     (b) "Contractor bid or proposal information" means cost or 
247.1   pricing data, indirect costs, and proprietary information marked 
247.2   as such by the bidder in accordance with applicable law. 
247.3      (c) "Particular expenditure" means a substantial 
247.4   expenditure as defined below, for a specified term, involving 
247.5   specific parties.  The renewal of an existing contract for the 
247.6   substantial expenditure of Medicaid funds is considered a 
247.7   separate, particular expenditure from the original contract. 
247.8      (d) "Source selection information" means any of the 
247.9   following information prepared for use by the state, county, or 
247.10  independent contractor for the purpose of evaluating a bid or 
247.11  proposal to enter into a Medicaid procurement contract, if that 
247.12  information has not been previously made available to the public 
247.13  or disclosed publicly: 
247.14     (1) bid prices submitted in response to a solicitation for 
247.15  sealed bids, or lists of the bid prices before bid opening; 
247.16     (2) proposed costs or prices submitted in response to a 
247.17  solicitation, or lists of those proposed costs or prices; 
247.18     (3) source selection plans; 
247.19     (4) technical evaluations plans; 
247.20     (5) technical evaluations of proposals; 
247.21     (6) cost or price evaluation of proposals; 
247.22     (7) competitive range determinations that identify 
247.23  proposals that have a reasonable chance of being selected for 
247.24  award of a contract; 
247.25     (8) rankings of bids, proposals, or competitors; 
247.26     (9) the reports and evaluations of source selection panels, 
247.27  boards, or advisory councils; and 
247.28     (10) other information marked as "source selection 
247.29  information" based on a case-by-case determination by the head 
247.30  of the agency, contractor, designees, or the contracting officer 
247.31  that disclosure of the information would jeopardize the 
247.32  integrity or successful completion of the Medicaid procurement 
247.33  to which the information relates. 
247.34     (e) "Substantial expenditure" and "substantial amounts" 
247.35  mean a purchase of goods or services in excess of $10,000,000 in 
247.36  Medicaid funding under this chapter or chapter 256L. 
248.1      Subd. 2.  [APPLICABILITY.] (a) Unless provided otherwise, 
248.2   this section applies to:  
248.3      (1) any state or local officer, employee, or independent 
248.4   contractor who is responsible for the substantial expenditures 
248.5   of medical assistance or MinnesotaCare funding under this 
248.6   chapter or chapter 256L for which federal Medicaid matching 
248.7   funds are available; 
248.8      (2) any individual who formerly was such an officer, 
248.9   employee, or independent contractor; and 
248.10     (3) any partner of such a state or local officer, employee, 
248.11  or independent contractor. 
248.12     (b) This section is intended to meet the requirements of 
248.13  state participation in the Medicaid program at United States 
248.14  Code, title 42, sections 1396a(a)(4) and 1396u-2(d)(3), which 
248.15  require that states have in place restrictions against conflicts 
248.16  of interest in the Medicaid procurement process, that are at 
248.17  least as stringent as those in effect under United States Code, 
248.18  title 41, section 423, and title 18, sections 207 and 208, as 
248.19  they apply to federal employees. 
248.20     Subd. 3.  [DISCLOSURE OF PROCUREMENT INFORMATION.] A person 
248.21  described in subdivision 2 may not knowingly disclose contractor 
248.22  bid or proposal information, or source selection information 
248.23  before the award by the state, county, or independent contractor 
248.24  of a Medicaid procurement contract to which the information 
248.25  relates unless the disclosure is otherwise authorized by law.  
248.26  No person, other than as provided by law, shall knowingly obtain 
248.27  contractor bid or proposal information or source selection 
248.28  information before the award of a Medicaid procurement contract 
248.29  to which the information relates. 
248.30     Subd. 4.  [OFFERS OF EMPLOYMENT.] When a person described 
248.31  in subdivision 2, paragraph (a), is participating personally and 
248.32  substantially in a Medicaid procurement for a contract contacts 
248.33  or is contacted by a person who is a bidder or offeror in the 
248.34  same procurement regarding possible employment outside of the 
248.35  entity by which the person is currently employed, the person 
248.36  must:  
249.1      (1) report the contact in writing to the person's 
249.2   supervisor and employer's ethics officer; and 
249.3      (2) either: 
249.4      (i) reject the possibility of employment with the bidder or 
249.5   offeror; or 
249.6      (ii) be disqualified from further participation in the 
249.7   procurement until the bidder or offeror is no longer involved in 
249.8   that procurement, or all discussions with the bidder or offeror 
249.9   regarding possible employment have terminated without an 
249.10  arrangement for employment.  A bidder or offeror may not engage 
249.11  in employment discussions with an official who is subject to 
249.12  this subdivision, until the bidder or offeror is no longer 
249.13  involved in that procurement. 
249.14     Subd. 5.  [ACCEPTANCE OF COMPENSATION BY A FORMER 
249.15  OFFICIAL.] (a) A former official of the state or county, or a 
249.16  former independent contractor, described in subdivision 2 may 
249.17  not accept compensation from a Medicaid contractor of a 
249.18  substantial expenditure as an employee, officer, director, or 
249.19  consultant of the contractor within one year after the former 
249.20  official or independent contractor: 
249.21     (1) served as the procuring contracting officer, the source 
249.22  selection authority, a member of the source selection evaluation 
249.23  board, or the chief of a financial or technical evaluation team 
249.24  in a procurement in which the contractor was selected for award; 
249.25     (2) served as the program manager, deputy program manager, 
249.26  or administrative contracting officer for a contract awarded to 
249.27  the contractor; or 
249.28     (3) personally made decisions for the state, county, or 
249.29  independent contractor to: 
249.30     (i) award a contract, subcontract, modification of a 
249.31  contract or subcontract, or a task order or delivery order to 
249.32  the contractor; 
249.33     (ii) establish overhead or other rates applicable to a 
249.34  contract or contracts with the contractor; 
249.35     (iii) approve issuance of a contract payment or payments to 
249.36  the contractor; or 
250.1      (iv) pay or settle a claim with the contractor. 
250.2      (b) Paragraph (a) does not prohibit a former official of 
250.3   the state, county, or independent contractor from accepting 
250.4   compensation from any division or affiliate of a contractor not 
250.5   involved in the same or similar products or services as the 
250.6   division or affiliate of the contractor that is responsible for 
250.7   the contract referred to in paragraph (a), clause (1), (2), or 
250.8   (3). 
250.9      (c) A contractor shall not provide compensation to a former 
250.10  official knowing that the former official is accepting that 
250.11  compensation in violation of this subdivision. 
250.12     Subd. 6.  [PERMANENT RESTRICTIONS ON REPRESENTATION AND 
250.13  COMMUNICATION.] (a) A person described in subdivision 2, after 
250.14  termination of his or her service with state, county, or 
250.15  independent contractor, is permanently restricted from knowingly 
250.16  making, with the intent to influence, any communication to or 
250.17  appearance before an officer or employee of a department, 
250.18  agency, or court of the United States, the state of Minnesota 
250.19  and its counties in connection with a particular expenditure: 
250.20     (1) in which the United States, the state of Minnesota, or 
250.21  a Minnesota county is a party or has a direct and substantial 
250.22  interest; 
250.23     (2) in which the person participated personally and 
250.24  substantially as an officer, employee, or independent 
250.25  contractor; and 
250.26     (3) which involved a specific party or parties at the time 
250.27  of participation. 
250.28     (b) For purposes of this subdivision and subdivisions 7 and 
250.29  9, "participated" means an action taken through decision, 
250.30  approval, disapproval, recommendation, the rendering of advice, 
250.31  investigation, or other such action. 
250.32     Subd. 7.  [TWO-YEAR RESTRICTIONS ON REPRESENTATION AND 
250.33  COMMUNICATION.] No person described in subdivision 2, within two 
250.34  years after termination of service with the state, county, or 
250.35  independent contractor, shall knowingly make, with the intent to 
250.36  influence, any communication to or appearance before any officer 
251.1   or employee of any government department, agency, or court in 
251.2   connection with a particular expenditure: 
251.3      (1) in which the United States, the state of Minnesota, or 
251.4   a Minnesota county is a party or has a direct and substantial 
251.5   interest; 
251.6      (2) which the person knows or reasonably should know was 
251.7   actually pending under the official's responsibility as an 
251.8   officer, employee, or independent contractor within one year 
251.9   before the termination of the official's service with the state, 
251.10  county, or independent contractor; and 
251.11     (3) which involved a specific party or parties at the time 
251.12  the expenditure was pending. 
251.13     Subd. 8.  [EXCEPTIONS TO PERMANENT AND TWO-YEAR 
251.14  RESTRICTIONS ON REPRESENTATION AND COMMUNICATION.] Subdivisions 
251.15  6 and 7 do not apply to: 
251.16     (1) communications or representations made in carrying out 
251.17  official duties on behalf of the United States, the state of 
251.18  Minnesota or local government, or as an elected official of the 
251.19  state or local government; 
251.20     (2) communications made solely for the purpose of 
251.21  furnishing scientific or technological information; or 
251.22     (3) giving testimony under oath.  A person subject to 
251.23  subdivisions 6 and 7 may serve as an expert witness in that 
251.24  matter, without restriction, for the state, county, or 
251.25  independent contractor.  Under court order, a person subject to 
251.26  subdivisions 6 and 7 may serve as an expert witness for others.  
251.27  Otherwise, the person may not serve as an expert witness in that 
251.28  matter. 
251.29     Subd. 9.  [WAIVER.] The commissioner of human services, or 
251.30  the governor in the case of the commissioner, may grant a waiver 
251.31  of a restriction in subdivisions 6 and 7 if he or she determines 
251.32  that a waiver is in the public interest and that the services of 
251.33  the officer or employee are critically needed for the benefit of 
251.34  the state or county government. 
251.35     Subd. 10.  [ACTS AFFECTING A PERSONAL FINANCIAL 
251.36  INTEREST.] A person described in subdivision 2, paragraph (a), 
252.1   clause (1), who participates in a particular expenditure in 
252.2   which the person has knowledge or has a financial interest, is 
252.3   subject to the penalties in subdivision 12.  For purposes of 
252.4   this subdivision, "financial interest" also includes the 
252.5   financial interest of a spouse, minor child, general partner, 
252.6   organization in which the officer or employee is serving as an 
252.7   officer, director, trustee, general partner, or employee, or any 
252.8   person or organization with whom the individual is negotiating 
252.9   or has any arrangement concerning prospective employment. 
252.10     Subd. 11.  [EXCEPTIONS TO PROHIBITIONS REGARDING FINANCIAL 
252.11  INTEREST.] Subdivision 10 does not apply if: 
252.12     (1) the person first advises the person's supervisor and 
252.13  the employer's ethics officer regarding the nature and 
252.14  circumstances of the particular expenditure and makes full 
252.15  disclosure of the financial interest and receives in advance a 
252.16  written determination made by the commissioner of human 
252.17  services, or the governor in the case of the commissioner, that 
252.18  the interest is not so substantial as to likely affect the 
252.19  integrity of the services which the government may expect from 
252.20  the officer, employee, or independent contractor; 
252.21     (2) the financial interest is listed as an exemption at 
252.22  Code of Federal Regulations, title 5, sections 2640.201 to 
252.23  2640.203, as too remote or inconsequential to affect the 
252.24  integrity of the services of the office, employee, or 
252.25  independent contractor to which the requirement applies. 
252.26     Subd. 12.  [CRIMINAL PENALTIES.] (a) A person who violates 
252.27  subdivisions 3 to 5 for the purpose of either exchanging the 
252.28  information covered by this section for anything of value, or 
252.29  for obtaining or giving anyone a competitive advantage in the 
252.30  award of a Medicaid contract, may be sentenced to imprisonment 
252.31  for not more than five years or payment of a fine of not more 
252.32  than $50,000 for each violation, or the amount of compensation 
252.33  which the person received or offered for the prohibited conduct, 
252.34  whichever is greater, or both. 
252.35     (b) A person who violates a provision of subdivisions 6 to 
252.36  11 may be sentenced to imprisonment for not more than one year 
253.1   or payment of a fine of not more than $50,000 for each violation 
253.2   or the amount of compensation which the person received or 
253.3   offered for the prohibited conduct, whichever amount is greater, 
253.4   or both.  A person who willfully engages in conduct in violation 
253.5   of subdivisions 6 to 11 may be sentenced to imprisonment for not 
253.6   more than five years or to payment of fine of not more than 
253.7   $50,000 for each violation or the amount of compensation which 
253.8   the person received or offered for the prohibited conduct, 
253.9   whichever amount is greater, or both. 
253.10     (c) Nothing in this section precludes prosecution under 
253.11  other laws such as section 609.43. 
253.12     Subd. 13.  [CIVIL PENALTIES AND INJUNCTIVE RELIEF.] (a) The 
253.13  Minnesota attorney general may bring a civil action in Ramsey 
253.14  county district court against a person who violates subdivisions 
253.15  3 to 5.  Upon proof of such conduct by a preponderance of 
253.16  evidence, the person is subject to a civil penalty.  An 
253.17  individual who violates subdivisions 3 to 5 is subject to a 
253.18  civil penalty of not more than $50,000 for each violation plus 
253.19  twice the amount of compensation which the individual received 
253.20  or offered for the prohibited conduct.  An organization that 
253.21  violates subdivisions 3 to 5 is subject to a civil penalty of 
253.22  not more than $500,000 for each violation plus twice the amount 
253.23  of compensation which the organization received or offered for 
253.24  the prohibited conduct. 
253.25     (b) If the Minnesota attorney general has reason to believe 
253.26  that a person is engaging in conduct in violation of subdivision 
253.27  6, 7, or 9, the attorney general may petition the Ramsey county 
253.28  district court for an order prohibiting that person from 
253.29  engaging in such conduct.  The court may issue an order 
253.30  prohibiting that person from engaging in such conduct if the 
253.31  court finds that the conduct constitutes such a violation.  The 
253.32  filing of a petition under this subdivision does not preclude 
253.33  any other remedy which is available by law. 
253.34     Subd. 14.  [ADMINISTRATIVE ACTIONS.] (a) If a state agency, 
253.35  local agency, or independent contractor receives information 
253.36  that a contractor or a person has violated subdivisions 3 to 5, 
254.1   the state agency, local agency, or independent contractor may: 
254.2      (1) cancel the procurement if a contract has not already 
254.3   been awarded; 
254.4      (2) rescind the contract; or 
254.5      (3) initiate suspension or debarment proceedings according 
254.6   to applicable state or federal law. 
254.7      (b) If the contract is rescinded, the state agency, local 
254.8   agency, or independent contractor is entitled to recover, in 
254.9   addition to any penalty prescribed by law, the amount expended 
254.10  under the contract. 
254.11     (c) This section does not: 
254.12     (1) restrict the disclosure of information to or from any 
254.13  person or class of persons authorized to receive that 
254.14  information; 
254.15     (2) restrict a contractor from disclosing the contractor's 
254.16  bid or proposal information or the recipient from receiving that 
254.17  information; 
254.18     (3) restrict the disclosure or receipt of information 
254.19  relating to a Medicaid procurement after it has been canceled by 
254.20  the state agency, county agency, or independent contractor 
254.21  before the contract award unless the agency or independent 
254.22  contractor plans to resume the procurement; or 
254.23     (4) limit the applicability of any requirements, sanctions, 
254.24  contract penalties, and remedies established under any other law 
254.25  or regulation. 
254.26     (d) No person may file a protest against the award or 
254.27  proposed award of a Medicaid contract alleging a violation of 
254.28  this section unless that person reported the information the 
254.29  person believes constitutes evidence of the offense to the 
254.30  applicable state agency, local agency, or independent contractor 
254.31  responsible for the procurement.  The report must be made no 
254.32  later than 14 days after the person first discovered the 
254.33  possible violation. 
254.34     Sec. 54.  Minnesota Statutes 1998, section 256B.0916, is 
254.35  amended to read: 
254.36     256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 
255.1   MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 
255.2      (a) The commissioner shall expand availability of home and 
255.3   community-based services for persons with mental retardation and 
255.4   related conditions to the extent allowed by federal law and 
255.5   regulation and shall assist counties in transferring persons 
255.6   from semi-independent living services to home and 
255.7   community-based services.  The commissioner may transfer funds 
255.8   from the state semi-independent living services account 
255.9   available under section 252.275, subdivision 8, and state 
255.10  community social services aids available under section 256E.15 
255.11  to the medical assistance account to pay for the nonfederal 
255.12  share of nonresidential and residential home and community-based 
255.13  services authorized under section 256B.092 for persons 
255.14  transferring from semi-independent living services. 
255.15     (b) Upon federal approval, county boards are not 
255.16  responsible for funding semi-independent living services as a 
255.17  social service for those persons who have transferred to the 
255.18  home and community-based waiver program as a result of the 
255.19  expansion under this subdivision.  The county responsibility for 
255.20  those persons transferred shall be assumed under section 
255.21  256B.092.  Notwithstanding the provisions of section 252.275, 
255.22  the commissioner shall continue to allocate funds under that 
255.23  section for semi-independent living services and county boards 
255.24  shall continue to fund services under sections 256E.06 and 
255.25  256E.14 for those persons who cannot access home and 
255.26  community-based services under section 256B.092. 
255.27     (c) Eighty percent of the state funds made available to the 
255.28  commissioner under section 252.275 as a result of persons 
255.29  transferring from the semi-independent living services program 
255.30  to the home and community-based services program shall be used 
255.31  to fund additional persons in the semi-independent living 
255.32  services program. 
255.33     (d) Beginning August 1, 1998, the commissioner shall issue 
255.34  an annual report on the home and community-based waiver for 
255.35  persons with mental retardation or related conditions, that 
255.36  includes a list of the counties in which less than 95 percent of 
256.1   the allocation provided, excluding the county waivered services 
256.2   reserve, has been committed for two or more quarters during the 
256.3   previous state fiscal year.  For each listed county, the report 
256.4   shall include the amount of funds allocated but not used, the 
256.5   number and ages of individuals screened and waiting for 
256.6   services, the services needed, a description of the technical 
256.7   assistance provided by the commissioner to assist the counties 
256.8   in jointly planning with other counties in order to serve more 
256.9   persons, and additional actions which will be taken to serve 
256.10  those screened and waiting for services. 
256.11     Subdivision 1.  [REDUCTION OF WAITING LIST.] (a) The 
256.12  legislature recognizes that as of January 1, 1999, 3,300 persons 
256.13  with mental retardation or related conditions have been screened 
256.14  and determined eligible for the home and community-based waiver 
256.15  services program for persons with mental retardation or related 
256.16  conditions.  Many wait for several years before receiving 
256.17  service. 
256.18     (b) The waiting list for this program shall be reduced or 
256.19  eliminated by June 30, 2003.  In order to reduce the number of 
256.20  eligible persons waiting for identified services provided 
256.21  through the home and community-based waiver for persons with 
256.22  mental retardation or related conditions, funding shall be 
256.23  increased to add 250 additional eligible persons each year 
256.24  beyond the November 1998 medical assistance forecast for the 
256.25  period July 1, 1999, to June 30, 2003. 
256.26     Subd. 2.  [DISTRIBUTION OF FUNDS; PARTNERSHIPS.] (a) 
256.27  Beginning with fiscal year 2000, the commissioner shall 
256.28  distribute all funding available for home and community-based 
256.29  waiver services for persons with mental retardation or related 
256.30  conditions to individual counties or to groups of counties that 
256.31  form partnerships to jointly plan, administer, and authorize 
256.32  funding for eligible individuals.  The commissioner shall 
256.33  encourage counties to form partnerships that have a sufficient 
256.34  number of recipients and funding to adequately manage the risk 
256.35  and maximize use of available resources.  
256.36     (b) Counties must submit a request for funds and a plan for 
257.1   administering the program as required by the commissioner.  The 
257.2   plan must identify the number of clients to be served, their 
257.3   ages, and their priority listing based on: 
257.4      (1) requirements in Minnesota Rules, part 9525.1880; 
257.5      (2) unstable living situations due to the age or incapacity 
257.6   of the primary caregiver; and 
257.7      (3) the need for services to avoid out-of-home placement of 
257.8   children.  
257.9   The plan must also identify changes made to improve services to 
257.10  eligible persons and to improve program management. 
257.11     (c) In allocating resources to counties, priority must be 
257.12  given to groups of counties that form partnerships to jointly 
257.13  plan, administer, and authorize funding for eligible individuals 
257.14  and to counties determined by the commissioner to have 
257.15  sufficient waiver capacity to maximize resource use. 
257.16     (d) Within 30 days after receiving the county request for 
257.17  funds and plans, the commissioner shall provide a written 
257.18  response to the plan that includes the level of resources 
257.19  available to serve additional persons. 
257.20     (e) Counties are eligible to receive medical assistance 
257.21  administrative reimbursement for administrative costs under 
257.22  criteria established by the commissioner.  
257.23     Subd. 3.  [FAILURE TO DEVELOP PARTNERSHIPS OR SUBMIT A 
257.24  PLAN.] (a) By October 1 of each year the commissioner shall 
257.25  notify the county board if any county determined by the 
257.26  commissioner to have insufficient capacity to maximize use of 
257.27  available resources fails to develop a partnership with other 
257.28  counties or fails to submit a plan as required in subdivision 
257.29  2.  The commissioner shall provide needed technical assistance 
257.30  to a county or group of counties that fails to form a 
257.31  partnership or submit a plan.  If a county has not joined a 
257.32  county partnership or submitted a plan within 30 days following 
257.33  the notice by the commissioner of its failure, the commissioner 
257.34  shall require and assist that county to develop a plan or 
257.35  contract with another county or group of counties to plan and 
257.36  administer the waiver services program in that county. 
258.1      (b) Counties may request technical assistance, management 
258.2   information, and administrative support from the commissioner at 
258.3   any time.  The commissioner shall respond to county requests 
258.4   within 30 days.  Priority shall be given to activities that 
258.5   support the administrative needs of newly formed county 
258.6   partnerships. 
258.7      Subd. 4.  [ALLOWED RESERVE.] Counties or groups of counties 
258.8   participating in partnerships that have submitted a plan under 
258.9   this section may develop an allowed reserve amount to meet 
258.10  crises and other unmet needs of current home and community-based 
258.11  waiver recipients.  The amount of the allowed reserve shall be a 
258.12  county specific amount based upon documented past experience and 
258.13  projected need for the coming year described in an allowed 
258.14  reserve plan submitted for approval to the commissioner with the 
258.15  allocation request for the fiscal year. 
258.16     Subd. 5.  [PRIORITIES FOR REASSIGNMENT OF RESOURCES AND 
258.17  APPROVAL OF INCREASED CAPACITY.] In order to maximize the number 
258.18  of persons served with waiver funds, the commissioner shall 
258.19  monitor county utilization of allocated resources and, as 
258.20  appropriate, reassign resources not utilized and approve 
258.21  increased capacity within available county allocations.  
258.22  Priority consideration for reassignment of resources and 
258.23  approval of increased capacity shall be given to counties with 
258.24  sufficient capacity and counties that form partnerships.  In 
258.25  addition to the priorities listed in Minnesota Rules, part 
258.26  9525.1880, the commissioner shall also give priority 
258.27  consideration to persons whose living situations are unstable 
258.28  due to the age or incapacity of the primary caregiver and to 
258.29  children to avoid out-of-home placement. 
258.30     Subd. 6.  [WAIVER REQUEST.] (a) The commissioner shall 
258.31  submit to the federal Health Care Financing Administration by 
258.32  September 1, 1999, a request for a waiver to include an option 
258.33  that would allow waiver service recipients to directly receive 
258.34  95 percent of the funds that would be allocated to individuals 
258.35  based on written county criteria and procedures approved by the 
258.36  commissioner for the purchase of services to meet their 
259.1   long-term care needs.  The waiver request must include a 
259.2   provision requiring recipients who receive funds directly to 
259.3   provide to the commissioner annually, a description of the type 
259.4   of services used, the amount paid for the services purchased, 
259.5   and the amount of unspent funds. 
259.6      (b) The commissioner, in cooperation with county 
259.7   representatives, waiver service providers, recipients, 
259.8   recipients' families, legal guardians, and advocacy groups, 
259.9   shall develop criteria for: 
259.10     (1) eligibility to receive funding directly; 
259.11     (2) determination of the amount of funds made available to 
259.12  each eligible person based on need; and 
259.13     (3) the accountability required of persons directly 
259.14  receiving funds. 
259.15     (c) If this waiver is approved and implemented, any unspent 
259.16  money from the waiver services allocation, including the five 
259.17  percent not directly allocated to recipients and any unspent 
259.18  portion of the money that is directly allocated, shall be used 
259.19  to meet the needs of other eligible persons waiting for services 
259.20  funded through the waiver. 
259.21     (d) The commissioner, in consultation with county social 
259.22  services agencies, waiver services providers, recipients, 
259.23  recipients' families, legal guardians, and advocacy groups shall 
259.24  evaluate the effectiveness of this option within two years of 
259.25  its implementation. 
259.26     Subd. 7.  [ANNUAL REPORT BY COMMISSIONER.] Beginning 
259.27  October 1, 1999, and each October 1 thereafter, the commissioner 
259.28  shall issue an annual report on county and state use of 
259.29  available resources for the home and community-based waiver for 
259.30  persons with mental retardation or related conditions.  For each 
259.31  county or county partnership, the report shall include: 
259.32     (1) the amount of funds allocated but not used; 
259.33     (2) the county specific allowed reserve amount approved and 
259.34  used; 
259.35     (3) the number, ages and living situations of individuals 
259.36  screened and waiting for services; 
260.1      (4) the urgency of need for services to begin within one, 
260.2   two, or more than two years for each individual; 
260.3      (5) the services needed; 
260.4      (6) the number of additional persons served by approval of 
260.5   increased capacity within existing allocations; 
260.6      (7) results of action by the commissioner to streamline 
260.7   administrative requirements and improve county resource 
260.8   management; and 
260.9      (8) additional action that would decrease the number of 
260.10  those eligible and waiting for waivered services. 
260.11  The commissioner shall specify intended outcomes for the program 
260.12  and the degree to which these specified outcomes are attained. 
260.13     (e) Subd. 8.  [FINANCIAL INFORMATION BY COUNTY.] The 
260.14  commissioner shall make available to interested parties, upon 
260.15  request, financial information by county including the amount of 
260.16  resources allocated for the home and community-based waiver for 
260.17  persons with mental retardation and related conditions, the 
260.18  resources committed, the number of persons screened and waiting 
260.19  for services, the type of services requested by those waiting, 
260.20  and the amount of allocated resources not committed. 
260.21     Subd. 9.  [LEGAL REPRESENTATIVE PARTICIPATION 
260.22  EXCEPTION.] The commissioner, in cooperation with 
260.23  representatives of counties, service providers, service 
260.24  recipients, family members, legal representatives and advocates, 
260.25  shall develop criteria to allow legal representatives to be 
260.26  reimbursed for providing specific support services to meet the 
260.27  person's needs when a plan which assures health and safety has 
260.28  been agreed upon and carried out by the legal representative, 
260.29  the person, and the county.  Legal representatives providing 
260.30  support under consumer-directed community support services 
260.31  pursuant to section 256B.092, subdivision 4, or the consumer 
260.32  support grant program pursuant to section 256B.092, subdivision 
260.33  7, shall not be considered to have a direct or indirect service 
260.34  provider interest under section 256B.092, subdivision 7, if a 
260.35  health and safety plan which meets the criteria established has 
260.36  been agreed upon and implemented.  By October 1, 1999, the 
261.1   commissioner shall submit, for federal approval, amendments to 
261.2   allow legal representatives to provide supports and receive 
261.3   reimbursement under the consumer-directed community support 
261.4   services section of the home and community-based waiver plan. 
261.5      Sec. 55.  Minnesota Statutes 1998, section 256B.0917, 
261.6   subdivision 8, is amended to read: 
261.7      Subd. 8.  [LIVING-AT-HOME/BLOCK NURSE PROGRAM GRANT.] (a) 
261.8   The organization awarded the contract under subdivision 7, shall 
261.9   develop and administer a grant program to establish or expand up 
261.10  to 27 37 community-based organizations that will implement 
261.11  living-at-home/block nurse programs that are designed to enable 
261.12  senior citizens to live as independently as possible in their 
261.13  homes and in their communities.  At least one-half of the 
261.14  programs must be in counties outside the seven-county 
261.15  metropolitan area.  Nonprofit organizations and units of local 
261.16  government are eligible to apply for grants to establish the 
261.17  community organizations that will implement living-at-home/block 
261.18  nurse programs.  In awarding grants, the organization awarded 
261.19  the contract under subdivision 7 shall give preference to 
261.20  nonprofit organizations and units of local government from 
261.21  communities that: 
261.22     (1) have high nursing home occupancy rates; 
261.23     (2) have a shortage of health care professionals; 
261.24     (3) are located in counties adjacent to, or are located in, 
261.25  counties with existing living-at-home/block nurse programs; and 
261.26     (4) meet other criteria established by LAH/BN, Inc., in 
261.27  consultation with the commissioner. 
261.28     (b) Grant applicants must also meet the following criteria: 
261.29     (1) the local community demonstrates a readiness to 
261.30  establish a community model of care, including the formation of 
261.31  a board of directors, advisory committee, or similar group, of 
261.32  which at least two-thirds is comprised of community citizens 
261.33  interested in community-based care for older persons; 
261.34     (2) the program has sponsorship by a credible, 
261.35  representative organization within the community; 
261.36     (3) the program has defined specific geographic boundaries 
262.1   and defined its organization, staffing and coordination/delivery 
262.2   of services; 
262.3      (4) the program demonstrates a team approach to 
262.4   coordination and care, ensuring that the older adult 
262.5   participants, their families, the formal and informal providers 
262.6   are all part of the effort to plan and provide services; and 
262.7      (5) the program provides assurances that all community 
262.8   resources and funding will be coordinated and that other funding 
262.9   sources will be maximized, including a person's own resources. 
262.10     (c) Grant applicants must provide a minimum of five percent 
262.11  of total estimated development costs from local community 
262.12  funding.  Grants shall be awarded for four-year periods, and the 
262.13  base amount shall not exceed $80,000 per applicant for the grant 
262.14  period.  The organization under contract may increase the grant 
262.15  amount for applicants from communities that have socioeconomic 
262.16  characteristics that indicate a higher level of need for 
262.17  assistance.  Subject to the availability of funding, grants and 
262.18  grant renewals awarded or entered into on or after July 1, 1997, 
262.19  shall be renewed by LAH/BN, Inc. every four years, unless 
262.20  LAH/BN, Inc. determines that the grant recipient has not 
262.21  satisfactorily operated the living-at-home/block nurse program 
262.22  in compliance with the requirements of paragraphs (b) and (d).  
262.23  Grants provided to living-at-home/block nurse programs under 
262.24  this paragraph may be used for both program development and the 
262.25  delivery of services. 
262.26     (d) Each living-at-home/block nurse program shall be 
262.27  designed by representatives of the communities being served to 
262.28  ensure that the program addresses the specific needs of the 
262.29  community residents.  The programs must be designed to: 
262.30     (1) incorporate the basic community, organizational, and 
262.31  service delivery principles of the living-at-home/block nurse 
262.32  program model; 
262.33     (2) provide senior citizens with registered nurse directed 
262.34  assessment, provision and coordination of health and personal 
262.35  care services on a sliding fee basis as an alternative to 
262.36  expensive nursing home care; 
263.1      (3) provide information, support services, homemaking 
263.2   services, counseling, and training for the client and family 
263.3   caregivers; 
263.4      (4) encourage the development and use of respite care, 
263.5   caregiver support, and in-home support programs, such as adult 
263.6   foster care and in-home adult day care; 
263.7      (5) encourage neighborhood residents and local 
263.8   organizations to collaborate in meeting the needs of senior 
263.9   citizens in their communities; 
263.10     (6) recruit, train, and direct the use of volunteers to 
263.11  provide informal services and other appropriate support to 
263.12  senior citizens and their caregivers; and 
263.13     (7) provide coordination and management of formal and 
263.14  informal services to senior citizens and their families using 
263.15  less expensive alternatives.  
263.16     Sec. 56.  Minnesota Statutes 1998, section 256B.0951, 
263.17  subdivision 1, is amended to read: 
263.18     Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
263.19  assurance commission is established.  The commission consists of 
263.20  at least 13 14 but not more than 20 21 members as follows:  at 
263.21  least three but not more than five members representing advocacy 
263.22  organizations; at least three but not more than five members 
263.23  representing consumers, families, and their legal 
263.24  representatives; at least three but not more than five members 
263.25  representing service providers; and at least three but not more 
263.26  than five members representing counties; and the commissioner of 
263.27  human services or the commissioner's designee.  Initial 
263.28  membership of the commission shall be recruited and approved by 
263.29  the region 10 stakeholders group.  Prior to approving the 
263.30  commission's membership, the stakeholders group shall provide to 
263.31  the commissioner a list of the membership in the stakeholders 
263.32  group, as of February 1, 1997, a brief summary of meetings held 
263.33  by the group since July 1, 1996, and copies of any materials 
263.34  prepared by the group for public distribution.  The first 
263.35  commission shall establish membership guidelines for the 
263.36  transition and recruitment of membership for the commission's 
264.1   ongoing existence.  Members of the commission who do not receive 
264.2   a salary or wages from an employer for time spent on commission 
264.3   duties may receive a per diem payment when performing commission 
264.4   duties and functions.  All members may be reimbursed for 
264.5   expenses related to commission activities.  Notwithstanding the 
264.6   provisions of section 15.059, subdivision 5, the commission 
264.7   expires on June 30, 2001. 
264.8      Sec. 57.  Minnesota Statutes 1998, section 256B.0951, 
264.9   subdivision 3, is amended to read: 
264.10     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
264.11  commission, in cooperation with the commissioners of human 
264.12  services and health, shall do the following:  (1) approve an 
264.13  alternative quality assurance licensing system based on the 
264.14  evaluation of outcomes; (2) approve measurable outcomes in the 
264.15  areas of health and safety, consumer evaluation, education and 
264.16  training, providers, and systems that shall be evaluated during 
264.17  the alternative licensing process; and (3) establish variable 
264.18  licensure periods not to exceed three years based on outcomes 
264.19  achieved.  For purposes of this subdivision, "outcome" means the 
264.20  behavior, action, or status of a person that can be observed or 
264.21  measured and can be reliably and validly determined. 
264.22     (b) By January 15, 1998, the commission shall approve, in 
264.23  cooperation with the commissioner of human services, a training 
264.24  program for members of the quality assurance teams established 
264.25  under section 256B.0952, subdivision 4. 
264.26     (c) The commission and the commissioner shall establish an 
264.27  ongoing review process for the alternative quality assurance 
264.28  licensing system.  The review shall take into account the 
264.29  comprehensive nature of the alternative system, which is 
264.30  designed to evaluate the broad spectrum of licensed and 
264.31  unlicensed entities that provide services to clients, as 
264.32  compared to the current licensing system.  
264.33     (d) The commission shall contract with an independent 
264.34  entity to conduct a financial review of the alternative quality 
264.35  assurance pilot project.  The review shall take into account the 
264.36  comprehensive nature of the alternative system, which is 
265.1   designed to evaluate the broad spectrum of licensed and 
265.2   unlicensed entities that provide services to clients, as 
265.3   compared to the current licensing system.  The review shall 
265.4   include an evaluation of possible budgetary savings within the 
265.5   department of human services as a result of implementation of 
265.6   the alternative quality assurance pilot project.  If a federal 
265.7   waiver is approved under subdivision 7, the financial review 
265.8   shall also evaluate possible savings within the department of 
265.9   health.  This review must be completed by December 15, 2000. 
265.10     (e) The commission shall submit a report to the legislature 
265.11  by January 15, 2001, on the results of the review process for 
265.12  the alternative quality assurance pilot project, a summary of 
265.13  the results of the independent financial review, and a 
265.14  recommendation on whether the pilot project should be extended 
265.15  beyond June 30, 2001. 
265.16     Sec. 58.  Minnesota Statutes 1998, section 256B.0955, is 
265.17  amended to read: 
265.18     256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
265.19     (a) Effective July 1, 1998, the commissioner of human 
265.20  services shall delegate authority to perform licensing functions 
265.21  and activities, in accordance with section 245A.16, to counties 
265.22  participating in the alternative licensing system.  The 
265.23  commissioner shall not license or reimburse a facility, program, 
265.24  or service for persons with developmental disabilities in a 
265.25  county that participates in the alternative licensing system if 
265.26  the commissioner has received from the appropriate county 
265.27  notification that the facility, program, or service has been 
265.28  reviewed by a quality assurance team and has failed to qualify 
265.29  for licensure. 
265.30     (b) The commissioner may conduct random licensing 
265.31  inspections based on outcomes adopted under section 256B.0951 at 
265.32  facilities, programs, and services governed by the alternative 
265.33  licensing system.  The role of such random inspections shall be 
265.34  to verify that the alternative licensing system protects the 
265.35  safety and well-being of consumers and maintains the 
265.36  availability of high-quality services for persons with 
266.1   developmental disabilities.  
266.2      (c) The commissioner shall provide technical assistance and 
266.3   support or training to the alternative licensing system pilot 
266.4   project. 
266.5      (d) The commissioner and the commission shall establish an 
266.6   ongoing evaluation process for the alternative licensing system. 
266.7      (e) The commissioner shall contract with an independent 
266.8   entity to conduct a financial review of the alternative 
266.9   licensing system, including an evaluation of possible budgetary 
266.10  savings within the department of human services and the 
266.11  department of health as a result of implementation of the 
266.12  alternative quality assurance licensing system.  This review 
266.13  must be completed by December 15, 2000.  
266.14     (f) The commissioner and the commission shall submit a 
266.15  report to the legislature by January 15, 2001, on the results of 
266.16  the evaluation process of the alternative licensing system, a 
266.17  summary of the results of the independent financial review, and 
266.18  a recommendation on whether the pilot project should be extended 
266.19  beyond June 30, 2001. 
266.20     Sec. 59.  Minnesota Statutes 1998, section 256B.48, 
266.21  subdivision 1, is amended to read: 
266.22     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
266.23  is not eligible to receive medical assistance payments unless it 
266.24  refrains from all of the following: 
266.25     (a) Charging private paying residents rates for similar 
266.26  services which exceed those which are approved by the state 
266.27  agency for medical assistance recipients as determined by the 
266.28  prospective desk audit rate, except under the following 
266.29  circumstances:  the nursing facility may (1) charge private 
266.30  paying residents a higher rate for a private room, and (2) 
266.31  charge for special services which are not included in the daily 
266.32  rate if medical assistance residents are charged separately at 
266.33  the same rate for the same services in addition to the daily 
266.34  rate paid by the commissioner.  Services covered by the payment 
266.35  rate must be the same regardless of payment source.  Special 
266.36  services, if offered, must be available to all residents in all 
267.1   areas of the nursing facility and charged separately at the same 
267.2   rate.  Residents are free to select or decline special 
267.3   services.  Special services must not include services which must 
267.4   be provided by the nursing facility in order to comply with 
267.5   licensure or certification standards and that if not provided 
267.6   would result in a deficiency or violation by the nursing 
267.7   facility.  Services beyond those required to comply with 
267.8   licensure or certification standards must not be charged 
267.9   separately as a special service if they were included in the 
267.10  payment rate for the previous reporting year.  A nursing 
267.11  facility that charges a private paying resident a rate in 
267.12  violation of this clause is subject to an action by the state of 
267.13  Minnesota or any of its subdivisions or agencies for civil 
267.14  damages.  A private paying resident or the resident's legal 
267.15  representative has a cause of action for civil damages against a 
267.16  nursing facility that charges the resident rates in violation of 
267.17  this clause.  The damages awarded shall include three times the 
267.18  payments that result from the violation, together with costs and 
267.19  disbursements, including reasonable attorneys' fees or their 
267.20  equivalent.  A private paying resident or the resident's legal 
267.21  representative, the state, subdivision or agency, or a nursing 
267.22  facility may request a hearing to determine the allowed rate or 
267.23  rates at issue in the cause of action.  Within 15 calendar days 
267.24  after receiving a request for such a hearing, the commissioner 
267.25  shall request assignment of an administrative law judge under 
267.26  sections 14.48 to 14.56 to conduct the hearing as soon as 
267.27  possible or according to agreement by the parties.  The 
267.28  administrative law judge shall issue a report within 15 calendar 
267.29  days following the close of the hearing.  The prohibition set 
267.30  forth in this clause shall not apply to facilities licensed as 
267.31  boarding care facilities which are not certified as skilled or 
267.32  intermediate care facilities level I or II for reimbursement 
267.33  through medical assistance. 
267.34     (b) Requiring an applicant for admission to the facility, 
267.35  or the guardian or conservator of the applicant, as a condition 
267.36  of admission, to pay any fee or deposit in excess of $100, loan 
268.1   any money to the nursing facility, or promise to leave all or 
268.2   part of the applicant's estate to the facility.  
268.3      (c) Requiring any resident of the nursing facility to 
268.4   utilize a vendor of health care services chosen by the nursing 
268.5   facility.  A nursing facility may require a resident to use 
268.6   pharmacies that utilize unit dose packing systems or other 
268.7   medication administration systems approved by the Minnesota 
268.8   board of pharmacy, and may require a resident to use pharmacies 
268.9   that are able to meet the nursing facility's standards for safe 
268.10  and timely administration of medications such as systems with 
268.11  specific number of doses, prompt delivery of medications, or 
268.12  access to medications on a 24-hour basis.  Nursing facilities 
268.13  shall not restrict a resident's choice of pharmacy because the 
268.14  pharmacy utilizes a specific system of unit dose drug packing, 
268.15  providing the system is consistent with the other systems used 
268.16  by the facility. 
268.17     (d) Providing differential treatment on the basis of status 
268.18  with regard to public assistance.  
268.19     (e) Discriminating in admissions, services offered, or room 
268.20  assignment on the basis of status with regard to public 
268.21  assistance or refusal to purchase special services.  Admissions 
268.22  discrimination shall include, but is not limited to:  
268.23     (1) basing admissions decisions upon assurance by the 
268.24  applicant to the nursing facility, or the applicant's guardian 
268.25  or conservator, that the applicant is neither eligible for nor 
268.26  will seek public assistance for payment of nursing facility care 
268.27  costs; and 
268.28     (2) engaging in preferential selection from waiting lists 
268.29  based on an applicant's ability to pay privately or an 
268.30  applicant's refusal to pay for a special service. 
268.31     The collection and use by a nursing facility of financial 
268.32  information of any applicant pursuant to a preadmission 
268.33  screening program established by law shall not raise an 
268.34  inference that the nursing facility is utilizing that 
268.35  information for any purpose prohibited by this paragraph.  
268.36     (f) Requiring any vendor of medical care as defined by 
269.1   section 256B.02, subdivision 7, who is reimbursed by medical 
269.2   assistance under a separate fee schedule, to pay any amount 
269.3   based on utilization or service levels or any portion of the 
269.4   vendor's fee to the nursing facility except as payment for 
269.5   renting or leasing space or equipment or purchasing support 
269.6   services from the nursing facility as limited by section 
269.7   256B.433.  All agreements must be disclosed to the commissioner 
269.8   upon request of the commissioner.  Nursing facilities and 
269.9   vendors of ancillary services that are found to be in violation 
269.10  of this provision shall each be subject to an action by the 
269.11  state of Minnesota or any of its subdivisions or agencies for 
269.12  treble civil damages on the portion of the fee in excess of that 
269.13  allowed by this provision and section 256B.433.  Damages awarded 
269.14  must include three times the excess payments together with costs 
269.15  and disbursements including reasonable attorney's fees or their 
269.16  equivalent.  
269.17     (g) Refusing, for more than 24 hours, to accept a resident 
269.18  returning to the same bed or a bed certified for the same level 
269.19  of care, in accordance with a physician's order authorizing 
269.20  transfer, after receiving inpatient hospital services. 
269.21     The prohibitions set forth in clause (b) shall not apply to 
269.22  a retirement facility with more than 325 beds including at least 
269.23  150 licensed nursing facility beds and which:  
269.24     (1) is owned and operated by an organization tax-exempt 
269.25  under section 290.05, subdivision 1, clause (i); and 
269.26     (2) accounts for all of the applicant's assets which are 
269.27  required to be assigned to the facility so that only expenses 
269.28  for the cost of care of the applicant may be charged against the 
269.29  account; and 
269.30     (3) agrees in writing at the time of admission to the 
269.31  facility to permit the applicant, or the applicant's guardian, 
269.32  or conservator, to examine the records relating to the 
269.33  applicant's account upon request, and to receive an audited 
269.34  statement of the expenditures charged against the applicant's 
269.35  individual account upon request; and 
269.36     (4) agrees in writing at the time of admission to the 
270.1   facility to permit the applicant to withdraw from the facility 
270.2   at any time and to receive, upon withdrawal, the balance of the 
270.3   applicant's individual account. 
270.4      For a period not to exceed 180 days, the commissioner may 
270.5   continue to make medical assistance payments to a nursing 
270.6   facility or boarding care home which is in violation of this 
270.7   section if extreme hardship to the residents would result.  In 
270.8   these cases the commissioner shall issue an order requiring the 
270.9   nursing facility to correct the violation.  The nursing facility 
270.10  shall have 20 days from its receipt of the order to correct the 
270.11  violation.  If the violation is not corrected within the 20-day 
270.12  period the commissioner may reduce the payment rate to the 
270.13  nursing facility by up to 20 percent.  The amount of the payment 
270.14  rate reduction shall be related to the severity of the violation 
270.15  and shall remain in effect until the violation is corrected.  
270.16  The nursing facility or boarding care home may appeal the 
270.17  commissioner's action pursuant to the provisions of chapter 14 
270.18  pertaining to contested cases.  An appeal shall be considered 
270.19  timely if written notice of appeal is received by the 
270.20  commissioner within 20 days of notice of the commissioner's 
270.21  proposed action.  
270.22     In the event that the commissioner determines that a 
270.23  nursing facility is not eligible for reimbursement for a 
270.24  resident who is eligible for medical assistance, the 
270.25  commissioner may authorize the nursing facility to receive 
270.26  reimbursement on a temporary basis until the resident can be 
270.27  relocated to a participating nursing facility.  
270.28     Certified beds in facilities which do not allow medical 
270.29  assistance intake on July 1, 1984, or after shall be deemed to 
270.30  be decertified for purposes of section 144A.071 only. 
270.31     Sec. 60.  Minnesota Statutes 1998, section 256B.501, 
270.32  subdivision 8a, is amended to read: 
270.33     Subd. 8a.  [PAYMENT FOR PERSONS WITH SPECIAL NEEDS FOR 
270.34  CRISIS INTERVENTION SERVICES.] State-operated, Community-based 
270.35  crisis services provided in accordance with section 252.50, 
270.36  subdivision 7, to authorized by the commissioner or the 
271.1   commissioner's designee for a resident of an intermediate care 
271.2   facility for persons with mental retardation (ICF/MR) reimbursed 
271.3   under this section shall be paid by medical assistance in 
271.4   accordance with the paragraphs (a) to (h) (g). 
271.5      (a) "Crisis services" means the specialized services listed 
271.6   in clauses (1) to (3) provided to prevent the recipient from 
271.7   requiring placement in a more restrictive institutional setting 
271.8   such as an inpatient hospital or regional treatment center and 
271.9   to maintain the recipient in the present community setting. 
271.10     (1) The crisis services provider shall assess the 
271.11  recipient's behavior and environment to identify factors 
271.12  contributing to the crisis. 
271.13     (2) The crisis services provider shall develop a 
271.14  recipient-specific intervention plan in coordination with the 
271.15  service planning team and provide recommendations for revisions 
271.16  to the individual service plan if necessary to prevent or 
271.17  minimize the likelihood of future crisis situations.  The 
271.18  intervention plan shall include a transition plan to aid the 
271.19  recipient in returning to the community-based ICF/MR if the 
271.20  recipient is receiving residential crisis services.  
271.21     (3) The crisis services provider shall consult with and 
271.22  provide training and ongoing technical assistance to the 
271.23  recipient's service providers to aid in the implementation of 
271.24  the intervention plan and revisions to the individual service 
271.25  plan. 
271.26     (b) "Residential crisis services" means crisis services 
271.27  that are provided to a recipient admitted to the crisis services 
271.28  foster care setting an alternative, state licensed site approved 
271.29  by the commissioner, because the ICF/MR receiving reimbursement 
271.30  under this section is not able, as determined by the 
271.31  commissioner, to provide the intervention and protection of the 
271.32  recipient and others living with the recipient that is necessary 
271.33  to prevent the recipient from requiring placement in a more 
271.34  restrictive institutional setting. 
271.35     (c) Residential crisis services providers must be licensed 
271.36  by maintain a license from the commissioner under section 
272.1   245A.03 to provide foster care, must exclusively provide for the 
272.2   residence when providing crisis services for short-term crisis 
272.3   intervention, and must not be located in a private residence. 
272.4      (d) Payment rates are determined annually for each crisis 
272.5   services provider based on cost of care for each provider as 
272.6   defined in section 246.50.  Interim payment rates are calculated 
272.7   on a per diem basis by dividing the projected cost of providing 
272.8   care by the projected number of contact days for the fiscal 
272.9   year, as estimated by the commissioner.  Final payment rates are 
272.10  calculated by dividing the actual cost of providing care by the 
272.11  actual number of contact days in the applicable fiscal year will 
272.12  be established consistent with county negotiated crisis 
272.13  intervention services.  
272.14     (e) Payment shall be made for each contact day.  "Contact 
272.15  day" means any day in which the crisis services provider has 
272.16  face-to-face contact with the recipient or any of the 
272.17  recipient's medical assistance service providers for the purpose 
272.18  of providing crisis services as defined in paragraph (c). 
272.19     (f) Payment for residential crisis services is limited to 
272.20  21 days, unless an additional period is authorized by the 
272.21  commissioner or part of an approved regional plan.  The 
272.22  additional period may not exceed 21 days. 
272.23     (g) (f) Payment for crisis services shall be made only for 
272.24  services provided while the ICF/MR receiving reimbursement under 
272.25  this section: 
272.26     (1) has a shared services agreement with the crisis 
272.27  services provider in effect in accordance with under section 
272.28  246.57; and 
272.29     (2) has reassigned payment for the provision of the crisis 
272.30  services under this subdivision to the commissioner in 
272.31  accordance with Code of Federal Regulations, title 42, section 
272.32  447.10(e); and 
272.33     (3) has executed a cooperative agreement with the crisis 
272.34  services provider to implement the intervention plan and 
272.35  revisions to the individual service plan as necessary to prevent 
272.36  or minimize the likelihood of future crisis situations, to 
273.1   maintain the recipient in the present community setting, and to 
273.2   prevent the recipient from requiring a more restrictive 
273.3   institutional setting. 
273.4      (h) (g) Payment to the ICF/MR receiving reimbursement under 
273.5   this section shall be made for up to 18 therapeutic leave days 
273.6   during which the recipient is receiving residential crisis 
273.7   services, if the ICF/MR is otherwise eligible to receive payment 
273.8   for a therapeutic leave day under Minnesota Rules, part 
273.9   9505.0415.  Payment under this paragraph shall be terminated if 
273.10  the commissioner determines that the ICF/MR is not meeting the 
273.11  terms of the cooperative shared service agreement under 
273.12  paragraph (g) (f) or that the recipient will not return to the 
273.13  ICF/MR. 
273.14     Sec. 61.  Minnesota Statutes 1998, section 256B.69, 
273.15  subdivision 3a, is amended to read: 
273.16     Subd. 3a.  [COUNTY AUTHORITY.] (a) The commissioner, when 
273.17  implementing the general assistance medical care, or medical 
273.18  assistance prepayment program within a county, must include the 
273.19  county board in the process of development, approval, and 
273.20  issuance of the request for proposals to provide services to 
273.21  eligible individuals within the proposed county.  County boards 
273.22  must be given reasonable opportunity to make recommendations 
273.23  regarding the development, issuance, review of responses, and 
273.24  changes needed in the request for proposals.  The commissioner 
273.25  must provide county boards the opportunity to review each 
273.26  proposal based on the identification of community needs under 
273.27  chapters 145A and 256E and county advocacy activities.  If a 
273.28  county board finds that a proposal does not address certain 
273.29  community needs, the county board and commissioner shall 
273.30  continue efforts for improving the proposal and network prior to 
273.31  the approval of the contract.  The county board shall make 
273.32  recommendations regarding the approval of local networks and 
273.33  their operations to ensure adequate availability and access to 
273.34  covered services.  The provider or health plan must respond 
273.35  directly to county advocates and the state prepaid medical 
273.36  assistance ombudsperson regarding service delivery and must be 
274.1   accountable to the state regarding contracts with medical 
274.2   assistance and general assistance medical care funds.  The 
274.3   county board may recommend a maximum number of participating 
274.4   health plans after considering the size of the enrolling 
274.5   population; ensuring adequate access and capacity; considering 
274.6   the client and county administrative complexity; and considering 
274.7   the need to promote the viability of locally developed health 
274.8   plans.  The county board or a single entity representing a group 
274.9   of county boards and the commissioner shall mutually select 
274.10  health plans for participation at the time of initial 
274.11  implementation of the prepaid medical assistance program in that 
274.12  county or group of counties and at the time of contract renewal. 
274.13  The commissioner shall also seek input for contract requirements 
274.14  from the county or single entity representing a group of county 
274.15  boards at each contract renewal and incorporate those 
274.16  recommendations into the contract negotiation process.  The 
274.17  commissioner, in conjunction with the county board, shall 
274.18  actively seek to develop a mutually agreeable timetable prior to 
274.19  the development of the request for proposal, but counties must 
274.20  agree to initial enrollment beginning on or before January 1, 
274.21  1999, in either the prepaid medical assistance and general 
274.22  assistance medical care programs or county-based purchasing 
274.23  under section 256B.692.  At least 90 days before enrollment in 
274.24  the medical assistance and general assistance medical care 
274.25  prepaid programs begins in a county in which the prepaid 
274.26  programs have not been established, the commissioner shall 
274.27  provide a report to the chairs of senate and house committees 
274.28  having jurisdiction over state health care programs which 
274.29  verifies that the commissioner complied with the requirements 
274.30  for county involvement that are specified in this subdivision. 
274.31     (b) The commissioner shall seek a federal waiver to allow a 
274.32  fee-for-service plan option to MinnesotaCare enrollees.  The 
274.33  commissioner shall develop an increase of the premium fees 
274.34  required under section 256L.06 up to 20 percent of the premium 
274.35  fees for the enrollees who elect the fee-for-service option.  
274.36  Prior to implementation, the commissioner shall submit this fee 
275.1   schedule to the chair and ranking minority member of the senate 
275.2   health care committee, the senate health care and family 
275.3   services funding division, the house of representatives health 
275.4   and human services committee, and the house of representatives 
275.5   health and human services finance division. 
275.6      (c) At the option of the county board, the board may 
275.7   develop contract requirements related to the achievement of 
275.8   local public health goals to meet the health needs of medical 
275.9   assistance and general assistance medical care enrollees.  These 
275.10  requirements must be reasonably related to the performance of 
275.11  health plan functions and within the scope of the medical 
275.12  assistance and general assistance medical care benefit sets.  If 
275.13  the county board and the commissioner mutually agree to such 
275.14  requirements, the department shall include such requirements in 
275.15  all health plan contracts governing the prepaid medical 
275.16  assistance and general assistance medical care programs in that 
275.17  county at initial implementation of the program in that county 
275.18  and at the time of contract renewal.  The county board may 
275.19  participate in the enforcement of the contract provisions 
275.20  related to local public health goals. 
275.21     (d) For counties in which prepaid medical assistance and 
275.22  general assistance medical care programs have not been 
275.23  established, the commissioner shall not implement those programs 
275.24  if a county board submits acceptable and timely preliminary and 
275.25  final proposals under section 256B.692, until county-based 
275.26  purchasing is no longer operational in that county.  For 
275.27  counties in which prepaid medical assistance and general 
275.28  assistance medical care programs are in existence on or after 
275.29  September 1, 1997, the commissioner must terminate contracts 
275.30  with health plans according to section 256B.692, subdivision 5, 
275.31  if the county board submits and the commissioner accepts 
275.32  preliminary and final proposals according to that subdivision.  
275.33  The commissioner is not required to terminate contracts that 
275.34  begin on or after September 1, 1997, according to section 
275.35  256B.692 until two years have elapsed from the date of initial 
275.36  enrollment. 
276.1      (e) In the event that a county board or a single entity 
276.2   representing a group of county boards and the commissioner 
276.3   cannot reach agreement regarding:  (i) the selection of 
276.4   participating health plans in that county; (ii) contract 
276.5   requirements; or (iii) implementation and enforcement of county 
276.6   requirements including provisions regarding local public health 
276.7   goals, the commissioner shall resolve all disputes after taking 
276.8   into account the recommendations of a three-person mediation 
276.9   panel.  The panel shall be composed of one designee of the 
276.10  president of the association of Minnesota counties, one designee 
276.11  of the commissioner of human services, and one designee of the 
276.12  commissioner of health. 
276.13     (f) If a county which elects to implement county-based 
276.14  purchasing ceases to implement county-based purchasing, it is 
276.15  prohibited from assuming the responsibility of county-based 
276.16  purchasing for a period of five years from the date it 
276.17  discontinues purchasing. 
276.18     (g) Notwithstanding the requirement in this subdivision 
276.19  that a county must agree to initial enrollment on or before 
276.20  January 1, 1999, the commissioner shall grant a delay of up to 
276.21  nine months in the implementation of the county-based purchasing 
276.22  authorized in section 256B.692 until federal waiver authority 
276.23  and approval has been granted, if the county or group of 
276.24  counties has submitted a preliminary proposal for county-based 
276.25  purchasing by September 1, 1997, has not already implemented the 
276.26  prepaid medical assistance program before January 1, 1998, and 
276.27  has submitted a written request for the delay to the 
276.28  commissioner by July 1, 1998.  In order for the delay to be 
276.29  continued, the county or group of counties must also submit to 
276.30  the commissioner the following information by December 1, 1998.  
276.31  The information must: 
276.32     (1) identify the proposed date of implementation, not later 
276.33  than October 1, 1999 as determined under section 256B.692, 
276.34  subdivision 5; 
276.35     (2) include copies of the county board resolutions which 
276.36  demonstrate the continued commitment to the implementation of 
277.1   county-based purchasing by the proposed date.  County board 
277.2   authorization may remain contingent on the submission of a final 
277.3   proposal which meets the requirements of section 256B.692, 
277.4   subdivision 5, paragraph (b); 
277.5      (3) demonstrate actions taken for the establishment of a 
277.6   governance structure between the participating counties and 
277.7   describe how the fiduciary responsibilities of county-based 
277.8   purchasing will be allocated between the counties, if more than 
277.9   one county is involved in the proposal; 
277.10     (4) describe how the risk of a deficit will be managed in 
277.11  the event expenditures are greater than total capitation 
277.12  payments.  This description must identify how any of the 
277.13  following strategies will be used: 
277.14     (i) risk contracts with licensed health plans; 
277.15     (ii) risk arrangements with providers who are not licensed 
277.16  health plans; 
277.17     (iii) risk arrangements with other licensed insurance 
277.18  entities; and 
277.19     (iv) funding from other county resources; 
277.20     (5) include, if county-based purchasing will not contract 
277.21  with licensed health plans or provider networks, letters of 
277.22  interest from local providers in at least the categories of 
277.23  hospital, physician, mental health, and pharmacy which express 
277.24  interest in contracting for services.  These letters must 
277.25  recognize any risk transfer identified in clause (4), item (ii); 
277.26  and 
277.27     (6) describe the options being considered to obtain the 
277.28  administrative services required in section 256B.692, 
277.29  subdivision 3, clauses (3) and (5). 
277.30     (h) For counties which receive a delay under this 
277.31  subdivision, the final proposals required under section 
277.32  256B.692, subdivision 5, paragraph (b), must be submitted at 
277.33  least six months prior to the requested implementation date.  
277.34  Authority to implement county-based purchasing remains 
277.35  contingent on approval of the final proposal as required under 
277.36  section 256B.692. 
278.1      (i) If the commissioner is unable to provide 
278.2   county-specific, individual-level fee-for-service claims to 
278.3   counties by June 4, 1998, the commissioner shall grant a delay 
278.4   under paragraph (g) of up to 12 months in the implementation of 
278.5   county-based purchasing, and shall require implementation not 
278.6   later than January 1, 2000.  In order to receive an extension of 
278.7   the proposed date of implementation under this paragraph, a 
278.8   county or group of counties must submit a written request for 
278.9   the extension to the commissioner by August 1, 1998, must submit 
278.10  the information required under paragraph (g) by December 1, 
278.11  1998, and must submit a final proposal as provided under 
278.12  paragraph (h). 
278.13     (j) Notwithstanding other requirements of this subdivision, 
278.14  the commissioner shall not require the implementation of the 
278.15  county-based purchasing authorized in section 256B.692 until six 
278.16  months after federal waiver approval has been obtained for 
278.17  county-based purchasing, if the county or counties have 
278.18  submitted the final plan as required in section 256B.692, 
278.19  subdivision 5.  The commissioner shall allow the county or 
278.20  counties which submitted information under section 256B.692, 
278.21  subdivision 5, to submit supplemental or additional information 
278.22  which was not possible to submit by April 1, 1999.  A county or 
278.23  counties shall continue to submit the required information and 
278.24  substantive detail necessary to obtain a prompt response and 
278.25  waiver approval.  If amendments to the final plan are necessary 
278.26  due to the terms and conditions of the waiver approval, the 
278.27  commissioner shall allow the county or group of counties 60 days 
278.28  to make the necessary amendments to the final plan and shall not 
278.29  require implementation of the county-based purchasing until six 
278.30  months after the revised final plan has been submitted. 
278.31     Sec. 62.  Minnesota Statutes 1998, section 256B.69, is 
278.32  amended by adding a subdivision to read: 
278.33     Subd. 3b.  [PROVISION OF DATA TO COUNTY BOARDS.] The 
278.34  commissioner of human services, in consultation with 
278.35  representatives of county boards of commissioners shall identify 
278.36  program information and data necessary on an ongoing basis for 
279.1   county boards to:  (1) make recommendations to the commissioner 
279.2   related to state purchasing under the prepaid medical assistance 
279.3   program; and (2) effectively administer county-based 
279.4   purchasing.  This information and data must include, but is not 
279.5   limited to, county-specific, individual-level fee-for-service 
279.6   and prepaid health plan claims information. 
279.7      Sec. 63.  Minnesota Statutes 1998, section 256B.69, is 
279.8   amended by adding a subdivision to read: 
279.9      Subd. 4b.  [INDIVIDUAL EDUCATION PLAN AND INDIVIDUALIZED 
279.10  FAMILY SERVICE PLAN SERVICES.] The commissioner shall amend the 
279.11  federal waiver allowing the state to separate out individual 
279.12  education plan and individualized family service plan services 
279.13  for children enrolled in the prepaid medical assistance program 
279.14  and the MinnesotaCare program.  Effective July 1, 1999, or upon 
279.15  federal approval, medical assistance coverage of eligible 
279.16  individual education plan and individualized family service plan 
279.17  services shall not be included in the capitated services for 
279.18  children enrolled in health plans through the prepaid medical 
279.19  assistance program and the MinnesotaCare program.  Upon federal 
279.20  approval, local school districts shall bill the commissioner for 
279.21  these services, and claims shall be paid on a fee-for-service 
279.22  basis. 
279.23     Sec. 64.  Minnesota Statutes 1998, section 256B.69, 
279.24  subdivision 5a, is amended to read: 
279.25     Subd. 5a.  [MANAGED CARE CONTRACTS.] Managed care contracts 
279.26  under this section, sections 256.9363, and 256D.03, shall be 
279.27  entered into or renewed on a calendar year basis beginning 
279.28  January 1, 1996.  Managed care contracts which were in effect on 
279.29  June 30, 1995, and set to renew on July 1, 1995, shall be 
279.30  renewed for the period July 1, 1995 through December 31, 1995 at 
279.31  the same terms that were in effect on June 30, 1995. 
279.32     A prepaid health plan providing covered health services for 
279.33  eligible persons pursuant to chapters 256B, 256D, and 256L, is 
279.34  responsible for complying with the terms of its contract with 
279.35  the commissioner.  Requirements applicable to managed care 
279.36  programs under chapters 256B, 256D, and 256L, established after 
280.1   the effective date of a contract with the commissioner take 
280.2   effect when the contract is next issued or renewed, subject to 
280.3   the terms and conditions negotiated by the prepaid health plan 
280.4   and the commissioner. 
280.5      Sec. 65.  Minnesota Statutes 1998, section 256B.69, 
280.6   subdivision 5b, is amended to read: 
280.7      Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
280.8   prepaid medical assistance and general assistance medical care 
280.9   program contract rates set by the commissioner under subdivision 
280.10  5 and effective on or after January 1, 1998, capitation rates 
280.11  for nonmetropolitan counties shall on a weighted average be no 
280.12  less than 88 percent of the capitation rates for metropolitan 
280.13  counties, excluding Hennepin county.  The commissioner shall 
280.14  make a pro rata adjustment in capitation rates paid to counties 
280.15  other than nonmetropolitan counties in order to make this 
280.16  provision budget neutral.  
280.17     (b) For prepaid medical assistance and general assistance 
280.18  medical care program contract rates set by the commissioner 
280.19  under subdivision 5 and effective on or after January 1, 2000, 
280.20  capitation rates for nonmetropolitan counties shall, on a 
280.21  weighted average, be no less than 92 percent of the capitation 
280.22  rates for metropolitan counties, excluding Hennepin county.  The 
280.23  commissioner shall adjust the capitation rate paid to Hennepin 
280.24  county in order to make this provision budget neutral.  
280.25     Sec. 66.  Minnesota Statutes 1998, section 256B.69, is 
280.26  amended by adding a subdivision to read: 
280.27     Subd. 5e.  [MEDICAL EDUCATION AND RESEARCH PAYMENTS.] For 
280.28  the calendar years 1999, 2000, and 2001, a hospital that 
280.29  participates in funding the federal share of the medical 
280.30  education and research trust fund payment under Laws 1998, 
280.31  chapter 407, article 1, section 3, shall not be held liable for 
280.32  any amounts attributable to this payment above the charge limit 
280.33  of section 256.969, subdivision 3a.  The commissioner of human 
280.34  services shall assume liability for any corresponding federal 
280.35  share of the payments above the charge limit. 
280.36     Sec. 67.  Minnesota Statutes 1998, section 256B.692, 
281.1   subdivision 2, is amended to read: 
281.2      Subd. 2.  [DUTIES OF THE COMMISSIONER OF HEALTH.] (a) 
281.3   Notwithstanding chapters 62D and 62N, a county that elects to 
281.4   purchase medical assistance and general assistance medical care 
281.5   in return for a fixed sum without regard to the frequency or 
281.6   extent of services furnished to any particular enrollee is not 
281.7   required to obtain a certificate of authority under chapter 62D 
281.8   or 62N.  The county board of commissioners is the governing body 
281.9   of a county-based purchasing program.  In a multicounty 
281.10  arrangement, the governing body is a joint powers board 
281.11  established under section 471.59.  
281.12     (b) A county that elects to purchase medical assistance and 
281.13  general assistance medical care services under this section must 
281.14  satisfy the commissioner of health that the requirements for 
281.15  assurance of consumer and provider protection and fiscal 
281.16  solvency of chapter 62D, applicable to health maintenance 
281.17  organizations, or chapter 62N, applicable to community 
281.18  integrated service networks, will be met.  
281.19     (c) A county must also assure the commissioner of health 
281.20  that the requirements of sections 62J.041; 62J.48; 62J.71 to 
281.21  62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 
281.22  62Q, including sections 62Q.07; 62Q.075; 62Q.105; 62Q.1055; 
281.23  62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 
281.24  62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 
281.25  62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met.  
281.26     (d) All enforcement and rulemaking powers available under 
281.27  chapters 62D, 62J, 62M, 62N, and 62Q are hereby granted to the 
281.28  commissioner of health with respect to counties that purchase 
281.29  medical assistance and general assistance medical care services 
281.30  under this section.  
281.31     (e) The commissioner, in consultation with county 
281.32  government, shall develop administrative and financial reporting 
281.33  requirements for county-based purchasing programs relating to 
281.34  sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 
281.35  62N.31, and other sections as necessary, that are specific to 
281.36  county administrative, accounting, and reporting systems and 
282.1   consistent with other statutory requirements of counties. 
282.2      Sec. 68.  Minnesota Statutes 1998, section 256B.75, is 
282.3   amended to read: 
282.4      256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
282.5      (a) For outpatient hospital facility fee payments for 
282.6   services rendered on or after October 1, 1992, the commissioner 
282.7   of human services shall pay the lower of (1) submitted charge, 
282.8   or (2) 32 percent above the rate in effect on June 30, 1992, 
282.9   except for those services for which there is a federal maximum 
282.10  allowable payment.  Effective for services rendered on or after 
282.11  January 1, 2000, payment rates for nonsurgical outpatient 
282.12  hospital facility fees and emergency room facility fees shall be 
282.13  increased by ten percent over the rates in effect on December 
282.14  31, 1999, except for those services for which there is a federal 
282.15  maximum allowable payment.  Services for which there is a 
282.16  federal maximum allowable payment shall be paid at the lower of 
282.17  (1) submitted charge, or (2) the federal maximum allowable 
282.18  payment.  Total aggregate payment for outpatient hospital 
282.19  facility fee services shall not exceed the Medicare upper 
282.20  limit.  If it is determined that a provision of this section 
282.21  conflicts with existing or future requirements of the United 
282.22  States government with respect to federal financial 
282.23  participation in medical assistance, the federal requirements 
282.24  prevail.  The commissioner may, in the aggregate, prospectively 
282.25  reduce payment rates to avoid reduced federal financial 
282.26  participation resulting from rates that are in excess of the 
282.27  Medicare upper limitations. 
282.28     (b) Notwithstanding paragraph (a), payment for outpatient, 
282.29  emergency, and ambulatory surgery hospital facility fee services 
282.30  for critical access hospitals designated under section 144.1483, 
282.31  clause (11), shall be paid on a cost-based payment system that 
282.32  is based on the cost-finding methods and allowable costs of the 
282.33  Medicare program. 
282.34     (Effective Date:  Section 68 (256B.75) is effective for 
282.35  services rendered on or after July 1, 1999.) 
282.36     Sec. 69.  Minnesota Statutes 1998, section 256B.76, is 
283.1   amended to read: 
283.2      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
283.3      (a) The physician reimbursement increase provided in 
283.4   section 256B.74, subdivision 2, shall not be implemented.  
283.5   Effective for services rendered on or after October 1, 1992, the 
283.6   commissioner shall make payments for physician services as 
283.7   follows: 
283.8      (1) payment for level one Health Care Finance 
283.9   Administration's common procedural coding system (HCPCS) codes 
283.10  titled "office and other outpatient services," "preventive 
283.11  medicine new and established patient," "delivery, antepartum, 
283.12  and postpartum care," "critical care," Caesarean delivery and 
283.13  pharmacologic management provided to psychiatric patients, and 
283.14  HCPCS level three codes for enhanced services for prenatal high 
283.15  risk, shall be paid at the lower of (i) submitted charges, or 
283.16  (ii) 25 percent above the rate in effect on June 30, 1992.  If 
283.17  the rate on any procedure code within these categories is 
283.18  different than the rate that would have been paid under the 
283.19  methodology in section 256B.74, subdivision 2, then the larger 
283.20  rate shall be paid; 
283.21     (2) payments for all other services shall be paid at the 
283.22  lower of (i) submitted charges, or (ii) 15.4 percent above the 
283.23  rate in effect on June 30, 1992; and 
283.24     (3) all physician rates shall be converted from the 50th 
283.25  percentile of 1982 to the 50th percentile of 1989, less the 
283.26  percent in aggregate necessary to equal the above increases 
283.27  except that payment rates for home health agency services shall 
283.28  be the rates in effect on September 30, 1992.; 
283.29     (4) effective for services rendered on or after October 1, 
283.30  1999, payment rates for physician and professional services 
283.31  shall be increased by four percent over the rates in effect on 
283.32  September 30, 1999, except for home health agency and family 
283.33  planning agency services; 
283.34     (5) the department shall present a proposal during the year 
283.35  2000 legislative session detailing physician and professional 
283.36  services payment methodology conversion to Resource Based 
284.1   Relative Value Scale; and 
284.2      (6) the increases in clause (4) shall be implemented 
284.3   January 1, 2000, for managed care. 
284.4      (b) The dental reimbursement increase provided in section 
284.5   256B.74, subdivision 5, shall not be implemented.  Effective for 
284.6   services rendered on or after October 1, 1992, the commissioner 
284.7   shall make payments for dental services as follows: 
284.8      (1) dental services shall be paid at the lower of (i) 
284.9   submitted charges, or (ii) 25 percent above the rate in effect 
284.10  on June 30, 1992; and 
284.11     (2) dental rates shall be converted from the 50th 
284.12  percentile of 1982 to the 50th percentile of 1989, less the 
284.13  percent in aggregate necessary to equal the above increases.; 
284.14     (3) effective for services rendered on or after October 1, 
284.15  1999, payment rates for dental services shall be increased by 
284.16  five percent over the rates in effect on September 30, 1999; 
284.17     (4) the department shall increase payments by 20 percent 
284.18  over the October 1, 1999, fee-for-service rates, for those 
284.19  fee-for-service providers for whom public programs under MA, 
284.20  GAMC, and MinnesotaCare account for 20 percent or more of their 
284.21  practice; 
284.22     (5) the commissioner shall award grants to community 
284.23  clinics or other nonprofit community organizations, political 
284.24  subdivisions, professional associations, or other organizations 
284.25  that demonstrate the ability to provide dental services 
284.26  effectively to public program recipients.  Grants may be used to 
284.27  fund the costs related to coordinating access for recipients, 
284.28  developing and implementing patient care criteria, upgrading or 
284.29  establishing new facilities, acquiring furnishings or equipment, 
284.30  recruiting new providers, or other development costs that will 
284.31  improve access to dental care in a region.  In awarding grants, 
284.32  the commissioner shall give priority to applicants that plan to 
284.33  serve areas of the state in which the number of dental providers 
284.34  is not currently sufficient to meet the needs of recipients of 
284.35  public programs or uninsured individuals.  The commissioner 
284.36  shall monitor the grants and may terminate a grant if the 
285.1   grantee does not increase dental access for public program 
285.2   recipients.  The commissioner shall consider grants for the 
285.3   following: 
285.4      (i) implementation of new programs or continued expansion 
285.5   of current access programs that have demonstrated success in 
285.6   providing dental services in underserved areas; 
285.7      (ii) a pilot program utilizing dental hygienists and dental 
285.8   assistants to provide education, training, and screening for 
285.9   dental care needs including referrals to dentists for dental 
285.10  care treatment; 
285.11     (iii) a pilot program for utilizing hygienists outside of a 
285.12  traditional dental office to provide dental hygiene services; 
285.13  and 
285.14     (iv) a program that organizes a network of volunteer 
285.15  dentists, establishes a system to refer eligible individuals to 
285.16  volunteer dentists, and through that network provides donated 
285.17  dental care services to public program recipients or uninsured 
285.18  individuals. 
285.19     (6) beginning October 1, 1999, the payment for tooth 
285.20  sealants and fluoride treatments shall be the lower of (i) 
285.21  submitted charge, or (ii) 80 percent of median 1997 charges; and 
285.22     (7) the increases listed in clauses (3), (4), and (6) shall 
285.23  be implemented January 1, 2000, for managed care. 
285.24     (c) An entity that operates both a Medicare certified 
285.25  comprehensive outpatient rehabilitation facility and a facility 
285.26  which was certified prior to January 1, 1993, that is licensed 
285.27  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
285.28  whom at least 33 percent of the clients receiving rehabilitation 
285.29  services in the most recent calendar year are medical assistance 
285.30  recipients, shall be reimbursed by the commissioner for 
285.31  rehabilitation services at rates that are 38 percent greater 
285.32  than the maximum reimbursement rate allowed under paragraph (a), 
285.33  clause (2), when those services are (1) provided within the 
285.34  comprehensive outpatient rehabilitation facility and (2) 
285.35  provided to residents of nursing facilities owned by the entity. 
285.36     Sec. 70.  Minnesota Statutes 1998, section 256B.77, 
286.1   subdivision 7a, is amended to read: 
286.2      Subd. 7a.  [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 
286.3   for the demonstration project as provided in this subdivision. 
286.4      (b) "Eligible individuals" means those persons living in 
286.5   the demonstration site who are eligible for medical assistance 
286.6   and are disabled based on a disability determination under 
286.7   section 256B.055, subdivisions 7 and 12, or who are eligible for 
286.8   medical assistance and have been diagnosed as having: 
286.9      (1) serious and persistent mental illness as defined in 
286.10  section 245.462, subdivision 20; 
286.11     (2) severe emotional disturbance as defined in section 
286.12  245.487 245.4871, subdivision 6; or 
286.13     (3) mental retardation, or being a mentally retarded person 
286.14  as defined in section 252A.02, or a related condition as defined 
286.15  in section 252.27, subdivision 1a. 
286.16  Other individuals may be included at the option of the county 
286.17  authority based on agreement with the commissioner. 
286.18     (c) Eligible individuals residing on a federally recognized 
286.19  Indian reservation may be excluded from participation in the 
286.20  demonstration project at the discretion of the tribal government 
286.21  based on agreement with the commissioner, in consultation with 
286.22  the county authority. 
286.23     (d) Eligible individuals include individuals in excluded 
286.24  time status, as defined in chapter 256G.  Enrollees in excluded 
286.25  time at the time of enrollment shall remain in excluded time 
286.26  status as long as they live in the demonstration site and shall 
286.27  be eligible for 90 days after placement outside the 
286.28  demonstration site if they move to excluded time status in a 
286.29  county within Minnesota other than their county of financial 
286.30  responsibility. 
286.31     (e) (d) A person who is a sexual psychopathic personality 
286.32  as defined in section 253B.02, subdivision 18a, or a sexually 
286.33  dangerous person as defined in section 253B.02, subdivision 18b, 
286.34  is excluded from enrollment in the demonstration project. 
286.35     Sec. 71.  Minnesota Statutes 1998, section 256B.77, is 
286.36  amended by adding a subdivision to read: 
287.1      Subd. 7b.  [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 
287.2   or after July 1, 1999, for American Indian recipients of medical 
287.3   assistance who are required to enroll with a county 
287.4   administrative entity or service delivery organization under 
287.5   subdivision 7, medical assistance shall cover health care 
287.6   services provided at American Indian health services facilities 
287.7   and facilities operated by a tribe or tribal organization under 
287.8   funding authorized by United States Code, title 25, sections 
287.9   450f to 450n, or title III of the Indian Self-Determination and 
287.10  Education Assistance Act, Public Law Number 93-638, if those 
287.11  services would otherwise be covered under section 256B.0625.  
287.12  Payments for services provided under this subdivision shall be 
287.13  made on a fee-for-service basis, and may, at the option of the 
287.14  tribe or tribal organization, be made according to rates 
287.15  authorized under sections 256.969, subdivision 16, and 
287.16  256B.0625, subdivision 34.  Implementation of this purchasing 
287.17  model is contingent on federal approval. 
287.18     (b) The commissioner of human services, in consultation 
287.19  with tribal governments, shall develop a plan for tribes to 
287.20  assist in the enrollment process for American Indian recipients 
287.21  enrolled in the demonstration project for people with 
287.22  disabilities under this section.  This plan also shall address 
287.23  how tribes will be included in ensuring the coordination of care 
287.24  for American Indian recipients between Indian health service or 
287.25  tribal providers and other providers. 
287.26     (c) For purposes of this subdivision, "American Indian" has 
287.27  the meaning given to persons to whom services will be provided 
287.28  for in Code of Federal Regulations, title 42, section 36.12. 
287.29     Sec. 72.  Minnesota Statutes 1998, section 256B.77, 
287.30  subdivision 8, is amended to read: 
287.31     Subd. 8.  [RESPONSIBILITIES OF THE COUNTY ADMINISTRATIVE 
287.32  ENTITY.] (a) The county administrative entity shall meet the 
287.33  requirements of this subdivision, unless the county authority or 
287.34  the commissioner, with written approval of the county authority, 
287.35  enters into a service delivery contract with a service delivery 
287.36  organization for any or all of the requirements contained in 
288.1   this subdivision. 
288.2      (b) The county administrative entity shall enroll eligible 
288.3   individuals regardless of health or disability status. 
288.4      (c) The county administrative entity shall provide all 
288.5   enrollees timely access to the medical assistance benefit set.  
288.6   Alternative services and additional services are available to 
288.7   enrollees at the option of the county administrative entity and 
288.8   may be provided if specified in the personal support plan.  
288.9   County authorities are not required to seek prior authorization 
288.10  from the department as required by the laws and rules governing 
288.11  medical assistance. 
288.12     (d) The county administrative entity shall cover necessary 
288.13  services as a result of an emergency without prior 
288.14  authorization, even if the services were rendered outside of the 
288.15  provider network. 
288.16     (e) The county administrative entity shall authorize 
288.17  necessary and appropriate services when needed and requested by 
288.18  the enrollee or the enrollee's legal representative in response 
288.19  to an urgent situation.  Enrollees shall have 24-hour access to 
288.20  urgent care services coordinated by experienced disability 
288.21  providers who have information about enrollees' needs and 
288.22  conditions. 
288.23     (f) The county administrative entity shall accept the 
288.24  capitation payment from the commissioner in return for the 
288.25  provision of services for enrollees. 
288.26     (g) The county administrative entity shall maintain 
288.27  internal grievance and complaint procedures, including an 
288.28  expedited informal complaint process in which the county 
288.29  administrative entity must respond to verbal complaints within 
288.30  ten calendar days, and a formal grievance process, in which the 
288.31  county administrative entity must respond to written complaints 
288.32  within 30 calendar days. 
288.33     (h) The county administrative entity shall provide a 
288.34  certificate of coverage, upon enrollment, to each enrollee and 
288.35  the enrollee's legal representative, if any, which describes the 
288.36  benefits covered by the county administrative entity, any 
289.1   limitations on those benefits, and information about providers 
289.2   and the service delivery network.  This information must also be 
289.3   made available to prospective enrollees.  This certificate must 
289.4   be approved by the commissioner. 
289.5      (i) The county administrative entity shall present evidence 
289.6   of an expedited process to approve exceptions to benefits, 
289.7   provider network restrictions, and other plan limitations under 
289.8   appropriate circumstances. 
289.9      (j) The county administrative entity shall provide 
289.10  enrollees or their legal representatives with written notice of 
289.11  their appeal rights under subdivision 16, and of ombudsman and 
289.12  advocacy programs under subdivisions 13 and 14, at the following 
289.13  times:  upon enrollment, upon submission of a written complaint, 
289.14  when a service is reduced, denied, or terminated, or when 
289.15  renewal of authorization for ongoing service is refused. 
289.16     (k) The county administrative entity shall determine 
289.17  immediate needs, including services, support, and assessments, 
289.18  within 30 calendar days of after enrollment, or within a shorter 
289.19  time frame if specified in the intergovernmental contract. 
289.20     (l) The county administrative entity shall assess the need 
289.21  for services of new enrollees within 60 calendar days of after 
289.22  enrollment, or within a shorter time frame if specified in the 
289.23  intergovernmental contract, and periodically reassess the need 
289.24  for services for all enrollees. 
289.25     (m) The county administrative entity shall ensure the 
289.26  development of a personal support plan for each person within 60 
289.27  calendar days of enrollment, or within a shorter time frame if 
289.28  specified in the intergovernmental contract, unless otherwise 
289.29  agreed to by the enrollee and the enrollee's legal 
289.30  representative, if any.  Until a personal support plan is 
289.31  developed and agreed to by the enrollee, enrollees must have 
289.32  access to the same amount, type, setting, duration, and 
289.33  frequency of covered services that they had at the time of 
289.34  enrollment unless other covered services are needed.  For an 
289.35  enrollee who is not receiving covered services at the time of 
289.36  enrollment and for enrollees whose personal support plan is 
290.1   being revised, access to the medical assistance benefit set must 
290.2   be assured until a personal support plan is developed or 
290.3   revised.  If an enrollee chooses not to develop a personal 
290.4   support plan, the enrollee will be subject to the network and 
290.5   prior authorization requirements of the county administrative 
290.6   entity or service delivery organization 60 days after 
290.7   enrollment.  An enrollee can choose to have a personal support 
290.8   plan developed at any time.  The personal support plan must be 
290.9   based on choices, preferences, and assessed needs and strengths 
290.10  of the enrollee.  The service coordinator shall develop the 
290.11  personal support plan, in consultation with the enrollee or the 
290.12  enrollee's legal representative and other individuals requested 
290.13  by the enrollee.  The personal support plan must be updated as 
290.14  needed or as requested by the enrollee.  Enrollees may choose 
290.15  not to have a personal support plan. 
290.16     (n) The county administrative entity shall ensure timely 
290.17  authorization, arrangement, and continuity of needed and covered 
290.18  supports and services. 
290.19     (o) The county administrative entity shall offer service 
290.20  coordination that fulfills the responsibilities under 
290.21  subdivision 12 and is appropriate to the enrollee's needs, 
290.22  choices, and preferences, including a choice of service 
290.23  coordinator. 
290.24     (p) The county administrative entity shall contract with 
290.25  schools and other agencies as appropriate to provide otherwise 
290.26  covered medically necessary medical assistance services as 
290.27  described in an enrollee's individual family support plan, as 
290.28  described in sections 125A.26 to 125A.48, or individual 
290.29  education plan, as described in chapter 125A. 
290.30     (q) The county administrative entity shall develop and 
290.31  implement strategies, based on consultation with affected 
290.32  groups, to respect diversity and ensure culturally competent 
290.33  service delivery in a manner that promotes the physical, social, 
290.34  psychological, and spiritual well-being of enrollees and 
290.35  preserves the dignity of individuals, families, and their 
290.36  communities. 
291.1      (r) When an enrollee changes county authorities, county 
291.2   administrative entities shall ensure coordination with the 
291.3   entity that is assuming responsibility for administering the 
291.4   medical assistance benefit set to ensure continuity of supports 
291.5   and services for the enrollee. 
291.6      (s) The county administrative entity shall comply with 
291.7   additional requirements as specified in the intergovernmental 
291.8   contract.  
291.9      (t) To the extent that alternatives are approved under 
291.10  subdivision 17, county administrative entities must provide for 
291.11  the health and safety of enrollees and protect the rights to 
291.12  privacy and to provide informed consent. 
291.13     Sec. 73.  Minnesota Statutes 1998, section 256B.77, 
291.14  subdivision 10, is amended to read: 
291.15     Subd. 10.  [CAPITATION PAYMENT.] (a) The commissioner shall 
291.16  pay a capitation payment to the county authority and, when 
291.17  applicable under subdivision 6, paragraph (a), to the service 
291.18  delivery organization for each medical assistance eligible 
291.19  enrollee.  The commissioner shall develop capitation payment 
291.20  rates for the initial contract period for each demonstration 
291.21  site in consultation with an independent actuary, to ensure that 
291.22  the cost of services under the demonstration project does not 
291.23  exceed the estimated cost for medical assistance services for 
291.24  the covered population under the fee-for-service system for the 
291.25  demonstration period.  For each year of the demonstration 
291.26  project, the capitation payment rate shall be based on 96 
291.27  percent of the projected per person costs that would otherwise 
291.28  have been paid under medical assistance fee-for-service during 
291.29  each of those years.  Rates shall be adjusted within the limits 
291.30  of the available risk adjustment technology, as mandated by 
291.31  section 62Q.03.  In addition, the commissioner shall implement 
291.32  appropriate risk and savings sharing provisions with county 
291.33  administrative entities and, when applicable under subdivision 
291.34  6, paragraph (a), service delivery organizations within the 
291.35  projected budget limits.  Capitation rates shall be adjusted, at 
291.36  least annually, to include any rate increases and payments for 
292.1   expanded or newly covered services for eligible individuals.  
292.2   The initial demonstration project rate shall include an amount 
292.3   in addition to the fee-for-service payments to adjust for 
292.4   underutilization of dental services.  Any savings beyond those 
292.5   allowed for the county authority, county administrative entity, 
292.6   or service delivery organization shall be first used to meet the 
292.7   unmet needs of eligible individuals.  Payments to providers 
292.8   participating in the project are exempt from the requirements of 
292.9   sections 256.966 and 256B.03, subdivision 2. 
292.10     (b) The commissioner shall monitor and evaluate annually 
292.11  the effect of the discount on consumers, the county authority, 
292.12  and providers of disability services.  Findings shall be 
292.13  reported and recommendations made, as appropriate, to ensure 
292.14  that the discount effect does not adversely affect the ability 
292.15  of the county administrative entity or providers of services to 
292.16  provide appropriate services to eligible individuals, and does 
292.17  not result in cost shifting of eligible individuals to the 
292.18  county authority. 
292.19     (c) For risk-sharing to occur under this subdivision, the 
292.20  aggregate fee-for-service cost of covered services provided by 
292.21  the county administrative entity under this section must exceed 
292.22  the aggregate sum of capitation payments made to the county 
292.23  administrative entity under this section.  The county authority 
292.24  is required to maintain its current level of nonmedical 
292.25  assistance spending on enrollees.  If the county authority 
292.26  spends less in nonmedical assistance dollars on enrollees than 
292.27  it spent the year prior to the contract year, the amount of 
292.28  underspending shall be deducted from the aggregate 
292.29  fee-for-service cost of covered services.  The commissioner 
292.30  shall then compare the fee-for-service costs and capitation 
292.31  payments related to the services provided for the term of this 
292.32  contract.  The commissioner shall base its calculation of the 
292.33  fee-for-service costs on application of the medical assistance 
292.34  fee schedule to services identified on the county administrative 
292.35  entity's encounter claims submitted to the commissioner.  The 
292.36  aggregate fee-for-service cost shall not include any third-party 
293.1   recoveries or cost-avoided amounts. 
293.2      If the commissioner finds that the aggregate 
293.3   fee-for-service cost is greater than the sum of the capitation 
293.4   payments, the commissioner shall settle according to the 
293.5   following schedule: 
293.6      (1) For the first contract year for each project, the 
293.7   commissioner shall pay the county administrative entity 100 
293.8   percent of the difference between the sum of the capitation 
293.9   payments and 100 percent of projected fee-for-service costs.  
293.10  For aggregate fee-for-service costs in excess of 100 percent of 
293.11  projected fee-for-service costs, the commissioner shall pay 50 
293.12  percent of the difference between the aggregate fee-for-service 
293.13  cost and the projected fee-for-service cost, up to 104 percent 
293.14  of the projected fee-for-service costs.  The county 
293.15  administrative entity shall be responsible for all costs in 
293.16  excess of 104 percent of projected fee-for-service costs. 
293.17     (2) For the second contract year for each project, the 
293.18  commissioner shall pay the county administrative entity 75 
293.19  percent of the difference between the sum of the capitation 
293.20  payments and 100 percent of projected fee-for-service costs.  
293.21  The county administrative entity shall be responsible for all 
293.22  costs in excess of 100 percent of projected fee-for-service 
293.23  costs. 
293.24     (3) For the third contract year for each project, the 
293.25  commissioner shall pay the county administrative entity 50 
293.26  percent of the difference between the sum of the capitation 
293.27  payments and 100 percent of projected fee-for-service costs.  
293.28  The county administrative entity shall be responsible for all 
293.29  costs in excess of 100 percent of projected fee-for-service 
293.30  costs. 
293.31     (4) For the fourth and subsequent contract years for each 
293.32  project, the county administrative entity shall be responsible 
293.33  for all costs in excess of the capitation payments. 
293.34     (d) In addition to other payments under this subdivision, 
293.35  the commissioner may increase payments by up to 0.5 percent of 
293.36  the projected per person costs that would otherwise have been 
294.1   paid under medical assistance fee-for-service.  The commissioner 
294.2   may make the increased payments to: 
294.3      (1) offset rate increases for regional treatment services 
294.4   under subdivision 22 which are higher than was expected by the 
294.5   commissioner when the capitation was set at 96 percent; and 
294.6      (2) implement incentives to encourage appropriate, high 
294.7   quality, efficient services. 
294.8      Sec. 74.  Minnesota Statutes 1998, section 256B.77, 
294.9   subdivision 14, is amended to read: 
294.10     Subd. 14.  [EXTERNAL ADVOCACY.] In addition to ombudsman 
294.11  services, enrollees shall have access to advocacy services on a 
294.12  local or regional basis.  The purpose of external advocacy 
294.13  includes providing individual advocacy services for enrollees 
294.14  who have complaints or grievances with the county administrative 
294.15  entity, service delivery organization, or a service provider; 
294.16  assisting enrollees to understand the service delivery system 
294.17  and select providers and, if applicable, a service delivery 
294.18  organization; and understand and exercise their rights as an 
294.19  enrollee.  External advocacy contractors must demonstrate that 
294.20  they have the expertise to advocate on behalf of all categories 
294.21  of eligible individuals and are independent of the commissioner, 
294.22  county authority, county administrative entity, service delivery 
294.23  organization, or any service provider within the demonstration 
294.24  project.  
294.25     These advocacy services shall be provided through the 
294.26  ombudsman for mental health and mental retardation directly, or 
294.27  under contract with private, nonprofit organizations, with 
294.28  funding provided through the demonstration project.  The funding 
294.29  shall be provided annually to the ombudsman's office based on 
294.30  0.1 percent of the projected per person costs that would 
294.31  otherwise have been paid under medical assistance 
294.32  fee-for-service during those years.  Funding for external 
294.33  advocacy shall be provided for each year of the demonstration 
294.34  period through general fund appropriations.  This funding is in 
294.35  addition to the capitation payment available under subdivision 
294.36  10. 
295.1      Sec. 75.  Minnesota Statutes 1998, section 256B.77, is 
295.2   amended by adding a subdivision to read: 
295.3      Subd. 27.  [SERVICE COORDINATION TRANSITION.] Demonstration 
295.4   sites designated under subdivision 5, with the permission of an 
295.5   eligible individual, may implement the provisions of subdivision 
295.6   12 beginning 60 calendar days prior to an individual's 
295.7   enrollment.  This implementation may occur prior to the 
295.8   enrollment of eligible individuals, but is restricted to 
295.9   eligible individuals. 
295.10     Sec. 76.  Minnesota Statutes 1998, section 256D.03, 
295.11  subdivision 4, is amended to read: 
295.12     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
295.13  For a person who is eligible under subdivision 3, paragraph (a), 
295.14  clause (3), general assistance medical care covers, except as 
295.15  provided in paragraph (c): 
295.16     (1) inpatient hospital services; 
295.17     (2) outpatient hospital services; 
295.18     (3) services provided by Medicare certified rehabilitation 
295.19  agencies; 
295.20     (4) prescription drugs and other products recommended 
295.21  through the process established in section 256B.0625, 
295.22  subdivision 13; 
295.23     (5) equipment necessary to administer insulin and 
295.24  diagnostic supplies and equipment for diabetics to monitor blood 
295.25  sugar level; 
295.26     (6) eyeglasses and eye examinations provided by a physician 
295.27  or optometrist; 
295.28     (7) hearing aids; 
295.29     (8) prosthetic devices; 
295.30     (9) laboratory and X-ray services; 
295.31     (10) physician's services; 
295.32     (11) medical transportation; 
295.33     (12) chiropractic services as covered under the medical 
295.34  assistance program; 
295.35     (13) podiatric services; 
295.36     (14) dental services; 
296.1      (15) outpatient services provided by a mental health center 
296.2   or clinic that is under contract with the county board and is 
296.3   established under section 245.62; 
296.4      (16) day treatment services for mental illness provided 
296.5   under contract with the county board; 
296.6      (17) prescribed medications for persons who have been 
296.7   diagnosed as mentally ill as necessary to prevent more 
296.8   restrictive institutionalization; 
296.9      (18) psychological services, medical supplies and 
296.10  equipment, and Medicare premiums, coinsurance and deductible 
296.11  payments; 
296.12     (19) medical equipment not specifically listed in this 
296.13  paragraph when the use of the equipment will prevent the need 
296.14  for costlier services that are reimbursable under this 
296.15  subdivision; 
296.16     (20) services performed by a certified pediatric nurse 
296.17  practitioner, a certified family nurse practitioner, a certified 
296.18  adult nurse practitioner, a certified obstetric/gynecological 
296.19  nurse practitioner, a certified neonatal nurse practitioner, or 
296.20  a certified geriatric nurse practitioner in independent 
296.21  practice, if the services are otherwise covered under this 
296.22  chapter as a physician service, if services provided on an 
296.23  inpatient basis are not included as part of the cost for 
296.24  inpatient services included in the operating payment rate, and 
296.25  if the service is within the scope of practice of the nurse 
296.26  practitioner's license as a registered nurse, as defined in 
296.27  section 148.171; and 
296.28     (21) services of a certified public health nurse or a 
296.29  registered nurse practicing in a public health nursing clinic 
296.30  that is a department of, or that operates under the direct 
296.31  authority of, a unit of government, if the service is within the 
296.32  scope of practice of the public health nurse's license as a 
296.33  registered nurse, as defined in section 148.171; and 
296.34     (22) telemedicine consultations, to the extent they are 
296.35  covered under section 256B.0625, subdivision 3b.  
296.36     (b) Except as provided in paragraph (c), for a recipient 
297.1   who is eligible under subdivision 3, paragraph (a), clause (1) 
297.2   or (2), general assistance medical care covers the services 
297.3   listed in paragraph (a) with the exception of special 
297.4   transportation services. 
297.5      (c) Gender reassignment surgery and related services are 
297.6   not covered services under this subdivision unless the 
297.7   individual began receiving gender reassignment services prior to 
297.8   July 1, 1995.  
297.9      (d) In order to contain costs, the commissioner of human 
297.10  services shall select vendors of medical care who can provide 
297.11  the most economical care consistent with high medical standards 
297.12  and shall where possible contract with organizations on a 
297.13  prepaid capitation basis to provide these services.  The 
297.14  commissioner shall consider proposals by counties and vendors 
297.15  for prepaid health plans, competitive bidding programs, block 
297.16  grants, or other vendor payment mechanisms designed to provide 
297.17  services in an economical manner or to control utilization, with 
297.18  safeguards to ensure that necessary services are provided.  
297.19  Before implementing prepaid programs in counties with a county 
297.20  operated or affiliated public teaching hospital or a hospital or 
297.21  clinic operated by the University of Minnesota, the commissioner 
297.22  shall consider the risks the prepaid program creates for the 
297.23  hospital and allow the county or hospital the opportunity to 
297.24  participate in the program in a manner that reflects the risk of 
297.25  adverse selection and the nature of the patients served by the 
297.26  hospital, provided the terms of participation in the program are 
297.27  competitive with the terms of other participants considering the 
297.28  nature of the population served.  Payment for services provided 
297.29  pursuant to this subdivision shall be as provided to medical 
297.30  assistance vendors of these services under sections 256B.02, 
297.31  subdivision 8, and 256B.0625.  For payments made during fiscal 
297.32  year 1990 and later years, the commissioner shall consult with 
297.33  an independent actuary in establishing prepayment rates, but 
297.34  shall retain final control over the rate methodology.  
297.35  Notwithstanding the provisions of subdivision 3, an individual 
297.36  who becomes ineligible for general assistance medical care 
298.1   because of failure to submit income reports or recertification 
298.2   forms in a timely manner, shall remain enrolled in the prepaid 
298.3   health plan and shall remain eligible for general assistance 
298.4   medical care coverage through the last day of the month in which 
298.5   the enrollee became ineligible for general assistance medical 
298.6   care. 
298.7      (e) The commissioner of human services may reduce payments 
298.8   provided under sections 256D.01 to 256D.21 and 261.23 in order 
298.9   to remain within the amount appropriated for general assistance 
298.10  medical care, within the following restrictions: 
298.11     (i) For the period July 1, 1985 to December 31, 1985, 
298.12  reductions below the cost per service unit allowable under 
298.13  section 256.966, are permitted only as follows:  payments for 
298.14  inpatient and outpatient hospital care provided in response to a 
298.15  primary diagnosis of chemical dependency or mental illness may 
298.16  be reduced no more than 30 percent; payments for all other 
298.17  inpatient hospital care may be reduced no more than 20 percent.  
298.18  Reductions below the payments allowable under general assistance 
298.19  medical care for the remaining general assistance medical care 
298.20  services allowable under this subdivision may be reduced no more 
298.21  than ten percent. 
298.22     (ii) For the period January 1, 1986 to December 31, 1986, 
298.23  reductions below the cost per service unit allowable under 
298.24  section 256.966 are permitted only as follows:  payments for 
298.25  inpatient and outpatient hospital care provided in response to a 
298.26  primary diagnosis of chemical dependency or mental illness may 
298.27  be reduced no more than 20 percent; payments for all other 
298.28  inpatient hospital care may be reduced no more than 15 percent.  
298.29  Reductions below the payments allowable under general assistance 
298.30  medical care for the remaining general assistance medical care 
298.31  services allowable under this subdivision may be reduced no more 
298.32  than five percent. 
298.33     (iii) For the period January 1, 1987 to June 30, 1987, 
298.34  reductions below the cost per service unit allowable under 
298.35  section 256.966 are permitted only as follows:  payments for 
298.36  inpatient and outpatient hospital care provided in response to a 
299.1   primary diagnosis of chemical dependency or mental illness may 
299.2   be reduced no more than 15 percent; payments for all other 
299.3   inpatient hospital care may be reduced no more than ten 
299.4   percent.  Reductions below the payments allowable under medical 
299.5   assistance for the remaining general assistance medical care 
299.6   services allowable under this subdivision may be reduced no more 
299.7   than five percent.  
299.8      (iv) For the period July 1, 1987 to June 30, 1988, 
299.9   reductions below the cost per service unit allowable under 
299.10  section 256.966 are permitted only as follows:  payments for 
299.11  inpatient and outpatient hospital care provided in response to a 
299.12  primary diagnosis of chemical dependency or mental illness may 
299.13  be reduced no more than 15 percent; payments for all other 
299.14  inpatient hospital care may be reduced no more than five percent.
299.15  Reductions below the payments allowable under medical assistance 
299.16  for the remaining general assistance medical care services 
299.17  allowable under this subdivision may be reduced no more than 
299.18  five percent. 
299.19     (v) For the period July 1, 1988 to June 30, 1989, 
299.20  reductions below the cost per service unit allowable under 
299.21  section 256.966 are permitted only as follows:  payments for 
299.22  inpatient and outpatient hospital care provided in response to a 
299.23  primary diagnosis of chemical dependency or mental illness may 
299.24  be reduced no more than 15 percent; payments for all other 
299.25  inpatient hospital care may not be reduced.  Reductions below 
299.26  the payments allowable under medical assistance for the 
299.27  remaining general assistance medical care services allowable 
299.28  under this subdivision may be reduced no more than five percent. 
299.29     (f) There shall be no copayment required of any recipient 
299.30  of benefits for any services provided under this subdivision.  A 
299.31  hospital receiving a reduced payment as a result of this section 
299.32  may apply the unpaid balance toward satisfaction of the 
299.33  hospital's bad debts. 
299.34     (g) Any county may, from its own resources, provide medical 
299.35  payments for which state payments are not made. 
299.36     (h) Chemical dependency services that are reimbursed under 
300.1   chapter 254B must not be reimbursed under general assistance 
300.2   medical care. 
300.3      (i) The maximum payment for new vendors enrolled in the 
300.4   general assistance medical care program after the base year 
300.5   shall be determined from the average usual and customary charge 
300.6   of the same vendor type enrolled in the base year. 
300.7      (j) The conditions of payment for services under this 
300.8   subdivision are the same as the conditions specified in rules 
300.9   adopted under chapter 256B governing the medical assistance 
300.10  program, unless otherwise provided by statute or rule. 
300.11     Sec. 77.  Minnesota Statutes 1998, section 256L.01, 
300.12  subdivision 4, is amended to read: 
300.13     Subd. 4.  [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] 
300.14  (a) "Gross individual or gross family income" for farm and 
300.15  nonfarm self-employed means income calculated using as the 
300.16  baseline the adjusted gross income reported on the applicant's 
300.17  federal income tax form for the previous year and adding back in 
300.18  reported depreciation, carryover loss, and net operating loss 
300.19  amounts that apply to the business in which the family is 
300.20  currently engaged.  
300.21     (b) "Gross individual or gross family income" for farm 
300.22  self-employed means income calculated using as the baseline the 
300.23  adjusted gross income reported on the applicant's federal income 
300.24  tax form for the previous year and adding back in reported 
300.25  depreciation amounts that apply to the business in which the 
300.26  family is currently engaged. 
300.27     (c) Applicants shall report the most recent financial 
300.28  situation of the family if it has changed from the period of 
300.29  time covered by the federal income tax form.  The report may be 
300.30  in the form of percentage increase or decrease. 
300.31     Sec. 78.  Minnesota Statutes 1998, section 256L.04, 
300.32  subdivision 2, is amended to read: 
300.33     Subd. 2.  [COOPERATION IN ESTABLISHING THIRD-PARTY 
300.34  LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 
300.35  eligible for MinnesotaCare, individuals and families must 
300.36  cooperate with the state agency to identify potentially liable 
301.1   third-party payers and assist the state in obtaining third-party 
301.2   payments.  "Cooperation" includes, but is not limited to, 
301.3   identifying any third party who may be liable for care and 
301.4   services provided under MinnesotaCare to the enrollee, providing 
301.5   relevant information to assist the state in pursuing a 
301.6   potentially liable third party, and completing forms necessary 
301.7   to recover third-party payments. 
301.8      (b) A parent, guardian, relative caretaker, or child 
301.9   enrolled in the MinnesotaCare program must cooperate with the 
301.10  department of human services and the local agency in 
301.11  establishing the paternity of an enrolled child and in obtaining 
301.12  medical care support and payments for the child and any other 
301.13  person for whom the person can legally assign rights, in 
301.14  accordance with applicable laws and rules governing the medical 
301.15  assistance program.  A child shall not be ineligible for or 
301.16  disenrolled from the MinnesotaCare program solely because the 
301.17  child's parent, relative caretaker, or guardian fails to 
301.18  cooperate in establishing paternity or obtaining medical support.
301.19     Sec. 79.  Minnesota Statutes 1998, section 256L.04, 
301.20  subdivision 8, is amended to read: 
301.21     Subd. 8.  [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 
301.22  ASSISTANCE.] (a) Individuals who receive supplemental security 
301.23  income or retirement, survivors, or disability benefits due to a 
301.24  disability, or other disability-based pension, who qualify under 
301.25  subdivision 7, but who are potentially eligible for medical 
301.26  assistance without a spenddown shall be allowed to enroll in 
301.27  MinnesotaCare for a period of 60 days, so long as the applicant 
301.28  meets all other conditions of eligibility.  The commissioner 
301.29  shall identify and refer the applications of such individuals to 
301.30  their county social service agency.  The county and the 
301.31  commissioner shall cooperate to ensure that the individuals 
301.32  obtain medical assistance coverage for any months for which they 
301.33  are eligible. 
301.34     (b) The enrollee must cooperate with the county social 
301.35  service agency in determining medical assistance eligibility 
301.36  within the 60-day enrollment period.  Enrollees who do not 
302.1   cooperate with medical assistance within the 60-day enrollment 
302.2   period shall be disenrolled from the plan within one calendar 
302.3   month.  Persons disenrolled for nonapplication for medical 
302.4   assistance may not reenroll until they have obtained a medical 
302.5   assistance eligibility determination.  Persons disenrolled for 
302.6   noncooperation with medical assistance may not reenroll until 
302.7   they have cooperated with the county agency and have obtained a 
302.8   medical assistance eligibility determination. 
302.9      (c) Beginning January 1, 2000, counties that choose to 
302.10  become MinnesotaCare enrollment sites shall consider 
302.11  MinnesotaCare applications of individuals described in paragraph 
302.12  (a) to also be applications for medical assistance and shall 
302.13  first determine whether medical assistance eligibility exists.  
302.14  Adults with children with family income under 175 percent of the 
302.15  federal poverty guidelines for the applicable family size, 
302.16  pregnant women, and children who qualify under subdivision 1 
302.17  Applicants who are potentially eligible for medical assistance, 
302.18  except for those described in paragraph (a), without a spenddown 
302.19  may choose to enroll in either MinnesotaCare or medical 
302.20  assistance. 
302.21     (d) The commissioner shall redetermine provider payments 
302.22  made under MinnesotaCare to the appropriate medical assistance 
302.23  payments for those enrollees who subsequently become eligible 
302.24  for medical assistance. 
302.25     Sec. 80.  Minnesota Statutes 1998, section 256L.04, 
302.26  subdivision 13, is amended to read: 
302.27     Subd. 13.  [FAMILIES WITH GRANDPARENTS, RELATIVE 
302.28  CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning 
302.29  January 1, 1999, in families that include a grandparent, 
302.30  relative caretaker as defined in the medical assistance program, 
302.31  foster parent, or legal guardian, the grandparent, relative 
302.32  caretaker, foster parent, or legal guardian may apply as a 
302.33  family or may apply separately for the children.  If the 
302.34  caretaker applies separately for the children, only the 
302.35  children's income is counted and the provisions of subdivision 
302.36  1, paragraph (b), do not apply.  If the grandparent, relative 
303.1   caretaker, foster parent, or legal guardian applies with the 
303.2   children, their income is included in the gross family income 
303.3   for determining eligibility and premium amount. 
303.4      Sec. 81.  Minnesota Statutes 1998, section 256L.05, 
303.5   subdivision 4, is amended to read: 
303.6      Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
303.7   human services shall determine an applicant's eligibility for 
303.8   MinnesotaCare no more than 30 days from the date that the 
303.9   application is received by the department of human services.  
303.10  Beginning January 1, 2000, this requirement also applies to 
303.11  local county human services agencies that determine eligibility 
303.12  for MinnesotaCare.  Once annually at application or 
303.13  reenrollment, to prevent processing delays, applicants or 
303.14  enrollees who, from the information provided on the application, 
303.15  appear to meet eligibility requirements shall be enrolled upon 
303.16  timely payment of premiums. The enrollee must provide all 
303.17  required verifications within 30 days of enrollment notification 
303.18  of the eligibility determination or coverage from the program 
303.19  shall be terminated.  Enrollees who are determined to be 
303.20  ineligible when verifications are provided shall be disenrolled 
303.21  from the program. 
303.22     Sec. 82.  Minnesota Statutes 1998, section 256L.06, 
303.23  subdivision 3, is amended to read: 
303.24     Subd. 3.  [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 
303.25  Premiums are dedicated to the commissioner for MinnesotaCare. 
303.26     (b) The commissioner shall develop and implement procedures 
303.27  to:  (1) require enrollees to report changes in income; (2) 
303.28  adjust sliding scale premium payments, based upon changes in 
303.29  enrollee income; and (3) disenroll enrollees from MinnesotaCare 
303.30  for failure to pay required premiums.  Beginning July 1, 1998, 
303.31  Failure to pay includes payment with a dishonored check and, a 
303.32  returned automatic bank withdrawal, or a refused credit card or 
303.33  debit card payment.  The commissioner may demand a guaranteed 
303.34  form of payment, including a cashier's check or a money order, 
303.35  as the only means to replace a dishonored check, returned, or 
303.36  refused payment. 
304.1      (c) Premiums are calculated on a calendar month basis and 
304.2   may be paid on a monthly, quarterly, or annual basis, with the 
304.3   first payment due upon notice from the commissioner of the 
304.4   premium amount required.  The commissioner shall inform 
304.5   applicants and enrollees of these premium payment options. 
304.6   Premium payment is required before enrollment is complete and to 
304.7   maintain eligibility in MinnesotaCare.  
304.8      (d) Nonpayment of the premium will result in disenrollment 
304.9   from the plan within one calendar month after the due date.  
304.10  Persons disenrolled for nonpayment or who voluntarily terminate 
304.11  coverage from the program may not reenroll until four calendar 
304.12  months have elapsed.  Persons disenrolled for nonpayment who pay 
304.13  all past due premiums as well as current premiums due, including 
304.14  premiums due for the period of disenrollment, within 20 days of 
304.15  disenrollment, shall be reenrolled retroactively to the first 
304.16  day of disenrollment.  Persons disenrolled for nonpayment or who 
304.17  voluntarily terminate coverage from the program may not reenroll 
304.18  for four calendar months unless the person demonstrates good 
304.19  cause for nonpayment.  Good cause does not exist if a person 
304.20  chooses to pay other family expenses instead of the premium.  
304.21  The commissioner shall define good cause in rule. 
304.22     Sec. 83.  Minnesota Statutes 1998, section 256L.07, is 
304.23  amended to read: 
304.24     256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 
304.25  SLIDING SCALE MINNESOTACARE.] 
304.26     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
304.27  enrolled in the original children's health plan as of September 
304.28  30, 1992, children who enrolled in the MinnesotaCare program 
304.29  after September 30, 1992, pursuant to Laws 1992, chapter 549, 
304.30  article 4, section 17, and children who have family gross 
304.31  incomes that are equal to or less than 150 percent of the 
304.32  federal poverty guidelines are eligible for subsidized premium 
304.33  payments without meeting the requirements of subdivision 2, as 
304.34  long as they maintain continuous coverage in the MinnesotaCare 
304.35  program or medical assistance.  Children who apply for 
304.36  MinnesotaCare on or after the implementation date of the 
305.1   employer-subsidized health coverage program as described in Laws 
305.2   1998, chapter 407, article 5, section 45, who have family gross 
305.3   incomes that are equal to or less than 150 percent of the 
305.4   federal poverty guidelines, must meet the requirements of 
305.5   subdivision 2 to be eligible for MinnesotaCare. 
305.6      (b) Families enrolled in MinnesotaCare under section 
305.7   256L.04, subdivision 1, whose income increases above 275 percent 
305.8   of the federal poverty guidelines, are no longer eligible for 
305.9   the program and shall be disenrolled by the commissioner.  
305.10  Individuals enrolled in MinnesotaCare under section 256L.04, 
305.11  subdivision 7, whose income increases above 175 percent of the 
305.12  federal poverty guidelines are no longer eligible for the 
305.13  program and shall be disenrolled by the commissioner.  For 
305.14  persons disenrolled under this subdivision, MinnesotaCare 
305.15  coverage terminates the last day of the calendar month following 
305.16  the month in which the commissioner determines that the income 
305.17  of a family or individual, determined over a four-month period 
305.18  as required by section 256L.15, subdivision 2, exceeds program 
305.19  income limits.  
305.20     (c) Notwithstanding paragraph (b), individuals and families 
305.21  may remain enrolled in MinnesotaCare if ten percent of their 
305.22  annual income is less than the annual premium for a policy with 
305.23  a $500 deductible available through the Minnesota comprehensive 
305.24  health association.  Individuals and families who are no longer 
305.25  eligible for MinnesotaCare under this subdivision shall be given 
305.26  an 18-month notice period from the date that ineligibility is 
305.27  determined before disenrollment.  
305.28     Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
305.29  COVERAGE.] (a) To be eligible for subsidized premium payments 
305.30  based on a sliding scale, a family or individual must not have 
305.31  access to subsidized health coverage through an employer.  A 
305.32  family or individual whose employer-subsidized coverage is lost 
305.33  due to an employer terminating health care coverage as an 
305.34  employee benefit during the previous 18 months is not eligible.  
305.35     (b) For purposes of this requirement, subsidized health 
305.36  coverage means health coverage for which the employer pays at 
306.1   least 50 percent of the cost of coverage for the employee or 
306.2   dependent, or a higher percentage as specified by the 
306.3   commissioner.  Children are eligible for employer-subsidized 
306.4   coverage through either parent, including the noncustodial 
306.5   parent.  The commissioner must treat employer contributions to 
306.6   Internal Revenue Code Section 125 plans and any other employer 
306.7   benefits intended to pay health care costs as qualified employer 
306.8   subsidies toward the cost of health coverage for employees for 
306.9   purposes of this subdivision. 
306.10     Subd. 3.  [OTHER HEALTH COVERAGE.] (a) Families and 
306.11  individuals enrolled in the MinnesotaCare program must have no 
306.12  health coverage while enrolled or for at least four months prior 
306.13  to application and renewal.  Children enrolled in the original 
306.14  children's health plan and children in families with income 
306.15  equal to or less than 150 percent of the federal poverty 
306.16  guidelines, who have other health insurance, are eligible if the 
306.17  other health coverage meets the requirements of Minnesota Rules, 
306.18  part 9506.0020, subpart 3, item B. coverage: 
306.19     (1) lacks two or more of the following: 
306.20     (i) basic hospital insurance; 
306.21     (ii) medical-surgical insurance; 
306.22     (iii) prescription drug coverage; 
306.23     (iv) dental coverage; or 
306.24     (v) vision coverage; 
306.25     (2) requires a deductible of $100 or more per person per 
306.26  year; or 
306.27     (3) lacks coverage because the child has exceeded the 
306.28  maximum coverage for a particular diagnosis or the policy 
306.29  excludes a particular diagnosis. 
306.30     The commissioner may change this eligibility criterion for 
306.31  sliding scale premiums in order to remain within the limits of 
306.32  available appropriations.  The requirement of no health coverage 
306.33  does not apply to newborns. 
306.34     (b) For purposes of this section, medical assistance, 
306.35  general assistance medical care, and civilian health and medical 
306.36  program of the uniformed service, CHAMPUS, are not considered 
307.1   insurance or health coverage. 
307.2      (c) For purposes of this section, Medicare Part A or B 
307.3   coverage under title XVIII of the Social Security Act, United 
307.4   States Code, title 42, sections 1395c to 1395w-4, is considered 
307.5   health coverage.  An applicant or enrollee may not refuse 
307.6   Medicare coverage to establish eligibility for MinnesotaCare. 
307.7      (d) Applicants who were recipients of medical assistance or 
307.8   general assistance medical care within one month of application 
307.9   must meet the provisions of this subdivision and subdivision 2. 
307.10     Sec. 84.  Minnesota Statutes 1998, section 256L.15, 
307.11  subdivision 1, is amended to read: 
307.12     Subdivision 1.  [PREMIUM DETERMINATION.] Families with 
307.13  children and individuals shall pay a premium determined 
307.14  according to a sliding fee based on the cost of coverage as a 
307.15  percentage of the family's gross family income.  Pregnant women 
307.16  and children under age two are exempt from the provisions of 
307.17  section 256L.06, subdivision 3, paragraph (b), clause (3), 
307.18  requiring disenrollment for failure to pay premiums.  For 
307.19  pregnant women, this exemption continues until the first day of 
307.20  the month following the 60th day postpartum.  Women who remain 
307.21  enrolled during pregnancy or the postpartum period, despite 
307.22  nonpayment of premiums, shall be disenrolled on the first of the 
307.23  month following the 60th day postpartum for the penalty period 
307.24  that otherwise applies under section 256L.06, unless they begin 
307.25  paying premiums. 
307.26     Sec. 85.  Minnesota Statutes 1998, section 256L.15, 
307.27  subdivision 1b, is amended to read: 
307.28     Subd. 1b.  [PAYMENTS NONREFUNDABLE.] Only MinnesotaCare 
307.29  premiums are not refundable paid for future months of coverage 
307.30  for which a health plan capitation fee has not been paid may be 
307.31  refunded. 
307.32     Sec. 86.  Minnesota Statutes 1998, section 256L.15, 
307.33  subdivision 2, is amended to read: 
307.34     Subd. 2.  [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 
307.35  GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 
307.36  establish a sliding fee scale to determine the percentage of 
308.1   gross individual or family income that households at different 
308.2   income levels must pay to obtain coverage through the 
308.3   MinnesotaCare program.  The sliding fee scale must be based on 
308.4   the enrollee's gross individual or family income during the 
308.5   previous four months.  The sliding fee scale must contain 
308.6   separate tables based on enrollment of one, two, or three or 
308.7   more persons.  The sliding fee scale begins with a premium of 
308.8   1.5 percent of gross individual or family income for individuals 
308.9   or families with incomes below the limits for the medical 
308.10  assistance program for families and children in effect on 
308.11  January 1, 1999, and proceeds through the following evenly 
308.12  spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 
308.13  percent.  These percentages are matched to evenly spaced income 
308.14  steps ranging from the medical assistance income limit for 
308.15  families and children in effect on January 1, 1999, to 275 
308.16  percent of the federal poverty guidelines for the applicable 
308.17  family size, up to a family size of five.  The sliding fee scale 
308.18  for a family of five must be used for families of more than 
308.19  five.  The sliding fee scale and percentages are not subject to 
308.20  the provisions of chapter 14.  If a family or individual reports 
308.21  increased income after enrollment, premiums shall not be 
308.22  adjusted until eligibility renewal. 
308.23     (b) Enrolled individuals and families whose gross annual 
308.24  income increases above 275 percent of the federal poverty 
308.25  guideline shall pay the maximum premium.  The maximum premium is 
308.26  defined as a base charge for one, two, or three or more 
308.27  enrollees so that if all MinnesotaCare cases paid the maximum 
308.28  premium, the total revenue would equal the total cost of 
308.29  MinnesotaCare medical coverage and administration.  In this 
308.30  calculation, administrative costs shall be assumed to equal ten 
308.31  percent of the total.  The costs of medical coverage for 
308.32  pregnant women and children under age two and the enrollees in 
308.33  these groups shall be excluded from the total.  The maximum 
308.34  premium for two enrollees shall be twice the maximum premium for 
308.35  one, and the maximum premium for three or more enrollees shall 
308.36  be three times the maximum premium for one. 
309.1      Sec. 87.  Laws 1995, chapter 178, article 2, section 46, 
309.2   subdivision 10, is amended to read: 
309.3      Subd. 10.  [ADDITIONAL WAIVER REQUEST FOR EMPLOYED DISABLED 
309.4   PERSONS.] The commissioner shall seek a federal waiver in order 
309.5   to implement a work incentive for disabled persons eligible for 
309.6   medical assistance who are not residents of long-term care 
309.7   facilities, when determining their eligibility for medical 
309.8   assistance.  The waiver shall request authorization to establish 
309.9   a medical assistance earned income disregard for employed 
309.10  disabled persons who, but for earned income, are eligible for 
309.11  SSDI and who receive require personal care assistance under the 
309.12  Medical Assistance Program.  The disregard shall be equivalent 
309.13  to the threshold amount applied to persons who qualify under 
309.14  section 1619(b) of the Social Security Act, except that when a 
309.15  disabled person's earned income reaches the maximum income 
309.16  permitted at the threshold under section 1619(b), the person 
309.17  shall retain medical assistance eligibility and must contribute 
309.18  to the costs of medical care on a sliding fee basis. 
309.19     Sec. 88.  Laws 1997, chapter 225, article 4, section 4, is 
309.20  amended to read: 
309.21     Sec. 4.  [SENIOR DRUG PROGRAM.] 
309.22     The commissioner shall administer the senior drug program 
309.23  so that the costs to the state total no more than $4,000,000 
309.24  plus the amount of the rebate.  The commissioner is authorized 
309.25  to discontinue enrollment in order to meet this level of funding.
309.26     The commissioner shall report to the legislature the 
309.27  estimated costs of the senior drug program without funding 
309.28  caps.  The report shall be included as part of the November and 
309.29  February forecasts. 
309.30     The commissioner of finance shall annually reimburse the 
309.31  general fund with health care access funds for the estimated 
309.32  increased costs in the QMB/SLMB program directly associated with 
309.33  the senior drug program.  This reimbursement shall sunset June 
309.34  30, 2001. 
309.35     Sec. 89.  [HOME-BASED MENTAL HEALTH SERVICES.] 
309.36     By January 1, 2000, the commissioner shall amend Minnesota 
310.1   Rules under the expedited process of Minnesota Statutes, section 
310.2   14.389, to effect the following changes: 
310.3      (1) amend Minnesota Rules, part 9505.0324, subpart 2, to 
310.4   permit a county board to contract with any agency qualified 
310.5   under Minnesota Rules, part 9505.0324, subparts 4 and 5, as an 
310.6   eligible provider of home-based mental health services; 
310.7      (2) amend Minnesota Rules, part 9505.0324, subpart 2, to 
310.8   permit children's mental health collaboratives approved by the 
310.9   children's cabinet under Minnesota Statutes, section 245.493, to 
310.10  provide or to contract with any agency qualified under Minnesota 
310.11  Rules, part 9505.0324, subparts 4 and 5, as an eligible provider 
310.12  of home-based mental health services. 
310.13     Sec. 90.  [AMENDING MEDICAL ASSISTANCE RULES.] 
310.14     By January 1, 2001, the commissioner shall amend Minnesota 
310.15  Rules, parts 9505.0323, 9505.0324, 9505.0326, and 9505.0327, as 
310.16  necessary to implement the changes outlined in Minnesota 
310.17  Statutes, section 256B.0625, subdivision 23. 
310.18     Sec. 91.  [PROGRAMS FOR SENIOR CITIZENS.] 
310.19     The commissioner of human services shall study the 
310.20  eligibility criteria of and benefits provided to persons age 65 
310.21  and over through the array of cash assistance and health care 
310.22  programs administered by the department, and the extent to which 
310.23  these programs can be combined, simplified, or coordinated to 
310.24  reduce administrative costs and improve access.  The 
310.25  commissioner shall also study potential barriers to enrollment 
310.26  for low-income seniors who would otherwise deplete resources 
310.27  necessary to maintain independent community living.  At a 
310.28  minimum, the study must include an evaluation of asset 
310.29  requirements and enrollment sites.  The commissioner shall 
310.30  report study findings and recommendations to the legislature by 
310.31  February 15, 2000. 
310.32     Sec. 92.  [REPORTS ON ALTERNATIVE RESOURCE ALLOCATION 
310.33  METHODS AND PARENTS OF MINORS.] 
310.34     (a) The commissioner of human services shall consider and 
310.35  evaluate administrative methods other than the current resource 
310.36  allocation system for the home and community-based waiver for 
311.1   persons with mental retardation and related conditions.  In 
311.2   developing the alternatives, the commissioner shall consult with 
311.3   county commissioners from large and small counties, county 
311.4   agencies, consumers, advocates, and providers.  The commissioner 
311.5   shall report to the chairs of the senate health and family 
311.6   security budget division and house health and human services 
311.7   finance committee by January 15, 2000. 
311.8      (b) By January 15, 2000, the commissioner of human services 
311.9   shall present recommendations to the legislature on the 
311.10  conditions under which parents of minors may be reimbursed for 
311.11  services, consistent with federal requirements, health and 
311.12  safety, the child's needs, and not supplanting typical parental 
311.13  responsibilities. 
311.14     Sec. 93.  [REPORT ON RATE SETTING AND RISK ADJUSTMENT.] 
311.15     The commissioner of human services shall report to the 
311.16  legislature, by January 15, 2000, on the current rate setting 
311.17  process for state prepaid health care programs, rate setting and 
311.18  risk adjustment methods in other states, and the results of the 
311.19  application of risk adjustment on a trial basis in Minnesota for 
311.20  calendar year 1999.  The report must also present an analysis of 
311.21  the feasibility of requiring prepaid health plans to report 
311.22  vendor costs rather than charges, an analysis of capitation rate 
311.23  equalization for MinnesotaCare and the prepaid medical 
311.24  assistance program, an analysis of the fiscal impact on state 
311.25  and county government of repealing Minnesota Statutes 1998, 
311.26  section 256B.69, subdivision 5d, and recommendations for 
311.27  providing actuarial and market analyses related to setting 
311.28  prepaid health plan rates to the legislature on a timely basis 
311.29  that would allow this information to be used in the 
311.30  appropriations process. 
311.31     Sec. 94.  [REPORT ON PREPAID MEDICAL ASSISTANCE PROGRAM.] 
311.32     The commissioner of human services shall present 
311.33  recommendations to the legislature, by December 15, 1999, on 
311.34  methods for implementing county board authority under the 
311.35  prepaid medical assistance program. 
311.36     Sec. 95.  [REQUEST FOR WAIVER.] 
312.1      By October 1, 1999, the commissioner of human services or 
312.2   health shall request a waiver from the federal Department of 
312.3   Health and Human Services to implement Minnesota Statutes, 
312.4   256B.0951, subdivision 7. 
312.5      Sec. 96.  [EXPANSION OF SPECIAL EDUCATION SERVICES.] 
312.6      The commissioner shall examine opportunities to expand the 
312.7   scope of providers eligible for reimbursement for medical 
312.8   assistance services listed in a child's individual education 
312.9   plan, based on state and federal requirements for provider 
312.10  qualifications.  The commissioner shall complete these 
312.11  activities, in consultation with the commissioner of children, 
312.12  families, and learning, by December 1999 and seek necessary 
312.13  federal approval. 
312.14     Sec. 97.  [DENTAL ACCESS STUDY.] 
312.15     The commissioner of human services, in consultation with 
312.16  the commissioner of health, dental care providers, 
312.17  representatives of community clinics, client advocacy groups, 
312.18  and counties, shall review the dental access problem, evaluate 
312.19  the effects of the dental access initiatives adopted by the 1999 
312.20  legislature, and make recommendations on other actions that 
312.21  could improve dental access for public program recipients.  The 
312.22  commissioner shall present a progress report to the legislature 
312.23  by January 15, 2000, and shall present a final report to the 
312.24  legislature by January 15, 2001. 
312.25     Sec. 98.  [EXPIRATION; DEFINITION OF INCOME.] 
312.26     The amendments to Minnesota Statutes, section 256L.01, 
312.27  subdivision 4, in section 77 expire July 1, 2002. 
312.28     Sec. 99.  [REVENUE MAXIMIZATION INITIATIVE.] 
312.29     Subdivision 1.  [PROPOSAL DESIGN.] The commissioner of 
312.30  human services, in consultation with representatives of county 
312.31  government, may, within the limits of available appropriations, 
312.32  design proposals to: 
312.33     (1) provide medical assistance coverage for mental health 
312.34  treatment and other related rehabilitative services provided to 
312.35  children or youth placed by a county in a residential treatment 
312.36  facility; 
313.1      (2) add rehabilitation services to the state medical 
313.2   assistance plan for adults with mental illness or other 
313.3   debilitating conditions, including, but not limited to, chemical 
313.4   dependency; and 
313.5      (3) provide medical assistance coverage for targeted case 
313.6   management service activities for adults receiving services 
313.7   through a county or state agency who are in need of service 
313.8   coordination, including, but not limited to:  people age 65 and 
313.9   older; people in need of adult protective services; people 
313.10  applying for financial assistance; people who have chemical 
313.11  dependency; and people who require community social services 
313.12  under Minnesota Statutes, chapter 256E. 
313.13     Subd. 2.  [RECOMMENDATIONS TO THE LEGISLATURE.] If 
313.14  proposals under this section are developed, the commissioner of 
313.15  human services shall submit to the legislature design and 
313.16  implementation recommendations, and draft legislation, for the 
313.17  proposals required by subdivision 1, by January 15, 2000.  
313.18  Implementation shall occur by July 1, 2000, but only upon 
313.19  legislative approval of these recommendations. 
313.20     Subd. 3.  [STATE MEDICAL ASSISTANCE PLAN AMENDMENTS.] The 
313.21  commissioner of human services may develop and submit to the 
313.22  federal Health Care Financing Administration, any medical 
313.23  assistance state plan amendments necessary for the 
313.24  implementation of the proposals in subdivision 1. 
313.25     Sec. 100.  [REPEALER.] 
313.26     Laws 1997, chapter 203, article 7, section 27, is repealed. 
313.27     Sec. 101.  [EFFECTIVE DATE.] 
313.28     When preparing the human services conference committee 
313.29  report for adoption by the legislature, the revisor shall 
313.30  combine all the bracketed effective date notations into this 
313.31  effective date section. 
313.32                             ARTICLE 5
313.33                 STATE-OPERATED SERVICES; CHEMICAL 
313.34                     DEPENDENCY; MENTAL HEALTH 
313.35     Section 1.  Minnesota Statutes 1998, section 16C.10, 
313.36  subdivision 5, is amended to read: 
314.1      Subd. 5.  [SPECIFIC PURCHASES.] The solicitation process 
314.2   described in this chapter is not required for acquisition of the 
314.3   following: 
314.4      (1) merchandise for resale purchased under policies 
314.5   determined by the commissioner; 
314.6      (2) farm and garden products which, as determined by the 
314.7   commissioner, may be purchased at the prevailing market price on 
314.8   the date of sale; 
314.9      (3) goods and services from the Minnesota correctional 
314.10  facilities; 
314.11     (4) goods and services from rehabilitation facilities and 
314.12  sheltered workshops that are certified by the commissioner of 
314.13  economic security; 
314.14     (5) goods and services for use by a community-based 
314.15  residential facility operated by the commissioner of human 
314.16  services; 
314.17     (6) goods purchased at auction or when submitting a sealed 
314.18  bid at auction provided that before authorizing such an action, 
314.19  the commissioner consult with the requesting agency to determine 
314.20  a fair and reasonable value for the goods considering factors 
314.21  including, but not limited to, costs associated with submitting 
314.22  a bid, travel, transportation, and storage.  This fair and 
314.23  reasonable value must represent the limit of the state's bid; 
314.24  and 
314.25     (7) utility services where no competition exists or where 
314.26  rates are fixed by law or ordinance. 
314.27     Sec. 2.  Minnesota Statutes 1998, section 245.462, 
314.28  subdivision 4, is amended to read: 
314.29     Subd. 4.  [CASE MANAGER MANAGEMENT SERVICE PROVIDER.] (a) 
314.30  "Case manager management service provider" means an individual a 
314.31  case manager or case manager associate employed by the county or 
314.32  other entity authorized by the county board to provide case 
314.33  management services specified in section 245.4711.  
314.34     A case manager must have a bachelor's degree in one of the 
314.35  behavioral sciences or related fields including, but not limited 
314.36  to, social work, psychology, or nursing from an accredited 
315.1   college or university and.  A case manager must have at least 
315.2   2,000 hours of supervised experience in the delivery of services 
315.3   to adults with mental illness, must be skilled in the process of 
315.4   identifying and assessing a wide range of client needs, and must 
315.5   be knowledgeable about local community resources and how to use 
315.6   those resources for the benefit of the client.  The case manager 
315.7   shall meet in person with a mental health professional at least 
315.8   once each month to obtain clinical supervision of the case 
315.9   manager's activities.  Case managers with a bachelor's degree 
315.10  but without 2,000 hours of supervised experience in the delivery 
315.11  of services to adults with mental illness must complete 40 hours 
315.12  of training approved by the commissioner of human services in 
315.13  case management skills and in the characteristics and needs of 
315.14  adults with serious and persistent mental illness and must 
315.15  receive clinical supervision regarding individual service 
315.16  delivery from a mental health professional at least once each 
315.17  week until the requirement of 2,000 hours of supervised 
315.18  experience is met.  
315.19     (b) Supervision for a case manager during the first year of 
315.20  service providing case management services shall be one hour per 
315.21  week of clinical supervision from a case management supervisor.  
315.22  After the first year, the case manager shall receive regular 
315.23  ongoing supervision totaling 38 hours per year, of which at 
315.24  least one hour per month must be clinical supervision regarding 
315.25  individual service delivery with a case management supervisor.  
315.26  The remainder may be provided by a case manager with two years 
315.27  of experience.  Group supervision may not constitute more than 
315.28  one-half of the required supervision hours.  Clinical 
315.29  supervision must be documented in the client record. 
315.30     (c) A case manager with a bachelor's degree who is not 
315.31  licensed, registered, or certified by a health-related licensing 
315.32  board must receive 30 hours of continuing education and training 
315.33  in mental illness and mental health services annually.  
315.34     (d) A case manager with a bachelor's degree but without 
315.35  2,000 hours of supervised experience described in paragraph (a), 
315.36  must complete 40 hours of training approved by the commissioner 
316.1   covering case management skills and the characteristics and 
316.2   needs of adults with serious and persistent mental illness.  
316.3      (e) Case managers without a bachelor's degree must meet one 
316.4   of the requirements in clauses (1) to (3):  
316.5      (1) have three or four years of experience as a case 
316.6   manager associate; 
316.7      (2) be a registered nurse without a bachelor's degree and 
316.8   have a combination of specialized training in psychiatry and 
316.9   work experience consisting of community interaction and 
316.10  involvement or community discharge planning in a mental health 
316.11  setting totaling three years; or 
316.12     (3) be a person who qualified as a case manager under the 
316.13  1998 department of human service federal waiver provision and 
316.14  meet the continuing education and mentoring requirements in this 
316.15  section.  
316.16     (f) A case manager associate (CMA) must work under the 
316.17  direction of a case manager or case management supervisor and 
316.18  must be at least 21 years of age.  A case manager associate must 
316.19  also have a high school diploma or its equivalent and meet one 
316.20  of the following criteria: 
316.21     (1) have an associate of arts degree in one of the 
316.22  behavioral sciences or human services; 
316.23     (2) be a registered nurse without a bachelor's degree; 
316.24     (3) within the previous ten years, have three years of life 
316.25  experience with serious and persistent mental illness as defined 
316.26  in section 245.462, subdivision 20; or as a child had severe 
316.27  emotional disturbance as defined in section 245.4871, 
316.28  subdivision 6; or have three years life experience as a primary 
316.29  caregiver to an adult with serious and persistent mental illness 
316.30  within the previous ten years; 
316.31     (4) have 6,000 hours work experience as a nondegreed state 
316.32  hospital technician; or 
316.33     (5) be a mental health practitioner as defined in section 
316.34  245.462, subdivision 17, clause (2). 
316.35     Individuals meeting one of the criteria in clauses (1) to 
316.36  (4) may qualify as a case manager after four years of supervised 
317.1   work experience as a case manager associate.  Individuals 
317.2   meeting the criteria in clause (5) may qualify as a case manager 
317.3   after three years of supervised experience as a case manager 
317.4   associate. 
317.5      Case management associates must have 40 hours preservice 
317.6   training under paragraph (d) and receive at least 40 hours of 
317.7   continuing education in mental illness and mental health 
317.8   services annually.  Case manager associates shall receive at 
317.9   least five hours of mentoring per week from a case management 
317.10  mentor.  A "case management mentor" means a qualified, 
317.11  practicing case manager or case management supervisor who 
317.12  teaches or advises and provides intensive training and clinical 
317.13  supervision to one or more case manager associates.  Mentoring 
317.14  may occur while providing direct services to consumers in the 
317.15  office or in the field and may be provided to individuals or 
317.16  groups of case manager associates.  At least two mentoring hours 
317.17  per week must be individual and face-to-face. 
317.18     (g) A case management supervisor must meet the criteria for 
317.19  mental health professionals, as specified in section 245.462, 
317.20  subdivision 18. 
317.21     (h) Until June 30, 1999, An immigrant who does not have the 
317.22  qualifications specified in this subdivision may provide case 
317.23  management services to adult immigrants with serious and 
317.24  persistent mental illness who are members of the same ethnic 
317.25  group as the case manager if the person:  (1) is currently 
317.26  enrolled in and is actively pursuing credits toward the 
317.27  completion of a bachelor's degree in one of the behavioral 
317.28  sciences or a related field including, but not limited to, 
317.29  social work, psychology, or nursing from an accredited college 
317.30  or university; (2) completes 40 hours of training as specified 
317.31  in this subdivision; and (3) receives clinical supervision at 
317.32  least once a week until the requirements of this subdivision are 
317.33  met. 
317.34     (b) The commissioner may approve waivers submitted by 
317.35  counties to allow case managers without a bachelor's degree but 
317.36  with 6,000 hours of supervised experience in the delivery of 
318.1   services to adults with mental illness if the person: 
318.2      (1) meets the qualifications for a mental health 
318.3   practitioner in subdivision 26; 
318.4      (2) has completed 40 hours of training approved by the 
318.5   commissioner in case management skills and in the 
318.6   characteristics and needs of adults with serious and persistent 
318.7   mental illness; and 
318.8      (3) demonstrates that the 6,000 hours of supervised 
318.9   experience are in identifying functional needs of persons with 
318.10  mental illness, coordinating assessment information and making 
318.11  referrals to appropriate service providers, coordinating a 
318.12  variety of services to support and treat persons with mental 
318.13  illness, and monitoring to ensure appropriate provision of 
318.14  services.  The county board is responsible to verify that all 
318.15  qualifications, including content of supervised experience, have 
318.16  been met. 
318.17     Sec. 3.  Minnesota Statutes 1998, section 245.462, 
318.18  subdivision 17, is amended to read: 
318.19     Subd. 17.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
318.20  practitioner" means a person providing services to persons with 
318.21  mental illness who is qualified in at least one of the following 
318.22  ways:  
318.23     (1) holds a bachelor's degree in one of the behavioral 
318.24  sciences or related fields from an accredited college or 
318.25  university and either: 
318.26     (i) has at least 2,000 hours of supervised experience in 
318.27  the delivery of services to persons with mental illness; or 
318.28     (ii) is fluent in the non-English language of the ethnic 
318.29  group to which over 50 percent of the practitioner's clients 
318.30  belong, completes 40 hours of training in the delivery of 
318.31  services to persons with mental illness, and is supervised by a 
318.32  mental health professional at least once a week until 2,000 
318.33  hours of supervised experience in delivering services to persons 
318.34  with mental illness is obtained; 
318.35     (2) has at least 6,000 hours of supervised experience in 
318.36  the delivery of services to persons with mental illness; 
319.1      (3) is a graduate student in one of the behavioral sciences 
319.2   or related fields and is formally assigned by an accredited 
319.3   college or university to an agency or facility for clinical 
319.4   training; or 
319.5      (4) holds a master's or other graduate degree in one of the 
319.6   behavioral sciences or related fields from an accredited college 
319.7   or university and has less than 4,000 hours post-master's 
319.8   experience in the treatment of mental illness. 
319.9      Sec. 4.  Minnesota Statutes 1998, section 245.4711, 
319.10  subdivision 1, is amended to read: 
319.11     Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
319.12  (a) By January 1, 1989, the county board shall provide case 
319.13  management services for all adults with serious and persistent 
319.14  mental illness who are residents of the county and who request 
319.15  or consent to the services and to each adult for whom the court 
319.16  appoints a case manager.  Staffing ratios must be sufficient to 
319.17  serve the needs of the clients.  The case manager must meet the 
319.18  requirements in section 245.462, subdivision 4.  
319.19     (b) Case management services provided to adults with 
319.20  serious and persistent mental illness eligible for medical 
319.21  assistance must be billed to the medical assistance program 
319.22  under sections 256B.02, subdivision 8, and 256B.0625. 
319.23     (c) Case management services are eligible for reimbursement 
319.24  under the medical assistance program.  Costs associated with 
319.25  mentoring, supervision, and continuing education may be included 
319.26  in the reimbursement rate methodology used for case management 
319.27  services under the medical assistance program. 
319.28     Sec. 5.  Minnesota Statutes 1998, section 245.4712, 
319.29  subdivision 2, is amended to read: 
319.30     Subd. 2.  [DAY TREATMENT SERVICES PROVIDED.] (a) Day 
319.31  treatment services must be developed as a part of the community 
319.32  support services available to adults with serious and persistent 
319.33  mental illness residing in the county.  Adults may be required 
319.34  to pay a fee according to section 245.481.  Day treatment 
319.35  services must be designed to:  
319.36     (1) provide a structured environment for treatment; 
320.1      (2) provide support for residing in the community; 
320.2      (3) prevent placement in settings that are more intensive, 
320.3   costly, or restrictive than necessary and appropriate to meet 
320.4   client need; 
320.5      (4) coordinate with or be offered in conjunction with a 
320.6   local education agency's special education program; and 
320.7      (5) operate on a continuous basis throughout the year.  
320.8      (b) For purposes of complying with medical assistance 
320.9   requirements, an adult day treatment program may choose among 
320.10  the methods of clinical supervision specified in: 
320.11     (1) Minnesota Rules, part 9505.0323, subpart 1, item F; 
320.12     (2) Minnesota Rules, part 9505.0324, subpart 6, item F; or 
320.13     (3) Minnesota Rules, part 9520.0800, subparts 2 to 6. 
320.14     A day treatment program may demonstrate compliance with 
320.15  these clinical supervision requirements by obtaining 
320.16  certification from the commissioner under Minnesota Rules, parts 
320.17  9520.0750 to 9520.0870, or by documenting in its own records 
320.18  that it complies with one of the above methods. 
320.19     (c) County boards may request a waiver from including day 
320.20  treatment services if they can document that:  
320.21     (1) an alternative plan of care exists through the county's 
320.22  community support services for clients who would otherwise need 
320.23  day treatment services; 
320.24     (2) day treatment, if included, would be duplicative of 
320.25  other components of the community support services; and 
320.26     (3) county demographics and geography make the provision of 
320.27  day treatment services cost ineffective and infeasible.  
320.28     Sec. 6.  Minnesota Statutes 1998, section 245.4871, 
320.29  subdivision 4, is amended to read: 
320.30     Subd. 4.  [CASE MANAGER MANAGEMENT SERVICE PROVIDER.] (a) 
320.31  "Case manager management service provider" means an individual a 
320.32  case manager or case manager associate employed by the county or 
320.33  other entity authorized by the county board to provide case 
320.34  management services specified in subdivision 3 for the child 
320.35  with severe emotional disturbance and the child's family.  A 
320.36  case manager must have experience and training in working with 
321.1   children. 
321.2      (b) A case manager must: 
321.3      (1) have at least a bachelor's degree in one of the 
321.4   behavioral sciences or a related field including, but not 
321.5   limited to, social work, psychology, or nursing from an 
321.6   accredited college or university; 
321.7      (2) have at least 2,000 hours of supervised experience in 
321.8   the delivery of mental health services to children; 
321.9      (3) have experience and training in identifying and 
321.10  assessing a wide range of children's needs; and 
321.11     (4) be knowledgeable about local community resources and 
321.12  how to use those resources for the benefit of children and their 
321.13  families. 
321.14     (c) The case manager may be a member of any professional 
321.15  discipline that is part of the local system of care for children 
321.16  established by the county board. 
321.17     (d) The case manager must meet in person with a mental 
321.18  health professional at least once each month to obtain clinical 
321.19  supervision shall receive regular ongoing supervision totaling 
321.20  38 hours per year, of which at least one hour per month must be 
321.21  clinical supervision regarding individual service delivery with 
321.22  a case management supervisor.  The remainder may be provided by 
321.23  a case manager with two years of experience.  Group supervision 
321.24  may not constitute more than one-half of the required 
321.25  supervision hours. 
321.26     (e) Case managers with a bachelor's degree but without 
321.27  2,000 hours of supervised experience in the delivery of mental 
321.28  health services to children with emotional disturbance must: 
321.29     (1) begin 40 hours of training approved by the commissioner 
321.30  of human services in case management skills and in the 
321.31  characteristics and needs of children with severe emotional 
321.32  disturbance before beginning to provide case management 
321.33  services; and 
321.34     (2) receive clinical supervision regarding individual 
321.35  service delivery from a mental health professional at least once 
321.36  one hour each week until the requirement of 2,000 hours of 
322.1   experience is met. 
322.2      (f) Clinical supervision must be documented in the child's 
322.3   record.  When the case manager is not a mental health 
322.4   professional, the county board must provide or contract for 
322.5   needed clinical supervision. 
322.6      (g) The county board must ensure that the case manager has 
322.7   the freedom to access and coordinate the services within the 
322.8   local system of care that are needed by the child. 
322.9      (h) Case managers who have a bachelor's degree but are not 
322.10  licensed, registered, or certified by a health-related licensing 
322.11  board must receive 30 hours of continuing education and training 
322.12  in severe emotional disturbance and mental health services 
322.13  annually. 
322.14     (i) Case managers without a bachelor's degree must meet one 
322.15  of the requirements in clauses (1) to (3): 
322.16     (1) have three or four years of experience as a case 
322.17  manager associate; 
322.18     (2) be a registered nurse without a bachelor's degree who 
322.19  has a combination of specialized training in psychiatry and work 
322.20  experience consisting of community interaction and involvement 
322.21  or community discharge planning in a mental health setting 
322.22  totaling three years; or 
322.23     (3) be a person who qualified as a case manager under the 
322.24  1998 department of human service federal waiver provision and 
322.25  meets the continuing education and mentoring requirements in 
322.26  this section. 
322.27     (j) A case manager associate (CMA) must work under the 
322.28  direction of a case manager or case management supervisor and 
322.29  must be at least 21 years of age.  A case manager associate must 
322.30  also have a high school diploma or its equivalent and meet one 
322.31  of the following criteria: 
322.32     (1) have an associate of arts degree in one of the 
322.33  behavioral sciences or human services; 
322.34     (2) be a registered nurse without a bachelor's degree; 
322.35     (3) have three years of life experience as a primary 
322.36  caregiver to a child with serious emotional disturbance as 
323.1   defined in section 245.4871, subdivision 6, within the previous 
323.2   ten years; 
323.3      (4) have 6,000 hours work experience as a nondegreed state 
323.4   hospital technician; or 
323.5      (5) be a mental health practitioner as defined in section 
323.6   245.462, subdivision 17, clause (2). 
323.7      Individuals meeting one of the criteria in clauses (1) to 
323.8   (4) may qualify as a case manager after four years of supervised 
323.9   work experience as a case manager associate.  Individuals 
323.10  meeting the criteria in clause (5) may qualify as a case manager 
323.11  after three years of supervised experience as a case manager 
323.12  associate. 
323.13     Case manager associates must have 40 hours of preservice 
323.14  training under paragraph (e), clause (1), and receive at least 
323.15  40 hours of continuing education in severe emotional disturbance 
323.16  and mental health service annually.  Case manager associates 
323.17  shall receive at least five hours of mentoring per week from a 
323.18  case management mentor.  A "case management mentor" means a 
323.19  qualified, practicing case manager or case management supervisor 
323.20  who teaches or advises and provides intensive training and 
323.21  clinical supervision to one or more case manager associates.  
323.22  Mentoring may occur while providing direct services to consumers 
323.23  in the office or in the field and may be provided to individuals 
323.24  or groups of case manager associates.  At least two mentoring 
323.25  hours per week must be individual and face-to-face. 
323.26     (k) A case management supervisor must meet the criteria for 
323.27  a mental health professional as specified in section 245.4871, 
323.28  subdivision 27. 
323.29     (l) Until June 30, 1999, An immigrant who does not have the 
323.30  qualifications specified in this subdivision may provide case 
323.31  management services to child immigrants with severe emotional 
323.32  disturbance of the same ethnic group as the immigrant if the 
323.33  person:  
323.34     (1) is currently enrolled in and is actively pursuing 
323.35  credits toward the completion of a bachelor's degree in one of 
323.36  the behavioral sciences or related fields at an accredited 
324.1   college or university; 
324.2      (2) completes 40 hours of training as specified in this 
324.3   subdivision; and 
324.4      (3) receives clinical supervision at least once a week 
324.5   until the requirements of obtaining a bachelor's degree and 
324.6   2,000 hours of supervised experience are met. 
324.7      (i) The commissioner may approve waivers submitted by 
324.8   counties to allow case managers without a bachelor's degree but 
324.9   with 6,000 hours of supervised experience in the delivery of 
324.10  services to children with severe emotional disturbance if the 
324.11  person: 
324.12     (1) meets the qualifications for a mental health 
324.13  practitioner in subdivision 26; 
324.14     (2) has completed 40 hours of training approved by the 
324.15  commissioner in case management skills and in the 
324.16  characteristics and needs of children with severe emotional 
324.17  disturbance; and 
324.18     (3) demonstrates that the 6,000 hours of supervised 
324.19  experience are in identifying functional needs of children with 
324.20  severe emotional disturbance, coordinating assessment 
324.21  information and making referrals to appropriate service 
324.22  providers, coordinating a variety of services to support and 
324.23  treat children with severe emotional disturbance, and monitoring 
324.24  to ensure appropriate provision of services.  The county board 
324.25  is responsible to verify that all qualifications, including 
324.26  content of supervised experience, have been met. 
324.27     Sec. 7.  Minnesota Statutes 1998, section 245.4871, 
324.28  subdivision 26, is amended to read: 
324.29     Subd. 26.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
324.30  practitioner" means a person providing services to children with 
324.31  emotional disturbances.  A mental health practitioner must have 
324.32  training and experience in working with children.  A mental 
324.33  health practitioner must be qualified in at least one of the 
324.34  following ways:  
324.35     (1) holds a bachelor's degree in one of the behavioral 
324.36  sciences or related fields from an accredited college or 
325.1   university and either: 
325.2      (i) has at least 2,000 hours of supervised experience in 
325.3   the delivery of mental health services to children with 
325.4   emotional disturbances; or 
325.5      (ii) is fluent in the non-English language of the ethnic 
325.6   group to which over 50 percent of the practitioner's clients 
325.7   belong, completes 40 hours of training in the delivery of 
325.8   services to children with emotional disturbances, and is 
325.9   supervised by a mental health professional at least once a week 
325.10  until 2,000 hours of supervised experience in delivering mental 
325.11  health services to children with emotional disturbances is 
325.12  obtained; 
325.13     (2) has at least 6,000 hours of supervised experience in 
325.14  the delivery of mental health services to children with 
325.15  emotional disturbances; 
325.16     (3) is a graduate student in one of the behavioral sciences 
325.17  or related fields and is formally assigned by an accredited 
325.18  college or university to an agency or facility for clinical 
325.19  training; or 
325.20     (4) holds a master's or other graduate degree in one of the 
325.21  behavioral sciences or related fields from an accredited college 
325.22  or university and has less than 4,000 hours post-master's 
325.23  experience in the treatment of emotional disturbance. 
325.24     Sec. 8.  Minnesota Statutes 1998, section 245.4881, 
325.25  subdivision 1, is amended to read: 
325.26     Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
325.27  (a) By April 1, 1992, the county board shall provide case 
325.28  management services for each child with severe emotional 
325.29  disturbance who is a resident of the county and the child's 
325.30  family who request or consent to the services.  Staffing ratios 
325.31  must be sufficient to serve the needs of the clients.  The case 
325.32  manager must meet the requirements in section 245.4871, 
325.33  subdivision 4.  
325.34     (b) Except as permitted by law and the commissioner under 
325.35  demonstration projects, case management services provided to 
325.36  children with severe emotional disturbance eligible for medical 
326.1   assistance must be billed to the medical assistance program 
326.2   under sections 256B.02, subdivision 8, and 256B.0625. 
326.3      (c) Case management services are eligible for reimbursement 
326.4   under the medical assistance program.  Costs of mentoring, 
326.5   supervision, and continuing education may be included in the 
326.6   reimbursement rate methodology used for case management services 
326.7   under the the medical assistance program. 
326.8      Sec. 9.  [245.99] [ADULT MENTAL ILLNESS CRISIS HOUSING 
326.9   ASSISTANCE PROGRAM.] 
326.10     Subdivision 1.  [CREATION.] The adult mental illness crisis 
326.11  housing assistance program is established in the department of 
326.12  human services. 
326.13     Subd. 2.  [RENTAL ASSISTANCE.] The program shall pay up to 
326.14  90 days of housing assistance for persons with a serious and 
326.15  persistent mental illness who require inpatient or residential 
326.16  care for stabilization.  The commissioner of human services may 
326.17  extend the length of assistance on a case-by-case basis. 
326.18     Subd. 3.  [ELIGIBILITY.] Housing assistance under this 
326.19  section is available only to persons of low or moderate income 
326.20  as determined by the commissioner. 
326.21     Subd. 4.  [ADMINISTRATION.] The commissioner may contract 
326.22  with organizations or government units experienced in housing 
326.23  assistance to operate the program under this section. 
326.24     Sec. 10.  [246.0136] [PLANNING FOR TRANSITION OF REGIONAL 
326.25  TREATMENT CENTERS AND OTHER STATE-OPERATED SERVICES TO 
326.26  ENTERPRISE ACTIVITIES.] 
326.27     Subdivision 1.  [PLANNING FOR ENTERPRISE ACTIVITIES.] The 
326.28  commissioner of human services is directed to study and make 
326.29  recommendations to the legislature on establishing enterprise 
326.30  activities within state-operated services.  Before implementing 
326.31  an enterprise activity, the commissioner must obtain statutory 
326.32  authorization for its implementation, except that the 
326.33  commissioner has authority to implement enterprise activities 
326.34  for adolescent services without statutory authorization.  
326.35  Enterprise activities are defined as the range of services, 
326.36  which are delivered by state employees, needed by people with 
327.1   disabilities and are fully funded by public or private 
327.2   third-party health insurance or other revenue sources available 
327.3   to clients that provide reimbursement for the services provided. 
327.4   Enterprise activities within state-operated services shall 
327.5   specialize in caring for vulnerable people for whom no other 
327.6   providers are available or for whom state-operated services may 
327.7   be the provider selected by the payer.  In subsequent biennia 
327.8   after an enterprise activity is established within a 
327.9   state-operated service, the base state appropriation for that 
327.10  state-operated service shall be reduced proportionate to the 
327.11  size of the enterprise activity. 
327.12     Subd. 2.  [REQUIRED COMPONENTS OF ANY PROPOSAL; 
327.13  CONSIDERATIONS.] In any proposal for an enterprise activity 
327.14  brought to the legislature by the commissioner, the commissioner 
327.15  must demonstrate that there is public or private third-party 
327.16  health insurance or other revenue available to the people 
327.17  served, that the anticipated revenues to be collected will fully 
327.18  fund the services, that there will be sufficient funds for cash 
327.19  flow purposes, and that access to services by vulnerable 
327.20  populations served by state-operated services will not be 
327.21  limited by implementation of an enterprise activity.  In 
327.22  studying the feasibility of establishing an enterprise activity, 
327.23  the commissioner must consider: 
327.24     (1) creating public or private partnerships to facilitate 
327.25  client access to needed services; 
327.26     (2) administrative simplification and efficiencies 
327.27  throughout the state-operated services system; 
327.28     (3) creating a public group practice for state-operated 
327.29  services medical staff to increase flexibility in meeting client 
327.30  needs and to maximize third-party reimbursement; 
327.31     (4) converting or disposing of buildings not utilized and 
327.32  surplus lands; and 
327.33     (5) exploring the efficiencies and benefits of establishing 
327.34  state-operated services as an independent state agency. 
327.35     Sec. 11.  Minnesota Statutes 1998, section 246.18, 
327.36  subdivision 6, is amended to read: 
328.1      Subd. 6.  [COLLECTIONS DEDICATED.] Except for 
328.2   state-operated programs and services funded through a direct 
328.3   appropriation from the legislature, money received within the 
328.4   regional treatment center system for the following 
328.5   state-operated services is dedicated to the commissioner for the 
328.6   provision of those services: 
328.7      (1) community-based residential and day training and 
328.8   habilitation services for mentally retarded persons; 
328.9      (2) community health clinic services; 
328.10     (3) accredited hospital outpatient department services; 
328.11     (4) certified rehabilitation agency and rehabilitation 
328.12  hospital services; or 
328.13     (5) community-based transitional support services for 
328.14  adults with serious and persistent mental illness.  Except for 
328.15  state-operated programs funded through a direct appropriation 
328.16  from the legislature, any state-operated program or service 
328.17  established and operated as an enterprise activity, shall retain 
328.18  the revenues earned in an interest-bearing account. 
328.19     When the commissioner determines the intent to transition 
328.20  from a direct appropriation to enterprise activity for which the 
328.21  commissioner has authority, all collections for the targeted 
328.22  state-operated service shall be retained and deposited into an 
328.23  interest-bearing account.  At the end of the fiscal year, prior 
328.24  to establishing the enterprise activity, collections up to the 
328.25  amount of the appropriation for the targeted service shall be 
328.26  deposited to the general fund.  All funds in excess of the 
328.27  amount of the appropriation will be retained and used by the 
328.28  enterprise activity for cash flow purposes. 
328.29     These funds must be deposited in the state treasury in a 
328.30  revolving account and funds in the revolving account are 
328.31  appropriated to the commissioner to operate the services 
328.32  authorized, and any unexpended balances do not cancel but are 
328.33  available until spent. 
328.34     Sec. 12.  Minnesota Statutes 1998, section 253B.045, is 
328.35  amended by adding a subdivision to read: 
328.36     Subd. 5.  [HEALTH PLAN COMPANY; DEFINITION.] For purposes 
329.1   of this section, "health plan company" has the meaning given it 
329.2   in section 62Q.01, subdivision 4, and also includes a 
329.3   demonstration provider as defined in section 256B.69, 
329.4   subdivision 2, paragraph (b), a county or group of counties 
329.5   participating in county-based purchasing according to section 
329.6   256B.692, and a children's mental health collaborative under 
329.7   contract to provide medical assistance for individuals enrolled 
329.8   in the prepaid medical assistance and MinnesotaCare programs 
329.9   according to sections 245.493 to 245.496. 
329.10     Sec. 13.  Minnesota Statutes 1998, section 253B.045, is 
329.11  amended by adding a subdivision to read: 
329.12     Subd. 6.  [COVERAGE.] A health plan company must provide 
329.13  coverage, according to the terms of the policy, contract, or 
329.14  certificate of coverage, for all medically necessary covered 
329.15  services as determined by section 62Q.53 provided to an enrollee 
329.16  that are ordered by the court under this chapter. 
329.17     Sec. 14.  Minnesota Statutes 1998, section 253B.07, 
329.18  subdivision 1, is amended to read: 
329.19     Subdivision 1.  [PREPETITION SCREENING.] (a) Prior to 
329.20  filing a petition for commitment of or early intervention for a 
329.21  proposed patient, an interested person shall apply to the 
329.22  designated agency in the county of the proposed patient's 
329.23  residence or presence for conduct of a preliminary 
329.24  investigation, except when the proposed patient has been 
329.25  acquitted of a crime under section 611.026 and the county 
329.26  attorney is required to file a petition for commitment.  The 
329.27  designated agency shall appoint a screening team to conduct an 
329.28  investigation which shall include:  
329.29     (i) a personal interview with the proposed patient and 
329.30  other individuals who appear to have knowledge of the condition 
329.31  of the proposed patient.  If the proposed patient is not 
329.32  interviewed, reasons must be documented; 
329.33     (ii) identification and investigation of specific alleged 
329.34  conduct which is the basis for application; 
329.35     (iii) identification, exploration, and listing of the 
329.36  reasons for rejecting or recommending alternatives to 
330.1   involuntary placement; and 
330.2      (iv) in the case of a commitment based on mental illness, 
330.3   the following information, if it is known or available:  
330.4   information that may be relevant to the administration of 
330.5   neuroleptic medications, if necessary, including the existence 
330.6   of a declaration under section 253B.03, subdivision 6d, or a 
330.7   health care directive under chapter 145C or a guardian, 
330.8   conservator, proxy, or agent with authority to make health care 
330.9   decisions for the proposed patient; information regarding the 
330.10  capacity of the proposed patient to make decisions regarding 
330.11  administration of neuroleptic medication; and whether the 
330.12  proposed patient is likely to consent or refuse consent to 
330.13  administration of the medication; and 
330.14     (v) seeking input from the proposed patient's health plan 
330.15  company to provide the court with information about services the 
330.16  enrollee needs and the least restrictive alternatives. 
330.17     (b) In conducting the investigation required by this 
330.18  subdivision, the screening team shall have access to all 
330.19  relevant medical records of proposed patients currently in 
330.20  treatment facilities.  Data collected pursuant to this clause 
330.21  shall be considered private data on individuals.  The 
330.22  prepetition screening report is not admissible in any court 
330.23  proceedings unrelated to the commitment proceedings. 
330.24     (c) When the prepetition screening team recommends 
330.25  commitment, a written report shall be sent to the county 
330.26  attorney for the county in which the petition is to be filed. 
330.27     (d) The prepetition screening team shall refuse to support 
330.28  a petition if the investigation does not disclose evidence 
330.29  sufficient to support commitment.  Notice of the prepetition 
330.30  screening team's decision shall be provided to the prospective 
330.31  petitioner.  
330.32     (e) If the interested person wishes to proceed with a 
330.33  petition contrary to the recommendation of the prepetition 
330.34  screening team, application may be made directly to the county 
330.35  attorney, who may determine whether or not to proceed with the 
330.36  petition.  Notice of the county attorney's determination shall 
331.1   be provided to the interested party.  
331.2      (f) If the proposed patient has been acquitted of a crime 
331.3   under section 611.026, the county attorney shall apply to the 
331.4   designated county agency in the county in which the acquittal 
331.5   took place for a preliminary investigation unless substantially 
331.6   the same information relevant to the proposed patient's current 
331.7   mental condition, as could be obtained by a preliminary 
331.8   investigation, is part of the court record in the criminal 
331.9   proceeding or is contained in the report of a mental examination 
331.10  conducted in connection with the criminal proceeding.  If a 
331.11  court petitions for commitment pursuant to the rules of criminal 
331.12  or juvenile procedure or a county attorney petitions pursuant to 
331.13  acquittal of a criminal charge under section 611.026, the 
331.14  prepetition investigation, if required by this section, shall be 
331.15  completed within seven days after the filing of the petition.  
331.16     Sec. 15.  Minnesota Statutes 1998, section 253B.185, is 
331.17  amended by adding a subdivision to read: 
331.18     Subd. 5.  [AFTERCARE AND CASE MANAGEMENT.] The state, in 
331.19  collaboration with the designated agency, is responsible for 
331.20  arranging and funding the aftercare and case management services 
331.21  for persons under commitment as sexual psychopathic 
331.22  personalities and sexually dangerous persons discharged after 
331.23  July 1, 1999. 
331.24     Sec. 16.  Minnesota Statutes 1998, section 254A.07, 
331.25  subdivision 2, is amended to read: 
331.26     Subd. 2.  The county boards may make grants for local 
331.27  agency programs for prevention, care, and treatment of alcohol 
331.28  and other drug abuse as developed and defined by the state 
331.29  authority.  Grants made for programs serving the American Indian 
331.30  community shall take into account the guidelines established in 
331.31  section 254A.03, subdivision 1, clause (j) (k).  Grants may be 
331.32  made for the cost of these local agency programs and services 
331.33  whether provided directly by county boards or by other public 
331.34  and private agencies and organizations, both profit and 
331.35  nonprofit, and individuals, pursuant to contract.  Nothing 
331.36  herein shall prevent the state authority from entering into 
332.1   contracts with and making grants to other state agencies for the 
332.2   purpose of providing specific services and programs, except that 
332.3   effective July 1, 2001, the state authority shall not make 
332.4   grants using state funds for chemical dependency prevention 
332.5   activities and for case management services for chronic 
332.6   alcoholics.  With the approval of the county board, the state 
332.7   authority may make grants or contracts for research or 
332.8   demonstration projects specific to needs within that county.  
332.9      Sec. 17.  Minnesota Statutes 1998, section 254B.01, is 
332.10  amended by adding a subdivision to read: 
332.11     Subd. 7.  [ROOM AND BOARD RATE.] "Room and board rate" 
332.12  means a rate set for shelter, fuel, food, utilities, household 
332.13  supplies, and other costs necessary to provide room and board 
332.14  for a person in need of chemical dependency services. 
332.15     Sec. 18.  Minnesota Statutes 1998, section 254B.02, 
332.16  subdivision 3, is amended to read: 
332.17     Subd. 3.  [RESERVE ACCOUNT.] The commissioner shall 
332.18  allocate money from the reserve account to counties that, during 
332.19  the current fiscal year, have met or exceeded the base level of 
332.20  expenditures for eligible chemical dependency services from 
332.21  local money.  The commissioner shall establish the base level 
332.22  for fiscal year 1988 as the amount of local money used for 
332.23  eligible services in calendar year 1986.  In later years, the 
332.24  base level must be increased in the same proportion as state 
332.25  appropriations to implement Laws 1986, chapter 394, sections 8 
332.26  to 20, are increased.  The base level must be decreased if the 
332.27  fund balance from which allocations are made under section 
332.28  254B.02, subdivision 1, is decreased in later years.  The local 
332.29  match rate for the reserve account is the same rate as applied 
332.30  to the initial allocation.  Reserve account payments must not be 
332.31  included when calculating the county adjustments made according 
332.32  to subdivision 2.  For counties providing medical assistance or 
332.33  general assistance medical care through managed care plans on 
332.34  January 1, 1996, the base year is fiscal year 1995.  For 
332.35  counties beginning provision of managed care after January 1, 
332.36  1996, the base year is the most recent fiscal year before 
333.1   enrollment in managed care begins.  For counties providing 
333.2   managed care, the base level will be increased or decreased in 
333.3   proportion to changes in the fund balance from which allocations 
333.4   are made under subdivision 2, but will be additionally increased 
333.5   or decreased in proportion to the change in county adjusted 
333.6   population made in subdivision 1, paragraphs (b) and 
333.7   (c).  Effective July 1, 1999, any funds deposited in the reserve 
333.8   account funds in excess of those needed to meet obligations 
333.9   incurred under this section and sections 254B.06 and 254B.09 
333.10  shall cancel to the general fund. 
333.11     Sec. 19.  Minnesota Statutes 1998, section 254B.03, 
333.12  subdivision 1, is amended to read: 
333.13     Subdivision 1.  [LOCAL AGENCY DUTIES.] (a) Every local 
333.14  agency shall provide chemical dependency services to persons 
333.15  residing within its jurisdiction who meet criteria established 
333.16  by the commissioner for placement in a chemical dependency 
333.17  residential or nonresidential treatment service.  Chemical 
333.18  dependency money must be administered by the local agencies 
333.19  according to law and rules adopted by the commissioner under 
333.20  sections 14.001 to 14.69. 
333.21     (b) In order to contain costs, the county board shall, with 
333.22  the approval of the commissioner of human services, select 
333.23  eligible vendors of chemical dependency services who can provide 
333.24  economical and appropriate treatment.  Unless the local agency 
333.25  is a social services department directly administered by a 
333.26  county or human services board, the local agency shall not be an 
333.27  eligible vendor under section 254B.05.  The commissioner may 
333.28  approve proposals from county boards to provide services in an 
333.29  economical manner or to control utilization, with safeguards to 
333.30  ensure that necessary services are provided.  If a county 
333.31  implements a demonstration or experimental medical services 
333.32  funding plan, the commissioner shall transfer the money as 
333.33  appropriate.  If a county selects a vendor located in another 
333.34  state, the county shall ensure that the vendor is in compliance 
333.35  with the rules governing licensure of programs located in the 
333.36  state. 
334.1      (c) The calendar year 1998 rate for vendors may not 
334.2   increase more than three percent above the rate approved in 
334.3   effect on January 1, 1997.  The calendar year 1999 rate for 
334.4   vendors may not increase more than three percent above the rate 
334.5   in effect on January 1, 1998. 
334.6      (d) A culturally specific vendor that provides assessments 
334.7   under a variance under Minnesota Rules, part 9530.6610, shall be 
334.8   allowed to provide assessment services to persons not covered by 
334.9   the variance. 
334.10     (e) The rates for vendors of inpatient treatment services 
334.11  for calendar year 2000 and calendar year 2001 may not increase 
334.12  above the rate in effect on January 1, 1999. 
334.13     (f) The calendar year 2000 rate for vendors of outpatient 
334.14  treatment services may not increase more than two percent above 
334.15  the rate in effect on January 1, 1999.  The calendar year 2001 
334.16  rate for vendors of outpatient treatment services may not 
334.17  increase more than two percent above the rate in effect on 
334.18  January 1, 2000. 
334.19     Sec. 20.  Minnesota Statutes 1998, section 254B.03, 
334.20  subdivision 2, is amended to read: 
334.21     Subd. 2.  [CHEMICAL DEPENDENCY SERVICES FUND PAYMENT.] (a) 
334.22  Payment from the chemical dependency fund is limited to payments 
334.23  for services other than detoxification that, if located outside 
334.24  of federally recognized tribal lands, would be required to be 
334.25  licensed by the commissioner as a chemical dependency treatment 
334.26  or rehabilitation program under sections 245A.01 to 245A.16, and 
334.27  services other than detoxification provided in another state 
334.28  that would be required to be licensed as a chemical dependency 
334.29  program if the program were in the state.  Out of state vendors 
334.30  must also provide the commissioner with assurances that the 
334.31  program complies substantially with state licensing requirements 
334.32  and possesses all licenses and certifications required by the 
334.33  host state to provide chemical dependency treatment.  Hospitals 
334.34  may apply for and receive licenses to be eligible vendors, 
334.35  notwithstanding the provisions of section 245A.03.  Except for 
334.36  chemical dependency transitional rehabilitation programs, 
335.1   vendors receiving payments from the chemical dependency fund 
335.2   must not require copayment from a recipient of benefits for 
335.3   services provided under this subdivision.  Payment from the 
335.4   chemical dependency fund shall be made for necessary room and 
335.5   board costs provided by vendors certified according to section 
335.6   254B.05, or in a community hospital licensed by the commissioner 
335.7   of health according to sections 144.50 to 144.56 to a client who 
335.8   is: 
335.9      (1) determined to meet the criteria for placement in a 
335.10  residential chemical dependency treatment program according to 
335.11  rules adopted under section 254A.03, subdivision 3; and 
335.12     (2) concurrently receiving a chemical dependency treatment 
335.13  service in a program licensed by the commissioner and reimbursed 
335.14  by the chemical dependency fund. 
335.15     (b) A county may, from its own resources, provide chemical 
335.16  dependency services for which state payments are not made.  A 
335.17  county may elect to use the same invoice procedures and obtain 
335.18  the same state payment services as are used for chemical 
335.19  dependency services for which state payments are made under this 
335.20  section if county payments are made to the state in advance of 
335.21  state payments to vendors.  When a county uses the state system 
335.22  for payment, the commissioner shall make monthly billings to the 
335.23  county using the most recent available information to determine 
335.24  the anticipated services for which payments will be made in the 
335.25  coming month.  Adjustment of any overestimate or underestimate 
335.26  based on actual expenditures shall be made by the state agency 
335.27  by adjusting the estimate for any succeeding month. 
335.28     (c) The commissioner shall coordinate chemical dependency 
335.29  services and determine whether there is a need for any proposed 
335.30  expansion of chemical dependency treatment services.  The 
335.31  commissioner shall deny vendor certification to any provider 
335.32  that has not received prior approval from the commissioner for 
335.33  the creation of new programs or the expansion of existing 
335.34  program capacity.  The commissioner shall consider the 
335.35  provider's capacity to obtain clients from outside the state 
335.36  based on plans, agreements, and previous utilization history, 
336.1   when determining the need for new treatment services. 
336.2      Sec. 21.  Minnesota Statutes 1998, section 254B.05, 
336.3   subdivision 1, is amended to read: 
336.4      Subdivision 1.  [LICENSURE REQUIRED.] Programs licensed by 
336.5   the commissioner are eligible vendors.  Hospitals may apply for 
336.6   and receive licenses to be eligible vendors, notwithstanding the 
336.7   provisions of section 245A.03.  American Indian programs located 
336.8   on federally recognized tribal lands that provide chemical 
336.9   dependency primary treatment, extended care, transitional 
336.10  residence, or outpatient treatment services, and are licensed by 
336.11  tribal government are eligible vendors.  Detoxification programs 
336.12  are not eligible vendors.  Programs that are not licensed as a 
336.13  chemical dependency residential or nonresidential treatment 
336.14  program by the commissioner or by tribal government are not 
336.15  eligible vendors.  To be eligible for payment under the 
336.16  Consolidated Chemical Dependency Treatment Fund, a vendor of a 
336.17  chemical dependency service must participate in the Drug and 
336.18  Alcohol Abuse Normative Evaluation System and the treatment 
336.19  accountability plan. 
336.20     Effective January 1, 2000, vendors of room and board are 
336.21  eligible for chemical dependency fund payment if the vendor:  
336.22     (1) is certified by the county or tribal governing body as 
336.23  having rules prohibiting residents bringing chemicals into the 
336.24  facility or using chemicals while residing in the facility and 
336.25  provide consequences for infractions of those rules; 
336.26     (2) has a current contract with a county or tribal 
336.27  governing body; 
336.28     (3) is determined to meet applicable health and safety 
336.29  requirements; 
336.30     (4) is not a jail or prison; and 
336.31     (5) is not concurrently receiving funds under chapter 256I 
336.32  for the recipient. 
336.33     Sec. 22.  Minnesota Statutes 1998, section 256.01, 
336.34  subdivision 6, is amended to read: 
336.35     Subd. 6.  [ADVISORY TASK FORCES.] The commissioner may 
336.36  appoint advisory task forces to provide consultation on any of 
337.1   the programs under the commissioner's administration and 
337.2   supervision.  A task force shall expire and the compensation, 
337.3   terms of office and removal of members shall be as provided in 
337.4   section 15.059.  Notwithstanding section 15.059, the 
337.5   commissioner may pay a per diem of $35 to consumers and family 
337.6   members whose participation is needed in legislatively 
337.7   authorized state-level task forces, and whose participation on 
337.8   the task force is not as a paid representative of any agency, 
337.9   organization, or association. 
337.10     Sec. 23.  Laws 1995, chapter 207, article 8, section 41, as 
337.11  amended by Laws 1997, chapter 203, article 7, section 25, is 
337.12  amended to read: 
337.13     Sec. 41.  [245.4661] [PILOT PROJECTS TO TEST PROVIDE 
337.14  ALTERNATIVES TO DELIVERY OF ADULT MENTAL HEALTH SERVICES.] 
337.15     Subdivision 1.  [AUTHORIZATION FOR PILOT PROJECTS.] The 
337.16  commissioner of human services may approve pilot projects to 
337.17  test provide alternatives to or the enhanced enhance 
337.18  coordination of the delivery of mental health services required 
337.19  under the Minnesota Comprehensive Adult Mental Health Act, 
337.20  Minnesota Statutes, sections 245.461 to 245.486. 
337.21     Subd. 2.  [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The 
337.22  pilot projects shall be established to design, plan, and improve 
337.23  the mental health service delivery system for adults with 
337.24  serious and persistent mental illness that would: 
337.25     (1) provide an expanded array of services from which 
337.26  clients can choose services appropriate to their needs; 
337.27     (2) be based on purchasing strategies that improve access 
337.28  and coordinate services without cost shifting; 
337.29     (3) incorporate existing state facilities and resources 
337.30  into the community mental health infrastructure through creative 
337.31  partnerships with local vendors; and 
337.32     (4) utilize existing categorical funding streams and 
337.33  reimbursement sources in combined and creative ways, except 
337.34  appropriations to regional treatment centers and all funds that 
337.35  are attributable to the operation of state-operated services are 
337.36  excluded unless appropriated specifically by the legislature for 
338.1   a purpose consistent with this section. 
338.2      (b) All projects funded by January 1, 1997, must complete 
338.3   the planning phase and be operational by June 30, 1997; all 
338.4   projects funded by January 1, 1998, must be operational by June 
338.5   30, 1998.  
338.6      Subd. 3.  [PROGRAM EVALUATION.] Evaluation of each project 
338.7   will be based on outcome evaluation criteria negotiated with 
338.8   each project prior to implementation. 
338.9      Subd. 4.  [NOTICE OF PROJECT DISCONTINUATION.] Each project 
338.10  may be discontinued for any reason by the project's managing 
338.11  entity or the commissioner of human services, after 90 days' 
338.12  written notice to the other party. 
338.13     Subd. 5.  [PLANNING FOR PILOT PROJECTS.] Each local plan 
338.14  for a pilot project must be developed under the direction of the 
338.15  county board, or multiple county boards acting jointly, as the 
338.16  local mental health authority.  The planning process for each 
338.17  pilot shall include, but not be limited to, mental health 
338.18  consumers, families, advocates, local mental health advisory 
338.19  councils, local and state providers, representatives of state 
338.20  and local public employee bargaining units, and the department 
338.21  of human services.  As part of the planning process, the county 
338.22  board or boards shall designate a managing entity responsible 
338.23  for receipt of funds and management of the pilot project. 
338.24     Subd. 6.  [DUTIES OF COMMISSIONER.] (a) For purposes of the 
338.25  pilot projects, the commissioner shall facilitate integration of 
338.26  funds or other resources as needed and requested by each 
338.27  project.  These resources may include: 
338.28     (1) residential services funds administered under Minnesota 
338.29  Rules, parts 9535.2000 to 9535.3000, in an amount to be 
338.30  determined by mutual agreement between the project's managing 
338.31  entity and the commissioner of human services after an 
338.32  examination of the county's historical utilization of facilities 
338.33  located both within and outside of the county and licensed under 
338.34  Minnesota Rules, parts 9520.0500 to 9520.0690; 
338.35     (2) community support services funds administered under 
338.36  Minnesota Rules, parts 9535.1700 to 9535.1760; 
339.1      (3) other mental health special project funds; 
339.2      (4) medical assistance, general assistance medical care, 
339.3   MinnesotaCare and group residential housing if requested by the 
339.4   project's managing entity, and if the commissioner determines 
339.5   this would be consistent with the state's overall health care 
339.6   reform efforts; and 
339.7      (5) regional treatment center nonfiscal resources to the 
339.8   extent agreed to by the project's managing entity and the 
339.9   regional treatment center. 
339.10     (b) The commissioner shall consider the following criteria 
339.11  in awarding start-up and implementation grants for the pilot 
339.12  projects: 
339.13     (1) the ability of the proposed projects to accomplish the 
339.14  objectives described in subdivision 2; 
339.15     (2) the size of the target population to be served; and 
339.16     (3) geographical distribution. 
339.17     (c) The commissioner shall review overall status of the 
339.18  projects initiatives at least every two years and recommend any 
339.19  legislative changes needed by January 15 of each odd-numbered 
339.20  year. 
339.21     (d) The commissioner may waive administrative rule 
339.22  requirements which are incompatible with the implementation of 
339.23  the pilot project. 
339.24     (e) The commissioner may exempt the participating counties 
339.25  from fiscal sanctions for noncompliance with requirements in 
339.26  laws and rules which are incompatible with the implementation of 
339.27  the pilot project. 
339.28     (f) The commissioner may award grants to an entity 
339.29  designated by a county board or group of county boards to pay 
339.30  for start-up and implementation costs of the pilot project. 
339.31     Subd. 7.  [DUTIES OF COUNTY BOARD.] The county board, or 
339.32  other entity which is approved to administer a pilot project, 
339.33  shall: 
339.34     (1) administer the project in a manner which is consistent 
339.35  with the objectives described in subdivision 2 and the planning 
339.36  process described in subdivision 5; 
340.1      (2) assure that no one is denied services for which they 
340.2   would otherwise be eligible; and 
340.3      (3) provide the commissioner of human services with timely 
340.4   and pertinent information through the following methods: 
340.5      (i) submission of community social services act plans and 
340.6   plan amendments; 
340.7      (ii) submission of social services expenditure and grant 
340.8   reconciliation reports, based on a coding format to be 
340.9   determined by mutual agreement between the project's managing 
340.10  entity and the commissioner; and 
340.11     (iii) submission of data and participation in an evaluation 
340.12  of the pilot projects, to be designed cooperatively by the 
340.13  commissioner and the projects. 
340.14     Subd. 8.  [EXPIRATION.] This section expires June 30, 2002. 
340.15     Sec. 24. [CONVEYANCE OF STATE LANDS TO COUNTY OF ISANTI.] 
340.16     (a) Notwithstanding Minnesota Statutes, sections 94.09 to 
340.17  94.16, the commissioner of human services, through the 
340.18  commissioner of administration, may transfer to the county of 
340.19  Isanti the lands described in paragraph (c), for no 
340.20  consideration.  The commissioner of human services and the 
340.21  county may attach to the transfer conditions that they agree are 
340.22  appropriate, including conditions that relate to water and sewer 
340.23  service.  The deed to convey the property must contain a clause 
340.24  that the property shall revert to the state if the property 
340.25  ceases to be used for a public purpose. 
340.26     (b) The conveyance must be in a form approved by the 
340.27  attorney general. 
340.28     (c) The land that may be transferred consists of 21.9 
340.29  acres, more or less, and is described as follows: 
340.30     That part of the Southwest Quarter of the Southeast Quarter 
340.31     and that part of Government Lot 4, both in Section 32, 
340.32     Township 36, Range 23, Isanti County, Minnesota, described 
340.33     jointly as follows:  Commencing at the southwest corner of 
340.34     the Southwest Quarter of the Southeast Quarter of Section 
340.35     32; thence North 89 degrees 45 minutes 12 seconds East, 
340.36     assumed bearing, along the south line of said SW 1/4 of SE 
341.1      1/4, a distance of 609.48 feet; thence North 1 degree 30 
341.2      minutes 30 seconds West, a distance of 149.17 feet to the 
341.3      point of beginning of the parcel to be herein described; 
341.4      thence continuing North 1 degrees 30 minutes 30 seconds 
341.5      West, a distance of 1113.59 feet; thence South 89 degrees 
341.6      59 minutes 36 seconds West, a distance of 496.41 feet; 
341.7      thence southwesterly along a tangential curve concave to 
341.8      the southeast, radius 318.10 feet, central angle 90 degrees 
341.9      16 minutes 37 seconds, for an arc length of 501.21 feet; 
341.10     thence South 0 degrees 17 minutes 01 seconds East, tangent 
341.11     to said curve, for a distance of 86.59 feet; thence 
341.12     southerly along a tangential curve concave to the west, 
341.13     radius 398.10 feet, central angle 29 degrees 47 minutes 02 
341.14     seconds, for an arc length of 206.94 feet; thence south 29 
341.15     degrees 30 minutes 01 seconds West, tangent to said curve, 
341.16     for a distance of 34.23 feet; thence southerly along a 
341.17     tangential curve concave to the east, radius 318.10 feet, 
341.18     central angle 29 degrees 49 minutes 32 seconds, for an arc 
341.19     length of 165.59 feet; thence South 0 degrees 19 minutes 31 
341.20     seconds East, tangent to said curve for a distance of 
341.21     320.65 feet to the point of intersection with a line that 
341.22     bears West (North 90 degrees 00 minutes West) from the 
341.23     point of beginning; thence East (North 90 degrees 00 
341.24     minutes East), a distance of 951.22 feet to the point of 
341.25     beginning. 
341.26     Subject to the existing City of Cambridge water main 
341.27     easement. 
341.28     (d) The county of Isanti may use the land for economic 
341.29  development.  Economic development is a public purpose within 
341.30  the meaning of the term as used in Laws 1990, chapter 610, 
341.31  article 1, section 12, subdivision 5, and sales or conveyances 
341.32  to private parties shall be considered economic development.  
341.33  Property conveyed by the state under this section shall not 
341.34  revert to the state if it is conveyed or otherwise encumbered by 
341.35  the county as part of the county economic development activity. 
341.36     Sec. 25.  [CONVEYANCE OF STATE LAND TO CITY OF CAMBRIDGE.] 
342.1      (a) Notwithstanding Minnesota Statutes, sections 94.09 to 
342.2   94.16, the commissioner of human services, through the 
342.3   commissioner of administration, may transfer to the city of 
342.4   Cambridge the lands described in paragraph (c), for no 
342.5   consideration.  The commissioner of human services and the city 
342.6   may attach to the transfer conditions that they agree are 
342.7   appropriate, including conditions that relate to water and sewer 
342.8   service.  The deed to convey the property must contain a clause 
342.9   that the property shall revert to the state if the property 
342.10  ceases to be used for a public purpose. 
342.11     (b) The conveyance must be in a form approved by the 
342.12  attorney general. 
342.13     (c) Subject to the right-of-way for state trunk highway No. 
342.14  293 and south Dellwood street and subject to other easements, 
342.15  reservations, road or street right-of-ways, and restrictions of 
342.16  record, if any, the land to be conveyed may include all or part 
342.17  of any of the parcels described as follows: 
342.18     (1) that part of the Northeast Quarter of the Northeast 
342.19     Quarter of Section 5, Township 35, Range 23, Isanti County, 
342.20     Minnesota, lying north of a line drawn parallel with and 50 
342.21     feet north of the center line of State Highway No. 293, as 
342.22     laid out and constructed and lying westerly of the 
342.23     following described line: 
342.24     Commencing at a point where the West line of the 
342.25     right-of-way of the Great Northern Railway Company 
342.26     (presently the Burlington Northern and Santa Fe Railway) 
342.27     intersects the North line of said Section 5, said point now 
342.28     being the intersection of the North line of said Section 5 
342.29     with the center line of State Trunk Highway No. 65 as now 
342.30     laid out and constructed (presently known as South Main 
342.31     Street); thence on a bearing of West and along the North 
342.32     line of said Section 5 a distance of 539.5 feet to the 
342.33     point of beginning of the line to be herein described; 
342.34     thence on a bearing of South, a distance of 451.75 feet to 
342.35     the point of intersection with a line drawn parallel with 
342.36     and distant 50 feet north of the center line of State 
343.1      Highway No. 293, as laid out and constructed and there 
343.2      terminating.  Containing 1/4 acre, more or less. 
343.3      (2) that part of the Northwest Quarter of the Southeast 
343.4      Quarter and that part of Governments Lots 3 and 4, all in 
343.5      Section 32, Township 36, Range 23, Isanti County, 
343.6      Minnesota, described jointly as follows: 
343.7      Commencing at the East quarter corner of Section 32, 
343.8      Township 36, Range 23, Isanti County, Minnesota; thence 
343.9      South 89 degrees 44 minutes 35 seconds West, assumed 
343.10     bearing, along the east-west quarter line of said Section 
343.11     32, a distance of 2251.43 feet; thence South 1 degree 48 
343.12     minutes 40 seconds East, a distance of 344.47 feet to the 
343.13     south line of Lot 30 of Auditor's Subdivision No. 9; thence 
343.14     South 89 degrees 35 minutes 5 seconds West, along said 
343.15     south line and the westerly projection thereof, a distance 
343.16     of 740.00 feet to the point of beginning of the parcel to 
343.17     be herein described; thence North 89 degrees 35 minutes, 05 
343.18     seconds East, retracing the last described course, a 
343.19     distance of 534.66 feet to the northwest corner of the 
343.20     recorded plat of RIVERWOOD VILLAGE; thence South 2 degrees 
343.21     40 minutes 50 seconds East, a distance of 338.38 feet, 
343.22     along the westerly line of said RIVERWOOD VILLAGE to the 
343.23     southwest corner of said RIVERWOOD VILLAGE; thence North 89 
343.24     degrees 44 minutes 50 seconds East, along the south line of 
343.25     said RIVERWOOD VILLAGE, a distance of 1074.56 feet; thence 
343.26     South 3 degrees 35 minutes 15 seconds East, a distance of 
343.27     258.66 feet; thence southwesterly along a tangential curve 
343.28     concave to the northwest, radius 318.10 feet, central angle 
343.29     93 degrees 34 minutes 51 seconds for an arc length of 
343.30     519.56 feet; thence South 89 degrees 59 minutes 37 seconds 
343.31     West tangent to said curve for a distance of 825.86 feet; 
343.32     thence southwesterly along a tangential curve concave to 
343.33     the southeast, radius 398.10 feet, central angle 70 degrees 
343.34     55 minutes 13 seconds, for an arc length of 492.76 feet; 
343.35     thence South 89 degrees 51 minutes 30 seconds West, not 
343.36     tangent to the last described curve for a distance of 
344.1      523.31 feet; thence South 1 degree 57 minutes 33 seconds 
344.2      West, a distance of 29.59 feet; thence South 89 degrees 57 
344.3      minutes 55 seconds West, a distance of 1020 feet, more or 
344.4      less, to the easterly shoreline of the Rum River; thence 
344.5      northerly along said easterly shoreline to the point of 
344.6      intersection with a line that bears North 45 degrees 24 
344.7      minutes 55 seconds West from the point of beginning; thence 
344.8      South 45 degrees 24 minutes 55 seconds East, along said 
344.9      line, a distance of 180 feet, more or less, to the point of 
344.10     beginning.  Containing 48 acres, more or less. 
344.11     (3) that part of the Northwest Quarter of the Northeast 
344.12     Quarter and that part of the Northeast Quarter of the 
344.13     Northwest Quarter, both in Section 5, Township 35, Range 
344.14     23, Isanti County, Minnesota, described jointly as follows: 
344.15     Beginning at the northwest corner of the NW 1/4 of NE 1/4 
344.16     of Section 5; thence North 89 degrees 45 minutes 12 seconds 
344.17     East, assumed bearing, along the north line of said NW 1/4 
344.18     of NE 1/4, a distance of 1321.82 feet to the northeast 
344.19     corner of said NW 1/4 of NE 1/4 thence South 4 degrees 04 
344.20     minutes 02 seconds West, along the east line of said NW 1/4 
344.21     of NE 1/4, a distance of 452.83 feet; thence South 89 
344.22     degrees 45 minutes 02 seconds West, a distance of 1393.6 
344.23     feet; thence northwesterly, along a non-tangential curve 
344.24     concave to the northeast, radius 318.17 feet, central angle 
344.25     75 degrees 28 minutes 03 seconds, for an arc length of 
344.26     419.08 feet (the chord of said curve bears North 38 degrees 
344.27     03 minutes 32 seconds West and has a length of 389.44 
344.28     feet); thence North 0 degrees 19 minutes 31 seconds West, 
344.29     tangent to said curve, for a distance of 142.65 feet to the 
344.30     north line of the NE 1/4 of NW 1/4 of said Section 5; 
344.31     thence North 89 degrees 32 minutes 15 seconds East, along 
344.32     said north line, a distance of 344.81 feet to the point of 
344.33     beginning.  Containing 16 acres, more or less.  
344.34     (4) that part of the Southwest Quarter of the Southeast 
344.35     Quarter, that part of the Northwest Quarter of the 
344.36     Southeast Quarter and that part of Government Lot 4, all in 
345.1      Section 32, Township 36, Range 23, Isanti County, 
345.2      Minnesota, described jointly as follows: 
345.3      Beginning at the southwest corner of the SW 1/4 of SE 1/4 
345.4      of Section 32; thence North 89 degrees 45 minutes 12 
345.5      seconds East, assumed bearing, along the south line of said 
345.6      SW 1/4 of SE 1/4, a distance of 1321.82 feet to the 
345.7      southeast corner of said SW 1/4 of SE 1/4 thence North 2 
345.8      degrees 40 minutes 49 seconds West, along the east line of 
345.9      said SW 1/4 of SE 1/4 and along the east line of the NW 1/4 
345.10     of SE 1/4, a distance of 1465.32 feet; thence southwesterly 
345.11     along a non-tangential curve concave to the northwest, 
345.12     radius 398.10 feet, central angle 60 degrees 52 minutes 54 
345.13     seconds, for an arc length of 423.02 feet (said curve has a 
345.14     chord that bears South 59 degrees 33 minutes 09 seconds 
345.15     West and a chord length of 403.40 feet); thence South 89 
345.16     degrees 59 minutes 37 seconds West, tangent to said curve, 
345.17     for a distance of 825.68 feet; thence southwesterly along a 
345.18     tangential curve concave to the southeast, radius 318.10 
345.19     feet, central angle 90 degrees 16 minutes 37 seconds, for 
345.20     an arc length of 501.21 feet; thence South 0 degrees 17 
345.21     minutes 01 seconds East, tangent to said curve, for a 
345.22     distance of 86.59 feet; thence southerly along a tangential 
345.23     curve concave to the West, radius 398.10 feet, central 
345.24     angle 29 degrees 47 minutes 02 seconds, for an arc length 
345.25     of 206.94 feet; thence South 29 degrees 30 minutes 01 
345.26     seconds West tangent to said curve, for a distance of 34.23 
345.27     feet; thence southerly along a tangential curve concave to 
345.28     the east, radius 318.20 feet, central angle 29 degrees 49 
345.29     minutes 32 seconds for an arc length of 165.59 feet; thence 
345.30     South 0 degrees 19 minutes 31 seconds East, tangent to said 
345.31     curve, for a distance of 475.17 feet to the south line of 
345.32     Government Lot 4, Section 32; thence North 89 degrees 32 
345.33     minutes 15 seconds East, along said south line, a distance 
345.34     of 344.81 feet to the point of beginning.  Containing 44.9 
345.35     acres, more or less. 
345.36     EXCEPTING THEREFROM that parcel described on Quit Claim 
346.1      Deed from the State of Minnesota to Wilfred R. and June E. 
346.2      Norman, filed in Book 92 of Deeds, page 647, in the office 
346.3      of the County Recorder, Isanti County, Minnesota.  
346.4      ALSO EXCEPTING THEREFROM that parcel described on Quit 
346.5      Claim Deed from the State of Minnesota to Frank C. Brody 
346.6      and Lorraine D.S. Brody, filed in Book 102 of Deeds, page 
346.7      232, in the office of the County Recorder, Isanti County, 
346.8      Minnesota. 
346.9      (d) The city of Cambridge may use the land for economic 
346.10  development.  Economic development is a public purpose within 
346.11  the meaning of the term as used in Laws 1990, chapter 610, 
346.12  article 1, section 12, subdivision 5, and sales or conveyances 
346.13  to private parties shall be considered economic development.  
346.14  Property conveyed by the state under this section shall not 
346.15  revert to the state if it is conveyed or otherwise encumbered by 
346.16  the city as a part of the city economic development activity. 
346.17     Sec. 26.  (CONVEYANCE OF CITY LAND TO STATE OF MINNESOTA.) 
346.18     (a) The commissioner of administration may accept all, or 
346.19  any part of, the land described in paragraph (d) from the city 
346.20  of Cambridge, after the city council passes a resolution which 
346.21  declares the property is surplus to its needs. 
346.22     (b) The conveyance shall be in a form approved by the 
346.23  attorney general. 
346.24     (c) The conveyance may be subject to a scenic easement, as 
346.25  defined in Minnesota Statutes, section 103F.311, subdivision 6.  
346.26  The easement shall be under the custodial control of the 
346.27  commissioner of natural resources and only required on the 
346.28  portion of conveyed land that is designated for inclusion in the 
346.29  wild and scenic river system under Minnesota Statutes, section 
346.30  103F.325.  The scenic easement shall allow for continued use of 
346.31  any existing structures located within the easement and for 
346.32  development of walking paths or trails within the easement. 
346.33     (d) Subject to the right-of-way for state trunk highway No. 
346.34  293, and subject to other easements, reservations, street 
346.35  right-of-ways, and restrictions of record, if any, the land to 
346.36  be conveyed may include all, or part of, the parcel described as 
347.1   follows: 
347.2      That part of Government Lot 4 and that part of the 
347.3      Northeast Quarter of the Northwest Quarter, all in Section 
347.4      5, Township 35, Range 23, Isanti County, Minnesota, 
347.5      described jointly as follows:  Commencing at the Northeast 
347.6      corner of the Northwest Quarter of Section 5, thence South 
347.7      89 degrees 47 minutes 10 seconds West, assumed bearing 
347.8      along the north line of the Northwest Quarter of Section 5, 
347.9      a distance of 656.00 feet to the point of beginning of the 
347.10     parcel to be herein described, thence South 00 degrees 03 
347.11     minutes 35 seconds East, a distance of 350.00 feet, thence 
347.12     South 89 degrees 47 minutes 10 seconds West, parallel with 
347.13     the north line of said Northwest Quarter of Section 5 to 
347.14     the easterly shoreline of the Rum River, thence 
347.15     northeasterly along said easterly shoreline to the north 
347.16     line of the Northwest Quarter of Section 5, thence North 89 
347.17     degrees 47 minutes 10 seconds East, along said north line 
347.18     to the point of beginning. 
347.19     Sec. 27.  [REPORT TO LEGISLATURE ON CHEMICAL DEPENDENCY 
347.20  GRANT PROGRAMS.] 
347.21     The commissioner of human services shall report and provide 
347.22  detailed outcome measures to the legislature, by January 1, 
347.23  2001, on chemical dependency grant activities for: 
347.24     (1) chemical dependency prevention, education, community 
347.25  awareness, and treatment services to Native Americans under 
347.26  Minnesota Statutes, sections 254A.03, subdivision 2, and 
347.27  254A.031; 
347.28     (2) chemical dependency case management services for 
347.29  chronic alcoholics under Minnesota Statutes, section 254A.07, 
347.30  subdivision 2; 
347.31     (3) chemical dependency prevention activities under 
347.32  Minnesota Statutes, section 254A.07, subdivision 2; and 
347.33     (4) chemical dependency treatment services to pregnant 
347.34  women and women with children under Minnesota Statutes, section 
347.35  254A.17, subdivision 1a. 
347.36     The report must contain sufficient information to assist 
348.1   the legislature in determining whether these grant activities 
348.2   are a cost-effective use of state funds and whether these grant 
348.3   activities should continue or be repealed. 
348.4      Sec. 28.  [REPORT TO LEGISLATURE ON ESTABLISHING ENTERPRISE 
348.5   ACTIVITIES WITHIN STATE-OPERATED SERVICES.] 
348.6      The commissioner of human services shall report and make 
348.7   recommendations to the legislature, by December 15, 1999, on 
348.8   establishing enterprise activities within state-operated 
348.9   services, under Minnesota Statutes, section 246.0136, and their 
348.10  status. 
348.11     Sec. 29.  [REPEALER.] 
348.12     (a) Minnesota Statutes 1998, section 254A.145, is repealed. 
348.13     (b) Minnesota Statutes 1998, sections 462A.208; and 
348.14  462A.21, subdivision 19, are repealed. 
348.15     (c) Minnesota Statutes, sections 254A.03, subdivision 2; 
348.16  254A.031; and 254A.17, subdivision 1a, are repealed June 30, 
348.17  2001. 
348.18                             ARTICLE 6 
348.19                      MFIP AND ADULT SUPPORTS
348.20     Section 1.  Minnesota Statutes 1998, section 256D.06, 
348.21  subdivision 5, is amended to read: 
348.22     Subd. 5.  Any applicant, otherwise eligible for general 
348.23  assistance and possibly eligible for maintenance benefits from 
348.24  any other source shall (a) make application for those benefits 
348.25  within 30 days of the general assistance application; and (b) 
348.26  execute an interim assistance authorization agreement on a form 
348.27  as directed by the commissioner.  The commissioner shall review 
348.28  a denial of an application for other maintenance benefits and 
348.29  may require a recipient of general assistance to file an appeal 
348.30  of the denial if appropriate.  If found eligible for benefits 
348.31  from other sources, and a payment received from another source 
348.32  relates to the period during which general assistance was also 
348.33  being received, the recipient shall be required to reimburse the 
348.34  county agency for the interim assistance paid.  Reimbursement 
348.35  shall not exceed the amount of general assistance paid during 
348.36  the time period to which the other maintenance benefits apply 
349.1   and shall not exceed the state standard applicable to that time 
349.2   period.  The commissioner shall adopt rules authorizing county 
349.3   agencies or other client representatives to retain from the 
349.4   amount recovered under an interim assistance agreement 25 
349.5   percent plus actual reasonable fees, costs, and disbursements of 
349.6   appeals and litigation, of providing special assistance to the 
349.7   recipient in processing the recipient's claim for maintenance 
349.8   benefits from another source.  The money retained under this 
349.9   section shall be from the state share of the recovery.  The 
349.10  commissioner or the county agency may contract with qualified 
349.11  persons to provide the special assistance.  The rules adopted by 
349.12  the commissioner shall include the methods by which county 
349.13  agencies shall identify, refer, and assist recipients who may be 
349.14  eligible for benefits under federal programs for the disabled.  
349.15  This subdivision does not require repayment of per diem payments 
349.16  made to shelters for battered women pursuant to section 256D.05, 
349.17  subdivision 3. 
349.18     Sec. 2.  Minnesota Statutes 1998, section 256J.02, 
349.19  subdivision 2, is amended to read: 
349.20     Subd. 2.  [USE OF MONEY.] State money appropriated for 
349.21  purposes of this section and TANF block grant money must be used 
349.22  for: 
349.23     (1) financial assistance to or on behalf of any minor child 
349.24  who is a resident of this state under section 256J.12; 
349.25     (2) employment and training services under this chapter or 
349.26  chapter 256K; 
349.27     (3) emergency financial assistance and services under 
349.28  section 256J.48; 
349.29     (4) diversionary assistance under section 256J.47; and 
349.30     (5) family assets for independence accounts under Laws 
349.31  1998, First Special Session chapter 1, article 1; 
349.32     (6) the pathways program under section 116L.04, subdivision 
349.33  1a; 
349.34     (7) welfare-to-work extended employment services for MFIP 
349.35  participants with severe impairment to employment as defined in 
349.36  section 268A.15, subdivision 1a; 
350.1      (8) the family homeless prevention and assistance program 
350.2   under section 462A.204; 
350.3      (9) the rent assistance for family stabilization 
350.4   demonstration project under section 462A.205; and 
350.5      (10) program administration under this chapter. 
350.6      Sec. 3.  Minnesota Statutes 1998, section 256J.08, 
350.7   subdivision 11, is amended to read: 
350.8      Subd. 11.  [CAREGIVER.] "Caregiver" means a minor child's 
350.9   natural or adoptive parent or parents and stepparent who live in 
350.10  the home with the minor child.  For purposes of determining 
350.11  eligibility for this program, caregiver also means any of the 
350.12  following individuals, if adults, who live with and provide care 
350.13  and support to a minor child when the minor child's natural or 
350.14  adoptive parent or parents or stepparents do not reside in the 
350.15  same home:  legal custodian or guardian, grandfather, 
350.16  grandmother, brother, sister, half-brother, half-sister, 
350.17  stepbrother, stepsister, uncle, aunt, first cousin or first 
350.18  cousin once removed, nephew, niece, person of preceding 
350.19  generation as denoted by prefixes of "great," "great-great," or 
350.20  "great-great-great," or a spouse of any person named in the 
350.21  above groups even after the marriage ends by death or divorce. 
350.22     Sec. 4.  Minnesota Statutes 1998, section 256J.08, is 
350.23  amended by adding a subdivision to read: 
350.24     Subd. 28a.  [ENCUMBRANCE.] "Encumbrance" means a legal 
350.25  claim against real or personal property that is payable upon the 
350.26  sale of that property. 
350.27     Sec. 5.  Minnesota Statutes 1998, section 256J.08, is 
350.28  amended by adding a subdivision to read: 
350.29     Subd. 55a.  [MFIP STANDARD OF NEED.] "MFIP standard of need"
350.30  means the appropriate standard used to determine MFIP benefit 
350.31  payments for the MFIP unit and applies to: 
350.32     (1) the transitional standard, sections 256J.08, 
350.33  subdivision 85, and 256J.24, subdivision 5; 
350.34     (2) the shared household standard, section 256J.24, 
350.35  subdivision 9; and 
350.36     (3) the interstate transition standard, section 256J.43. 
351.1      Sec. 6.  Minnesota Statutes 1998, section 256J.08, 
351.2   subdivision 65, is amended to read: 
351.3      Subd. 65.  [PARTICIPANT.] "Participant" means a person who 
351.4   is currently receiving cash assistance and or the food portion 
351.5   available through MFIP-S MFIP as funded by TANF and the food 
351.6   stamp program.  A person who fails to withdraw or access 
351.7   electronically any portion of the person's cash and food 
351.8   assistance payment by the end of the payment month, who makes a 
351.9   written request for closure before the first of a payment month 
351.10  and repays cash and food assistance electronically issued for 
351.11  that payment month within that payment month, or who returns any 
351.12  uncashed assistance check and food coupons and withdraws from 
351.13  the program is not a participant.  A person who withdraws a cash 
351.14  or food assistance payment by electronic transfer or receives 
351.15  and cashes a cash an MFIP assistance check or food coupons and 
351.16  is subsequently determined to be ineligible for assistance for 
351.17  that period of time is a participant, regardless whether that 
351.18  assistance is repaid.  The term "participant" includes the 
351.19  caregiver relative and the minor child whose needs are included 
351.20  in the assistance payment.  A person in an assistance unit who 
351.21  does not receive a cash and food assistance payment because the 
351.22  person has been suspended from MFIP-S or because the person's 
351.23  need falls below the $10 minimum payment level MFIP is a 
351.24  participant. 
351.25     Sec. 7.  Minnesota Statutes 1998, section 256J.08, 
351.26  subdivision 82, is amended to read: 
351.27     Subd. 82.  [SANCTION.] "Sanction" means the reduction of a 
351.28  family's assistance payment by a specified percentage of 
351.29  the applicable transitional MFIP standard of need because:  a 
351.30  nonexempt participant fails to comply with the requirements of 
351.31  sections 256J.52 to 256J.55; a parental caregiver fails without 
351.32  good cause to cooperate with the child support enforcement 
351.33  requirements; or a participant fails to comply with the 
351.34  insurance, tort liability, or other requirements of this chapter.
351.35     Sec. 8.  Minnesota Statutes 1998, section 256J.08, 
351.36  subdivision 86a, is amended to read: 
352.1      Subd. 86a.  [UNRELATED MEMBER.] "Unrelated member" means an 
352.2   individual in the household who does not meet the definition of 
352.3   an eligible caregiver, but does not include an individual who 
352.4   provides child care to a child in the assistance unit. 
352.5      Sec. 9.  Minnesota Statutes 1998, section 256J.11, 
352.6   subdivision 2, is amended to read: 
352.7      Subd. 2.  [NONCITIZENS; FOOD PORTION.] (a) For the period 
352.8   September 1, 1997, to October 31, 1997, noncitizens who do not 
352.9   meet one of the exemptions in section 412 of the Personal 
352.10  Responsibility and Work Opportunity Reconciliation Act of 1996, 
352.11  but were residing in this state as of July 1, 1997, are eligible 
352.12  for the 6/10 of the average value of food stamps for the same 
352.13  family size and composition until MFIP-S is operative in the 
352.14  noncitizen's county of financial responsibility and thereafter, 
352.15  the 6/10 of the food portion of MFIP-S.  However, federal food 
352.16  stamp dollars cannot be used to fund the food portion of MFIP-S 
352.17  benefits for an individual under this subdivision. 
352.18     (b) For the period November 1, 1997, to June 30, 1999, 
352.19  noncitizens who do not meet one of the exemptions in section 412 
352.20  of the Personal Responsibility and Work Opportunity 
352.21  Reconciliation Act of 1996 , and are receiving cash assistance 
352.22  under the AFDC, family general assistance, MFIP or MFIP-S 
352.23  programs are eligible for the average value of food stamps for 
352.24  the same family size and composition until MFIP-S is operative 
352.25  in the noncitizen's county of financial responsibility and 
352.26  thereafter, the food portion of MFIP-S.  However, federal food 
352.27  stamp dollars cannot be used to fund the food portion of MFIP-S 
352.28  benefits for an individual under this subdivision State dollars 
352.29  shall fund the food portion of a noncitizen's MFIP benefits when 
352.30  federal food stamp dollars cannot be used to fund those 
352.31  benefits.  The assistance provided under this subdivision, which 
352.32  is designated as a supplement to replace lost benefits under the 
352.33  federal food stamp program, must be disregarded as income in all 
352.34  programs that do not count food stamps as income where the 
352.35  commissioner has the authority to make the income disregard 
352.36  determination for the program. 
353.1      (c) The commissioner shall submit a state plan to the 
353.2   secretary of agriculture to allow the commissioner to purchase 
353.3   federal Food Stamp Program benefits in an amount equal to the 
353.4   MFIP-S food portion for each legal noncitizen receiving MFIP-S 
353.5   assistance who is ineligible to participate in the federal Food 
353.6   Stamp Program solely due to the provisions of section 402 or 403 
353.7   of Public Law Number 104-193, as authorized by Title VII of the 
353.8   1997 Emergency Supplemental Appropriations Act, Public Law 
353.9   Number 105-18.  The commissioner shall enter into a contract as 
353.10  necessary with the secretary to use the existing federal Food 
353.11  Stamp Program benefits delivery system for the purposes of 
353.12  administering the food portion of MFIP-S under this subdivision. 
353.13     Sec. 10.  Minnesota Statutes 1998, section 256J.11, 
353.14  subdivision 3, is amended to read: 
353.15     Subd. 3.  [BENEFITS FUNDED WITH STATE MONEY.] Legal adult 
353.16  noncitizens who have resided in the country for four years or 
353.17  more as a lawful permanent resident, whose benefits are funded 
353.18  entirely with state money, and who are under 70 years of age, 
353.19  must, as a condition of eligibility: 
353.20     (1) be enrolled in a literacy class, English as a second 
353.21  language class, or a citizen class; 
353.22     (2) be applying for admission to a literacy class, English 
353.23  as a second language class, and is on a waiting list; 
353.24     (3) be in the process of applying for a waiver from the 
353.25  Immigration and Naturalization Service of the English language 
353.26  or civics requirements of the citizenship test; 
353.27     (4) have submitted an application for citizenship to the 
353.28  Immigration and Naturalization Service and is waiting for a 
353.29  testing date or a subsequent swearing in ceremony; or 
353.30     (5) have been denied citizenship due to a failure to pass 
353.31  the test after two attempts or because of an inability to 
353.32  understand the rights and responsibilities of becoming a United 
353.33  States citizen, as documented by the Immigration and 
353.34  Naturalization Service or the county. 
353.35     If the county social service agency determines that a legal 
353.36  noncitizen subject to the requirements of this subdivision will 
354.1   require more than one year of English language training, then 
354.2   the requirements of clause (1) or (2) shall be imposed after the 
354.3   legal noncitizen has resided in the country for three years.  
354.4   Individuals who reside in a facility licensed under chapter 
354.5   144A, 144D, 245A, or 256I are exempt from the requirements of 
354.6   this subdivision. 
354.7      Sec. 11.  Minnesota Statutes 1998, section 256J.12, 
354.8   subdivision 1a, is amended to read: 
354.9      Subd. 1a.  [30-DAY RESIDENCY REQUIREMENT.] An assistance 
354.10  unit is considered to have established residency in this state 
354.11  only when a child or caregiver has resided in this state for at 
354.12  least 30 consecutive days with the intention of making the 
354.13  person's home here and not for any temporary purpose.  The birth 
354.14  of a child in Minnesota to a member of the assistance unit does 
354.15  not automatically establish the residency in this state under 
354.16  this subdivision of the other members of the assistance unit.  
354.17  Time spent in a shelter for battered women shall count toward 
354.18  satisfying the 30-day residency requirement. 
354.19     Sec. 12.  Minnesota Statutes 1998, section 256J.12, 
354.20  subdivision 2, is amended to read: 
354.21     Subd. 2.  [EXCEPTIONS.] (a) A county shall waive the 30-day 
354.22  residency requirement where unusual hardship would result from 
354.23  denial of assistance. 
354.24     (b) For purposes of this section, unusual hardship means an 
354.25  assistance unit: 
354.26     (1) is without alternative shelter; or 
354.27     (2) is without available resources for food. 
354.28     (c) For purposes of this subdivision, the following 
354.29  definitions apply (1) "metropolitan statistical area" is as 
354.30  defined by the U.S. Census Bureau; (2) "alternative shelter" 
354.31  includes any shelter that is located within the metropolitan 
354.32  statistical area containing the county and for which the family 
354.33  is eligible, provided the assistance unit does not have to 
354.34  travel more than 20 miles to reach the shelter and has access to 
354.35  transportation to the shelter.  Clause (2) does not apply to 
354.36  counties in the Minneapolis-St. Paul metropolitan statistical 
355.1   area. 
355.2      (d) Applicants are considered to meet the residency 
355.3   requirement under subdivision 1a if they once resided in 
355.4   Minnesota and: 
355.5      (1) joined the United States armed services, returned to 
355.6   Minnesota within 30 days of leaving the armed services, and 
355.7   intend to remain in Minnesota; or 
355.8      (2) left to attend school in another state, paid 
355.9   nonresident tuition or Minnesota tuition rates under a 
355.10  reciprocity agreement, and returned to Minnesota within 30 days 
355.11  of graduation with the intent to remain in Minnesota. 
355.12     (e) The 30-day residence requirement is met when: 
355.13     (1) a minor child or a minor caregiver moves from another 
355.14  state to the residence of a relative caregiver; and 
355.15     (2) the minor caregiver applies for and receives family 
355.16  cash assistance; 
355.17     (3) the relative caregiver chooses not to be part of the 
355.18  MFIP-S assistance unit; and 
355.19     (4) the relative caregiver has resided in Minnesota for at 
355.20  least 30 days prior to the date the assistance unit applies for 
355.21  cash assistance.  
355.22     (f) Ineligible mandatory unit members who have resided in 
355.23  Minnesota for 12 months immediately before the unit's date of 
355.24  application establish the other assistance unit members' 
355.25  eligibility for the MFIP-S transitional standard. 
355.26     (2) the relative caregiver has resided in Minnesota for at 
355.27  least 30 consecutive days and:  
355.28     (i) the minor caregiver applies for and receives MFIP; or 
355.29     (ii) the relative caregiver applies for assistance for the 
355.30  minor child but does not choose to be a member of the MFIP 
355.31  assistance unit. 
355.32     Sec. 13.  Minnesota Statutes 1998, section 256J.14, is 
355.33  amended to read: 
355.34     256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
355.35     (a) The definitions in this paragraph only apply to this 
355.36  subdivision. 
356.1      (1) "Household of a parent, legal guardian, or other adult 
356.2   relative" means the place of residence of: 
356.3      (i) a natural or adoptive parent; 
356.4      (ii) a legal guardian according to appointment or 
356.5   acceptance under section 260.242, 525.615, or 525.6165, and 
356.6   related laws; 
356.7      (iii) a caregiver as defined in section 256J.08, 
356.8   subdivision 11; or 
356.9      (iv) an appropriate adult relative designated by a county 
356.10  agency. 
356.11     (2) "Adult-supervised supportive living arrangement" means 
356.12  a private family setting which assumes responsibility for the 
356.13  care and control of the minor parent and minor child, or other 
356.14  living arrangement, not including a public institution, licensed 
356.15  by the commissioner of human services which ensures that the 
356.16  minor parent receives adult supervision and supportive services, 
356.17  such as counseling, guidance, independent living skills 
356.18  training, or supervision. 
356.19     (b) A minor parent and the minor child who is in the care 
356.20  of the minor parent must reside in the household of a parent, 
356.21  legal guardian, other adult relative, or in an adult-supervised 
356.22  supportive living arrangement in order to receive MFIP-S MFIP 
356.23  unless: 
356.24     (1) the minor parent has no living parent, other adult 
356.25  relative, or legal guardian whose whereabouts is known; 
356.26     (2) no living parent, other adult relative, or legal 
356.27  guardian of the minor parent allows the minor parent to live in 
356.28  the parent's, other adult relative's, or legal guardian's home; 
356.29     (3) the minor parent lived apart from the minor parent's 
356.30  own parent or legal guardian for a period of at least one year 
356.31  before either the birth of the minor child or the minor parent's 
356.32  application for MFIP-S MFIP; 
356.33     (4) the physical or emotional health or safety of the minor 
356.34  parent or minor child would be jeopardized if the minor parent 
356.35  and the minor child resided in the same residence with the minor 
356.36  parent's parent, other adult relative, or legal guardian; or 
357.1      (5) an adult supervised supportive living arrangement is 
357.2   not available for the minor parent and child in the county in 
357.3   which the minor parent and child currently reside.  If an adult 
357.4   supervised supportive living arrangement becomes available 
357.5   within the county, the minor parent and child must reside in 
357.6   that arrangement. 
357.7      (c) The county agency shall inform minor applicants must be 
357.8   informed both orally and in writing about the eligibility 
357.9   requirements and, their rights and obligations under the MFIP-S 
357.10  MFIP program, and any other applicable orientation information.  
357.11  The county must advise the minor of the possible exemptions and 
357.12  specifically ask whether one or more of these exemptions is 
357.13  applicable.  If the minor alleges one or more of these 
357.14  exemptions, then the county must assist the minor in obtaining 
357.15  the necessary verifications to determine whether or not these 
357.16  exemptions apply. 
357.17     (d) If the county worker has reason to suspect that the 
357.18  physical or emotional health or safety of the minor parent or 
357.19  minor child would be jeopardized if they resided with the minor 
357.20  parent's parent, other adult relative, or legal guardian, then 
357.21  the county worker must make a referral to child protective 
357.22  services to determine if paragraph (b), clause (4), applies.  A 
357.23  new determination by the county worker is not necessary if one 
357.24  has been made within the last six months, unless there has been 
357.25  a significant change in circumstances which justifies a new 
357.26  referral and determination. 
357.27     (e) If a minor parent is not living with a parent, legal 
357.28  guardian, or other adult relative due to paragraph (b), clause 
357.29  (1), (2), or (4), the minor parent must reside, when possible, 
357.30  in a living arrangement that meets the standards of paragraph 
357.31  (a), clause (2). 
357.32     (f) When a minor parent and minor child live with a parent, 
357.33  other adult relative, legal guardian, or in an adult-supervised 
357.34  supportive Regardless of living arrangement, MFIP-S MFIP must be 
357.35  paid, when possible, in the form of a protective payment on 
357.36  behalf of the minor parent and minor child according to section 
358.1   256J.39, subdivisions 2 to 4. 
358.2      Sec. 14.  Minnesota Statutes 1998, section 256J.20, 
358.3   subdivision 3, is amended to read: 
358.4      Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
358.5   MFIP-S MFIP, the equity value of all nonexcluded real and 
358.6   personal property of the assistance unit must not exceed $2,000 
358.7   for applicants and $5,000 for ongoing participants.  The value 
358.8   of assets in clauses (1) to (20) must be excluded when 
358.9   determining the equity value of real and personal property: 
358.10     (1) a licensed vehicle up to a loan value of less than or 
358.11  equal to $7,500.  The county agency shall apply any excess loan 
358.12  value as if it were equity value to the asset limit described in 
358.13  this section.  If the assistance unit owns more than one 
358.14  licensed vehicle, the county agency shall determine the vehicle 
358.15  with the highest loan value and count only the loan value over 
358.16  $7,500, excluding:  (i) the value of one vehicle per physically 
358.17  disabled person when the vehicle is needed to transport the 
358.18  disabled unit member; this exclusion does not apply to mentally 
358.19  disabled people; (ii) the value of special equipment for a 
358.20  handicapped member of the assistance unit; and (iii) any vehicle 
358.21  used for long-distance travel, other than daily commuting, for 
358.22  the employment of a unit member. 
358.23     The county agency shall count the loan value of all other 
358.24  vehicles and apply this amount as if it were equity value to the 
358.25  asset limit described in this section.  The value of special 
358.26  equipment for a handicapped member of the assistance unit is 
358.27  excluded.  To establish the loan value of vehicles, a county 
358.28  agency must use the N.A.D.A. Official Used Car Guide, Midwest 
358.29  Edition, for newer model cars.  When a vehicle is not listed in 
358.30  the guidebook, or when the applicant or participant disputes the 
358.31  loan value listed in the guidebook as unreasonable given the 
358.32  condition of the particular vehicle, the county agency may 
358.33  require the applicant or participant document the loan value by 
358.34  securing a written statement from a motor vehicle dealer 
358.35  licensed under section 168.27, stating the amount that the 
358.36  dealer would pay to purchase the vehicle.  The county agency 
359.1   shall reimburse the applicant or participant for the cost of a 
359.2   written statement that documents a lower loan value; 
359.3      (2) the value of life insurance policies for members of the 
359.4   assistance unit; 
359.5      (3) one burial plot per member of an assistance unit; 
359.6      (4) the value of personal property needed to produce earned 
359.7   income, including tools, implements, farm animals, inventory, 
359.8   business loans, business checking and savings accounts used at 
359.9   least annually and used exclusively for the operation of a 
359.10  self-employment business, and any motor vehicles if at least 50 
359.11  percent of the vehicle's use is to produce income and if the 
359.12  vehicles are essential for the self-employment business; 
359.13     (5) the value of personal property not otherwise specified 
359.14  which is commonly used by household members in day-to-day living 
359.15  such as clothing, necessary household furniture, equipment, and 
359.16  other basic maintenance items essential for daily living; 
359.17     (6) the value of real and personal property owned by a 
359.18  recipient of Supplemental Security Income or Minnesota 
359.19  supplemental aid; 
359.20     (7) the value of corrective payments, but only for the 
359.21  month in which the payment is received and for the following 
359.22  month; 
359.23     (8) a mobile home or other vehicle used by an applicant or 
359.24  participant as the applicant's or participant's home; 
359.25     (9) money in a separate escrow account that is needed to 
359.26  pay real estate taxes or insurance and that is used for this 
359.27  purpose; 
359.28     (10) money held in escrow to cover employee FICA, employee 
359.29  tax withholding, sales tax withholding, employee worker 
359.30  compensation, business insurance, property rental, property 
359.31  taxes, and other costs that are paid at least annually, but less 
359.32  often than monthly; 
359.33     (11) monthly assistance, emergency assistance, and 
359.34  diversionary payments for the current month's needs; 
359.35     (12) the value of school loans, grants, or scholarships for 
359.36  the period they are intended to cover; 
360.1      (13) payments listed in section 256J.21, subdivision 2, 
360.2   clause (9), which are held in escrow for a period not to exceed 
360.3   three months to replace or repair personal or real property; 
360.4      (14) income received in a budget month through the end of 
360.5   the payment month; 
360.6      (15) savings from earned income of a minor child or a minor 
360.7   parent that are set aside in a separate account designated 
360.8   specifically for future education or employment costs; 
360.9      (16) the federal earned income credit, Minnesota working 
360.10  family credit, state and federal income tax refunds, state 
360.11  homeowners and renters credits under chapter 290A, property tax 
360.12  rebates under Laws 1997, chapter 231, article 1, section 16, and 
360.13  other federal or state tax rebates in the month received and the 
360.14  following month; 
360.15     (17) payments excluded under federal law as long as those 
360.16  payments are held in a separate account from any nonexcluded 
360.17  funds; 
360.18     (18) money received by a participant of the corps to career 
360.19  program under section 84.0887, subdivision 2, paragraph (b), as 
360.20  a postservice benefit under the federal Americorps Act; 
360.21     (19) the assets of children ineligible to receive MFIP-S 
360.22  MFIP benefits because foster care or adoption assistance 
360.23  payments are made on their behalf; and 
360.24     (20) the assets of persons whose income is excluded under 
360.25  section 256J.21, subdivision 2, clause (43). 
360.26     Sec. 15.  Minnesota Statutes 1998, section 256J.21, 
360.27  subdivision 2, is amended to read: 
360.28     Subd. 2.  [INCOME EXCLUSIONS.] (a) The following must be 
360.29  excluded in determining a family's available income: 
360.30     (1) payments for basic care, difficulty of care, and 
360.31  clothing allowances received for providing family foster care to 
360.32  children or adults under Minnesota Rules, parts 9545.0010 to 
360.33  9545.0260 and 9555.5050 to 9555.6265, and payments received and 
360.34  used for care and maintenance of a third-party beneficiary who 
360.35  is not a household member; 
360.36     (2) reimbursements for employment training received through 
361.1   the Job Training Partnership Act, United States Code, title 29, 
361.2   chapter 19, sections 1501 to 1792b; 
361.3      (3) reimbursement for out-of-pocket expenses incurred while 
361.4   performing volunteer services, jury duty, or employment, or 
361.5   informal carpooling arrangements directly related to employment; 
361.6      (4) all educational assistance, except the county agency 
361.7   must count graduate student teaching assistantships, 
361.8   fellowships, and other similar paid work as earned income and, 
361.9   after allowing deductions for any unmet and necessary 
361.10  educational expenses, shall count scholarships or grants awarded 
361.11  to graduate students that do not require teaching or research as 
361.12  unearned income; 
361.13     (5) loans, regardless of purpose, from public or private 
361.14  lending institutions, governmental lending institutions, or 
361.15  governmental agencies; 
361.16     (6) loans from private individuals, regardless of purpose, 
361.17  provided an applicant or participant documents that the lender 
361.18  expects repayment; 
361.19     (7)(i) state income tax refunds; and 
361.20     (ii) federal income tax refunds; 
361.21     (8)(i) federal earned income credits; 
361.22     (ii) Minnesota working family credits; 
361.23     (iii) state homeowners and renters credits under chapter 
361.24  290A; and 
361.25     (iv) property tax rebates under Laws 1997, chapter 231, 
361.26  article 1, section 16; and 
361.27     (v) other federal or state tax rebates; 
361.28     (9) funds received for reimbursement, replacement, or 
361.29  rebate of personal or real property when these payments are made 
361.30  by public agencies, awarded by a court, solicited through public 
361.31  appeal, or made as a grant by a federal agency, state or local 
361.32  government, or disaster assistance organizations, subsequent to 
361.33  a presidential declaration of disaster; 
361.34     (10) the portion of an insurance settlement that is used to 
361.35  pay medical, funeral, and burial expenses, or to repair or 
361.36  replace insured property; 
362.1      (11) reimbursements for medical expenses that cannot be 
362.2   paid by medical assistance; 
362.3      (12) payments by a vocational rehabilitation program 
362.4   administered by the state under chapter 268A, except those 
362.5   payments that are for current living expenses; 
362.6      (13) in-kind income, including any payments directly made 
362.7   by a third party to a provider of goods and services; 
362.8      (14) assistance payments to correct underpayments, but only 
362.9   for the month in which the payment is received; 
362.10     (15) emergency assistance payments; 
362.11     (16) funeral and cemetery payments as provided by section 
362.12  256.935; 
362.13     (17) nonrecurring cash gifts of $30 or less, not exceeding 
362.14  $30 per participant in a calendar month; 
362.15     (18) any form of energy assistance payment made through 
362.16  Public Law Number 97-35, Low-Income Home Energy Assistance Act 
362.17  of 1981, payments made directly to energy providers by other 
362.18  public and private agencies, and any form of credit or rebate 
362.19  payment issued by energy providers; 
362.20     (19) Supplemental Security Income, including retroactive 
362.21  payments; 
362.22     (20) Minnesota supplemental aid, including retroactive 
362.23  payments; 
362.24     (21) proceeds from the sale of real or personal property; 
362.25     (22) adoption assistance payments under section 259.67; 
362.26     (23) state-funded family subsidy program payments made 
362.27  under section 252.32 to help families care for children with 
362.28  mental retardation or related conditions; 
362.29     (24) interest payments and dividends from property that is 
362.30  not excluded from and that does not exceed the asset limit; 
362.31     (25) rent rebates; 
362.32     (26) income earned by a minor caregiver or, minor child 
362.33  through age 6, or a minor child who is at least a half-time 
362.34  student in an approved elementary or secondary education 
362.35  program; 
362.36     (27) income earned by a caregiver under age 20 who is at 
363.1   least a half-time student in an approved elementary or secondary 
363.2   education program; 
363.3      (28) MFIP-S MFIP child care payments under section 119B.05; 
363.4      (29) all other payments made through MFIP-S MFIP to support 
363.5   a caregiver's pursuit of greater self-support; 
363.6      (30) income a participant receives related to shared living 
363.7   expenses; 
363.8      (31) reverse mortgages; 
363.9      (32) benefits provided by the Child Nutrition Act of 1966, 
363.10  United States Code, title 42, chapter 13A, sections 1771 to 
363.11  1790; 
363.12     (33) benefits provided by the women, infants, and children 
363.13  (WIC) nutrition program, United States Code, title 42, chapter 
363.14  13A, section 1786; 
363.15     (34) benefits from the National School Lunch Act, United 
363.16  States Code, title 42, chapter 13, sections 1751 to 1769e; 
363.17     (35) relocation assistance for displaced persons under the 
363.18  Uniform Relocation Assistance and Real Property Acquisition 
363.19  Policies Act of 1970, United States Code, title 42, chapter 61, 
363.20  subchapter II, section 4636, or the National Housing Act, United 
363.21  States Code, title 12, chapter 13, sections 1701 to 1750jj; 
363.22     (36) benefits from the Trade Act of 1974, United States 
363.23  Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
363.24     (37) war reparations payments to Japanese Americans and 
363.25  Aleuts under United States Code, title 50, sections 1989 to 
363.26  1989d; 
363.27     (38) payments to veterans or their dependents as a result 
363.28  of legal settlements regarding Agent Orange or other chemical 
363.29  exposure under Public Law Number 101-239, section 10405, 
363.30  paragraph (a)(2)(E); 
363.31     (39) income that is otherwise specifically excluded from 
363.32  the MFIP-S program MFIP consideration in federal law, state law, 
363.33  or federal regulation; 
363.34     (40) security and utility deposit refunds; 
363.35     (41) American Indian tribal land settlements excluded under 
363.36  Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 
364.1   Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 
364.2   reservations and payments to members of the White Earth Band, 
364.3   under United States Code, title 25, chapter 9, section 331, and 
364.4   chapter 16, section 1407; 
364.5      (42) all income of the minor parent's parent parents and 
364.6   stepparent stepparents when determining the grant for the minor 
364.7   parent in households that include a minor parent living with a 
364.8   parent parents or stepparent stepparents on MFIP-S MFIP with 
364.9   other children; and 
364.10     (43) income of the minor parent's parent parents and 
364.11  stepparent stepparents equal to 200 percent of the federal 
364.12  poverty guideline for a family size not including the minor 
364.13  parent and the minor parent's child in households that include a 
364.14  minor parent living with a parent parents or stepparent 
364.15  stepparents not on MFIP-S MFIP when determining the grant for 
364.16  the minor parent.  The remainder of income is deemed as 
364.17  specified in section 256J.37, subdivision 1b; 
364.18     (44) payments made to children eligible for relative 
364.19  custody assistance under section 257.85; 
364.20     (45) vendor payments for goods and services made on behalf 
364.21  of a client unless the client has the option of receiving the 
364.22  payment in cash; and 
364.23     (46) the principal portion of a contract for deed payment. 
364.24     Sec. 16.  Minnesota Statutes 1998, section 256J.21, 
364.25  subdivision 3, is amended to read: 
364.26     Subd. 3.  [INITIAL INCOME TEST.] The county agency shall 
364.27  determine initial eligibility by considering all earned and 
364.28  unearned income that is not excluded under subdivision 2.  To be 
364.29  eligible for MFIP-S MFIP, the assistance unit's countable income 
364.30  minus the disregards in paragraphs (a) and (b) must be below the 
364.31  transitional standard of assistance according to section 256J.24 
364.32  for that size assistance unit. 
364.33     (a) The initial eligibility determination must disregard 
364.34  the following items: 
364.35     (1) the employment disregard is 18 percent of the gross 
364.36  earned income whether or not the member is working full time or 
365.1   part time; 
365.2      (2) dependent care costs must be deducted from gross earned 
365.3   income for the actual amount paid for dependent care up to a 
365.4   maximum of $200 per month for each child less than two years of 
365.5   age, and $175 per month for each child two years of age and 
365.6   older under this chapter and chapter 119B; 
365.7      (3) all payments made according to a court order for 
365.8   spousal support or the support of children not living in the 
365.9   assistance unit's household shall be disregarded from the income 
365.10  of the person with the legal obligation to pay support, provided 
365.11  that, if there has been a change in the financial circumstances 
365.12  of the person with the legal obligation to pay support since the 
365.13  support order was entered, the person with the legal obligation 
365.14  to pay support has petitioned for a modification of the support 
365.15  order; and 
365.16     (4) an allocation for the unmet need of an ineligible 
365.17  spouse or an ineligible child under the age of 21 for whom the 
365.18  caregiver is financially responsible and who lives with the 
365.19  caregiver according to section 256J.36. 
365.20     (b) Notwithstanding paragraph (a), when determining initial 
365.21  eligibility for applicant units when at least one member has 
365.22  received AFDC, family general assistance, MFIP, MFIP-R, work 
365.23  first, or MFIP-S MFIP in this state within four months of the 
365.24  most recent application for MFIP-S MFIP, the employment 
365.25  disregard for all unit members is 36 percent of the gross earned 
365.26  income. 
365.27     After initial eligibility is established, the assistance 
365.28  payment calculation is based on the monthly income test. 
365.29     Sec. 17.  Minnesota Statutes 1998, section 256J.21, 
365.30  subdivision 4, is amended to read: 
365.31     Subd. 4.  [MONTHLY INCOME TEST AND DETERMINATION OF 
365.32  ASSISTANCE PAYMENT.] The county agency shall determine ongoing 
365.33  eligibility and the assistance payment amount according to the 
365.34  monthly income test.  To be eligible for MFIP-S MFIP, the result 
365.35  of the computations in paragraphs (a) to (e) must be at least $1.
365.36     (a) Apply a 36 percent income disregard to gross earnings 
366.1   and subtract this amount from the family wage level.  If the 
366.2   difference is equal to or greater than the transitional MFIP 
366.3   standard of need, the assistance payment is equal to 
366.4   the transitional MFIP standard of need.  If the difference is 
366.5   less than the transitional MFIP standard of need, the assistance 
366.6   payment is equal to the difference.  The employment disregard in 
366.7   this paragraph must be deducted every month there is earned 
366.8   income. 
366.9      (b) All payments made according to a court order for 
366.10  spousal support or the support of children not living in the 
366.11  assistance unit's household must be disregarded from the income 
366.12  of the person with the legal obligation to pay support, provided 
366.13  that, if there has been a change in the financial circumstances 
366.14  of the person with the legal obligation to pay support since the 
366.15  support order was entered, the person with the legal obligation 
366.16  to pay support has petitioned for a modification of the court 
366.17  order. 
366.18     (c) An allocation for the unmet need of an ineligible 
366.19  spouse or an ineligible child under the age of 21 for whom the 
366.20  caregiver is financially responsible and who lives with the 
366.21  caregiver must be made according to section 256J.36. 
366.22     (d) Subtract unearned income dollar for dollar from 
366.23  the MFIP transitional standard of need to determine the 
366.24  assistance payment amount. 
366.25     (e) When income is both earned and unearned, the amount of 
366.26  the assistance payment must be determined by first treating 
366.27  gross earned income as specified in paragraph (a).  After 
366.28  determining the amount of the assistance payment under paragraph 
366.29  (a), unearned income must be subtracted from that amount dollar 
366.30  for dollar to determine the assistance payment amount. 
366.31     (f) When the monthly income is greater than the 
366.32  transitional or family wage level MFIP standard of need after 
366.33  applicable deductions and the income will only exceed the 
366.34  standard for one month, the county agency must suspend the 
366.35  assistance payment for the payment month. 
366.36     Sec. 18.  Minnesota Statutes 1998, section 256J.24, 
367.1   subdivision 2, is amended to read: 
367.2      Subd. 2.  [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 
367.3   for minor caregivers and their children who must be in a 
367.4   separate assistance unit from the other persons in the 
367.5   household, when the following individuals live together, they 
367.6   must be included in the assistance unit: 
367.7      (1) a minor child, including a pregnant minor; 
367.8      (2) the minor child's minor siblings, minor half-siblings, 
367.9   and minor step-siblings; 
367.10     (3) the minor child's natural parents, adoptive parents, 
367.11  and stepparents; and 
367.12     (4) the spouse of a pregnant woman.  
367.13     Sec. 19.  Minnesota Statutes 1998, section 256J.24, 
367.14  subdivision 3, is amended to read: 
367.15     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
367.16  ASSISTANCE UNIT.] (a) The following individuals who are part of 
367.17  the assistance unit determined under subdivision 2 are 
367.18  ineligible to receive MFIP-S MFIP: 
367.19     (1) individuals receiving Supplemental Security Income or 
367.20  Minnesota supplemental aid; 
367.21     (2) individuals living at home while performing 
367.22  court-imposed, unpaid community service work due to a criminal 
367.23  conviction; 
367.24     (3) individuals disqualified from the food stamp program or 
367.25  MFIP-S MFIP, until the disqualification ends; 
367.26     (4) (3) children on whose behalf federal, state, or local 
367.27  foster care payments are made, except as provided in sections 
367.28  256J.13, subdivision 2, and 256J.74, subdivision 2; and 
367.29     (5) (4) children receiving ongoing monthly adoption 
367.30  assistance payments under section 259.67.  
367.31     (b) The exclusion of a person under this subdivision does 
367.32  not alter the mandatory assistance unit composition. 
367.33     Sec. 20.  Minnesota Statutes 1998, section 256J.24, 
367.34  subdivision 7, is amended to read: 
367.35     Subd. 7.  [FAMILY WAGE LEVEL STANDARD.] The family wage 
367.36  level standard is 110 percent of the transitional standard under 
368.1   subdivision 5 and is the standard used when there is earned 
368.2   income in the assistance unit.  As specified in section 256J.21, 
368.3   earned income is subtracted from the family wage level to 
368.4   determine the amount of the assistance payment.  Not including 
368.5   the family wage level standard, assistance payments may not 
368.6   exceed the shared household standard or the transitional MFIP 
368.7   standard of need for the assistance unit, whichever is less. 
368.8      Sec. 21.  Minnesota Statutes 1998, section 256J.24, 
368.9   subdivision 8, is amended to read: 
368.10     Subd. 8.  [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE UNITS.] 
368.11  Except for assistance units where a nonparental caregiver is not 
368.12  included in the grant, payments for shelter up to the amount of 
368.13  the cash portion of MFIP-S MFIP benefits for which the 
368.14  assistance unit is eligible shall be vendor paid for as many 
368.15  months as the assistance unit is eligible or six months, 
368.16  whichever comes first.  The residual amount of the grant after 
368.17  vendor payment, if any, must be paid to the MFIP-S MFIP 
368.18  caregiver. 
368.19     Sec. 22.  Minnesota Statutes 1998, section 256J.24, 
368.20  subdivision 9, is amended to read: 
368.21     Subd. 9.  [SHARED HOUSEHOLD STANDARD; MFIP-S MFIP.] (a) 
368.22  Except as prohibited in paragraph (b), the county agency must 
368.23  use the shared household standard when the household includes 
368.24  one or more unrelated members, as that term is defined in 
368.25  section 256J.08, subdivision 86a.  The county agency must use 
368.26  the shared household standard, unless a member of the assistance 
368.27  unit is a victim of domestic violence and has an approved safety 
368.28  plan, regardless of the number of unrelated members in the 
368.29  household. 
368.30     (b) The county agency must not use the shared household 
368.31  standard when all unrelated members are one of the following: 
368.32     (1) a recipient of public assistance benefits, including 
368.33  food stamps, Supplemental Security Income, adoption assistance, 
368.34  relative custody assistance, or foster care payments; 
368.35     (2) a roomer or boarder, or a person to whom the assistance 
368.36  unit is paying room or board; 
369.1      (3) a minor child under the age of 18; 
369.2      (4) a minor caregiver living with the minor caregiver's 
369.3   parents or in an approved supervised living arrangement; or 
369.4      (5) a caregiver who is not the parent of the minor child in 
369.5   the assistance unit; or 
369.6      (6) an individual who provides child care to a minor child 
369.7   in the MFIP assistance unit. 
369.8      (c) The shared household standard must be discontinued if 
369.9   it is not approved by the United States Department of 
369.10  Agriculture under the MFIP-S MFIP waiver. 
369.11     Sec. 23.  Minnesota Statutes 1998, section 256J.26, 
369.12  subdivision 1, is amended to read: 
369.13     Subdivision 1.  [PERSON CONVICTED OF DRUG OFFENSES.] (a) 
369.14  Applicants or participants who have been convicted of a drug 
369.15  offense committed after July 1, 1997, may, if otherwise 
369.16  eligible, receive AFDC or MFIP-S MFIP benefits subject to the 
369.17  following conditions: 
369.18     (1) Benefits for the entire assistance unit must be paid in 
369.19  vendor form for shelter and utilities during any time the 
369.20  applicant is part of the assistance unit. 
369.21     (2) The convicted applicant or participant shall be subject 
369.22  to random drug testing as a condition of continued eligibility 
369.23  and following any positive test for an illegal controlled 
369.24  substance is subject to the following sanctions: 
369.25     (i) for failing a drug test the first time, the 
369.26  participant's grant shall be reduced by ten percent of the 
369.27  MFIP-S transitional MFIP standard of need, the shared household 
369.28  standard, or the interstate transitional standard, whichever is 
369.29  applicable prior to making vendor payments for shelter and 
369.30  utility costs; or 
369.31     (ii) for failing a drug test two or more times, the 
369.32  residual amount of the participant's grant after making vendor 
369.33  payments for shelter and utility costs, if any, must be reduced 
369.34  by an amount equal to 30 percent of the MFIP-S transitional 
369.35  standard, the shared household standard, or the interstate 
369.36  transitional standard, whichever is applicable MFIP standard of 
370.1   need. 
370.2      (3) A participant who fails an initial drug test and is 
370.3   under a sanction due to other MFIP program requirements is 
370.4   subject to the sanction in clause (2)(ii). 
370.5      (b) Applicants requesting only food stamps or participants 
370.6   receiving only food stamps, who have been convicted of a drug 
370.7   offense that occurred after July 1, 1997, may, if otherwise 
370.8   eligible, receive food stamps if the convicted applicant or 
370.9   participant is subject to random drug testing as a condition of 
370.10  continued eligibility.  Following a positive test for an illegal 
370.11  controlled substance, the applicant is subject to the following 
370.12  sanctions: 
370.13     (1) for failing a drug test the first time, food stamps 
370.14  shall be reduced by ten percent of the applicable food stamp 
370.15  allotment; and 
370.16     (2) for failing a drug test two or more times, food stamps 
370.17  shall be reduced by an amount equal to 30 percent of the 
370.18  applicable food stamp allotment.  
370.19     (c) For the purposes of this subdivision, "drug offense" 
370.20  means a conviction an offense that occurred after July 1, 1997, 
370.21  of sections 152.021 to 152.025, 152.0261, or 152.096.  Drug 
370.22  offense also means a conviction in another jurisdiction of the 
370.23  possession, use, or distribution of a controlled substance, or 
370.24  conspiracy to commit any of these offenses, if the offense 
370.25  occurred after July 1, 1997, and the conviction is a felony 
370.26  offense in that jurisdiction, or in the case of New Jersey, a 
370.27  high misdemeanor. 
370.28     Sec. 24.  Minnesota Statutes 1998, section 256J.30, 
370.29  subdivision 2, is amended to read: 
370.30     Subd. 2.  [REQUIREMENT TO APPLY FOR OTHER BENEFITS.] An 
370.31  applicant or participant must apply for, accept if eligible, and 
370.32  follow through with appealing any denials of eligibility for 
370.33  benefits from other programs for which the applicant or 
370.34  participant is potentially eligible and which would, if 
370.35  received, offset assistance payments.  An applicant's or 
370.36  participant's failure to complete application for these benefits 
371.1   without good cause results in denial or termination of 
371.2   assistance.  Good cause for failure to apply for these benefits 
371.3   is allowed when circumstances beyond the control of the 
371.4   applicant or participant prevent the applicant or participant 
371.5   from making an application. 
371.6      Sec. 25.  Minnesota Statutes 1998, section 256J.30, 
371.7   subdivision 7, is amended to read: 
371.8      Subd. 7.  [DUE DATE OF MFIP-S MFIP HOUSEHOLD REPORT FORM.] 
371.9   An MFIP-S MFIP household report form must be received by the 
371.10  county agency by the eighth calendar day of the month following 
371.11  the reporting period covered by the form.  When the eighth 
371.12  calendar day of the month falls on a weekend or holiday, 
371.13  the MFIP-S MFIP household report form must be received by the 
371.14  county agency the first working day that follows the eighth 
371.15  calendar day.  The county agency must send a notice of 
371.16  termination because of a late or incomplete MFIP-S household 
371.17  report form. 
371.18     Sec. 26.  Minnesota Statutes 1998, section 256J.30, 
371.19  subdivision 8, is amended to read: 
371.20     Subd. 8.  [LATE MFIP-S MFIP HOUSEHOLD REPORT FORMS.] 
371.21  Paragraphs (a) to (d) apply to the reporting requirements in 
371.22  subdivision 7. 
371.23     (a) When a caregiver submits the county agency receives an 
371.24  incomplete MFIP-S MFIP household report form before the last 
371.25  working day of the month on which a ten-day notice of 
371.26  termination can be issued, the county agency must immediately 
371.27  return the incomplete form on or before the ten-day notice 
371.28  deadline or any previously sent ten-day notice of termination is 
371.29  invalid and clearly state what the caregiver must do for the 
371.30  form to be complete. 
371.31     (b) When a complete MFIP-S household report form is not 
371.32  received by a county agency before the last ten days of the 
371.33  month in which the form is due, the county agency must send A 
371.34  The automated eligibility system must send a notice of proposed 
371.35  termination of assistance to the assistance unit if a complete 
371.36  MFIP household report form is not received by a county agency.  
372.1   The automated notice must be mailed to the caregiver by 
372.2   approximately the 16th of the month.  When a caregiver submits 
372.3   an incomplete form on or after the date a notice of proposed 
372.4   termination has been sent, the termination is valid unless the 
372.5   caregiver submits a complete form before the end of the month. 
372.6      (c) An assistance unit required to submit an MFIP-S MFIP 
372.7   household report form is considered to have continued its 
372.8   application for assistance if a complete MFIP-S MFIP household 
372.9   report form is received within a calendar month after the month 
372.10  in which assistance was received the form was due and assistance 
372.11  shall be paid for the period beginning with the first day of the 
372.12  month in which the report was due that calendar month. 
372.13     (d) A county agency must allow good cause exemptions from 
372.14  the reporting requirements under subdivisions 5 and 6 when any 
372.15  of the following factors cause a caregiver to fail to provide 
372.16  the county agency with a completed MFIP-S MFIP household report 
372.17  form before the end of the month in which the form is due: 
372.18     (1) an employer delays completion of employment 
372.19  verification; 
372.20     (2) a county agency does not help a caregiver complete the 
372.21  MFIP-S MFIP household report form when the caregiver asks for 
372.22  help; 
372.23     (3) a caregiver does not receive an MFIP-S MFIP household 
372.24  report form due to mistake on the part of the department or the 
372.25  county agency or due to a reported change in address; 
372.26     (4) a caregiver is ill, or physically or mentally 
372.27  incapacitated; or 
372.28     (5) some other circumstance occurs that a caregiver could 
372.29  not avoid with reasonable care which prevents the caregiver from 
372.30  providing a completed MFIP-S MFIP household report form before 
372.31  the end of the month in which the form is due. 
372.32     Sec. 27.  Minnesota Statutes 1998, section 256J.30, 
372.33  subdivision 9, is amended to read: 
372.34     Subd. 9.  [CHANGES THAT MUST BE REPORTED.] A caregiver must 
372.35  report the changes or anticipated changes specified in clauses 
372.36  (1) to (16) (17) within ten days of the date they occur, within 
373.1   ten days of the date the caregiver learns that the change will 
373.2   occur, at the time of the periodic recertification of 
373.3   eligibility under section 256J.32, subdivision 6, or within 
373.4   eight calendar days of a reporting period as in subdivision 5 or 
373.5   6, whichever occurs first.  A caregiver must report other 
373.6   changes at the time of the periodic recertification of 
373.7   eligibility under section 256J.32, subdivision 6, or at the end 
373.8   of a reporting period under subdivision 5 or 6, as applicable.  
373.9   A caregiver must make these reports in writing to the county 
373.10  agency.  When a county agency could have reduced or terminated 
373.11  assistance for one or more payment months if a delay in 
373.12  reporting a change specified under clauses (1) to (16) had not 
373.13  occurred, the county agency must determine whether a timely 
373.14  notice under section 256J.31, subdivision 4, could have been 
373.15  issued on the day that the change occurred.  When a timely 
373.16  notice could have been issued, each month's overpayment 
373.17  subsequent to that notice must be considered a client error 
373.18  overpayment under section 256J.38.  Calculation of overpayments 
373.19  for late reporting under clause (17) is specified in section 
373.20  256J.09, subdivision 9.  Changes in circumstances which must be 
373.21  reported within ten days must also be reported on the MFIP-S 
373.22  MFIP household report form for the reporting period in which 
373.23  those changes occurred.  Within ten days, a caregiver must 
373.24  report: 
373.25     (1) a change in initial employment; 
373.26     (2) a change in initial receipt of unearned income; 
373.27     (3) a recurring change in unearned income; 
373.28     (4) a nonrecurring change of unearned income that exceeds 
373.29  $30; 
373.30     (5) the receipt of a lump sum; 
373.31     (6) an increase in assets that may cause the assistance 
373.32  unit to exceed asset limits; 
373.33     (7) a change in the physical or mental status of an 
373.34  incapacitated member of the assistance unit if the physical or 
373.35  mental status is the basis of exemption from an MFIP-S work and 
373.36  training MFIP employment services program; 
374.1      (8) a change in employment status; 
374.2      (9) a change in household composition, including births, 
374.3   returns to and departures from the home of assistance unit 
374.4   members and financially responsible persons, or a change in the 
374.5   custody of a minor child information affecting an exception 
374.6   under section 256J.24, subdivision 9; 
374.7      (10) a change in health insurance coverage; 
374.8      (11) the marriage or divorce of an assistance unit member; 
374.9      (12) the death of a parent, minor child, or financially 
374.10  responsible person; 
374.11     (13) a change in address or living quarters of the 
374.12  assistance unit; 
374.13     (14) the sale, purchase, or other transfer of property; 
374.14     (15) a change in school attendance of a custodial parent or 
374.15  an employed child; and 
374.16     (16) filing a lawsuit, a workers' compensation claim, or a 
374.17  monetary claim against a third party; and 
374.18     (17) a change in household composition, including births, 
374.19  returns to and departures from the home of assistance unit 
374.20  members and financially responsible persons, or a change in the 
374.21  custody of a minor child. 
374.22     Sec. 28.  Minnesota Statutes 1998, section 256J.31, 
374.23  subdivision 5, is amended to read: 
374.24     Subd. 5.  [MAILING OF NOTICE.] The notice of adverse action 
374.25  shall be issued according to paragraphs (a) to (c) (d). 
374.26     (a) A county agency shall mail a notice of adverse action 
374.27  must be mailed at least ten days before the effective date of 
374.28  the adverse action, except as provided in paragraphs (b) and (c) 
374.29  to (d). 
374.30     (b) A county agency must mail a notice of adverse action at 
374.31  least five days before the effective date of the adverse action 
374.32  when the county agency has factual information that requires an 
374.33  action to reduce, suspend, or terminate assistance based on 
374.34  probable fraud. 
374.35     (c) A county agency shall mail A notice of adverse action 
374.36  before or on the effective date of the adverse action must be 
375.1   mailed no later than four working days before the end of the 
375.2   month when the county agency: 
375.3      (1) receives the caregiver's signed monthly MFIP-S 
375.4   household report form that includes information that requires 
375.5   payment reduction, suspension, or termination; 
375.6      (2) is informed of the death of a participant the only 
375.7   caregiver or the payee in an assistance unit; 
375.8      (3) (2) receives a signed statement from the caregiver that 
375.9   assistance is no longer wanted; 
375.10     (4) receives a signed statement from the caregiver that 
375.11  provides information that requires the termination or reduction 
375.12  of assistance (3) has factual information to reduce, suspend, or 
375.13  terminate assistance based on the failure to timely report 
375.14  changes; 
375.15     (5) verifies that a member of the assistance unit is absent 
375.16  from the home and does not meet temporary absence provisions in 
375.17  section 256J.13; 
375.18     (6) (4) verifies that a member of the assistance unit has 
375.19  entered a regional treatment center or a licensed residential 
375.20  facility for medical or psychological treatment or 
375.21  rehabilitation; 
375.22     (7) (5) verifies that a member of an assistance unit has 
375.23  been removed from the home as a result of a judicial 
375.24  determination or placed in foster care, and the provisions of 
375.25  section 256J.13, subdivision 2, paragraph (c), clause (2), do 
375.26  not apply; 
375.27     (8) verifies that a member of an assistance unit has been 
375.28  approved to receive assistance by another state; or 
375.29     (9) (6) cannot locate a caregiver. 
375.30     (c) A notice of adverse action must be mailed for a payment 
375.31  month when the caregiver makes a written request for closure 
375.32  before the first of that payment month. 
375.33     (d) A notice of adverse action must be mailed before the 
375.34  effective date of the adverse action when the county agency 
375.35  receives the caregiver's signed and completed MFIP household 
375.36  report form or recertification form that includes information 
376.1   that requires payment reduction, suspension, or termination. 
376.2      Sec. 29.  Minnesota Statutes 1998, section 256J.31, 
376.3   subdivision 12, is amended to read: 
376.4      Subd. 12.  [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 
376.5   participant who is not in vendor payment status may discontinue 
376.6   receipt of the cash assistance portion of MFIP-S the MFIP 
376.7   assistance grant and retain eligibility for child care 
376.8   assistance under section 119B.05 and for medical assistance 
376.9   under sections 256B.055, subdivision 3a, and 256B.0635.  For the 
376.10  months a participant chooses to discontinue the receipt of the 
376.11  cash portion of the MFIP grant, the assistance unit accrues 
376.12  months of eligibility to be applied toward eligibility for child 
376.13  care under section 119B.05 and for medical assistance under 
376.14  sections 256B.055, subdivision 3a, and 256B.0635. 
376.15     Sec. 30.  Minnesota Statutes 1998, section 256J.32, 
376.16  subdivision 4, is amended to read: 
376.17     Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
376.18  verify the following at application: 
376.19     (1) identity of adults; 
376.20     (2) presence of the minor child in the home, if 
376.21  questionable; 
376.22     (3) relationship of a minor child to caregivers in the 
376.23  assistance unit; 
376.24     (4) age, if necessary to determine MFIP-S MFIP eligibility; 
376.25     (5) immigration status; 
376.26     (6) social security number according to the requirements of 
376.27  section 256J.30, subdivision 12; 
376.28     (7) income; 
376.29     (8) self-employment expenses used as a deduction; 
376.30     (9) source and purpose of deposits and withdrawals from 
376.31  business accounts; 
376.32     (10) spousal support and child support payments made to 
376.33  persons outside the household; 
376.34     (11) real property; 
376.35     (12) vehicles; 
376.36     (13) checking and savings accounts; 
377.1      (14) savings certificates, savings bonds, stocks, and 
377.2   individual retirement accounts; 
377.3      (15) pregnancy, if related to eligibility; 
377.4      (16) inconsistent information, if related to eligibility; 
377.5      (17) medical insurance; 
377.6      (18) anticipated graduation date of an 18-year-old; 
377.7      (19) burial accounts; 
377.8      (20) (19) school attendance, if related to eligibility; 
377.9      (21) (20) residence; 
377.10     (22) (21) a claim of domestic violence if used as a basis 
377.11  for a deferral or exemption from the 60-month time limit in 
377.12  section 256J.42 or employment and training services requirements 
377.13  in section 256J.56; and 
377.14     (23) (22) disability if used as an exemption from 
377.15  employment and training services requirements under section 
377.16  256J.56; and 
377.17     (23) information needed to establish an exception under 
377.18  section 256J.24, subdivision 9. 
377.19     Sec. 31.  Minnesota Statutes 1998, section 256J.32, 
377.20  subdivision 6, is amended to read: 
377.21     Subd. 6.  [RECERTIFICATION.] The county agency shall 
377.22  recertify eligibility in an annual face-to-face interview with 
377.23  the participant and verify the following: 
377.24     (1) presence of the minor child in the home, if 
377.25  questionable; 
377.26     (2) income, unless excluded, including self-employment 
377.27  expenses used as a deduction or deposits or withdrawals from 
377.28  business accounts; 
377.29     (3) assets when the value is within $200 of the asset 
377.30  limit; and 
377.31     (4) information to establish an exception under section 
377.32  256J.24, subdivision 9, if questionable; and 
377.33     (5) inconsistent information, if related to eligibility.  
377.34     Sec. 32.  Minnesota Statutes 1998, section 256J.33, is 
377.35  amended to read: 
377.36     256J.33 [PROSPECTIVE AND RETROSPECTIVE DETERMINATION OF 
378.1   MFIP-S MFIP ELIGIBILITY.] 
378.2      Subdivision 1.  [DETERMINATION OF ELIGIBILITY.] A county 
378.3   agency must determine MFIP-S MFIP eligibility prospectively for 
378.4   a payment month based on retrospectively assessing income and 
378.5   the county agency's best estimate of the circumstances that will 
378.6   exist in the payment month. 
378.7      Except as described in section 256J.34, subdivision 1, when 
378.8   prospective eligibility exists, a county agency must calculate 
378.9   the amount of the assistance payment using retrospective 
378.10  budgeting.  To determine MFIP-S MFIP eligibility and the 
378.11  assistance payment amount, a county agency must apply countable 
378.12  income, described in section 256J.37, subdivisions 3 to 10, 
378.13  received by members of an assistance unit or by other persons 
378.14  whose income is counted for the assistance unit, described under 
378.15  sections 256J.21 and 256J.37, subdivisions 1 to 2. 
378.16     This income must be applied to the transitional MFIP 
378.17  standard, shared household standard, of need or family 
378.18  wage standard level subject to this section and sections 256J.34 
378.19  to 256J.36.  Income received in a calendar month and not 
378.20  otherwise excluded under section 256J.21, subdivision 2, must be 
378.21  applied to the needs of an assistance unit. 
378.22     Subd. 2.  [PROSPECTIVE ELIGIBILITY.] A county agency must 
378.23  determine whether the eligibility requirements that pertain to 
378.24  an assistance unit, including those in sections 256J.11 to 
378.25  256J.15 and 256J.20, will be met prospectively for the payment 
378.26  month.  Except for the provisions in section 256J.34, 
378.27  subdivision 1, the income test will be applied retrospectively. 
378.28     Subd. 3.  [RETROSPECTIVE ELIGIBILITY.] After the first two 
378.29  months of MFIP-S MFIP eligibility, a county agency must continue 
378.30  to determine whether an assistance unit is prospectively 
378.31  eligible for the payment month by looking at all factors other 
378.32  than income and then determine whether the assistance unit is 
378.33  retrospectively income eligible by applying the monthly income 
378.34  test to the income from the budget month.  When the monthly 
378.35  income test is not satisfied, the assistance payment must be 
378.36  suspended when ineligibility exists for one month or ended when 
379.1   ineligibility exists for more than one month. 
379.2      Subd. 4.  [MONTHLY INCOME TEST.] A county agency must apply 
379.3   the monthly income test retrospectively for each month of MFIP-S 
379.4   MFIP eligibility.  An assistance unit is not eligible when the 
379.5   countable income equals or exceeds the transitional MFIP 
379.6   standard, shared household standard, of need or the family wage 
379.7   level for the assistance unit.  The income applied against the 
379.8   monthly income test must include: 
379.9      (1) gross earned income from employment, prior to mandatory 
379.10  payroll deductions, voluntary payroll deductions, wage 
379.11  authorizations, and after the disregards in section 256J.21, 
379.12  subdivision 4, and the allocations in section 256J.36, unless 
379.13  the employment income is specifically excluded under section 
379.14  256J.21, subdivision 2; 
379.15     (2) gross earned income from self-employment less 
379.16  deductions for self-employment expenses in section 256J.37, 
379.17  subdivision 5, but prior to any reductions for personal or 
379.18  business state and federal income taxes, personal FICA, personal 
379.19  health and life insurance, and after the disregards in section 
379.20  256J.21, subdivision 4, and the allocations in section 256J.36; 
379.21     (3) unearned income after deductions for allowable expenses 
379.22  in section 256J.37, subdivision 9, and allocations in section 
379.23  256J.36, unless the income has been specifically excluded in 
379.24  section 256J.21, subdivision 2; 
379.25     (4) gross earned income from employment as determined under 
379.26  clause (1) which is received by a member of an assistance unit 
379.27  who is a minor child or minor caregiver and less than a 
379.28  half-time student; 
379.29     (5) child support and spousal support received or 
379.30  anticipated to be received by an assistance unit; 
379.31     (6) the income of a parent when that parent is not included 
379.32  in the assistance unit; 
379.33     (7) the income of an eligible relative and spouse who seek 
379.34  to be included in the assistance unit; and 
379.35     (8) the unearned income of a minor child included in the 
379.36  assistance unit. 
380.1      Subd. 5.  [WHEN TO TERMINATE ASSISTANCE.] When an 
380.2   assistance unit is ineligible for MFIP-S MFIP assistance for two 
380.3   consecutive months, the county agency must terminate MFIP-S MFIP 
380.4   assistance. 
380.5      Sec. 33.  Minnesota Statutes 1998, section 256J.34, 
380.6   subdivision 1, is amended to read: 
380.7      Subdivision 1.  [PROSPECTIVE BUDGETING.] A county agency 
380.8   must use prospective budgeting to calculate the assistance 
380.9   payment amount for the first two months for an applicant who has 
380.10  not received assistance in this state for at least one payment 
380.11  month preceding the first month of payment under a current 
380.12  application.  Notwithstanding subdivision 3, paragraph (a), 
380.13  clause (2), a county agency must use prospective budgeting for 
380.14  the first two months for a person who applies to be added to an 
380.15  assistance unit.  Prospective budgeting is not subject to 
380.16  overpayments or underpayments unless fraud is determined under 
380.17  section 256.98. 
380.18     (a) The county agency must apply the income received or 
380.19  anticipated in the first month of MFIP-S MFIP eligibility 
380.20  against the need of the first month.  The county agency must 
380.21  apply the income received or anticipated in the second month 
380.22  against the need of the second month. 
380.23     (b) When the assistance payment for any part of the first 
380.24  two months is based on anticipated income, the county agency 
380.25  must base the initial assistance payment amount on the 
380.26  information available at the time the initial assistance payment 
380.27  is made. 
380.28     (c) The county agency must determine the assistance payment 
380.29  amount for the first two months of MFIP-S MFIP eligibility by 
380.30  budgeting both recurring and nonrecurring income for those two 
380.31  months. 
380.32     (d) The county agency must budget the child support income 
380.33  received or anticipated to be received by an assistance unit to 
380.34  determine the assistance payment amount from the month of 
380.35  application through the date in which MFIP-S MFIP eligibility is 
380.36  determined and assistance is authorized.  Child support income 
381.1   which has been budgeted to determine the assistance payment in 
381.2   the initial two months is considered nonrecurring income.  An 
381.3   assistance unit must forward any payment of child support to the 
381.4   child support enforcement unit of the county agency following 
381.5   the date in which assistance is authorized. 
381.6      Sec. 34.  Minnesota Statutes 1998, section 256J.34, 
381.7   subdivision 3, is amended to read: 
381.8      Subd. 3.  [ADDITIONAL USES OF RETROSPECTIVE BUDGETING.] 
381.9   Notwithstanding subdivision 1, the county agency must use 
381.10  retrospective budgeting to calculate the monthly assistance 
381.11  payment amount for the first two months under paragraphs (a) and 
381.12  (b). 
381.13     (a) The county agency must use retrospective budgeting to 
381.14  determine the amount of the assistance payment in the first two 
381.15  months of MFIP-S MFIP eligibility: 
381.16     (1) when an assistance unit applies for assistance for the 
381.17  same month for which assistance has been interrupted, the 
381.18  interruption in eligibility is less than one payment month, the 
381.19  assistance payment for the preceding month was issued in this 
381.20  state, and the assistance payment for the immediately preceding 
381.21  month was determined retrospectively; or 
381.22     (2) when a person applies in order to be added to an 
381.23  assistance unit, that assistance unit has received assistance in 
381.24  this state for at least the two preceding months, and that 
381.25  person has been living with and has been financially responsible 
381.26  for one or more members of that assistance unit for at least the 
381.27  two preceding months. 
381.28     (b) Except as provided in clauses (1) to (4), the county 
381.29  agency must use retrospective budgeting and apply income 
381.30  received in the budget month by an assistance unit and by a 
381.31  financially responsible household member who is not included in 
381.32  the assistance unit against the appropriate transitional or 
381.33  family wage level MFIP standard of need or family wage level to 
381.34  determine the assistance payment to be issued for the payment 
381.35  month. 
381.36     (1) When a source of income ends prior to the third payment 
382.1   month, that income is not considered in calculating the 
382.2   assistance payment for that month.  When a source of income ends 
382.3   prior to the fourth payment month, that income is not considered 
382.4   when determining the assistance payment for that month. 
382.5      (2) When a member of an assistance unit or a financially 
382.6   responsible household member leaves the household of the 
382.7   assistance unit, the income of that departed household member is 
382.8   not budgeted retrospectively for any full payment month in which 
382.9   that household member does not live with that household and is 
382.10  not included in the assistance unit. 
382.11     (3) When an individual is removed from an assistance unit 
382.12  because the individual is no longer a minor child, the income of 
382.13  that individual is not budgeted retrospectively for payment 
382.14  months in which that individual is not a member of the 
382.15  assistance unit, except that income of an ineligible child in 
382.16  the household must continue to be budgeted retrospectively 
382.17  against the child's needs when the parent or parents of that 
382.18  child request allocation of their income against any unmet needs 
382.19  of that ineligible child. 
382.20     (4) When a person ceases to have financial responsibility 
382.21  for one or more members of an assistance unit, the income of 
382.22  that person is not budgeted retrospectively for the payment 
382.23  months which follow the month in which financial responsibility 
382.24  ends. 
382.25     Sec. 35.  Minnesota Statutes 1998, section 256J.34, 
382.26  subdivision 4, is amended to read: 
382.27     Subd. 4.  [SIGNIFICANT CHANGE IN GROSS INCOME.] The county 
382.28  agency must recalculate the assistance payment when an 
382.29  assistance unit experiences a significant change, as defined in 
382.30  section 256J.08, resulting in a reduction in the gross income 
382.31  received in the payment month from the gross income received in 
382.32  the budget month.  The county agency must issue a supplemental 
382.33  assistance payment based on the county agency's best estimate of 
382.34  the assistance unit's income and circumstances for the payment 
382.35  month.  Budget adjustments Supplemental assistance payments that 
382.36  result from significant changes are limited to two in a 12-month 
383.1   period regardless of the reason for the change.  Budget 
383.2   adjustments Notwithstanding any other statute or rule of law, 
383.3   supplementary assistance payments shall not be made when the 
383.4   significant change in income is the result of receipt of a lump 
383.5   sum, receipt of an extra paycheck, business fluctuation in 
383.6   self-employment income, or an assistance unit member's 
383.7   participation in a strike or other labor action.  Supplementary 
383.8   assistance payments due to a significant change in the amount of 
383.9   direct support received must not be made after the date the 
383.10  assistance unit is required to forward support to the child 
383.11  support enforcement unit under subdivision 1, paragraph (d). 
383.12     Sec. 36.  Minnesota Statutes 1998, section 256J.35, is 
383.13  amended to read: 
383.14     256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 
383.15     Except as provided in paragraphs (a) to (d) (c), the amount 
383.16  of an assistance payment is equal to the difference between the 
383.17  transitional MFIP standard, shared household standard, of need 
383.18  or the Minnesota family wage level in section 256J.24, whichever 
383.19  is less, and countable income. 
383.20     (a) When MFIP-S MFIP eligibility exists for the month of 
383.21  application, the amount of the assistance payment for the month 
383.22  of application must be prorated from the date of application or 
383.23  the date all other eligibility factors are met for that 
383.24  applicant, whichever is later.  This provision applies when an 
383.25  applicant loses at least one day of MFIP-S MFIP eligibility. 
383.26     (b) MFIP-S MFIP overpayments to an assistance unit must be 
383.27  recouped according to section 256J.38, subdivision 4. 
383.28     (c) An initial assistance payment must not be made to an 
383.29  applicant who is not eligible on the date payment is made. 
383.30     (d) An individual whose needs have been otherwise provided 
383.31  for in another state, in whole or in part by county, state, or 
383.32  federal dollars during a month, is ineligible to receive MFIP-S 
383.33  for the month. 
383.34     Sec. 37.  Minnesota Statutes 1998, section 256J.36, is 
383.35  amended to read: 
383.36     256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 
384.1   MEMBERS.] 
384.2      Except as prohibited in paragraphs (a) and (b), an 
384.3   allocation of income is allowed from the caregiver's income to 
384.4   meet the unmet need of an ineligible spouse or an ineligible 
384.5   child under the age of 21 for whom the caregiver is financially 
384.6   responsible who also lives with the caregiver.  That allocation 
384.7   is allowed in an amount up to the difference between the MFIP-S 
384.8   transitional MFIP standard of need for the assistance unit when 
384.9   that ineligible person is included in the assistance unit and 
384.10  the MFIP-S family allowance MFIP standard of need for the 
384.11  assistance unit when the ineligible person is not included in 
384.12  the assistance unit.  These allocations must be deducted from 
384.13  the caregiver's counted earnings and from unearned income 
384.14  subject to paragraphs (a) and (b). 
384.15     (a) Income of a minor child in the assistance unit must not 
384.16  be allocated to meet the need of an ineligible person, including 
384.17  the child's parent, even when that parent is the payee of the 
384.18  child's income. 
384.19     (b) Income of a caregiver must not be allocated to meet the 
384.20  needs of a disqualified person. 
384.21     Sec. 38.  Minnesota Statutes 1998, section 256J.37, 
384.22  subdivision 1, is amended to read: 
384.23     Subdivision 1.  [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 
384.24  MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 
384.25  the income of ineligible household members must be deemed after 
384.26  allowing the following disregards: 
384.27     (1) the first 18 percent of the ineligible family member's 
384.28  gross earned income; 
384.29     (2) amounts the ineligible person actually paid to 
384.30  individuals not living in the same household but whom the 
384.31  ineligible person claims or could claim as dependents for 
384.32  determining federal personal income tax liability; 
384.33     (3) all payments made by the ineligible person according to 
384.34  a court order for spousal support or the support of children not 
384.35  living in the assistance unit's household, provided that, if 
384.36  there has been a change in the financial circumstances of the 
385.1   ineligible person since the support order was entered, the 
385.2   ineligible person has petitioned for a modification of the 
385.3   support order; and 
385.4      (4) an amount for the needs of the ineligible person and 
385.5   other persons who live in the household but are not included in 
385.6   the assistance unit and are or could be claimed by an ineligible 
385.7   person as dependents for determining federal personal income tax 
385.8   liability.  This amount is equal to the difference between the 
385.9   MFIP-S transitional MFIP standard of need when the ineligible 
385.10  person is included in the assistance unit and the MFIP-S 
385.11  transitional MFIP standard of need when the ineligible person is 
385.12  not included in the assistance unit. 
385.13     Sec. 39.  Minnesota Statutes 1998, section 256J.37, 
385.14  subdivision 1a, is amended to read: 
385.15     Subd. 1a.  [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 
385.16  income of disqualified members must be deemed after allowing the 
385.17  following disregards: 
385.18     (1) the first 18 percent of the disqualified member's gross 
385.19  earned income; 
385.20     (2) amounts the disqualified member actually paid to 
385.21  individuals not living in the same household but whom the 
385.22  disqualified member claims or could claim as dependents for 
385.23  determining federal personal income tax liability; 
385.24     (3) all payments made by the disqualified member according 
385.25  to a court order for spousal support or the support of children 
385.26  not living in the assistance unit's household, provided that, if 
385.27  there has been a change in the financial circumstances of the 
385.28  disqualified member's legal obligation to pay support since the 
385.29  support order was entered, the disqualified member has 
385.30  petitioned for a modification of the support order; and 
385.31     (4) an amount for the needs of other persons who live in 
385.32  the household but are not included in the assistance unit and 
385.33  are or could be claimed by the disqualified member as dependents 
385.34  for determining federal personal income tax liability.  This 
385.35  amount is equal to the difference between the MFIP-S 
385.36  transitional MFIP standard of need when the ineligible person is 
386.1   included in the assistance unit and the MFIP-S transitional MFIP 
386.2   standard of need when the ineligible person is not included in 
386.3   the assistance unit.  An amount shall not be allowed for the 
386.4   needs of a disqualified member. 
386.5      Sec. 40.  Minnesota Statutes 1998, section 256J.37, 
386.6   subdivision 2, is amended to read: 
386.7      Subd. 2.  [DEEMED INCOME AND ASSETS OF SPONSOR OF 
386.8   NONCITIZENS.] (a) If a noncitizen applies for or receives MFIP, 
386.9   the county must deem the income and assets of the noncitizen's 
386.10  sponsor and the sponsor's spouse as provided in this paragraph 
386.11  and paragraph (b) or (c), whichever is applicable.  The deemed 
386.12  income of a sponsor and the sponsor's spouse is considered 
386.13  unearned income of the noncitizen.  The deemed assets of a 
386.14  sponsor and the sponsor's spouse are considered available assets 
386.15  of the noncitizen. 
386.16     (b) The income and assets of a sponsor who signed an 
386.17  affidavit of support under title IV, sections 421, 422, and 423, 
386.18  of Public Law Number 104-193, the Personal Responsibility and 
386.19  Work Opportunity Reconciliation Act of 1996, and the income and 
386.20  assets of the sponsor's spouse, must be deemed to the noncitizen 
386.21  to the extent required by those sections of Public Law Number 
386.22  104-193. 
386.23     (c) The income and assets of a sponsor and the sponsor's 
386.24  spouse to whom the provisions of paragraph (b) do not apply must 
386.25  be deemed to the noncitizen to the full extent allowed under 
386.26  title V, section 5505, of Public Law Number 105-33, the Balanced 
386.27  Budget Act of 1997. 
386.28     If a noncitizen applies for or receives MFIP-S, the county 
386.29  must deem the income and assets of the noncitizen's sponsor and 
386.30  the sponsor's spouse who have signed an affidavit of support for 
386.31  the noncitizen as specified in Public Law Number 104-193, title 
386.32  IV, sections 421 and 422, the Personal Responsibility and Work 
386.33  Opportunity Reconciliation Act of 1996.  The income of a sponsor 
386.34  and the sponsor's spouse is considered unearned income of the 
386.35  noncitizen.  The assets of a sponsor and the sponsor's spouse 
386.36  are considered available assets of the noncitizen.  
387.1      Sec. 41.  Minnesota Statutes 1998, section 256J.37, 
387.2   subdivision 9, is amended to read: 
387.3      Subd. 9.  [UNEARNED INCOME.] (a) The county agency must 
387.4   apply unearned income to the transitional MFIP standard of 
387.5   need.  When determining the amount of unearned income, the 
387.6   county agency must deduct the costs necessary to secure payments 
387.7   of unearned income.  These costs include legal fees, medical 
387.8   fees, and mandatory deductions such as federal and state income 
387.9   taxes. 
387.10     (b) Effective July 1, 1999, the county agency shall count 
387.11  $100 of the value of public and assisted rental subsidies 
387.12  provided through the Department of Housing and Urban Development 
387.13  (HUD) as unearned income.  The full amount of the subsidy must 
387.14  be counted as unearned income when the subsidy is less than $100.
387.15     (c) The provisions of paragraph (b) shall not apply to MFIP 
387.16  participants who are exempt from the employment and training 
387.17  services component because they are: 
387.18     (i) individuals who are age 60 or older; 
387.19     (ii) individuals who are suffering from a professionally 
387.20  certified permanent or temporary illness, injury, or incapacity 
387.21  which is expected to continue for more than 30 days and which 
387.22  prevents the person from obtaining or retaining employment; or 
387.23     (iii) caregivers whose presence in the home is required 
387.24  because of the professionally certified illness or incapacity of 
387.25  another member in the assistance unit, a relative in the 
387.26  household, or a foster child in the household. 
387.27     (d) The provisions of paragraph (b) shall not apply to an 
387.28  MFIP assistance unit where the parental caregiver receives 
387.29  supplemental security income. 
387.30     Sec. 42.  Minnesota Statutes 1998, section 256J.37, 
387.31  subdivision 10, is amended to read: 
387.32     Subd. 10.  [TREATMENT OF LUMP SUMS.] (a) The county agency 
387.33  must treat lump-sum payments as earned or unearned income.  If 
387.34  the lump-sum payment is included in the category of income 
387.35  identified in subdivision 9, it must be treated as unearned 
387.36  income.  A lump sum is counted as income in the month received 
388.1   and budgeted either prospectively or retrospectively depending 
388.2   on the budget cycle at the time of receipt.  When an individual 
388.3   receives a lump-sum payment, that lump sum must be combined with 
388.4   all other earned and unearned income received in the same budget 
388.5   month, and it must be applied according to paragraphs (a) to 
388.6   (c). A lump sum may not be carried over into subsequent months.  
388.7   Any funds that remain in the third month after the month of 
388.8   receipt are counted in the asset limit. 
388.9      (b) For a lump sum received by an applicant during the 
388.10  first two months, prospective budgeting is used to determine the 
388.11  payment and the lump sum must be combined with other earned or 
388.12  unearned income received and budgeted in that prospective month. 
388.13     (c) For a lump sum received by a participant after the 
388.14  first two months of MFIP-S MFIP eligibility, the lump sum must 
388.15  be combined with other income received in that budget month, and 
388.16  the combined amount must be applied retrospectively against the 
388.17  applicable payment month. 
388.18     (d) When a lump sum, combined with other income under 
388.19  paragraphs (b) and (c), is less than the transitional MFIP 
388.20  standard of need for the applicable appropriate payment month, 
388.21  the assistance payment must be reduced according to the amount 
388.22  of the countable income.  When the countable income is greater 
388.23  than the transitional MFIP standard or the family wage 
388.24  standard or family wage level, the assistance payment must be 
388.25  suspended for the payment month. 
388.26     Sec. 43.  Minnesota Statutes 1998, section 256J.38, 
388.27  subdivision 4, is amended to read: 
388.28     Subd. 4.  [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 
388.29  participant may voluntarily repay, in part or in full, an 
388.30  overpayment even if assistance is reduced under this 
388.31  subdivision, until the total amount of the overpayment is 
388.32  repaid.  When an overpayment occurs due to fraud, the county 
388.33  agency must recover ten percent of the transitional applicable 
388.34  standard or the amount of the monthly assistance payment, 
388.35  whichever is less.  When a nonfraud overpayment occurs, the 
388.36  county agency must recover three percent of the transitional 
389.1   MFIP standard of need or the amount of the monthly assistance 
389.2   payment, whichever is less.  
389.3      Sec. 44.  Minnesota Statutes 1998, section 256J.42, 
389.4   subdivision 1, is amended to read: 
389.5      Subdivision 1.  [TIME LIMIT.] (a) Except for the exemptions 
389.6   in this section and in section 256J.11, subdivision 2, an 
389.7   assistance unit in which any adult caregiver has received 60 
389.8   months of cash assistance funded in whole or in part by the TANF 
389.9   block grant in this or any other state or United States 
389.10  territory, MFIP-S or from a tribal TANF program, MFIP, AFDC, or 
389.11  family general assistance, funded in whole or in part by state 
389.12  appropriations, is ineligible to receive MFIP-S MFIP.  Any cash 
389.13  assistance funded with TANF dollars in this or any other state 
389.14  or United States territory, or from a tribal TANF program, or 
389.15  MFIP-S MFIP assistance funded in whole or in part by state 
389.16  appropriations, that was received by the unit on or after the 
389.17  date TANF was implemented, including any assistance received in 
389.18  states or United States territories of prior residence, counts 
389.19  toward the 60-month limitation.  The 60-month limit applies to a 
389.20  minor who is the head of a household or who is married to the 
389.21  head of a household except under subdivision 5.  The 60-month 
389.22  time period does not need to be consecutive months for this 
389.23  provision to apply.  
389.24     (b) The months before July 1998 in which individuals 
389.25  receive received assistance as part of the field trials as an 
389.26  MFIP, MFIP-R, or MFIP or MFIP-R comparison group family under 
389.27  sections 256.031 to 256.0361 or sections 256.047 to 256.048 are 
389.28  not included in the 60-month time limit. 
389.29     Sec. 45.  Minnesota Statutes 1998, section 256J.42, 
389.30  subdivision 5, is amended to read: 
389.31     Subd. 5.  [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 
389.32  assistance received by an assistance unit does not count toward 
389.33  the 60-month limit on assistance during a month in which the 
389.34  caregiver is in the category in section 256J.56, paragraph (a), 
389.35  clause (1).  The exemption applies for the period of time the 
389.36  caregiver belongs to one of the categories specified in this 
390.1   subdivision. 
390.2      (b) From July 1, 1997, until the date MFIP-S MFIP is 
390.3   operative in the caregiver's county of financial responsibility, 
390.4   any cash assistance received by a caregiver who is complying 
390.5   with sections 256.73, subdivision 5a, and 256.736, if 
390.6   applicable, does not count toward the 60-month limit on 
390.7   assistance.  Thereafter, any cash assistance received by a minor 
390.8   caregiver who is complying with the requirements of sections 
390.9   256J.14 and 256J.54, if applicable, does not count towards the 
390.10  60-month limit on assistance. 
390.11     (c) Any diversionary assistance or emergency assistance 
390.12  received does not count toward the 60-month limit. 
390.13     (d) Any cash assistance received by an 18- or 19-year-old 
390.14  caregiver who is complying with the requirements of section 
390.15  256J.54 does not count toward the 60-month limit. 
390.16     Sec. 46.  Minnesota Statutes 1998, section 256J.43, is 
390.17  amended to read: 
390.18     256J.43 [INTERSTATE PAYMENT TRANSITIONAL STANDARDS.] 
390.19     Subdivision 1.  [PAYMENT.] (a) Effective July 1, 1997, the 
390.20  amount of assistance paid to an eligible unit in which all 
390.21  members have resided in this state for fewer than 12 consecutive 
390.22  calendar months immediately preceding the date of application 
390.23  shall be the lesser of either the interstate transitional 
390.24  standard that would have been received by the assistance unit 
390.25  from the state of immediate prior residence, or the amount 
390.26  calculated in accordance with AFDC or MFIP-S MFIP standards.  
390.27  The lesser payment must continue until the assistance unit meets 
390.28  the 12-month requirement.  An assistance unit that has not 
390.29  resided in Minnesota for 12 months from the date of application 
390.30  is not exempt from the interstate payment transitional standards 
390.31  provisions solely because a child is born in Minnesota to a 
390.32  member of the assistance unit.  Payment must be calculated by 
390.33  applying this state's MFIP's budgeting policies, and the unit's 
390.34  net income must be deducted from the payment standard in the 
390.35  other state or the MFIP transitional or shared household 
390.36  standard in this state, whichever is lower.  Payment shall be 
391.1   made in vendor form for shelter and utilities, up to the limit 
391.2   of the grant amount, and residual amounts, if any, shall be paid 
391.3   directly to the assistance unit. 
391.4      (b) During the first 12 months an assistance unit resides 
391.5   in this state, the number of months that a unit is eligible to 
391.6   receive AFDC or MFIP-S MFIP benefits is limited to the number of 
391.7   months the assistance unit would have been eligible to receive 
391.8   similar benefits in the state of immediate prior residence. 
391.9      (c) This policy applies whether or not the assistance unit 
391.10  received similar benefits while residing in the state of 
391.11  previous residence. 
391.12     (d) When an assistance unit moves to this state from 
391.13  another state where the assistance unit has exhausted that 
391.14  state's time limit for receiving benefits under that state's 
391.15  TANF program, the unit will not be eligible to receive any AFDC 
391.16  or MFIP-S MFIP benefits in this state for 12 months from the 
391.17  date the assistance unit moves here. 
391.18     (e) For the purposes of this section, "state of immediate 
391.19  prior residence" means: 
391.20     (1) the state in which the applicant declares the applicant 
391.21  spent the most time in the 30 days prior to moving to this 
391.22  state; or 
391.23     (2) the state in which an applicant who is a migrant worker 
391.24  maintains a home. 
391.25     (f) The commissioner shall annually verify and update all 
391.26  other states' payment standards as they are to be in effect in 
391.27  July of each year. 
391.28     (g) Applicants must provide verification of their state of 
391.29  immediate prior residence, in the form of tax statements, a 
391.30  driver's license, automobile registration, rent receipts, or 
391.31  other forms of verification approved by the commissioner. 
391.32     (h) Migrant workers, as defined in section 256J.08, and 
391.33  their immediate families are exempt from this section, provided 
391.34  the migrant worker provides verification that the migrant family 
391.35  worked in this state within the last 12 months and earned at 
391.36  least $1,000 in gross wages during the time the migrant worker 
392.1   worked in this state. 
392.2      Subd. 2.  [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 
392.3   assistance unit that has met the requirements of section 
392.4   256J.12, the number of months that the assistance unit receives 
392.5   benefits under the interstate payment transitional standards in 
392.6   this section is not affected by an absence from Minnesota for 
392.7   fewer than 30 consecutive days. 
392.8      (b) For an assistance unit that has met the requirements of 
392.9   section 256J.12, the number of months that the assistance unit 
392.10  receives benefits under the interstate payment transitional 
392.11  standards in this section is not affected by an absence from 
392.12  Minnesota for more than 30 consecutive days but fewer than 90 
392.13  consecutive days, provided the assistance unit continues to 
392.14  maintain a residence in Minnesota during the period of absence. 
392.15     Subd. 3.  [EXCEPTIONS TO THE INTERSTATE PAYMENT POLICY.] 
392.16  Applicants who lived in another state in the 12 months prior to 
392.17  applying for assistance are exempt from the interstate payment 
392.18  policy for the months that a member of the unit: 
392.19     (1) served in the United States armed services, provided 
392.20  the person returned to Minnesota within 30 days of leaving the 
392.21  armed forces, and intends to remain in Minnesota; 
392.22     (2) attended school in another state, paid nonresident 
392.23  tuition or Minnesota tuition rates under a reciprocity 
392.24  agreement, provided the person left Minnesota specifically to 
392.25  attend school and returned to Minnesota within 30 days of 
392.26  graduation with the intent to remain in Minnesota; or 
392.27     (3) meets the following criteria: 
392.28     (i) a minor child or a minor caregiver moves from another 
392.29  state to the residence of a relative caregiver; 
392.30     (ii) the minor caregiver applies for and receives family 
392.31  cash assistance; 
392.32     (iii) the relative caregiver chooses not to be part of the 
392.33  MFIP-S assistance unit; and 
392.34     (iv) the relative caregiver has resided in Minnesota for at 
392.35  least 12 months from the date the assistance unit applies for 
392.36  cash assistance. 
393.1      Subd. 4.  [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 
393.2   mandatory unit members who have resided in Minnesota for 12 
393.3   months immediately before the unit's date of application 
393.4   establish the other assistance unit members' eligibility for the 
393.5   MFIP-S MFIP transitional standard, shared household or family 
393.6   wage level, whichever is applicable. 
393.7      Sec. 47.  Minnesota Statutes 1998, section 256J.45, 
393.8   subdivision 1, is amended to read: 
393.9      Subdivision 1.  [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 
393.10  county agency must provide each MFIP-S MFIP caregiver who is not 
393.11  exempt under section 256J.56, paragraph (a), clause (6) or (8), 
393.12  with a face-to-face orientation.  The caregiver must attend the 
393.13  orientation.  The county agency must inform the caregiver 
393.14  caregivers who are not exempt under section 256J.56, paragraph 
393.15  (a), clause (6) or (8), that failure to attend the orientation 
393.16  is considered an occurrence of noncompliance with program 
393.17  requirements, and will result in the imposition of a sanction 
393.18  under section 256J.46.  If the client complies with the 
393.19  orientation requirement prior to the first day of the month in 
393.20  which the grant reduction is proposed to occur, the orientation 
393.21  sanction shall be lifted.  
393.22     Sec. 48.  Minnesota Statutes 1998, section 256J.45, is 
393.23  amended by adding a subdivision to read: 
393.24     Subd. 1a.  [PREGNANT AND PARENTING MINORS.] Pregnant and 
393.25  parenting minors who are complying with the provisions of 
393.26  section 256J.54 are exempt from the requirement under 
393.27  subdivision 1, however, the county agency must provide 
393.28  information to the minor as required under section 256J.14. 
393.29     Sec. 49.  Minnesota Statutes 1998, section 256J.46, 
393.30  subdivision 1, is amended to read: 
393.31     Subdivision 1.  [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 
393.32  WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 
393.33  good cause to comply with the requirements of this chapter, and 
393.34  who is not subject to a sanction under subdivision 2, shall be 
393.35  subject to a sanction as provided in this subdivision. 
393.36     A sanction under this subdivision becomes effective the 
394.1   month following the month in which a required notice is given.  
394.2   A sanction must not be imposed when a participant comes into 
394.3   compliance with the requirements for orientation under section 
394.4   256J.45 or third-party liability for medical services under 
394.5   section 256J.30, subdivision 10, prior to the effective date of 
394.6   the sanction.  A sanction must not be imposed when a participant 
394.7   comes into compliance with the requirements for employment and 
394.8   training services under sections 256J.49 to 256J.72 ten days 
394.9   prior to the effective date of the sanction.  For purposes of 
394.10  this subdivision, each month that a participant fails to comply 
394.11  with a requirement of this chapter shall be considered a 
394.12  separate occurrence of noncompliance.  A participant who has had 
394.13  one or more sanctions imposed must remain in compliance with the 
394.14  provisions of this chapter for six months in order for a 
394.15  subsequent occurrence of noncompliance to be considered a first 
394.16  occurrence.  
394.17     (b) Sanctions for noncompliance shall be imposed as follows:
394.18     (1) For the first occurrence of noncompliance by a 
394.19  participant in a single-parent household or by one participant 
394.20  in a two-parent household, the assistance unit's grant shall be 
394.21  reduced by ten percent of the MFIP-S transitional MFIP standard, 
394.22  the shared household standard, or the interstate transitional 
394.23  standard of need for an assistance unit of the same size, 
394.24  whichever is applicable, with the residual grant paid to the 
394.25  participant.  The reduction in the grant amount must be in 
394.26  effect for a minimum of one month and shall be removed in the 
394.27  month following the month that the participant returns to 
394.28  compliance.  
394.29     (2) For a second or subsequent occurrence of noncompliance, 
394.30  or when both participants in a two-parent household are out of 
394.31  compliance at the same time, the assistance unit's shelter costs 
394.32  shall be vendor paid up to the amount of the cash portion of the 
394.33  MFIP-S MFIP grant for which the participant's assistance unit is 
394.34  eligible.  At county option, the assistance unit's utilities may 
394.35  also be vendor paid up to the amount of the cash portion of the 
394.36  MFIP-S MFIP grant remaining after vendor payment of the 
395.1   assistance unit's shelter costs.  The residual amount of the 
395.2   grant after vendor payment, if any, must be reduced by an amount 
395.3   equal to 30 percent of the MFIP-S transitional MFIP standard, 
395.4   the shared household standard, or the interstate transitional 
395.5   standard of need for an assistance unit of the same size, 
395.6   whichever is applicable, before the residual grant is paid to 
395.7   the assistance unit.  The reduction in the grant amount must be 
395.8   in effect for a minimum of one month and shall be removed in the 
395.9   month following the month that a participant in a one-parent 
395.10  household returns to compliance.  In a two-parent household, the 
395.11  grant reduction must be in effect for a minimum of one month and 
395.12  shall be removed in the month following the month both 
395.13  participants return to compliance.  The vendor payment of 
395.14  shelter costs and, if applicable, utilities shall be removed six 
395.15  months after the month in which the participant or participants 
395.16  return to compliance. 
395.17     (c) No later than during the second month that a sanction 
395.18  under paragraph (b), clause (2), is in effect due to 
395.19  noncompliance with employment services, the participant's case 
395.20  file must be reviewed to determine if: 
395.21     (i) the continued noncompliance can be explained and 
395.22  mitigated by providing a needed preemployment activity, as 
395.23  defined in section 256J.49, subdivision 13, clause (16); 
395.24     (ii) the participant qualifies for a good cause exception 
395.25  under section 256J.57; or 
395.26     (iii) the participant qualifies for an exemption under 
395.27  section 256J.56. 
395.28     If the lack of an identified activity can explain the 
395.29  noncompliance, the county must work with the participant to 
395.30  provide the identified activity, and the county must restore the 
395.31  participant's grant amount to the full amount for which the 
395.32  assistance unit is eligible.  The grant must be restored 
395.33  retroactively to the first day of the month in which the 
395.34  participant was found to lack preemployment activities or to 
395.35  qualify for an exemption or good cause exception. 
395.36     If the participant is found to qualify for a good cause 
396.1   exception or an exemption, the county must restore the 
396.2   participant's grant to the full amount for which the assistance 
396.3   unit is eligible.  
396.4      Sec. 50.  Minnesota Statutes 1998, section 256J.46, 
396.5   subdivision 2, is amended to read: 
396.6      Subd. 2.  [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 
396.7   REQUIREMENTS.] The grant of an MFIP-S MFIP caregiver who refuses 
396.8   to cooperate, as determined by the child support enforcement 
396.9   agency, with support requirements under section 256.741, shall 
396.10  be subject to sanction as specified in this subdivision.  The 
396.11  assistance unit's grant must be reduced by 25 percent of the 
396.12  applicable transitional MFIP standard of need.  The residual 
396.13  amount of the grant, if any, must be paid to the caregiver.  A 
396.14  sanction under this subdivision becomes effective the first 
396.15  month following the month in which a required notice is given.  
396.16  A sanction must not be imposed when a caregiver comes into 
396.17  compliance with the requirements under section 256.741 prior to 
396.18  the effective date of the sanction.  The sanction shall be 
396.19  removed in the month following the month that the caregiver 
396.20  cooperates with the support requirements.  Each month that 
396.21  an MFIP-S MFIP caregiver fails to comply with the requirements 
396.22  of section 256.741 must be considered a separate occurrence of 
396.23  noncompliance.  An MFIP-S MFIP caregiver who has had one or more 
396.24  sanctions imposed must remain in compliance with the 
396.25  requirements of section 256.741 for six months in order for a 
396.26  subsequent sanction to be considered a first occurrence. 
396.27     Sec. 51.  Minnesota Statutes 1998, section 256J.46, 
396.28  subdivision 2a, is amended to read: 
396.29     Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
396.30  provisions of subdivisions 1 and 2, for a participant subject to 
396.31  a sanction for refusal to comply with child support requirements 
396.32  under subdivision 2 and subject to a concurrent sanction for 
396.33  refusal to cooperate with other program requirements under 
396.34  subdivision 1, sanctions shall be imposed in the manner 
396.35  prescribed in this subdivision. 
396.36     A participant who has had one or more sanctions imposed 
397.1   under this subdivision must remain in compliance with the 
397.2   provisions of this chapter for six months in order for a 
397.3   subsequent occurrence of noncompliance to be considered a first 
397.4   occurrence.  Any vendor payment of shelter costs or utilities 
397.5   under this subdivision must remain in effect for six months 
397.6   after the month in which the participant is no longer subject to 
397.7   sanction under subdivision 1. 
397.8      (b) If the participant was subject to sanction for: 
397.9      (i) noncompliance under subdivision 1 before being subject 
397.10  to sanction for noncooperation under subdivision 2; or 
397.11     (ii) noncooperation under subdivision 2 before being 
397.12  subject to sanction for noncompliance under subdivision 1; 
397.13  the participant shall be sanctioned as provided in subdivision 
397.14  1, paragraph (b), clause (2), and the requirement that the 
397.15  county conduct a review as specified in subdivision 1, paragraph 
397.16  (c), remains in effect. 
397.17     (c) A participant who first becomes subject to sanction 
397.18  under both subdivisions 1 and 2 in the same month is subject to 
397.19  sanction as follows: 
397.20     (i) in the first month of noncompliance and noncooperation, 
397.21  the participant's grant must be reduced by 25 percent of the 
397.22  applicable transitional MFIP standard of need, with any residual 
397.23  amount paid to the participant; 
397.24     (ii) in the second and subsequent months of noncompliance 
397.25  and noncooperation, the participant shall be sanctioned as 
397.26  provided in subdivision 1, paragraph (b), clause (2). 
397.27     The requirement that the county conduct a review as 
397.28  specified in subdivision 1, paragraph (c), remains in effect. 
397.29     (d) A participant remains subject to sanction under 
397.30  subdivision 2 if the participant: 
397.31     (i) returns to compliance and is no longer subject to 
397.32  sanction under subdivision 1; or 
397.33     (ii) has the sanction under subdivision 1, paragraph (b), 
397.34  removed upon completion of the review under subdivision 1, 
397.35  paragraph (c). 
397.36     A participant remains subject to sanction under subdivision 
398.1   1, paragraph (b), if the participant cooperates and is no longer 
398.2   subject to sanction under subdivision 2. 
398.3      Sec. 52.  Minnesota Statutes 1998, section 256J.47, 
398.4   subdivision 4, is amended to read: 
398.5      Subd. 4.  [INELIGIBILITY FOR MFIP-S MFIP; EMERGENCY 
398.6   ASSISTANCE; AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of 
398.7   diversionary assistance, the family is ineligible for MFIP-S 
398.8   MFIP, emergency assistance, and emergency general assistance for 
398.9   a period of time.  To determine the period of ineligibility, the 
398.10  county shall use the following formula:  regardless of household 
398.11  changes, the county agency must calculate the number of days of 
398.12  ineligibility by dividing the diversionary assistance issued by 
398.13  the transitional MFIP standard of need a family of the same size 
398.14  and composition would have received under MFIP-S, or if 
398.15  applicable the interstate transitional standard, MFIP multiplied 
398.16  by 30, truncating the result.  The ineligibility period begins 
398.17  the date the diversionary assistance is issued. 
398.18     Sec. 53.  Minnesota Statutes 1998, section 256J.48, 
398.19  subdivision 2, is amended to read: 
398.20     Subd. 2.  [ELIGIBILITY.] Notwithstanding other eligibility 
398.21  provisions of this chapter, any family without resources 
398.22  immediately available to meet emergency needs identified in 
398.23  subdivision 3 shall be eligible for an emergency grant under the 
398.24  following conditions: 
398.25     (1) a family member has resided in this state for at least 
398.26  30 days; 
398.27     (2) the family is without resources immediately available 
398.28  to meet emergency needs; 
398.29     (3) assistance is necessary to avoid destitution or provide 
398.30  emergency shelter arrangements; 
398.31     (4) the family's destitution or need for shelter or 
398.32  utilities did not arise because the assistance unit is under 
398.33  sanction, the caregiver is disqualified, or the child or 
398.34  relative caregiver refused without good cause under section 
398.35  256J.57 to accept employment or training for employment in this 
398.36  state or another state; and 
399.1      (5) at least one child or pregnant woman in the emergency 
399.2   assistance unit meets MFIP-S MFIP citizenship requirements in 
399.3   section 256J.11. 
399.4      Sec. 54.  Minnesota Statutes 1998, section 256J.48, 
399.5   subdivision 3, is amended to read: 
399.6      Subd. 3.  [EMERGENCY NEEDS.] Emergency needs are limited to 
399.7   the following: 
399.8      (a)  [RENT.] A county agency may deny assistance to prevent 
399.9   eviction from rented or leased shelter of an otherwise eligible 
399.10  applicant when the county agency determines that an applicant's 
399.11  anticipated income will not cover continued payment for shelter, 
399.12  subject to conditions in clauses (1) to (3): 
399.13     (1) a county agency must not deny assistance when an 
399.14  applicant can document that the applicant is unable to locate 
399.15  habitable shelter, unless the county agency can document that 
399.16  one or more habitable shelters are available in the community 
399.17  that will result in at least a 20 percent reduction in monthly 
399.18  expense for shelter and that this shelter will be cost-effective 
399.19  for the applicant; 
399.20     (2) when no alternative shelter can be identified by either 
399.21  the applicant or the county agency, the county agency shall not 
399.22  deny assistance because anticipated income will not cover rental 
399.23  obligation; and 
399.24     (3) when cost-effective alternative shelter is identified, 
399.25  the county agency shall issue assistance for moving expenses as 
399.26  provided in paragraph (e). 
399.27     (b)  [DEFINITIONS.] For purposes of paragraph (a), the 
399.28  following definitions apply (1) "metropolitan statistical area" 
399.29  is as defined by the United States Census Bureau; (2) 
399.30  "alternative shelter" includes any shelter that is located 
399.31  within the metropolitan statistical area containing the county 
399.32  and for which the applicant is eligible, provided the applicant 
399.33  does not have to travel more than 20 miles to reach the shelter 
399.34  and has access to transportation to the shelter.  Clause (2) 
399.35  does not apply to counties in the Minneapolis-St. Paul 
399.36  metropolitan statistical area. 
400.1      (c)  [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 
400.2   agency shall issue assistance for mortgage or contract for deed 
400.3   arrearages on behalf of an otherwise eligible applicant 
400.4   according to clauses (1) to (4): 
400.5      (1) assistance for arrearages must be issued only when a 
400.6   home is owned, occupied, and maintained by the applicant; 
400.7      (2) assistance for arrearages must be issued only when no 
400.8   subsequent foreclosure action is expected within the 12 months 
400.9   following the issuance; 
400.10     (3) assistance for arrearages must be issued only when an 
400.11  applicant has been refused refinancing through a bank or other 
400.12  lending institution and the amount payable, when combined with 
400.13  any payments made by the applicant, will be accepted by the 
400.14  creditor as full payment of the arrearage; 
400.15     (4) costs paid by a family which are counted toward the 
400.16  payment requirements in this clause are:  principal and interest 
400.17  payments on mortgages or contracts for deed, balloon payments, 
400.18  homeowner's insurance payments, manufactured home lot rental 
400.19  payments, and tax or special assessment payments related to the 
400.20  homestead.  Costs which are not counted include closing costs 
400.21  related to the sale or purchase of real property. 
400.22     To be eligible for assistance for costs specified in clause 
400.23  (4) which are outstanding at the time of foreclosure, an 
400.24  applicant must have paid at least 40 percent of the family's 
400.25  gross income toward these costs in the month of application and 
400.26  the 11-month period immediately preceding the month of 
400.27  application. 
400.28     When an applicant is eligible under clause (4), a county 
400.29  agency shall issue assistance up to a maximum of four times the 
400.30  MFIP-S MFIP transitional standard of need for a comparable 
400.31  assistance unit. 
400.32     (d)  [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 
400.33  issue assistance for damage or utility deposits when necessary 
400.34  to alleviate the emergency.  The county may require that 
400.35  assistance paid in the form of a damage deposit, less any amount 
400.36  retained by the landlord to remedy a tenant's default in payment 
401.1   of rent or other funds due to the landlord under a rental 
401.2   agreement, or to restore the premises to the condition at the 
401.3   commencement of the tenancy, ordinary wear and tear excepted, be 
401.4   returned to the county when the individual vacates the premises 
401.5   or be paid to the recipient's new landlord as a vendor payment.  
401.6   The county may require that assistance paid in the form of a 
401.7   utility deposit less any amount retained to satisfy outstanding 
401.8   utility costs be returned to the county when the person vacates 
401.9   the premises, or be paid for the person's new housing unit as a 
401.10  vendor payment.  The vendor payment of returned funds shall not 
401.11  be considered a new use of emergency assistance. 
401.12     (e)  [MOVING EXPENSES.] A county agency shall issue 
401.13  assistance for expenses incurred when a family must move to a 
401.14  different shelter according to clauses (1) to (4): 
401.15     (1) moving expenses include the cost to transport personal 
401.16  property belonging to a family, the cost for utility connection, 
401.17  and the cost for securing different shelter; 
401.18     (2) moving expenses must be paid only when the county 
401.19  agency determines that a move is cost-effective; 
401.20     (3) moving expenses must be paid at the request of an 
401.21  applicant, but only when destitution or threatened destitution 
401.22  exists; and 
401.23     (4) moving expenses must be paid when a county agency 
401.24  denies assistance to prevent an eviction because the county 
401.25  agency has determined that an applicant's anticipated income 
401.26  will not cover continued shelter obligation in paragraph (a). 
401.27     (f)  [HOME REPAIRS.] A county agency shall pay for repairs 
401.28  to the roof, foundation, wiring, heating system, chimney, and 
401.29  water and sewer system of a home that is owned and lived in by 
401.30  an applicant. 
401.31     The applicant shall document, and the county agency shall 
401.32  verify the need for and method of repair. 
401.33     The payment must be cost-effective in relation to the 
401.34  overall condition of the home and in relation to the cost and 
401.35  availability of alternative housing. 
401.36     (g)  [UTILITY COSTS.] Assistance for utility costs must be 
402.1   made when an otherwise eligible family has had a termination or 
402.2   is threatened with a termination of municipal water and sewer 
402.3   service, electric, gas or heating fuel service, refuse removal 
402.4   service, or lacks wood when that is the heating source, subject 
402.5   to the conditions in clauses (1) and (2): 
402.6      (1) a county agency must not issue assistance unless the 
402.7   county agency receives confirmation from the utility provider 
402.8   that assistance combined with payment by the applicant will 
402.9   continue or restore the utility; and 
402.10     (2) a county agency shall not issue assistance for utility 
402.11  costs unless a family paid at least eight percent of the 
402.12  family's gross income toward utility costs due during the 
402.13  preceding 12 months. 
402.14     Clauses (1) and (2) must not be construed to prevent the 
402.15  issuance of assistance when a county agency must take immediate 
402.16  and temporary action necessary to protect the life or health of 
402.17  a child. 
402.18     (h)  [SPECIAL DIETS.] Effective January 1, 1998, a county 
402.19  shall pay for special diets or dietary items for MFIP-S MFIP 
402.20  participants.  Persons receiving emergency assistance funds for 
402.21  special diets or dietary items are also eligible to receive 
402.22  emergency assistance for shelter and utility emergencies, if 
402.23  otherwise eligible.  The need for special diets or dietary items 
402.24  must be prescribed by a licensed physician.  Costs for special 
402.25  diets shall be determined as percentages of the allotment for a 
402.26  one-person household under the Thrifty Food Plan as defined by 
402.27  the United States Department of Agriculture.  The types of diets 
402.28  and the percentages of the Thrifty Food Plan that are covered 
402.29  are as follows: 
402.30     (1) high protein diet, at least 80 grams daily, 25 percent 
402.31  of Thrifty Food Plan; 
402.32     (2) controlled protein diet, 40 to 60 grams and requires 
402.33  special products, 100 percent of Thrifty Food Plan; 
402.34     (3) controlled protein diet, less than 40 grams and 
402.35  requires special products, 125 percent of Thrifty Food Plan; 
402.36     (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 
403.1      (5) high residue diet, 20 percent of Thrifty Food Plan; 
403.2      (6) pregnancy and lactation diet, 35 percent of Thrifty 
403.3   Food Plan; 
403.4      (7) gluten-free diet, 25 percent of Thrifty Food Plan; 
403.5      (8) lactose-free diet, 25 percent of Thrifty Food Plan; 
403.6      (9) antidumping diet, 15 percent of Thrifty Food Plan; 
403.7      (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 
403.8      (11) ketogenic diet, 25 percent of Thrifty Food Plan. 
403.9      Sec. 55.  Minnesota Statutes 1998, section 256J.50, 
403.10  subdivision 1, is amended to read: 
403.11     Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
403.12  OF MFIP-S MFIP.] (a) By January 1, 1998, each county must 
403.13  develop and implement an employment and training services 
403.14  component of MFIP-S MFIP which is designed to put participants 
403.15  on the most direct path to unsubsidized employment.  
403.16  Participation in these services is mandatory for all MFIP-S MFIP 
403.17  caregivers, unless the caregiver is exempt under section 256J.56.
403.18     (b) A county may provide employment and training services 
403.19  to MFIP-S caregivers who are exempt from the employment and 
403.20  training services component but volunteer for the services. A 
403.21  county must provide employment and training services under 
403.22  sections 256J.515 to 256J.74 within 30 days after the 
403.23  caregiver's participation becomes mandatory under subdivision 5. 
403.24     Sec. 56.  Minnesota Statutes 1998, section 256J.515, is 
403.25  amended to read: 
403.26     256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 
403.27     During the first meeting with participants, job counselors 
403.28  must ensure that an overview of employment and training services 
403.29  is provided that: 
403.30     (1) stresses the necessity and opportunity of immediate 
403.31  employment; 
403.32     (2) outlines the job search resources offered; 
403.33     (3) outlines education or training opportunities available; 
403.34     (4) describes the range of work activities, including 
403.35  activities under section 256J.49, subdivision 13, clause (18), 
403.36  that are allowable under MFIP-S to meet the individual needs of 
404.1   participants; 
404.2      (5) explains the requirements to comply with an employment 
404.3   plan; 
404.4      (6) explains the consequences for failing to comply; and 
404.5      (7) explains the services that are available to support job 
404.6   search and work and education. 
404.7      Failure to attend the overview of employment and training 
404.8   services without good cause results in the imposition of a 
404.9   sanction under section 256J.46. 
404.10     Sec. 57.  Minnesota Statutes 1998, section 256J.52, 
404.11  subdivision 1, is amended to read: 
404.12     Subdivision 1.  [APPLICATION LIMITED TO CERTAIN 
404.13  PARTICIPANTS.] This section applies to participants receiving 
404.14  MFIP-S MFIP assistance who are not exempt under section 256J.56, 
404.15  and to caregivers who volunteer for employment and training 
404.16  services under section 256J.50. 
404.17     Sec. 58.  Minnesota Statutes 1998, section 256J.52, 
404.18  subdivision 3, is amended to read: 
404.19     Subd. 3.  [JOB SEARCH; JOB SEARCH SUPPORT PLAN.] (a) If, 
404.20  after the initial assessment, the job counselor determines that 
404.21  the participant possesses sufficient skills that the participant 
404.22  is likely to succeed in obtaining suitable employment, the 
404.23  participant must conduct job search for a period of up to eight 
404.24  weeks, for at least 30 hours per week.  The participant must 
404.25  accept any offer of suitable employment.  Upon agreement by the 
404.26  job counselor and the participant, a job search support plan may 
404.27  limit a job search to jobs that are consistent with the 
404.28  participant's employment goal.  The job counselor and 
404.29  participant must develop a job search support plan which 
404.30  specifies, at a minimum:  whether the job search is to be 
404.31  supervised or unsupervised; support services that will be 
404.32  provided while the participant conducts job search activities; 
404.33  the courses necessary to obtain certification or licensure, if 
404.34  applicable, and after obtaining the license or certificate, the 
404.35  client must comply with subdivision 5; and how frequently the 
404.36  participant must report to the job counselor on the status of 
405.1   the participant's job search activities.  The job search support 
405.2   plan may also specify that the participant fulfill a specified 
405.3   portion of the required hours of job search through attending 
405.4   adult basic education or English as a second language classes. 
405.5      (b) During the eight-week job search period, either the job 
405.6   counselor or the participant may request a review of the 
405.7   participant's job search plan and progress towards obtaining 
405.8   suitable employment.  If a review is requested by the 
405.9   participant, the job counselor must concur that the review is 
405.10  appropriate for the participant at that time.  If a review is 
405.11  conducted, the job counselor may make a determination to conduct 
405.12  a secondary assessment prior to the conclusion of the job search.
405.13     (c) Failure to conduct the required job search, to accept 
405.14  any offer of suitable employment, to develop or comply with a 
405.15  job search support plan, or voluntarily quitting suitable 
405.16  employment without good cause results in the imposition of a 
405.17  sanction under section 256J.46.  If at the end of eight weeks 
405.18  the participant has not obtained suitable employment, the job 
405.19  counselor must conduct a secondary assessment of the participant 
405.20  under subdivision 3. 
405.21     Sec. 59.  Minnesota Statutes 1998, section 256J.52, 
405.22  subdivision 4, is amended to read: 
405.23     Subd. 4.  [SECONDARY ASSESSMENT.] (a) The job counselor 
405.24  must conduct a secondary assessment for those participants who: 
405.25     (1) in the judgment of the job counselor, have barriers to 
405.26  obtaining employment that will not be overcome with a job search 
405.27  support plan under subdivision 3; 
405.28     (2) have completed eight weeks of job search under 
405.29  subdivision 3 without obtaining suitable employment; 
405.30     (3) have not received a secondary assessment, are working 
405.31  at least 20 hours per week, and the participant, job counselor, 
405.32  or county agency requests a secondary assessment; or 
405.33     (4) have an existing job search plan or employment plan 
405.34  developed for another program or are already involved in 
405.35  training or education activities under section 256J.55, 
405.36  subdivision 5. 
406.1      (b) In the secondary assessment the job counselor must 
406.2   evaluate the participant's skills and prior work experience, 
406.3   family circumstances, interests and abilities, need for 
406.4   preemployment activities, supportive or educational services, 
406.5   and the extent of any barriers to employment.  Failure to 
406.6   complete a secondary assessment shall result in the imposition 
406.7   of a sanction as specified in sections 256J.46 and 256J.57.  The 
406.8   job counselor must use the information gathered through the 
406.9   secondary assessment to develop an employment plan under 
406.10  subdivision 5. 
406.11     (c) In the secondary assessment the job counselor may 
406.12  require the participant to complete an appropriate and 
406.13  culturally competent professional chemical use assessment to be 
406.14  performed according to the rules adopted under section 254A.03, 
406.15  subdivision 3, or a professional psychological assessment as a 
406.16  component of the secondary assessment, when the job counselor 
406.17  has a reasonable belief, based on objective evidence, that a 
406.18  participant's ability to obtain and retain suitable employment 
406.19  is impaired by a medical condition.  The job counselor must 
406.20  ensure that appropriate services, including child care 
406.21  assistance and transportation, are available to the participant 
406.22  to meet needs identified by the assessment.  Data gathered as 
406.23  part of a professional assessment must be classified and 
406.24  disclosed according to the provisions in section 13.46. 
406.25     (d) The provider shall make available to participants 
406.26  information regarding additional vendors or resources which 
406.27  provide employment and training services that may be available 
406.28  to the participant under a plan developed under this 
406.29  section.  At a minimum, the provider must make available 
406.30  information on the following resources:  business and higher 
406.31  education partnerships operated under the Minnesota job skills 
406.32  partnership, community and technical colleges, adult basic 
406.33  education programs, and services offered by vocational 
406.34  rehabilitation programs.  The information must include a brief 
406.35  summary of services provided and related performance 
406.36  indicators.  Performance indicators must include, but are not 
407.1   limited to, the average time to complete program offerings, 
407.2   placement rates, entry and average wages, and retention rates.  
407.3   To be included in the information given to participants, a 
407.4   vendor or resource must provide counties with relevant 
407.5   information in the format required by the county. 
407.6      Sec. 60.  Minnesota Statutes 1998, section 256J.52, 
407.7   subdivision 5, is amended to read: 
407.8      Subd. 5.  [EMPLOYMENT PLAN; CONTENTS.] Based on the 
407.9   secondary assessment under subdivision 4, the job counselor and 
407.10  the participant must develop an employment plan for the 
407.11  participant that includes specific activities that are tied to 
407.12  an employment goal and a plan for long-term self-sufficiency, 
407.13  and that is designed to move the participant along the most 
407.14  direct path to unsubsidized employment.  The employment plan 
407.15  must list the specific steps that will be taken to obtain 
407.16  employment and a timetable for completion of each of the steps.  
407.17  Upon agreement by the job counselor and the participant, the 
407.18  employment plan may limit a job search to jobs that are 
407.19  consistent with the participant's employment goal.  As part of 
407.20  the development of the participant's employment plan, the 
407.21  participant shall have the option of selecting from among the 
407.22  vendors or resources that the job counselor determines will be 
407.23  effective in supplying one or more of the services necessary to 
407.24  meet the employment goals specified in the participant's plan. 
407.25  In compiling the list of vendors and resources that the job 
407.26  counselor determines would be effective in meeting the 
407.27  participant's employment goals, the job counselor must determine 
407.28  that adequate financial resources are available for the vendors 
407.29  or resources ultimately selected by the participant.  The job 
407.30  counselor and the participant must sign the developed plan to 
407.31  indicate agreement between the job counselor and the participant 
407.32  on the contents of the plan.  
407.33     Sec. 61.  Minnesota Statutes 1998, section 256J.52, is 
407.34  amended by adding a subdivision to read: 
407.35     Subd. 5a.  [BASIC EDUCATION ACTIVITIES IN 
407.36  PLAN.] Participants with low skills in reading or mathematics 
408.1   who are proficient only at or below an eighth-grade level must 
408.2   be allowed to include basic education activities or an English 
408.3   as a second language program in a job search support plan or an 
408.4   employment plan, whichever is applicable.  An English as a 
408.5   second language program may be included in a participant's job 
408.6   search support plan or employment plan under this subdivision 
408.7   for as long as the participant is making satisfactory progress 
408.8   in the program and the participant's lack of proficiency in 
408.9   English remains a barrier to obtaining suitable employment. 
408.10     Sec. 62.  Minnesota Statutes 1998, section 256J.54, 
408.11  subdivision 2, is amended to read: 
408.12     Subd. 2.  [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 
408.13  PLAN.] For caregivers who are under age 18 without a high school 
408.14  diploma or its equivalent, the assessment under subdivision 1 
408.15  and the employment plan under subdivision 3 must be completed by 
408.16  the social services agency under section 257.33.  For caregivers 
408.17  who are age 18 or 19 without a high school diploma or its 
408.18  equivalent, the assessment under subdivision 1 and the 
408.19  employment plan under subdivision 3 must be completed by the job 
408.20  counselor or, at county option, by the social services agency 
408.21  under section 257.33.  Upon reaching age 18 or 19 a caregiver 
408.22  who received social services under section 257.33 and is without 
408.23  a high school diploma or its equivalent has the option to choose 
408.24  whether to continue receiving services under the caregiver's 
408.25  plan from the social services agency or to utilize an MFIP 
408.26  employment and training service provider.  The social services 
408.27  agency or the job counselor shall consult with representatives 
408.28  of educational agencies that are required to assist in 
408.29  developing educational plans under section 124D.331. 
408.30     Sec. 63.  Minnesota Statutes 1998, section 256J.55, 
408.31  subdivision 4, is amended to read: 
408.32     Subd. 4.  [CHOICE OF PROVIDER.] A participant MFIP 
408.33  caregivers must be able to choose from at least two employment 
408.34  and training service providers, unless the county has 
408.35  demonstrated to the commissioner that the provision of multiple 
408.36  employment and training service providers would result in 
409.1   financial hardship for the county, or the county is utilizing a 
409.2   workforce center as specified in section 256J.50, subdivision 
409.3   8.  Both parents in a two-parent family must choose the same 
409.4   employment and training service provider unless a special need, 
409.5   such as bilingual services, is identified but not available 
409.6   through one service provider. 
409.7      Sec. 64.  Minnesota Statutes 1998, section 256J.56, is 
409.8   amended to read: 
409.9      256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
409.10  EXEMPTIONS.] 
409.11     (a) An MFIP-S MFIP caregiver is exempt from the 
409.12  requirements of sections 256J.52 to 256J.55 if the caregiver 
409.13  belongs to any of the following groups: 
409.14     (1) individuals who are age 60 or older; 
409.15     (2) individuals who are suffering from a professionally 
409.16  certified permanent or temporary illness, injury, or incapacity 
409.17  which is expected to continue for more than 30 days and which 
409.18  prevents the person from obtaining or retaining employment.  
409.19  Persons in this category with a temporary illness, injury, or 
409.20  incapacity must be reevaluated at least quarterly; 
409.21     (3) caregivers whose presence in the home is required 
409.22  because of the professionally certified illness or incapacity of 
409.23  another member in the assistance unit, a relative in the 
409.24  household, or a foster child in the household; 
409.25     (4) women who are pregnant, if the pregnancy has resulted 
409.26  in a professionally certified incapacity that prevents the woman 
409.27  from obtaining or retaining employment; 
409.28     (5) caregivers of a child under the age of one year who 
409.29  personally provide full-time care for the child.  This exemption 
409.30  may be used for only 12 months in a lifetime.  In two-parent 
409.31  households, only one parent or other relative may qualify for 
409.32  this exemption; 
409.33     (6) individuals who are single parents, or one parent in a 
409.34  two-parent family, employed at least 35 hours per week; 
409.35     (7) individuals experiencing a personal or family crisis 
409.36  that makes them incapable of participating in the program, as 
410.1   determined by the county agency.  If the participant does not 
410.2   agree with the county agency's determination, the participant 
410.3   may seek professional certification, as defined in section 
410.4   256J.08, that the participant is incapable of participating in 
410.5   the program. 
410.6      Persons in this exemption category must be reevaluated 
410.7   every 60 days; or 
410.8      (8) second parents in two-parent families employed for 20 
410.9   or more hours per week, provided the first parent is employed at 
410.10  least 35 hours per week. 
410.11     A caregiver who is exempt under clause (5) must enroll in 
410.12  and attend an early childhood and family education class, a 
410.13  parenting class, or some similar activity, if available, during 
410.14  the period of time the caregiver is exempt under this section.  
410.15  Notwithstanding section 256J.46, failure to attend the required 
410.16  activity shall not result in the imposition of a sanction. 
410.17     (b) The county agency must provide employment and training 
410.18  services to MFIP-S MFIP caregivers who are exempt under this 
410.19  section, but who volunteer to participate.  Exempt volunteers 
410.20  may request approval for any work activity under section 
410.21  256J.49, subdivision 13.  The hourly participation requirements 
410.22  for nonexempt caregivers under section 256J.50, subdivision 5, 
410.23  do not apply to exempt caregivers who volunteer to participate. 
410.24     Sec. 65.  Minnesota Statutes 1998, section 256J.62, 
410.25  subdivision 1, is amended to read: 
410.26     Subdivision 1.  [ALLOCATION.] Money appropriated for MFIP-S 
410.27  MFIP employment and training services must be allocated to 
410.28  counties and eligible tribal providers as specified in this 
410.29  section. 
410.30     Sec. 66.  Minnesota Statutes 1998, section 256J.62, is 
410.31  amended by adding a subdivision to read: 
410.32     Subd. 2a.  [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 
410.33  state fiscal year 2000, and for all subsequent years, money 
410.34  shall be allocated to counties and eligible tribal providers 
410.35  based on their average number of MFIP cases as a proportion of 
410.36  the statewide total number of MFIP cases:  
411.1      (1) the average number of cases must be based upon counts 
411.2   of MFIP or tribal TANF cases as of March 31, June 30, September 
411.3   30, and December 31 of the previous calendar year, less the 
411.4   number of child only cases and cases where all the caregivers 
411.5   are age 60 or over.  Two-parent cases, with the exception of 
411.6   those with a caregiver age 60 or over, will be multiplied by a 
411.7   factor of two; 
411.8      (2) the MFIP or tribal TANF case count for each eligible 
411.9   tribal provider shall be based upon the number of MFIP or tribal 
411.10  TANF cases who are enrolled in, or are eligible for enrollment 
411.11  in the tribe; and the case must be an active MFIP case; and the 
411.12  case members must reside within the tribal program's service 
411.13  delivery area; 
411.14     (3) MFIP or tribal TANF cases counted for determining 
411.15  allocations to tribal providers shall be removed from the case 
411.16  counts of the respective counties where they reside to prevent 
411.17  duplicate counts; and 
411.18     (4) prior to allocating funds to counties and tribal 
411.19  providers, $1,000,000 shall be set aside to allow the 
411.20  commissioner to use these set-aside funds to provide funding to 
411.21  county or tribal providers who experience an unforeseen influx 
411.22  of participants or other emergent situations beyond their 
411.23  control. 
411.24  Any funds specified in this paragraph that remain unspent by 
411.25  March 31 of each year shall be reallocated out to county and 
411.26  tribal providers using the funding formula detailed in clauses 
411.27  (1) to (4). 
411.28     Sec. 67.  Minnesota Statutes 1998, section 256J.62, 
411.29  subdivision 6, is amended to read: 
411.30     Subd. 6.  [BILINGUAL EMPLOYMENT AND TRAINING SERVICES TO 
411.31  REFUGEES.] Funds appropriated to cover the costs of bilingual 
411.32  employment and training services to refugees shall be allocated 
411.33  to county agencies as follows: 
411.34     (1) for state fiscal year 1998, the allocation shall be 
411.35  based on the county's proportion of the total statewide number 
411.36  of AFDC refugee cases in the previous fiscal year.  Counties 
412.1   with less than one percent of the statewide number of AFDC, 
412.2   MFIP-R, or MFIP refugee cases shall not receive an allocation of 
412.3   bilingual employment and training services funds; and 
412.4      (2) for each subsequent fiscal year, the allocation shall 
412.5   be based on the county's proportion of the total statewide 
412.6   number of MFIP-S MFIP refugee cases in the previous fiscal year. 
412.7   Counties with less than one percent of the statewide number of 
412.8   MFIP-S MFIP refugee cases shall not receive an allocation of 
412.9   bilingual employment and training services funds. 
412.10     Sec. 68.  Minnesota Statutes 1998, section 256J.62, 
412.11  subdivision 7, is amended to read: 
412.12     Subd. 7.  [WORK LITERACY LANGUAGE PROGRAMS.] Funds 
412.13  appropriated to cover the costs of work literacy language 
412.14  programs to non-English-speaking recipients shall be allocated 
412.15  to county agencies as follows: 
412.16     (1) for state fiscal year 1998, the allocation shall be 
412.17  based on the county's proportion of the total statewide number 
412.18  of AFDC or MFIP cases in the previous fiscal year where the lack 
412.19  of English is a barrier to employment.  Counties with less than 
412.20  two percent of the statewide number of AFDC or MFIP cases where 
412.21  the lack of English is a barrier to employment shall not receive 
412.22  an allocation of the work literacy language program funds; and 
412.23     (2) for each subsequent fiscal year, the allocation shall 
412.24  be based on the county's proportion of the total statewide 
412.25  number of MFIP-S MFIP cases in the previous fiscal year where 
412.26  the lack of English is a barrier to employment.  Counties with 
412.27  less than two percent of the statewide number of MFIP-S MFIP 
412.28  cases where the lack of English is a barrier to employment shall 
412.29  not receive an allocation of the work literacy language program 
412.30  funds. 
412.31     Sec. 69.  Minnesota Statutes 1998, section 256J.62, 
412.32  subdivision 8, is amended to read: 
412.33     Subd. 8.  [REALLOCATION.] The commissioner of human 
412.34  services shall review county agency expenditures of MFIP-S MFIP 
412.35  employment and training services funds at the end of the third 
412.36  quarter of the first year of the biennium and each quarter after 
413.1   that and may reallocate unencumbered or unexpended money 
413.2   appropriated under this section to those county agencies that 
413.3   can demonstrate a need for additional money. 
413.4      Sec. 70.  Minnesota Statutes 1998, section 256J.62, 
413.5   subdivision 9, is amended to read: 
413.6      Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] At the 
413.7   request of the caregiver, the county may continue to provide 
413.8   case management, counseling or other support services to a 
413.9   participant following the participant's achievement of the 
413.10  employment goal, for up to six 12 months following termination 
413.11  of the participant's eligibility for MFIP-S MFIP. 
413.12     A county may expend funds for a specific employment and 
413.13  training service for the duration of that service to a 
413.14  participant if the funds are obligated or expended prior to the 
413.15  participant losing MFIP-S MFIP eligibility. 
413.16     Sec. 71.  Minnesota Statutes 1998, section 256J.67, 
413.17  subdivision 4, is amended to read: 
413.18     Subd. 4.  [EMPLOYMENT PLAN.] (a) The caretaker's employment 
413.19  plan must include the length of time needed in the work 
413.20  experience program, the need to continue job-seeking activities 
413.21  while participating in work experience, and the caregiver's 
413.22  employment goals. 
413.23     (b) After each six months of a caregiver's participation in 
413.24  a work experience job placement, and at the conclusion of each 
413.25  work experience assignment under this section, the county agency 
413.26  shall reassess and revise, as appropriate, the caregiver's 
413.27  employment plan. 
413.28     (c) A caregiver may claim good cause under section 256J.57, 
413.29  subdivision 1, for failure to cooperate with a work experience 
413.30  job placement.  
413.31     (d) The county agency shall limit the maximum number of 
413.32  hours any participant may work under this section to the amount 
413.33  of the transitional MFIP standard of need divided by the federal 
413.34  or applicable state minimum wage, whichever is higher.  After a 
413.35  participant has been assigned to a position for nine months, the 
413.36  participant may not continue in that assignment unless the 
414.1   maximum number of hours a participant works is no greater than 
414.2   the amount of the transitional MFIP standard of need divided by 
414.3   the rate of pay for individuals employed in the same or similar 
414.4   occupations by the same employer at the same site.  This limit 
414.5   does not apply if it would prevent a participant from counting 
414.6   toward the federal work participation rate. 
414.7      Sec. 72.  Minnesota Statutes 1998, section 256J.74, 
414.8   subdivision 2, is amended to read: 
414.9      Subd. 2.  [CONCURRENT ELIGIBILITY, LIMITATIONS.] (a) An 
414.10  individual whose needs have been otherwise provided for in 
414.11  another state, in whole or in part by county, state, or federal 
414.12  dollars during a month, is ineligible to receive MFIP for the 
414.13  month.  
414.14     (b) A county agency must not count an applicant or 
414.15  participant as a member of more than one assistance unit in this 
414.16  state in a given payment month, except as provided in clauses 
414.17  (1) and (2). 
414.18     (1) A participant who is a member of an assistance unit in 
414.19  this state is eligible to be included in a second assistance 
414.20  unit the first full month after the month the participant joins 
414.21  the second unit. 
414.22     (2) An applicant whose needs are met through federal, 
414.23  state, or local foster care that is reimbursed under title IV-E 
414.24  of the Social Security Act payments for the first part of an 
414.25  application month is eligible to receive assistance for the 
414.26  remaining part of the month in which the applicant returns 
414.27  home.  Title IV-E Foster care payments and adoption assistance 
414.28  payments must be considered prorated payments rather than a 
414.29  duplication of MFIP-S MFIP need. 
414.30     Sec. 73.  [256J.751] [COUNTY PERFORMANCE MANAGEMENT.] 
414.31     (a) From July 1, 1999, to June 30, 2001, the commissioner 
414.32  shall report quarterly to all counties each county's performance 
414.33  on the following measures: 
414.34     (1) percent of MFIP caseload working in paid employment; 
414.35     (2) percent of MFIP caseload receiving only the food 
414.36  portion of assistance; 
415.1      (3) number of MFIP cases that have left assistance; 
415.2      (4) federal participation requirements as specified in 
415.3   title 1 of Public Law Number 104-193; and 
415.4      (5) median placement wage. 
415.5      (b) By January 1, 2000, the commissioner shall, in 
415.6   consultation with counties, develop measures for county 
415.7   performance in addition to those in paragraph (a).  In 
415.8   developing these measures, the commissioner must consider: 
415.9      (1) a measure for MFIP cases that leave assistance due to 
415.10  employment; 
415.11     (2) job retention after participants leave MFIP; 
415.12     (3) participant's earnings at a follow-up point after the 
415.13  participant has left MFIP; and 
415.14     (4) customer satisfaction, including participant and 
415.15  employer satisfaction. 
415.16     (c) If sanctions occur for failure to meet the performance 
415.17  standards specified in title 1 of Public Law Number 104-193 of 
415.18  the Personal Responsibility and Work Opportunity Act of 1996, 
415.19  the state shall pay 88 percent of the sanction.  The remaining 
415.20  12 percent of the sanction will be paid by the counties.  The 
415.21  county portion of the sanction will be distributed across all 
415.22  counties in proportion to each county's percentage of the MFIP 
415.23  average monthly caseload during the period for which the 
415.24  sanction was applied. 
415.25     (d) If a county fails to meet the performance standards 
415.26  specified in title 1 of Public Law Number 104-193 of the 
415.27  Personal Responsibility and Work Opportunity Act of 1996 for any 
415.28  year, the commissioner shall work with counties to organize a 
415.29  joint state-county technical assistance team to work with the 
415.30  county.  The commissioner shall coordinate any technical 
415.31  assistance with other departments and agencies including the 
415.32  departments of economic security and children, families, and 
415.33  learning as necessary to achieve the purpose of this paragraph. 
415.34     Sec. 74.  Minnesota Statutes 1998, section 256J.76, 
415.35  subdivision 1, is amended to read: 
415.36     Subdivision 1.  [ADMINISTRATIVE FUNCTIONS.] Beginning July 
416.1   1, 1997, counties will receive federal funds from the TANF block 
416.2   grant for use in supporting eligibility, fraud control, and 
416.3   other related administrative functions.  The federal funds 
416.4   available for distribution, as determined by the commissioner, 
416.5   must be an amount equal to federal administrative aid 
416.6   distributed for fiscal year 1996 under titles IV-A and IV-F of 
416.7   the Social Security Act in effect prior to October 1, 1996.  
416.8   This amount must include the amount paid for local 
416.9   collaboratives under sections 245.4932 and 256F.13, but must not 
416.10  include administrative aid associated with child care under 
416.11  section 119B.05, with emergency assistance intensive family 
416.12  preservation services under section 256.8711, with 
416.13  administrative activities as part of the employment and training 
416.14  services under section 256.736, or with fraud prevention 
416.15  investigation activities under section 256.983.  Before July 15, 
416.16  1999, a county may ask for a review of the commissioner's 
416.17  determination where the county believes fiscal year 1996 
416.18  information was inaccurate or incomplete.  By August 15, 1999, 
416.19  the commissioner must adjust that county's base when the 
416.20  commissioner has determined that inaccurate or incomplete 
416.21  information was used to develop that base.  The commissioner 
416.22  shall adjust the county's 1999 allocation amount to reflect the 
416.23  base change. 
416.24     Sec. 75.  Minnesota Statutes 1998, section 256J.76, 
416.25  subdivision 2, is amended to read: 
416.26     Subd. 2.  [ALLOCATION OF COUNTY FUNDS.] (a) The 
416.27  commissioner shall determine and allocate the funds available to 
416.28  each county, on a calendar year basis, proportional to the 
416.29  amount paid to each county for fiscal year 1996, excluding the 
416.30  amount paid for local collaboratives under sections 245.4932 and 
416.31  256F.13.  For the period beginning July 1, 1997, and ending 
416.32  December 31, 1998, each county shall receive 150 percent of its 
416.33  base year allocation. 
416.34     (b) Beginning January 1, 2000, the commissioner shall 
416.35  allocate funds made available under this section on a calendar 
416.36  year basis to each county first, in amounts equal to each 
417.1   county's guaranteed floor as described in clause (1), second, to 
417.2   provide an allocation of up to $2,000 to each county as provided 
417.3   for in clause (2), and third, any remaining funds shall be 
417.4   allocated in proportion to the sum of each county's average 
417.5   monthly MFIP cases plus ten percent of each county's average 
417.6   monthly MFIP recipients with budgeted earnings as determined by 
417.7   the most recent calendar year data available. 
417.8      (1) Each county's guaranteed floor shall be calculated as 
417.9   follows: 
417.10     (i) 90 percent of that county's allocation in the preceding 
417.11  calendar year; or 
417.12     (ii) when the amount of funds available is less than the 
417.13  guaranteed floor, each county's allocation shall be equal to the 
417.14  previous calendar year allocation reduced by the same percentage 
417.15  that the statewide allocation was reduced. 
417.16     (2) Each county shall be allocated up to $2,000.  If, after 
417.17  application of the guaranteed floor, funds are insufficient to 
417.18  provide $2,000 per county, each county's allocation under this 
417.19  clause shall be an equal share of remaining funds available. 
417.20     Sec. 76.  Minnesota Statutes 1998, section 256J.76, 
417.21  subdivision 4, is amended to read: 
417.22     Subd. 4.  [REPORTING REQUIREMENT AND REIMBURSEMENT.] The 
417.23  commissioner shall specify requirements for reporting according 
417.24  to section 256.01, subdivision 2, paragraph (17).  Each county 
417.25  shall be reimbursed at a rate of 50 percent of eligible 
417.26  expenditures up to the limit of its allocation.  The 
417.27  commissioner shall regularly review each county's eligible 
417.28  expenditures compared to its allocation.  The commissioner may 
417.29  reallocate funds at any time, from counties which have not or 
417.30  will not have expended their allocations, to counties that have 
417.31  eligible expenditures in excess of their allocation. 
417.32     Sec. 77.  [256J.80] [TRUANCY PREVENTION PROGRAM.] 
417.33     Subdivision 1.  [PILOT PROJECTS.] The commissioner of human 
417.34  services, in consultation with the commissioner of children, 
417.35  families, and learning, shall develop a truancy prevention pilot 
417.36  program to prevent tardiness and ensure school attendance of 
418.1   children receiving assistance under this chapter.  The pilot 
418.2   program shall be developed in at least two school districts, one 
418.3   rural and one urban.  The pilots shall be developed in voluntary 
418.4   collaboration with local school districts and county social 
418.5   service agencies and shall serve families on MFIP whose children 
418.6   are under the age of 13 and are subject to the compulsory 
418.7   attendance requirements of section 120A.22, and are frequently 
418.8   tardy or are not attending school regularly, as defined by the 
418.9   local school district.  The program shall require the local 
418.10  schools to refer these families to county social service 
418.11  agencies for an assessment and development of a corrective 
418.12  action plan to ensure punctual and regular school attendance by 
418.13  the children in the family.  The corrective action plan must 
418.14  require that the children demonstrate satisfactory attendance as 
418.15  defined by the local school district.  Families that fail to 
418.16  follow the corrective action plan shall be reported to the 
418.17  county agency and may be subject to sanction under section 
418.18  256J.46, subdivision 1, paragraphs (a) and (b).  The 
418.19  commissioner of human services may at its discretion expand the 
418.20  program to other districts with the districts' agreement and 
418.21  shall present a report to the legislature by November 30, 2000, 
418.22  on the success of the implementation of the pilot projects 
418.23  authorized by this section.  
418.24     Subd. 2.  [TRANSFER OF ATTENDANCE DATA.] Notwithstanding 
418.25  section 13.32, the commissioners of children, families, and 
418.26  learning and human services shall develop procedures to 
418.27  implement the transmittal of data on student attendance, to the 
418.28  extent consistent with federal law, to county social services 
418.29  agencies to implement the program authorized by this section.  
418.30     Sec. 78.  [RECOMMENDATIONS TO 60-MONTH LIMIT.] 
418.31     By January 15, 2000, the commissioner of human services 
418.32  shall submit to the legislature recommendations regarding MFIP 
418.33  families that include an adult caregiver who has received 60 
418.34  months of cash assistance funded in whole or in part by the TANF 
418.35  block grant. 
418.36     Sec. 79.  [PROPOSAL REQUIRED.] 
419.1      By January 15, 2000, the commissioner shall submit to the 
419.2   legislature a proposal for creating an MFIP incentive bonus 
419.3   program for high-performing counties.  The proposal must include 
419.4   recommendations on how to implement a system that would provide 
419.5   an incentive bonus to a county that demonstrates high 
419.6   performance with respect to the county's MFIP participants, as 
419.7   reflected in wage rate measures and career advancement measures 
419.8   reported by the county.  
419.9      Sec. 80.  [ASSESSMENT PROTOCOLS.] 
419.10     The commissioner of human services shall consult with 
419.11  county agencies, employment and training service providers, the 
419.12  commissioner of human rights, and advocates to develop protocols 
419.13  to guide the implementation of Minnesota Statutes, section 
419.14  256J.52, subdivision 4, paragraph (c), as amended.  
419.15     Sec. 81.  [FATHER PROJECT; TIME-LIMITED WAIVER OF EXISTING 
419.16  STATUTORY PROVISIONS.] 
419.17     The commissioner of human services shall waive the 
419.18  enforcement of any existing specific statutory program 
419.19  requirements, administrative rules, and standards, including the 
419.20  relevant provisions of the following sections of Minnesota 
419.21  Statutes: 
419.22     (1) 256.741, subdivision 2, paragraph (a); 
419.23     (2) 256J.30, subdivision 11; 
419.24     (3) 256J.33, subdivision 4, clause (5); and 
419.25     (4) 256J.34, subdivision 1, paragraph (d). 
419.26  The waivers permitted under this section are for the limited 
419.27  purposes of allowing the entire amount of direct child support 
419.28  payments to be passed through for the children of individuals 
419.29  participating in the FATHER project and excluding any direct 
419.30  child support payments paid by participants in the FATHER 
419.31  project as income under the MFIP program for individuals 
419.32  receiving the child support payments who also receive MFIP 
419.33  assistance.  State dollars to offset the increased costs to the 
419.34  state of implementing the waivers are available only to the 
419.35  extent that they are matched on a dollar for dollar basis by 
419.36  money provided by the private philanthropical community.  The 
420.1   waiver authority granted by this section sunsets on July 1, 2002.
420.2      Sec. 82.  [REPEALER.] 
420.3      Minnesota Statutes 1998, sections 256D.053, subdivision 4; 
420.4   and 256J.62, subdivisions 2, 3, and 5; and Laws 1997, chapter 
420.5   85, article 1, section 63, are repealed. 
420.6                              ARTICLE 7 
420.7                            CHILD SUPPORT 
420.8      Section 1.  Minnesota Statutes 1998, section 13.46, 
420.9   subdivision 2, is amended to read: 
420.10     Subd. 2.  [GENERAL.] (a) Unless the data is summary data or 
420.11  a statute specifically provides a different classification, data 
420.12  on individuals collected, maintained, used, or disseminated by 
420.13  the welfare system is private data on individuals, and shall not 
420.14  be disclosed except:  
420.15     (1) according to section 13.05; 
420.16     (2) according to court order; 
420.17     (3) according to a statute specifically authorizing access 
420.18  to the private data; 
420.19     (4) to an agent of the welfare system, including a law 
420.20  enforcement person, attorney, or investigator acting for it in 
420.21  the investigation or prosecution of a criminal or civil 
420.22  proceeding relating to the administration of a program; 
420.23     (5) to personnel of the welfare system who require the data 
420.24  to determine eligibility, amount of assistance, and the need to 
420.25  provide services of additional programs to the individual; 
420.26     (6) to administer federal funds or programs; 
420.27     (7) between personnel of the welfare system working in the 
420.28  same program; 
420.29     (8) the amounts of cash public assistance and relief paid 
420.30  to welfare recipients in this state, including their names, 
420.31  social security numbers, income, addresses, and other data as 
420.32  required, upon request by the department of revenue to 
420.33  administer the property tax refund law, supplemental housing 
420.34  allowance, early refund of refundable tax credits, and the 
420.35  income tax.  "Refundable tax credits" means the dependent care 
420.36  credit under section 290.067, the Minnesota working family 
421.1   credit under section 290.0671, the property tax refund under 
421.2   section 290A.04, and, if the required federal waiver or waivers 
421.3   are granted, the federal earned income tax credit under section 
421.4   32 of the Internal Revenue Code; 
421.5      (9) between the department of human services and the 
421.6   Minnesota department of economic security for the purpose of 
421.7   monitoring the eligibility of the data subject for reemployment 
421.8   insurance, for any employment or training program administered, 
421.9   supervised, or certified by that agency, for the purpose of 
421.10  administering any rehabilitation program, whether alone or in 
421.11  conjunction with the welfare system, or to monitor and evaluate 
421.12  the statewide Minnesota family investment program by exchanging 
421.13  data on recipients and former recipients of food stamps, cash 
421.14  assistance under chapter 256, 256D, 256J, or 256K, child care 
421.15  assistance under chapter 119B, or medical programs under chapter 
421.16  256B, 256D, or 256L; 
421.17     (10) to appropriate parties in connection with an emergency 
421.18  if knowledge of the information is necessary to protect the 
421.19  health or safety of the individual or other individuals or 
421.20  persons; 
421.21     (11) data maintained by residential programs as defined in 
421.22  section 245A.02 may be disclosed to the protection and advocacy 
421.23  system established in this state according to Part C of Public 
421.24  Law Number 98-527 to protect the legal and human rights of 
421.25  persons with mental retardation or other related conditions who 
421.26  live in residential facilities for these persons if the 
421.27  protection and advocacy system receives a complaint by or on 
421.28  behalf of that person and the person does not have a legal 
421.29  guardian or the state or a designee of the state is the legal 
421.30  guardian of the person; 
421.31     (12) to the county medical examiner or the county coroner 
421.32  for identifying or locating relatives or friends of a deceased 
421.33  person; 
421.34     (13) data on a child support obligor who makes payments to 
421.35  the public agency may be disclosed to the higher education 
421.36  services office to the extent necessary to determine eligibility 
422.1   under section 136A.121, subdivision 2, clause (5); 
422.2      (14) participant social security numbers and names 
422.3   collected by the telephone assistance program may be disclosed 
422.4   to the department of revenue to conduct an electronic data match 
422.5   with the property tax refund database to determine eligibility 
422.6   under section 237.70, subdivision 4a; 
422.7      (15) the current address of a recipient of aid to families 
422.8   with dependent children or Minnesota family investment 
422.9   program-statewide may be disclosed to law enforcement officers 
422.10  who provide the name of the recipient and notify the agency that:
422.11     (i) the recipient: 
422.12     (A) is a fugitive felon fleeing to avoid prosecution, or 
422.13  custody or confinement after conviction, for a crime or attempt 
422.14  to commit a crime that is a felony under the laws of the 
422.15  jurisdiction from which the individual is fleeing; or 
422.16     (B) is violating a condition of probation or parole imposed 
422.17  under state or federal law; 
422.18     (ii) the location or apprehension of the felon is within 
422.19  the law enforcement officer's official duties; and 
422.20     (iii)  the request is made in writing and in the proper 
422.21  exercise of those duties; 
422.22     (16) the current address of a recipient of general 
422.23  assistance or general assistance medical care may be disclosed 
422.24  to probation officers and corrections agents who are supervising 
422.25  the recipient and to law enforcement officers who are 
422.26  investigating the recipient in connection with a felony level 
422.27  offense; 
422.28     (17) information obtained from food stamp applicant or 
422.29  recipient households may be disclosed to local, state, or 
422.30  federal law enforcement officials, upon their written request, 
422.31  for the purpose of investigating an alleged violation of the 
422.32  Food Stamp Act, according to Code of Federal Regulations, title 
422.33  7, section 272.1(c); 
422.34     (18) the address, social security number, and, if 
422.35  available, photograph of any member of a household receiving 
422.36  food stamps shall be made available, on request, to a local, 
423.1   state, or federal law enforcement officer if the officer 
423.2   furnishes the agency with the name of the member and notifies 
423.3   the agency that:  
423.4      (i) the member: 
423.5      (A) is fleeing to avoid prosecution, or custody or 
423.6   confinement after conviction, for a crime or attempt to commit a 
423.7   crime that is a felony in the jurisdiction the member is 
423.8   fleeing; 
423.9      (B) is violating a condition of probation or parole imposed 
423.10  under state or federal law; or 
423.11     (C) has information that is necessary for the officer to 
423.12  conduct an official duty related to conduct described in subitem 
423.13  (A) or (B); 
423.14     (ii) locating or apprehending the member is within the 
423.15  officer's official duties; and 
423.16     (iii) the request is made in writing and in the proper 
423.17  exercise of the officer's official duty; 
423.18     (19) certain information regarding child support obligors 
423.19  who are in arrears may be made public according to section 
423.20  518.575; 
423.21     (20) data on child support payments made by a child support 
423.22  obligor and data on the distribution of those payments excluding 
423.23  identifying information on obligees may be disclosed to all 
423.24  obligees to whom the obligor owes support, and data on the 
423.25  enforcement actions undertaken by the public authority, the 
423.26  status of those actions, and data on the income of the obligor 
423.27  or obligee may be disclosed to the other party; 
423.28     (21) data in the work reporting system may be disclosed 
423.29  under section 256.998, subdivision 7; 
423.30     (22) to the department of children, families, and learning 
423.31  for the purpose of matching department of children, families, 
423.32  and learning student data with public assistance data to 
423.33  determine students eligible for free and reduced price meals, 
423.34  meal supplements, and free milk according to United States Code, 
423.35  title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to 
423.36  produce accurate numbers of students receiving aid to families 
424.1   with dependent children or Minnesota family investment 
424.2   program-statewide as required by section 126C.06; to allocate 
424.3   federal and state funds that are distributed based on income of 
424.4   the student's family; and to verify receipt of energy assistance 
424.5   for the telephone assistance plan; 
424.6      (23) the current address and telephone number of program 
424.7   recipients and emergency contacts may be released to the 
424.8   commissioner of health or a local board of health as defined in 
424.9   section 145A.02, subdivision 2, when the commissioner or local 
424.10  board of health has reason to believe that a program recipient 
424.11  is a disease case, carrier, suspect case, or at risk of illness, 
424.12  and the data are necessary to locate the person; 
424.13     (24) to other state agencies, statewide systems, and 
424.14  political subdivisions of this state, including the attorney 
424.15  general, and agencies of other states, interstate information 
424.16  networks, federal agencies, and other entities as required by 
424.17  federal regulation or law for the administration of the child 
424.18  support enforcement program; 
424.19     (25) to personnel of public assistance programs as defined 
424.20  in section 256.741, for access to the child support system 
424.21  database for the purpose of administration, including monitoring 
424.22  and evaluation of those public assistance programs; or 
424.23     (26) to monitor and evaluate the statewide Minnesota family 
424.24  investment program by exchanging data between the departments of 
424.25  human services and children, families, and learning, on 
424.26  recipients and former recipients of food stamps, cash assistance 
424.27  under chapter 256, 256D, 256J, or 256K, child care assistance 
424.28  under chapter 119B, or medical programs under chapter 256B, 
424.29  256D, or 256L; or 
424.30     (27) to evaluate child support program performance and to 
424.31  identify and prevent fraud in the child support program by 
424.32  exchanging data between the department of human services, 
424.33  department of revenue, department of health, department of 
424.34  economic security, and other state agencies as is reasonably 
424.35  necessary to perform these functions.  
424.36     (b) Information on persons who have been treated for drug 
425.1   or alcohol abuse may only be disclosed according to the 
425.2   requirements of Code of Federal Regulations, title 42, sections 
425.3   2.1 to 2.67. 
425.4      (c) Data provided to law enforcement agencies under 
425.5   paragraph (a), clause (15), (16), (17), or (18), or paragraph 
425.6   (b), are investigative data and are confidential or protected 
425.7   nonpublic while the investigation is active.  The data are 
425.8   private after the investigation becomes inactive under section 
425.9   13.82, subdivision 5, paragraph (a) or (b). 
425.10     (d) Mental health data shall be treated as provided in 
425.11  subdivisions 7, 8, and 9, but is not subject to the access 
425.12  provisions of subdivision 10, paragraph (b). 
425.13     Sec. 2.  Minnesota Statutes 1998, section 256.87, 
425.14  subdivision 1a, is amended to read: 
425.15     Subd. 1a.  [CONTINUING SUPPORT CONTRIBUTIONS.] In addition 
425.16  to granting the county or state agency a money judgment, the 
425.17  court may, upon a motion or order to show cause, order 
425.18  continuing support contributions by a parent found able to 
425.19  reimburse the county or state agency.  The order shall be 
425.20  effective for the period of time during which the recipient 
425.21  receives public assistance from any county or state agency and 
425.22  thereafter.  The order shall require support according to 
425.23  chapter 518 and include the names and social security numbers of 
425.24  the father, mother, and the child or children.  An order for 
425.25  continuing contributions is reinstated without further hearing 
425.26  upon notice to the parent by any county or state agency that 
425.27  public assistance, as defined in section 256.741, is again being 
425.28  provided for the child of the parent.  The notice shall be in 
425.29  writing and shall indicate that the parent may request a hearing 
425.30  for modification of the amount of support or maintenance. 
425.31     Sec. 3.  Minnesota Statutes 1998, section 256.978, 
425.32  subdivision 1, is amended to read: 
425.33     Subdivision 1.  [REQUEST FOR INFORMATION.] (a) The public 
425.34  authority responsible for child support in this state or any 
425.35  other state, in order to locate a person or to obtain 
425.36  information necessary to establish paternity and child support 
426.1   or to modify or enforce child support or distribute collections, 
426.2   may request information reasonably necessary to the inquiry from 
426.3   the records of (1) all departments, boards, bureaus, or other 
426.4   agencies of this state, which shall, notwithstanding the 
426.5   provisions of section 268.19 or any other law to the contrary, 
426.6   provide the information necessary for this purpose.; and (2) 
426.7   employers, utility companies, insurance companies, financial 
426.8   institutions, credit grantors, and labor associations doing 
426.9   business in this state.  They shall provide information as 
426.10  provided under subdivision 2 a response upon written or 
426.11  electronic request by an agency responsible for child support 
426.12  enforcement regarding individuals owing or allegedly owing a 
426.13  duty to support within 30 days of service of the request made by 
426.14  the public authority.  Information requested and used or 
426.15  transmitted by the commissioner according to the authority 
426.16  conferred by this section may be made available to other 
426.17  agencies, statewide systems, and political subdivisions of this 
426.18  state, and agencies of other states, interstate information 
426.19  networks, federal agencies, and other entities as required by 
426.20  federal regulation or law for the administration of the child 
426.21  support enforcement program.  
426.22     (b) For purposes of this section, "state" includes the 
426.23  District of Columbia, Puerto Rico, the United States Virgin 
426.24  Islands, and any territory or insular possession subject to the 
426.25  jurisdiction of the United States. 
426.26     Sec. 4.  Minnesota Statutes 1998, section 257.62, 
426.27  subdivision 5, is amended to read: 
426.28     Subd. 5.  [POSITIVE TEST RESULTS.] (a) If the results of 
426.29  blood or genetic tests completed in a laboratory accredited by 
426.30  the American Association of Blood Banks indicate that the 
426.31  likelihood of the alleged father's paternity, calculated with a 
426.32  prior probability of no more than 0.5 (50 percent), is 92 
426.33  percent or greater, upon motion the court shall order the 
426.34  alleged father to pay temporary child support determined 
426.35  according to chapter 518.  The alleged father shall pay the 
426.36  support money to the public authority if the public authority is 
427.1   a party and is providing services to the parties or, if not, 
427.2   into court pursuant to the rules of civil procedure to await the 
427.3   results of the paternity proceedings.  
427.4      (b) If the results of blood or genetic tests completed in a 
427.5   laboratory accredited by the American Association of Blood Banks 
427.6   indicate that likelihood of the alleged father's paternity, 
427.7   calculated with a prior probability of no more than 0.5 (50 
427.8   percent), is 99 percent or greater, the alleged father is 
427.9   presumed to be the parent and the party opposing the 
427.10  establishment of the alleged father's paternity has the burden 
427.11  of proving by clear and convincing evidence that the alleged 
427.12  father is not the father of the child. 
427.13     Sec. 5.  Minnesota Statutes 1998, section 257.75, 
427.14  subdivision 2, is amended to read: 
427.15     Subd. 2.  [REVOCATION OF RECOGNITION.] A recognition may be 
427.16  revoked in a writing signed by the mother or father before a 
427.17  notary public and filed with the state registrar of vital 
427.18  statistics within the earlier of 30 60 days after the 
427.19  recognition is executed or the date of an administrative or 
427.20  judicial hearing relating to the child in which the revoking 
427.21  party is a party to the related action.  A joinder in a 
427.22  recognition may be revoked in a writing signed by the man who 
427.23  executed the joinder and filed with the state registrar of vital 
427.24  statistics within 30 60 days after the joinder is executed.  
427.25  Upon receipt of a revocation of the recognition of parentage or 
427.26  joinder in a recognition, the state registrar of vital 
427.27  statistics shall forward a copy of the revocation to the 
427.28  nonrevoking parent, or, in the case of a joinder in a 
427.29  recognition, to the mother and father who executed the 
427.30  recognition.  
427.31     Sec. 6.  Minnesota Statutes 1998, section 518.10, is 
427.32  amended to read: 
427.33     518.10 [REQUISITES OF PETITION.] 
427.34     The petition for dissolution of marriage or legal 
427.35  separation shall state and allege: 
427.36     (a) the name, address, and, in circumstances in which child 
428.1   support or spousal maintenance will be addressed, social 
428.2   security number of the petitioner and any prior or other name 
428.3   used by the petitioner; 
428.4      (b) the name and, if known, the address and, in 
428.5   circumstances in which child support or spousal maintenance will 
428.6   be addressed, social security number of the respondent and any 
428.7   prior or other name used by the respondent and known to the 
428.8   petitioner; 
428.9      (c) the place and date of the marriage of the parties; 
428.10     (d) in the case of a petition for dissolution, that either 
428.11  the petitioner or the respondent or both:  
428.12     (1) has resided in this state for not less than 180 days 
428.13  immediately preceding the commencement of the proceeding, or 
428.14     (2) has been a member of the armed services and has been 
428.15  stationed in this state for not less than 180 days immediately 
428.16  preceding the commencement of the proceeding, or 
428.17     (3) has been a domiciliary of this state for not less than 
428.18  180 days immediately preceding the commencement of the 
428.19  proceeding; 
428.20     (e) the name at the time of the petition and any prior or 
428.21  other name, social security number, age, and date of birth of 
428.22  each living minor or dependent child of the parties born before 
428.23  the marriage or born or adopted during the marriage and a 
428.24  reference to, and the expected date of birth of, a child of the 
428.25  parties conceived during the marriage but not born; 
428.26     (f) whether or not a separate proceeding for dissolution, 
428.27  legal separation, or custody is pending in a court in this state 
428.28  or elsewhere; 
428.29     (g) in the case of a petition for dissolution, that there 
428.30  has been an irretrievable breakdown of the marriage 
428.31  relationship; 
428.32     (h) in the case of a petition for legal separation, that 
428.33  there is a need for a decree of legal separation; 
428.34     (i) any temporary or permanent maintenance, child support, 
428.35  child custody, disposition of property, attorneys' fees, costs 
428.36  and disbursements applied for without setting forth the amounts; 
429.1   and 
429.2      (j) whether an order for protection under chapter 518B or a 
429.3   similar law of another state that governs the parties or a party 
429.4   and a minor child of the parties is in effect and, if so, the 
429.5   district court or similar jurisdiction in which it was entered. 
429.6      The petition shall be verified by the petitioner or 
429.7   petitioners, and its allegations established by competent 
429.8   evidence. 
429.9      Sec. 7.  [518.146] [SOCIAL SECURITY NUMBERS; TAX RETURNS; 
429.10  IDENTITY PROTECTION.] 
429.11     The social security numbers and tax returns required under 
429.12  this chapter are private data, except that they must be 
429.13  disclosed to the other parties to a proceeding. 
429.14     Sec. 8.  Minnesota Statutes 1998, section 518.551, is 
429.15  amended by adding a subdivision to read: 
429.16     Subd. 15.  [LICENSE SUSPENSION.] (a) Upon motion of an 
429.17  obligee or the public authority, which has been properly served 
429.18  on the obligor by first class mail at the last known address or 
429.19  in person, and if at a hearing, the court or an administrative 
429.20  law judge finds (1) the obligor is in arrears in court-ordered 
429.21  child support or maintenance payments, or both, in an amount 
429.22  equal to or greater than three times the obligor's total monthly 
429.23  support and maintenance payments and is not in compliance with a 
429.24  written payment agreement regarding both current support and 
429.25  arrearages, or (2) has failed, after receiving notice, to comply 
429.26  with a subpoena relating to a paternity or child support 
429.27  proceeding, the court or administrative law judge may direct the 
429.28  commissioner of natural resources to suspend or bar receipt of 
429.29  the obligor's recreational license or licenses. 
429.30     (b) For the purposes of this subdivision, a recreational 
429.31  license includes all licenses, permits, and stamps issued 
429.32  centrally by the commissioner of natural resources under 
429.33  sections 97B.301, 97B.401, 97B.501, 97B.515, 97B.601, 97B.715, 
429.34  97B.721, 97B.801, 97C.301, and 97C.305. 
429.35     (c) An obligor whose recreational license or licenses have 
429.36  been suspended or barred may provide proof to the court or 
430.1   administrative law judge that the obligor is in compliance with 
430.2   all written payment agreements regarding both current support 
430.3   and arrearages.  Within 15 days of receipt of that proof, the 
430.4   court or administrative law judge may notify the commissioner of 
430.5   natural resources that the obligor's recreational license or 
430.6   licenses should no longer be suspended nor should receipt be 
430.7   barred. 
430.8      Sec. 9.  Minnesota Statutes 1998, section 518.57, 
430.9   subdivision 3, is amended to read: 
430.10     Subd. 3.  [SATISFACTION OF CHILD SUPPORT OBLIGATION.] The 
430.11  court may must conclude that an obligor has satisfied a child 
430.12  support obligation by providing a home, care, and support for 
430.13  the child while the child is living with the obligor, if the 
430.14  court finds that the child was integrated into the family of the 
430.15  obligor with the consent or acquiescence of the obligee and 
430.16  child support payments were not assigned to the public agency 
430.17  under section 256.74. 
430.18     Sec. 10.  Minnesota Statutes 1998, section 518.5851, is 
430.19  amended by adding a subdivision to read: 
430.20     Subd. 6.  [CREDITOR COLLECTIONS.] The central collections 
430.21  unit under this section is not a third party under chapters 550, 
430.22  552, and 571 for purposes of creditor collection efforts against 
430.23  child support and maintenance order obligors or obligees, and 
430.24  shall not be subject to creditor levy, attachment, or 
430.25  garnishment. 
430.26     Sec. 11.  Minnesota Statutes 1998, section 518.5853, is 
430.27  amended by adding a subdivision to read: 
430.28     Subd. 11.  [COLLECTIONS UNIT RECOUPMENT ACCOUNT.] The 
430.29  commissioner of human services may establish a revolving account 
430.30  to cover funds issued in error due to insufficient funds or 
430.31  other reasons.  Appropriations for this purpose and all 
430.32  recoupments against payments from the account shall be deposited 
430.33  in the collections unit's recoupment account and are 
430.34  appropriated to the commissioner.  Any unexpended balance in the 
430.35  account does not cancel, but is available until expended. 
430.36     Sec. 12.  Minnesota Statutes 1998, section 518.64, 
431.1   subdivision 2, is amended to read: 
431.2      Subd. 2.  [MODIFICATION.] (a) The terms of an order 
431.3   respecting maintenance or support may be modified upon a showing 
431.4   of one or more of the following:  (1) substantially increased or 
431.5   decreased earnings of a party; (2) substantially increased or 
431.6   decreased need of a party or the child or children that are the 
431.7   subject of these proceedings; (3) receipt of assistance under 
431.8   sections 256.72 to 256.87 or 256B.01 to 256B.40; (4) a change in 
431.9   the cost of living for either party as measured by the federal 
431.10  bureau of statistics, any of which makes the terms unreasonable 
431.11  and unfair; (5) extraordinary medical expenses of the child not 
431.12  provided for under section 518.171; or (6) the addition of 
431.13  work-related or education-related child care expenses of the 
431.14  obligee or a substantial increase or decrease in existing 
431.15  work-related or education-related child care expenses.  
431.16     On a motion to modify support, the needs of any child the 
431.17  obligor has after the entry of the support order that is the 
431.18  subject of a modification motion shall be considered as provided 
431.19  by section 518.551, subdivision 5f. 
431.20     (b) It is presumed that there has been a substantial change 
431.21  in circumstances under paragraph (a) and the terms of a current 
431.22  support order shall be rebuttably presumed to be unreasonable 
431.23  and unfair if: 
431.24     (1) the application of the child support guidelines in 
431.25  section 518.551, subdivision 5, to the current circumstances of 
431.26  the parties results in a calculated court order that is at least 
431.27  20 percent and at least $50 per month higher or lower than the 
431.28  current support order; 
431.29     (2) the medical support provisions of the order established 
431.30  under section 518.171 are not enforceable by the public 
431.31  authority or the custodial parent; 
431.32     (3) health coverage ordered under section 518.171 is not 
431.33  available to the child for whom the order is established by the 
431.34  parent ordered to provide; or 
431.35     (4) the existing support obligation is in the form of a 
431.36  statement of percentage and not a specific dollar amount.  
432.1      (c) On a motion for modification of maintenance, including 
432.2   a motion for the extension of the duration of a maintenance 
432.3   award, the court shall apply, in addition to all other relevant 
432.4   factors, the factors for an award of maintenance under section 
432.5   518.552 that exist at the time of the motion.  On a motion for 
432.6   modification of support, the court:  
432.7      (1) shall apply section 518.551, subdivision 5, and shall 
432.8   not consider the financial circumstances of each party's spouse, 
432.9   if any; and 
432.10     (2) shall not consider compensation received by a party for 
432.11  employment in excess of a 40-hour work week, provided that the 
432.12  party demonstrates, and the court finds, that: 
432.13     (i) the excess employment began after entry of the existing 
432.14  support order; 
432.15     (ii) the excess employment is voluntary and not a condition 
432.16  of employment; 
432.17     (iii) the excess employment is in the nature of additional, 
432.18  part-time employment, or overtime employment compensable by the 
432.19  hour or fractions of an hour; 
432.20     (iv) the party's compensation structure has not been 
432.21  changed for the purpose of affecting a support or maintenance 
432.22  obligation; 
432.23     (v) in the case of an obligor, current child support 
432.24  payments are at least equal to the guidelines amount based on 
432.25  income not excluded under this clause; and 
432.26     (vi) in the case of an obligor who is in arrears in child 
432.27  support payments to the obligee, any net income from excess 
432.28  employment must be used to pay the arrearages until the 
432.29  arrearages are paid in full. 
432.30     (d) A modification of support or maintenance, including 
432.31  interest that accrued pursuant to section 548.091, may be made 
432.32  retroactive only with respect to any period during which the 
432.33  petitioning party has pending a motion for modification but only 
432.34  from the date of service of notice of the motion on the 
432.35  responding party and on the public authority if public 
432.36  assistance is being furnished or the county attorney is the 
433.1   attorney of record.  However, modification may be applied to an 
433.2   earlier period if the court makes express findings that:  
433.3      (1) the party seeking modification was precluded from 
433.4   serving a motion by reason of a significant physical or mental 
433.5   disability, a material misrepresentation of another party, or 
433.6   fraud upon the court and that the party seeking modification, 
433.7   when no longer precluded, promptly served a motion; 
433.8      (2) the party seeking modification was a recipient of 
433.9   federal Supplemental Security Income (SSI), Title II Older 
433.10  Americans, Survivor's Disability Insurance (OASDI), other 
433.11  disability benefits, or public assistance based upon need during 
433.12  the period for which retroactive modification is sought; or 
433.13     (3) the order for which the party seeks amendment was 
433.14  entered by default, the party shows good cause for not 
433.15  appearing, and the record contains no factual evidence, or 
433.16  clearly erroneous evidence regarding the individual obligor's 
433.17  ability to pay.  
433.18     The court may provide that a reduction in the amount 
433.19  allocated for child care expenses based on a substantial 
433.20  decrease in the expenses is effective as of the date the 
433.21  expenses decreased. 
433.22     (e) Except for an award of the right of occupancy of the 
433.23  homestead, provided in section 518.63, all divisions of real and 
433.24  personal property provided by section 518.58 shall be final, and 
433.25  may be revoked or modified only where the court finds the 
433.26  existence of conditions that justify reopening a judgment under 
433.27  the laws of this state, including motions under section 518.145, 
433.28  subdivision 2.  The court may impose a lien or charge on the 
433.29  divided property at any time while the property, or subsequently 
433.30  acquired property, is owned by the parties or either of them, 
433.31  for the payment of maintenance or support money, or may 
433.32  sequester the property as is provided by section 518.24. 
433.33     (f) The court need not hold an evidentiary hearing on a 
433.34  motion for modification of maintenance or support. 
433.35     (g) Section 518.14 shall govern the award of attorney fees 
433.36  for motions brought under this subdivision. 
434.1      Sec. 13.  Minnesota Statutes 1998, section 548.09, 
434.2   subdivision 1, is amended to read: 
434.3      Subdivision 1.  [ENTRY AND DOCKETING; SURVIVAL OF 
434.4   JUDGMENT.] Except as provided in section 548.091, every judgment 
434.5   requiring the payment of money shall be docketed entered by the 
434.6   court administrator upon its entry when ordered by the court and 
434.7   will be docketed by the court administrator upon the filing of 
434.8   an affidavit as provided in subdivision 2.  Upon a transcript of 
434.9   the docket being filed with the court administrator in any other 
434.10  county, the court administrator shall also docket it.  From the 
434.11  time of docketing the judgment is a lien, in the amount unpaid, 
434.12  upon all real property in the county then or thereafter owned by 
434.13  the judgment debtor, but it is not a lien upon registered land 
434.14  unless it is also filed pursuant to sections 508.63 and 
434.15  508A.63.  The judgment survives, and the lien continues, for ten 
434.16  years after its entry.  Child support judgments may be 
434.17  renewed by service of notice upon the debtor.  Service shall be 
434.18  by certified mail at the last known address of the debtor or in 
434.19  the manner provided for the service of civil process.  Upon the 
434.20  filing of the notice and proof of service the court 
434.21  administrator shall renew the judgment for child support without 
434.22  any additional filing fee pursuant to section 548.091. 
434.23     Sec. 14.  Minnesota Statutes 1998, section 548.091, 
434.24  subdivision 1, is amended to read: 
434.25     Subdivision 1.  [ENTRY AND DOCKETING OF MAINTENANCE 
434.26  JUDGMENT.] (a) A judgment for unpaid amounts under a judgment or 
434.27  decree of dissolution or legal separation that provides for 
434.28  installment or periodic payments of maintenance shall be entered 
434.29  and docketed by the court administrator only when ordered by the 
434.30  court or shall be entered and docketed by the court 
434.31  administrator when the following conditions are met:  
434.32     (a) (1) the obligee determines that the obligor is at least 
434.33  30 days in arrears; 
434.34     (b) (2) the obligee serves a copy of an affidavit of 
434.35  default and notice of intent to enter and docket judgment on the 
434.36  obligor by first class mail at the obligor's last known post 
435.1   office address.  Service shall be deemed complete upon mailing 
435.2   in the manner designated.  The affidavit shall state the full 
435.3   name, occupation, place of residence, and last known post office 
435.4   address of the obligor, the name and post office address of the 
435.5   obligee, the date of the first unpaid amount, the date of the 
435.6   last unpaid amount, and the total amount unpaid; 
435.7      (c) (3) the obligor fails within 20 days after mailing of 
435.8   the notice either to pay all unpaid amounts or to request a 
435.9   hearing on the issue of whether arrears claimed owing have been 
435.10  paid and to seek, ex parte, a stay of entry of judgment; and 
435.11     (d) (4) not less than 20 days after service on the obligor 
435.12  in the manner provided, the obligee files with the court 
435.13  administrator the affidavit of default together with proof of 
435.14  service and, if payments have been received by the obligee since 
435.15  execution of the affidavit of default, a supplemental affidavit 
435.16  setting forth the amount of payment received and the amount for 
435.17  which judgment is to be entered and docketed. 
435.18     (b) A judgment entered and docketed under this subdivision 
435.19  has the same effect and is subject to the same procedures, 
435.20  defenses, and proceedings as any other judgment in district 
435.21  court, and may be enforced or satisfied in the same manner as 
435.22  judgments under section 548.09. 
435.23     (c) An obligor whose property is subject to the lien of a 
435.24  judgment for installment of periodic payments of maintenance 
435.25  under section 548.09, and who claims that no amount of 
435.26  maintenance is in arrears, may move the court ex parte for an 
435.27  order directing the court administrator to vacate the lien of 
435.28  the judgment on the docket and register of the action where it 
435.29  was entered.  The obligor shall file with the motion an 
435.30  affidavit stating: 
435.31     (1) the lien attached upon the docketing of a judgment or 
435.32  decree of dissolution or separate maintenance; 
435.33     (2) the docket was made while no installment or periodic 
435.34  payment of maintenance was unpaid or overdue; and 
435.35     (3) no installment or periodic payment of maintenance that 
435.36  was due prior to the filing of the motion remains unpaid or 
436.1   overdue. 
436.2      The court shall grant the obligor's motion as soon as 
436.3   possible if the pleadings and affidavit show that there is and 
436.4   has been no default.  
436.5      Sec. 15.  Minnesota Statutes 1998, section 548.091, 
436.6   subdivision 1a, is amended to read: 
436.7      Subd. 1a.  [CHILD SUPPORT JUDGMENT BY OPERATION OF LAW.] 
436.8   (a) Any payment or installment of support required by a judgment 
436.9   or decree of dissolution or legal separation, determination of 
436.10  parentage, an order under chapter 518C, an order under section 
436.11  256.87, or an order under section 260.251, that is not paid or 
436.12  withheld from the obligor's income as required under section 
436.13  518.6111, or which is ordered as child support by judgment, 
436.14  decree, or order by a court in any other state, is a judgment by 
436.15  operation of law on and after the date it is due and, is 
436.16  entitled to full faith and credit in this state and any other 
436.17  state, and shall be entered and docketed by the court 
436.18  administrator on the filing of affidavits as provided in 
436.19  subdivision 2a.  Except as otherwise provided by paragraph (b), 
436.20  interest accrues from the date the unpaid amount due is greater 
436.21  than the current support due at the annual rate provided in 
436.22  section 549.09, subdivision 1, plus two percent, not to exceed 
436.23  an annual rate of 18 percent.  A payment or installment of 
436.24  support that becomes a judgment by operation of law between the 
436.25  date on which a party served notice of a motion for modification 
436.26  under section 518.64, subdivision 2, and the date of the court's 
436.27  order on modification may be modified under that subdivision. 
436.28     (b) Notwithstanding the provisions of section 549.09, upon 
436.29  motion to the court and upon proof by the obligor of 36 
436.30  consecutive months of complete and timely payments of both 
436.31  current support and court-ordered paybacks of a child support 
436.32  debt or arrearage, the court may order interest on the remaining 
436.33  debt or arrearage to stop accruing.  Timely payments are those 
436.34  made in the month in which they are due.  If, after that time, 
436.35  the obligor fails to make complete and timely payments of both 
436.36  current support and court-ordered paybacks of child support debt 
437.1   or arrearage, the public authority or the obligee may move the 
437.2   court for the reinstatement of interest as of the month in which 
437.3   the obligor ceased making complete and timely payments. 
437.4      The court shall provide copies of all orders issued under 
437.5   this section to the public authority.  The commissioner of human 
437.6   services shall prepare and make available to the court and the 
437.7   parties forms to be submitted by the parties in support of a 
437.8   motion under this paragraph. 
437.9      (c) Notwithstanding the provisions of section 549.09, upon 
437.10  motion to the court, the court may order interest on a child 
437.11  support debt to stop accruing where the court finds that the 
437.12  obligor is: 
437.13     (1) unable to pay support because of a significant physical 
437.14  or mental disability; or 
437.15     (2) a recipient of Supplemental Security Income (SSI), 
437.16  Title II Older Americans Survivor's Disability Insurance 
437.17  (OASDI), other disability benefits, or public assistance based 
437.18  upon need. 
437.19     Sec. 16.  Minnesota Statutes 1998, section 548.091, 
437.20  subdivision 2a, is amended to read: 
437.21     Subd. 2a.  [ENTRY AND DOCKETING OF CHILD SUPPORT 
437.22  JUDGMENT.] (a) On or after the date an unpaid amount becomes a 
437.23  judgment by operation of law under subdivision 1a, the obligee 
437.24  or the public authority may file with the court administrator, 
437.25  either electronically or by other means: 
437.26     (1) a statement identifying, or a copy of, the judgment or 
437.27  decree of dissolution or legal separation, determination of 
437.28  parentage, order under chapter 518B or 518C, an order under 
437.29  section 256.87, an order under section 260.251, or judgment, 
437.30  decree, or order for child support by a court in any other 
437.31  state, which provides for periodic installments of child 
437.32  support, or a judgment or notice of attorney fees and collection 
437.33  costs under section 518.14, subdivision 2; 
437.34     (2) an affidavit of default.  The affidavit of default must 
437.35  state the full name, occupation, place of residence, and last 
437.36  known post office address of the obligor, the name and post 
438.1   office address of the obligee, the date or dates payment was due 
438.2   and not received and judgment was obtained by operation of law, 
438.3   the total amount of the judgments to the date of filing, and the 
438.4   amount and frequency of the periodic installments of child 
438.5   support that will continue to become due and payable subsequent 
438.6   to the date of filing be entered and docketed; and 
438.7      (3) an affidavit of service of a notice of intent to enter 
438.8   and docket judgment and to recover attorney fees and collection 
438.9   costs on the obligor, in person or by first class mail at the 
438.10  obligor's last known post office address.  Service is completed 
438.11  upon mailing in the manner designated.  Where applicable, a 
438.12  notice of interstate lien in the form promulgated under United 
438.13  States Code, title 42, section 652(a), is sufficient to satisfy 
438.14  the requirements of clauses (1) and (2). 
438.15     (b) A judgment entered and docketed under this subdivision 
438.16  has the same effect and is subject to the same procedures, 
438.17  defenses, and proceedings as any other judgment in district 
438.18  court, and may be enforced or satisfied in the same manner as 
438.19  judgments under section 548.09, except as otherwise provided. 
438.20     Sec. 17.  Minnesota Statutes 1998, section 548.091, 
438.21  subdivision 3a, is amended to read: 
438.22     Subd. 3a.  [ENTRY, DOCKETING, AND SURVIVAL OF CHILD SUPPORT 
438.23  JUDGMENT.] Upon receipt of the documents filed under subdivision 
438.24  2a, the court administrator shall enter and docket the judgment 
438.25  in the amount of the unpaid obligation identified in the 
438.26  affidavit of default. and note the amount and frequency of the 
438.27  periodic installments of child support that will continue to 
438.28  become due and payable after the date of docketing.  From the 
438.29  time of docketing, the judgment is a lien upon all the real 
438.30  property in the county owned by the judgment debtor, but it is 
438.31  not a lien on registered land unless the obligee or the public 
438.32  authority causes a notice of judgment lien or certified copy of 
438.33  the judgment to be memorialized on the certificate of title or 
438.34  certificate of possessory title under section 508.63 or 
438.35  508A.63.  The judgment survives and the lien continues for ten 
438.36  years after the date the judgment was docketed.  
439.1      Subd. 3b.  [CHILD SUPPORT JUDGMENT ADMINISTRATIVE 
439.2   RENEWALS.] Child support judgments may be renewed by service of 
439.3   notice upon the debtor.  Service shall must be by certified 
439.4   first class mail at the last known address of the debtor, with 
439.5   service deemed complete upon mailing in the manner designated, 
439.6   or in the manner provided for the service of civil process.  
439.7   Upon the filing of the notice and proof of service, the court 
439.8   administrator shall administratively renew the judgment for 
439.9   child support without any additional filing fee in the same 
439.10  court file as the original child support judgment.  The judgment 
439.11  must be renewed in an amount equal to the unpaid principle plus 
439.12  the accrued unpaid interest.  Child support judgments may be 
439.13  renewed multiple times until paid. 
439.14     Sec. 18.  Minnesota Statutes 1998, section 548.091, 
439.15  subdivision 4, is amended to read: 
439.16     Subd. 4.  [CHILD SUPPORT HEARING.] A child support obligor 
439.17  may request a hearing under the rules of civil procedure on the 
439.18  issue of whether the judgment amount or amounts have been paid 
439.19  and may move the court for an order directing the court 
439.20  administrator to vacate or modify the judgment or judgments on 
439.21  the docket and register in any county or other jurisdiction in 
439.22  which judgment or judgments were entered pursuant to this action.
439.23     The court shall grant the obligor's motion if it determines 
439.24  that there is no default. 
439.25     Sec. 19.  Minnesota Statutes 1998, section 548.091, is 
439.26  amended by adding a subdivision to read: 
439.27     Subd. 5a.  [ADDITIONAL CHILD SUPPORT JUDGMENTS.] As child 
439.28  support payments continue to become due and are unpaid, 
439.29  additional judgments may be entered and docketed by following 
439.30  the procedures in subdivision 1a.  Each judgment entered and 
439.31  docketed for unpaid child support payments must be treated as a 
439.32  distinct judgment for purposes of enforcement and satisfaction. 
439.33     Sec. 20.  Minnesota Statutes 1998, section 548.091, 
439.34  subdivision 10, is amended to read: 
439.35     Subd. 10.  [RELEASE OF LIEN.] Upon payment of the amount 
439.36  due under subdivision 5, the public authority shall execute and 
440.1   deliver a satisfaction of the judgment lien within five business 
440.2   days. 
440.3      Sec. 21.  Minnesota Statutes 1998, section 548.091, 
440.4   subdivision 11, is amended to read: 
440.5      Subd. 11.  [SPECIAL PROCEDURES.] The public authority shall 
440.6   negotiate a release of lien on specific property for less than 
440.7   the full amount due where the proceeds of a sale or financing, 
440.8   less reasonable and necessary closing expenses, are not 
440.9   sufficient to satisfy all encumbrances on the liened property.  
440.10  Partial releases do not release the obligor's personal liability 
440.11  for the amount unpaid.  A partial satisfaction for the amount 
440.12  received must be filed with the court administrator. 
440.13     Sec. 22.  Minnesota Statutes 1998, section 548.091, 
440.14  subdivision 12, is amended to read: 
440.15     Subd. 12.  [CORRECTING ERRORS.] The public authority shall 
440.16  maintain a process to review the identity of the obligor and to 
440.17  issue releases of lien in cases of misidentification.  The 
440.18  public authority shall maintain a process to review the amount 
440.19  of child support determined to be delinquent and to issue 
440.20  amended notices of judgment lien in cases of incorrectly 
440.21  docketed judgments arising by operation of law.  The public 
440.22  authority may move the court for an order to amend the judgment 
440.23  when the amount of judgment entered and docketed is incorrect. 
440.24     Sec. 23.  Minnesota Statutes 1998, section 552.05, 
440.25  subdivision 10, is amended to read: 
440.26     Subd. 10.  [FORMS.] The commissioner of human services 
440.27  shall develop statutory forms for use as required under this 
440.28  chapter.  In developing these forms, the commissioner shall 
440.29  consult with the attorney general, representatives of financial 
440.30  institutions, and legal services.  The commissioner shall report 
440.31  back to the legislature by February 1, 1998, with recommended 
440.32  forms to be included in this chapter.  The supreme court is 
440.33  requested to develop forms for use in proceedings under this 
440.34  chapter.  
440.35     Sec. 24.  Laws 1995, chapter 257, article 1, section 35, 
440.36  subdivision 1, is amended to read: 
441.1      Subdivision 1.  [CHILD SUPPORT ASSURANCE.] The commissioner 
441.2   of human services shall seek a waiver from the secretary of the 
441.3   United States Department of Health and Human Services to enable 
441.4   the department of human services to operate a demonstration 
441.5   project of child support assurance.  The commissioner shall seek 
441.6   authority from the legislature to implement a demonstration 
441.7   project of child support assurance when enhanced federal funds 
441.8   become available for this purpose.  The department of human 
441.9   services shall continue to plan a demonstration project of child 
441.10  support assurance by administering the grant awarded under the 
441.11  federal program entitled "Developing a Plan for a Child Support 
441.12  Assurance Program."  
441.13     Sec. 25.  [REPEALER.] 
441.14     Minnesota Statutes 1998, section 548.091, subdivisions 3, 
441.15  5, and 6, are repealed. 
441.16                             ARTICLE 8 
441.17                         HEALTH OCCUPATIONS
441.18     Section 1.  [144E.37] [COMPREHENSIVE ADVANCED LIFE 
441.19  SUPPORT.] 
441.20     The board shall establish a comprehensive advanced life 
441.21  support educational program to train rural medical personnel, 
441.22  including physicians, physician assistants, nurses, and allied 
441.23  health care providers, in a team approach to anticipate, 
441.24  recognize, and treat life-threatening emergencies before serious 
441.25  injury or cardiac arrest occurs. 
441.26                             ARTICLE 9 
441.27                          CHILD PROTECTION
441.28     Section 1.  Minnesota Statutes 1998, section 256.01, 
441.29  subdivision 2, is amended to read: 
441.30     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
441.31  section 241.021, subdivision 2, the commissioner of human 
441.32  services shall: 
441.33     (1) Administer and supervise all forms of public assistance 
441.34  provided for by state law and other welfare activities or 
441.35  services as are vested in the commissioner.  Administration and 
441.36  supervision of human services activities or services includes, 
442.1   but is not limited to, assuring timely and accurate distribution 
442.2   of benefits, completeness of service, and quality program 
442.3   management.  In addition to administering and supervising human 
442.4   services activities vested by law in the department, the 
442.5   commissioner shall have the authority to: 
442.6      (a) require county agency participation in training and 
442.7   technical assistance programs to promote compliance with 
442.8   statutes, rules, federal laws, regulations, and policies 
442.9   governing human services; 
442.10     (b) monitor, on an ongoing basis, the performance of county 
442.11  agencies in the operation and administration of human services, 
442.12  enforce compliance with statutes, rules, federal laws, 
442.13  regulations, and policies governing welfare services and promote 
442.14  excellence of administration and program operation; 
442.15     (c) develop a quality control program or other monitoring 
442.16  program to review county performance and accuracy of benefit 
442.17  determinations; 
442.18     (d) require county agencies to make an adjustment to the 
442.19  public assistance benefits issued to any individual consistent 
442.20  with federal law and regulation and state law and rule and to 
442.21  issue or recover benefits as appropriate; 
442.22     (e) delay or deny payment of all or part of the state and 
442.23  federal share of benefits and administrative reimbursement 
442.24  according to the procedures set forth in section 256.017; 
442.25     (f) make contracts with and grants to public and private 
442.26  agencies and organizations, both profit and nonprofit, and 
442.27  individuals, using appropriated funds; and 
442.28     (g) enter into contractual agreements with federally 
442.29  recognized Indian tribes with a reservation in Minnesota to the 
442.30  extent necessary for the tribe to operate a federally approved 
442.31  family assistance program or any other program under the 
442.32  supervision of the commissioner.  The commissioner shall consult 
442.33  with the affected county or counties in the contractual 
442.34  agreement negotiations, if the county or counties wish to be 
442.35  included, in order to avoid the duplication of county and tribal 
442.36  assistance program services.  The commissioner may establish 
443.1   necessary accounts for the purposes of receiving and disbursing 
443.2   funds as necessary for the operation of the programs. 
443.3      (2) Inform county agencies, on a timely basis, of changes 
443.4   in statute, rule, federal law, regulation, and policy necessary 
443.5   to county agency administration of the programs. 
443.6      (3) Administer and supervise all child welfare activities; 
443.7   promote the enforcement of laws protecting handicapped, 
443.8   dependent, neglected and delinquent children, and children born 
443.9   to mothers who were not married to the children's fathers at the 
443.10  times of the conception nor at the births of the children; 
443.11  license and supervise child-caring and child-placing agencies 
443.12  and institutions; supervise the care of children in boarding and 
443.13  foster homes or in private institutions; and generally perform 
443.14  all functions relating to the field of child welfare now vested 
443.15  in the state board of control. 
443.16     (4) Administer and supervise all noninstitutional service 
443.17  to handicapped persons, including those who are visually 
443.18  impaired, hearing impaired, or physically impaired or otherwise 
443.19  handicapped.  The commissioner may provide and contract for the 
443.20  care and treatment of qualified indigent children in facilities 
443.21  other than those located and available at state hospitals when 
443.22  it is not feasible to provide the service in state hospitals. 
443.23     (5) Assist and actively cooperate with other departments, 
443.24  agencies and institutions, local, state, and federal, by 
443.25  performing services in conformity with the purposes of Laws 
443.26  1939, chapter 431. 
443.27     (6) Act as the agent of and cooperate with the federal 
443.28  government in matters of mutual concern relative to and in 
443.29  conformity with the provisions of Laws 1939, chapter 431, 
443.30  including the administration of any federal funds granted to the 
443.31  state to aid in the performance of any functions of the 
443.32  commissioner as specified in Laws 1939, chapter 431, and 
443.33  including the promulgation of rules making uniformly available 
443.34  medical care benefits to all recipients of public assistance, at 
443.35  such times as the federal government increases its participation 
443.36  in assistance expenditures for medical care to recipients of 
444.1   public assistance, the cost thereof to be borne in the same 
444.2   proportion as are grants of aid to said recipients. 
444.3      (7) Establish and maintain any administrative units 
444.4   reasonably necessary for the performance of administrative 
444.5   functions common to all divisions of the department. 
444.6      (8) Act as designated guardian of both the estate and the 
444.7   person of all the wards of the state of Minnesota, whether by 
444.8   operation of law or by an order of court, without any further 
444.9   act or proceeding whatever, except as to persons committed as 
444.10  mentally retarded.  For children under the guardianship of the 
444.11  commissioner whose interests would be best served by adoptive 
444.12  placement, the commissioner may contract with a licensed 
444.13  child-placing agency to provide adoption services.  A contract 
444.14  with a licensed child-placing agency must be designed to 
444.15  supplement existing county efforts and may not replace existing 
444.16  county programs, unless the replacement is agreed to by the 
444.17  county board and the appropriate exclusive bargaining 
444.18  representative or the commissioner has evidence that child 
444.19  placements of the county continue to be substantially below that 
444.20  of other counties.  Funds encumbered and obligated under an 
444.21  agreement for a specific child shall remain available until the 
444.22  terms of the agreement are fulfilled or the agreement is 
444.23  terminated. 
444.24     (9) Act as coordinating referral and informational center 
444.25  on requests for service for newly arrived immigrants coming to 
444.26  Minnesota. 
444.27     (10) The specific enumeration of powers and duties as 
444.28  hereinabove set forth shall in no way be construed to be a 
444.29  limitation upon the general transfer of powers herein contained. 
444.30     (11) Establish county, regional, or statewide schedules of 
444.31  maximum fees and charges which may be paid by county agencies 
444.32  for medical, dental, surgical, hospital, nursing and nursing 
444.33  home care and medicine and medical supplies under all programs 
444.34  of medical care provided by the state and for congregate living 
444.35  care under the income maintenance programs. 
444.36     (12) Have the authority to conduct and administer 
445.1   experimental projects to test methods and procedures of 
445.2   administering assistance and services to recipients or potential 
445.3   recipients of public welfare.  To carry out such experimental 
445.4   projects, it is further provided that the commissioner of human 
445.5   services is authorized to waive the enforcement of existing 
445.6   specific statutory program requirements, rules, and standards in 
445.7   one or more counties.  The order establishing the waiver shall 
445.8   provide alternative methods and procedures of administration, 
445.9   shall not be in conflict with the basic purposes, coverage, or 
445.10  benefits provided by law, and in no event shall the duration of 
445.11  a project exceed four years.  It is further provided that no 
445.12  order establishing an experimental project as authorized by the 
445.13  provisions of this section shall become effective until the 
445.14  following conditions have been met: 
445.15     (a) The secretary of health, education, and welfare of the 
445.16  United States has agreed, for the same project, to waive state 
445.17  plan requirements relative to statewide uniformity. 
445.18     (b) A comprehensive plan, including estimated project 
445.19  costs, shall be approved by the legislative advisory commission 
445.20  and filed with the commissioner of administration.  
445.21     (13) According to federal requirements, establish 
445.22  procedures to be followed by local welfare boards in creating 
445.23  citizen advisory committees, including procedures for selection 
445.24  of committee members. 
445.25     (14) Allocate federal fiscal disallowances or sanctions 
445.26  which are based on quality control error rates for the aid to 
445.27  families with dependent children, Minnesota family investment 
445.28  program-statewide, medical assistance, or food stamp program in 
445.29  the following manner:  
445.30     (a) One-half of the total amount of the disallowance shall 
445.31  be borne by the county boards responsible for administering the 
445.32  programs.  For the medical assistance, MFIP-S, and AFDC 
445.33  programs, disallowances shall be shared by each county board in 
445.34  the same proportion as that county's expenditures for the 
445.35  sanctioned program are to the total of all counties' 
445.36  expenditures for the AFDC, MFIP-S, and medical assistance 
446.1   programs.  For the food stamp program, sanctions shall be shared 
446.2   by each county board, with 50 percent of the sanction being 
446.3   distributed to each county in the same proportion as that 
446.4   county's administrative costs for food stamps are to the total 
446.5   of all food stamp administrative costs for all counties, and 50 
446.6   percent of the sanctions being distributed to each county in the 
446.7   same proportion as that county's value of food stamp benefits 
446.8   issued are to the total of all benefits issued for all 
446.9   counties.  Each county shall pay its share of the disallowance 
446.10  to the state of Minnesota.  When a county fails to pay the 
446.11  amount due hereunder, the commissioner may deduct the amount 
446.12  from reimbursement otherwise due the county, or the attorney 
446.13  general, upon the request of the commissioner, may institute 
446.14  civil action to recover the amount due. 
446.15     (b) Notwithstanding the provisions of paragraph (a), if the 
446.16  disallowance results from knowing noncompliance by one or more 
446.17  counties with a specific program instruction, and that knowing 
446.18  noncompliance is a matter of official county board record, the 
446.19  commissioner may require payment or recover from the county or 
446.20  counties, in the manner prescribed in paragraph (a), an amount 
446.21  equal to the portion of the total disallowance which resulted 
446.22  from the noncompliance, and may distribute the balance of the 
446.23  disallowance according to paragraph (a).  
446.24     (15) Develop and implement special projects that maximize 
446.25  reimbursements and result in the recovery of money to the 
446.26  state.  For the purpose of recovering state money, the 
446.27  commissioner may enter into contracts with third parties.  Any 
446.28  recoveries that result from projects or contracts entered into 
446.29  under this paragraph shall be deposited in the state treasury 
446.30  and credited to a special account until the balance in the 
446.31  account reaches $1,000,000.  When the balance in the account 
446.32  exceeds $1,000,000, the excess shall be transferred and credited 
446.33  to the general fund.  All money in the account is appropriated 
446.34  to the commissioner for the purposes of this paragraph. 
446.35     (16) Have the authority to make direct payments to 
446.36  facilities providing shelter to women and their children 
447.1   according to section 256D.05, subdivision 3.  Upon the written 
447.2   request of a shelter facility that has been denied payments 
447.3   under section 256D.05, subdivision 3, the commissioner shall 
447.4   review all relevant evidence and make a determination within 30 
447.5   days of the request for review regarding issuance of direct 
447.6   payments to the shelter facility.  Failure to act within 30 days 
447.7   shall be considered a determination not to issue direct payments.
447.8      (17) Have the authority to establish and enforce the 
447.9   following county reporting requirements:  
447.10     (a) The commissioner shall establish fiscal and statistical 
447.11  reporting requirements necessary to account for the expenditure 
447.12  of funds allocated to counties for human services programs.  
447.13  When establishing financial and statistical reporting 
447.14  requirements, the commissioner shall evaluate all reports, in 
447.15  consultation with the counties, to determine if the reports can 
447.16  be simplified or the number of reports can be reduced. 
447.17     (b) The county board shall submit monthly or quarterly 
447.18  reports to the department as required by the commissioner.  
447.19  Monthly reports are due no later than 15 working days after the 
447.20  end of the month.  Quarterly reports are due no later than 30 
447.21  calendar days after the end of the quarter, unless the 
447.22  commissioner determines that the deadline must be shortened to 
447.23  20 calendar days to avoid jeopardizing compliance with federal 
447.24  deadlines or risking a loss of federal funding.  Only reports 
447.25  that are complete, legible, and in the required format shall be 
447.26  accepted by the commissioner.  
447.27     (c) If the required reports are not received by the 
447.28  deadlines established in clause (b), the commissioner may delay 
447.29  payments and withhold funds from the county board until the next 
447.30  reporting period.  When the report is needed to account for the 
447.31  use of federal funds and the late report results in a reduction 
447.32  in federal funding, the commissioner shall withhold from the 
447.33  county boards with late reports an amount equal to the reduction 
447.34  in federal funding until full federal funding is received.  
447.35     (d) A county board that submits reports that are late, 
447.36  illegible, incomplete, or not in the required format for two out 
448.1   of three consecutive reporting periods is considered 
448.2   noncompliant.  When a county board is found to be noncompliant, 
448.3   the commissioner shall notify the county board of the reason the 
448.4   county board is considered noncompliant and request that the 
448.5   county board develop a corrective action plan stating how the 
448.6   county board plans to correct the problem.  The corrective 
448.7   action plan must be submitted to the commissioner within 45 days 
448.8   after the date the county board received notice of noncompliance.
448.9      (e) The final deadline for fiscal reports or amendments to 
448.10  fiscal reports is one year after the date the report was 
448.11  originally due.  If the commissioner does not receive a report 
448.12  by the final deadline, the county board forfeits the funding 
448.13  associated with the report for that reporting period and the 
448.14  county board must repay any funds associated with the report 
448.15  received for that reporting period. 
448.16     (f) The commissioner may not delay payments, withhold 
448.17  funds, or require repayment under paragraph (c) or (e) if the 
448.18  county demonstrates that the commissioner failed to provide 
448.19  appropriate forms, guidelines, and technical assistance to 
448.20  enable the county to comply with the requirements.  If the 
448.21  county board disagrees with an action taken by the commissioner 
448.22  under paragraph (c) or (e), the county board may appeal the 
448.23  action according to sections 14.57 to 14.69. 
448.24     (g) Counties subject to withholding of funds under 
448.25  paragraph (c) or forfeiture or repayment of funds under 
448.26  paragraph (e) shall not reduce or withhold benefits or services 
448.27  to clients to cover costs incurred due to actions taken by the 
448.28  commissioner under paragraph (c) or (e). 
448.29     (18) Allocate federal fiscal disallowances or sanctions for 
448.30  audit exceptions when federal fiscal disallowances or sanctions 
448.31  are based on a statewide random sample for the foster care 
448.32  program under title IV-E of the Social Security Act, United 
448.33  States Code, title 42, in direct proportion to each county's 
448.34  title IV-E foster care maintenance claim for that period. 
448.35     (19) Be responsible for ensuring the detection, prevention, 
448.36  investigation, and resolution of fraudulent activities or 
449.1   behavior by applicants, recipients, and other participants in 
449.2   the human services programs administered by the department. 
449.3      (20) Require county agencies to identify overpayments, 
449.4   establish claims, and utilize all available and cost-beneficial 
449.5   methodologies to collect and recover these overpayments in the 
449.6   human services programs administered by the department. 
449.7      (21) Have the authority to administer a drug rebate program 
449.8   for drugs purchased pursuant to the senior citizen drug program 
449.9   established under section 256.955 after the beneficiary's 
449.10  satisfaction of any deductible established in the program.  The 
449.11  commissioner shall require a rebate agreement from all 
449.12  manufacturers of covered drugs as defined in section 256B.0625, 
449.13  subdivision 13.  For each drug, the amount of the rebate shall 
449.14  be equal to the basic rebate as defined for purposes of the 
449.15  federal rebate program in United States Code, title 42, section 
449.16  1396r-8(c)(1).  This basic rebate shall be applied to 
449.17  single-source and multiple-source drugs.  The manufacturers must 
449.18  provide full payment within 30 days of receipt of the state 
449.19  invoice for the rebate within the terms and conditions used for 
449.20  the federal rebate program established pursuant to section 1927 
449.21  of title XIX of the Social Security Act.  The manufacturers must 
449.22  provide the commissioner with any information necessary to 
449.23  verify the rebate determined per drug.  The rebate program shall 
449.24  utilize the terms and conditions used for the federal rebate 
449.25  program established pursuant to section 1927 of title XIX of the 
449.26  Social Security Act. 
449.27     Sec. 2.  Minnesota Statutes 1998, section 256B.094, 
449.28  subdivision 3, is amended to read: 
449.29     Subd. 3.  [COORDINATION AND PROVISION OF SERVICES.] (a) In 
449.30  a county or reservation where a prepaid medical assistance 
449.31  provider has contracted under section 256B.031 or 256B.69 to 
449.32  provide mental health services, the case management provider 
449.33  shall coordinate with the prepaid provider to ensure that all 
449.34  necessary mental health services required under the contract are 
449.35  provided to recipients of case management services. 
449.36     (b) When the case management provider determines that a 
450.1   prepaid provider is not providing mental health services as 
450.2   required under the contract, the case management provider shall 
450.3   assist the recipient to appeal the prepaid provider's denial 
450.4   pursuant to section 256.045, and may make other arrangements for 
450.5   provision of the covered services.  
450.6      (c) The case management provider may bill the provider of 
450.7   prepaid health care services for any mental health services 
450.8   provided to a recipient of case management services which the 
450.9   county or tribal social services arranges for or provides and 
450.10  which are included in the prepaid provider's contract, and which 
450.11  were determined to be medically necessary as a result of an 
450.12  appeal pursuant to section 256.045.  The prepaid provider must 
450.13  reimburse the mental health provider, at the prepaid provider's 
450.14  standard rate for that service, for any services delivered under 
450.15  this subdivision. 
450.16     (d) If the county or tribal social services has not 
450.17  obtained prior authorization for this service, or an appeal 
450.18  results in a determination that the services were not medically 
450.19  necessary, the county or tribal social services may not seek 
450.20  reimbursement from the prepaid provider. 
450.21     Sec. 3.  Minnesota Statutes 1998, section 256B.094, 
450.22  subdivision 5, is amended to read: 
450.23     Subd. 5.  [CASE MANAGER.] To provide case management 
450.24  services, a case manager must be employed or contracted by and 
450.25  authorized by the case management provider to provide case 
450.26  management services and meet all requirements under section 
450.27  256F.10. 
450.28     Sec. 4.  Minnesota Statutes 1998, section 256B.094, 
450.29  subdivision 6, is amended to read: 
450.30     Subd. 6.  [MEDICAL ASSISTANCE REIMBURSEMENT OF CASE 
450.31  MANAGEMENT SERVICES.] (a) Medical assistance reimbursement for 
450.32  services under this section shall be made on a monthly basis.  
450.33  Payment is based on face-to-face or telephone contacts between 
450.34  the case manager and the client, client's family, primary 
450.35  caregiver, legal representative, or other relevant person 
450.36  identified as necessary to the development or implementation of 
451.1   the goals of the individual service plan regarding the status of 
451.2   the client, the individual service plan, or the goals for the 
451.3   client.  These contacts must meet the minimum standards in 
451.4   clauses (1) and (2):  
451.5      (1) there must be a face-to-face contact at least once a 
451.6   month except as provided in clause (2); and 
451.7      (2) for a client placed outside of the county of financial 
451.8   responsibility in an excluded time facility under section 
451.9   256G.02, subdivision 6, or through the Interstate Compact on the 
451.10  Placement of Children, section 257.40, and the placement in 
451.11  either case is more than 60 miles beyond the county boundaries, 
451.12  there must be at least one contact per month and not more than 
451.13  two consecutive months without a face-to-face contact. 
451.14     (b) Except as provided under paragraph (c), the payment 
451.15  rate is established using time study data on activities of 
451.16  provider service staff and reports required under sections 
451.17  245.482, 256.01, subdivision 2, paragraph (17), and 256E.08, 
451.18  subdivision 8. 
451.19     (c) Payments for tribes may be made according to section 
451.20  256B.0625 for child welfare targeted case management provided by 
451.21  Indian health services and facilities operated by a tribe or 
451.22  tribal organization. 
451.23     (d) Payment for case management provided by county or 
451.24  tribal social services contracted vendors shall be based on a 
451.25  monthly rate negotiated by the host county or tribal social 
451.26  services.  The negotiated rate must not exceed the rate charged 
451.27  by the vendor for the same service to other payers.  If the 
451.28  service is provided by a team of contracted vendors, the county 
451.29  or tribal social services may negotiate a team rate with a 
451.30  vendor who is a member of the team.  The team shall determine 
451.31  how to distribute the rate among its members.  No reimbursement 
451.32  received by contracted vendors shall be returned to the county 
451.33  or tribal social services, except to reimburse the county or 
451.34  tribal social services for advance funding provided by the 
451.35  county or tribal social services to the vendor. 
451.36     (e) If the service is provided by a team that includes 
452.1   contracted vendors and county or tribal social services staff, 
452.2   the costs for county or tribal social services staff 
452.3   participation in the team shall be included in the rate for 
452.4   county or tribal social services provided services.  In this 
452.5   case, the contracted vendor and the county or tribal social 
452.6   services may each receive separate payment for services provided 
452.7   by each entity in the same month.  To prevent duplication of 
452.8   services, each entity must document, in the recipient's file, 
452.9   the need for team case management and a description of the roles 
452.10  and services of the team members. 
452.11     Separate payment rates may be established for different 
452.12  groups of providers to maximize reimbursement as determined by 
452.13  the commissioner.  The payment rate will be reviewed annually 
452.14  and revised periodically to be consistent with the most recent 
452.15  time study and other data.  Payment for services will be made 
452.16  upon submission of a valid claim and verification of proper 
452.17  documentation described in subdivision 7.  Federal 
452.18  administrative revenue earned through the time study, or under 
452.19  paragraph (c), shall be distributed according to earnings, to 
452.20  counties, reservations, or groups of counties or reservations 
452.21  which have the same payment rate under this subdivision, and to 
452.22  the group of counties or reservations which are not certified 
452.23  providers under section 256F.10.  The commissioner shall modify 
452.24  the requirements set out in Minnesota Rules, parts 9550.0300 to 
452.25  9550.0370, as necessary to accomplish this. 
452.26     Sec. 5.  Minnesota Statutes 1998, section 256F.03, 
452.27  subdivision 5, is amended to read: 
452.28     Subd. 5.  [FAMILY-BASED SERVICES.] "Family-based services" 
452.29  means one or more of the services described in paragraphs (a) 
452.30  to (f) (e) provided to families primarily in their own home for 
452.31  a limited time.  
452.32     (a)  [CRISIS SERVICES.] "Crisis services" means 
452.33  professional services provided within 24 hours of referral to 
452.34  alleviate a family crisis and to offer an alternative to placing 
452.35  a child outside the family home.  The services are intensive and 
452.36  time limited.  The service may offer transition to other 
453.1   appropriate community-based services. 
453.2      (b)  [COUNSELING SERVICES.] "Counseling services" means 
453.3   professional family counseling provided to alleviate individual 
453.4   and family dysfunction; provide an alternative to placing a 
453.5   child outside the family home; or permit a child to return 
453.6   home.  The duration, frequency, and intensity of the service is 
453.7   determined in the individual or family service plan. 
453.8      (c)  [LIFE MANAGEMENT SKILLS SERVICES.] "Life management 
453.9   skills services" means paraprofessional services that teach 
453.10  family members skills in such areas as parenting, budgeting, 
453.11  home management, and communication.  The goal is to strengthen 
453.12  family skills as an alternative to placing a child outside the 
453.13  family home or to permit a child to return home.  A social 
453.14  worker shall coordinate these services within the family case 
453.15  plan. 
453.16     (d)  [CASE COORDINATION SERVICES.] "Case coordination 
453.17  services" means professional services provided to an individual, 
453.18  family, or caretaker as an alternative to placing a child 
453.19  outside the family home, to permit a child to return home, or to 
453.20  stabilize the long-term or permanent placement of a child.  
453.21  Coordinated services are provided directly, are arranged, or are 
453.22  monitored to meet the needs of a child and family.  The 
453.23  duration, frequency, and intensity of services is determined in 
453.24  the individual or family service plan. 
453.25     (e)  [MENTAL HEALTH SERVICES.] "Mental health services" 
453.26  means the professional services defined in section 245.4871, 
453.27  subdivision 31. 
453.28     (f) (e)  [EARLY INTERVENTION SERVICES.] "Early intervention 
453.29  services" means family-based intervention services designed to 
453.30  help at-risk families avoid crisis situations. 
453.31     Sec. 6.  Minnesota Statutes 1998, section 256F.05, 
453.32  subdivision 8, is amended to read: 
453.33     Subd. 8.  [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 
453.34  county which has not demonstrated that year that its family 
453.35  preservation core services are developed as provided in 
453.36  subdivision 1a, must use its family preservation fund grant 
454.1   exclusively for family preservation services defined in section 
454.2   256F.03, subdivision 5, paragraphs (a), (b), (c), and (e) (d). 
454.3      (b) A county which has demonstrated that year that its 
454.4   family preservation core services are developed becomes eligible 
454.5   either to continue using its family preservation fund grant as 
454.6   provided in paragraph (a), or to exercise the expanded service 
454.7   option under paragraph (c). 
454.8      (c) The expanded service option permits an eligible county 
454.9   to use its family preservation fund grant for child welfare 
454.10  preventive services.  For purposes of this section, child 
454.11  welfare preventive services are those services directed toward a 
454.12  specific child or family that further the goals of section 
454.13  256F.01 and include assessments, family preservation services, 
454.14  service coordination, community-based treatment, crisis nursery 
454.15  services when the parents retain custody and there is no 
454.16  voluntary placement agreement with a child-placing agency, 
454.17  respite care except when it is provided under a medical 
454.18  assistance waiver, home-based services, and other related 
454.19  services.  For purposes of this section, child welfare 
454.20  preventive services shall not include shelter care or other 
454.21  placement services under the authority of the court or public 
454.22  agency to address an emergency.  To exercise this option, an 
454.23  eligible county must notify the commissioner in writing of its 
454.24  intention to do so no later than 30 days into the quarter during 
454.25  which it intends to begin or select this option in its county 
454.26  plan, as provided in section 256F.04, subdivision 2.  Effective 
454.27  with the first day of that quarter the grant period in which 
454.28  this option is selected, the county must maintain its base level 
454.29  of expenditures for child welfare preventive services and use 
454.30  the family preservation fund to expand them.  The base level of 
454.31  expenditures for a county shall be that established under 
454.32  section 256F.10, subdivision 7.  For counties which have no such 
454.33  base established, a comparable base shall be established with 
454.34  the base year being the calendar year ending at least two 
454.35  calendar quarters before the first calendar quarter in which the 
454.36  county exercises its expanded service option.  The commissioner 
455.1   shall, at the request of the counties, reduce, suspend, or 
455.2   eliminate either or both of a county's obligations to continue 
455.3   the base level of expenditures and to expand child welfare 
455.4   preventive services under extraordinary circumstances.  
455.5      (d) Notwithstanding paragraph (a), a county that is 
455.6   participating in the child protection assessments or 
455.7   investigations community collaboration pilot program under 
455.8   section 626.5560, or in the concurrent permanency planning pilot 
455.9   program under section 257.0711, may use its family preservation 
455.10  fund grant for those programs. 
455.11     Sec. 7.  Minnesota Statutes 1998, section 256F.10, 
455.12  subdivision 1, is amended to read: 
455.13     Subdivision 1.  [ELIGIBILITY.] Persons under 21 years of 
455.14  age who are eligible to receive medical assistance are eligible 
455.15  for child welfare targeted case management services under 
455.16  section 256B.094 and this section if they have received an 
455.17  assessment and have been determined by the local county or 
455.18  tribal social services agency to be:  
455.19     (1) at risk of placement or in placement as described in 
455.20  section 257.071, subdivision 1; 
455.21     (2) at risk of maltreatment or experiencing maltreatment as 
455.22  defined in section 626.556, subdivision 10e; or 
455.23     (3) in need of protection or services as defined in section 
455.24  260.015, subdivision 2a. 
455.25     Sec. 8.  Minnesota Statutes 1998, section 256F.10, 
455.26  subdivision 4, is amended to read: 
455.27     Subd. 4.  [PROVIDER QUALIFICATIONS AND CERTIFICATION 
455.28  STANDARDS.] The commissioner must certify each provider before 
455.29  enrolling it as a child welfare targeted case management 
455.30  provider of services under section 256B.094 and this section.  
455.31  The certification process shall examine the provider's ability 
455.32  to meet the qualification requirements and certification 
455.33  standards in this subdivision and other federal and state 
455.34  requirements of this service.  A certified child welfare 
455.35  targeted case management provider is an enrolled medical 
455.36  assistance provider who is determined by the commissioner to 
456.1   have all of the following: 
456.2      (1) the legal authority to provide public welfare under 
456.3   sections 393.01, subdivision 7, and 393.07 or a federally 
456.4   recognized Indian tribe; 
456.5      (2) the demonstrated capacity and experience to provide the 
456.6   components of case management to coordinate and link community 
456.7   resources needed by the eligible population; 
456.8      (3) administrative capacity and experience in serving the 
456.9   target population for whom it will provide services and in 
456.10  ensuring quality of services under state and federal 
456.11  requirements; 
456.12     (4) the legal authority to provide complete investigative 
456.13  and protective services under section 626.556, subdivision 10, 
456.14  and child welfare and foster care services under section 393.07, 
456.15  subdivisions 1 and 2 or a federally recognized Indian tribe; 
456.16     (5) a financial management system that provides accurate 
456.17  documentation of services and costs under state and federal 
456.18  requirements; and 
456.19     (6) the capacity to document and maintain individual case 
456.20  records under state and federal requirements. 
456.21     Sec. 9.  Minnesota Statutes 1998, section 256F.10, 
456.22  subdivision 6, is amended to read: 
456.23     Subd. 6.  [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 
456.24  for portion set aside in paragraph (b), the federal funds earned 
456.25  under this section and section 256B.094 by counties providers 
456.26  shall be paid to each county provider based on its earnings, and 
456.27  must be used by each county provider to expand preventive child 
456.28  welfare services. 
456.29  If a county or tribal social services chooses to be a provider 
456.30  of child welfare targeted case management and if that county or 
456.31  tribal social services also joins a local children's mental 
456.32  health collaborative as authorized by the 1993 legislature, then 
456.33  the federal reimbursement received by the county or tribal 
456.34  social services for providing child welfare targeted case 
456.35  management services to children served by the local 
456.36  collaborative shall be transferred by the county or tribal 
457.1   social services to the integrated fund.  The federal 
457.2   reimbursement transferred to the integrated fund by the 
457.3   county or tribal social services must not be used for 
457.4   residential care other than respite care described under 
457.5   subdivision 7, paragraph (d). 
457.6      (b) The commissioner shall set aside a portion of the 
457.7   federal funds earned under this section to repay the special 
457.8   revenue maximization account under section 256.01, subdivision 
457.9   2, clause (15).  The repayment is limited to: 
457.10     (1) the costs of developing and implementing this section 
457.11  and sections 256.8711 and 256B.094; 
457.12     (2) programming the information systems; and 
457.13     (3) the lost federal revenue for the central office claim 
457.14  directly caused by the implementation of these sections. 
457.15     Any unexpended funds from the set aside under this 
457.16  paragraph shall be distributed to counties providers according 
457.17  to paragraph (a). 
457.18     Sec. 10.  Minnesota Statutes 1998, section 256F.10, 
457.19  subdivision 7, is amended to read: 
457.20     Subd. 7.  [EXPANSION OF SERVICES AND BASE LEVEL OF 
457.21  EXPENDITURES.] (a) Counties and tribal social services must 
457.22  continue the base level of expenditures for preventive child 
457.23  welfare services from either or both of any state, county, or 
457.24  federal funding source, which, in the absence of federal funds 
457.25  earned under this section, would have been available for these 
457.26  services.  The commissioner shall review the county or tribal 
457.27  social services expenditures annually using reports required 
457.28  under sections 245.482, 256.01, subdivision 2, paragraph 17, and 
457.29  256E.08, subdivision 8, to ensure that the base level of 
457.30  expenditures for preventive child welfare services is continued 
457.31  from sources other than the federal funds earned under this 
457.32  section. 
457.33     (b) The commissioner may reduce, suspend, or eliminate 
457.34  either or both of a county's or tribal social services' 
457.35  obligations to continue the base level of expenditures and to 
457.36  expand child welfare preventive services if the commissioner 
458.1   determines that one or more of the following conditions apply to 
458.2   that county or reservation: 
458.3      (1) imposition of levy limits that significantly reduce 
458.4   available social service funds; 
458.5      (2) reduction in the net tax capacity of the taxable 
458.6   property within a county or reservation that significantly 
458.7   reduces available social service funds; 
458.8      (3) reduction in the number of children under age 19 in the 
458.9   county or reservation by 25 percent when compared with the 
458.10  number in the base year using the most recent data provided by 
458.11  the state demographer's office; or 
458.12     (4) termination of the federal revenue earned under this 
458.13  section. 
458.14     (c) The commissioner may suspend for one year either or 
458.15  both of a county's or tribal social services' obligations to 
458.16  continue the base level of expenditures and to expand child 
458.17  welfare preventive services if the commissioner determines that 
458.18  in the previous year one or more of the following conditions 
458.19  applied to that county or reservation: 
458.20     (1) the total number of children in placement under 
458.21  sections 257.071 and 393.07, subdivisions 1 and 2, has been 
458.22  reduced by 50 percent from the total number in the base year; or 
458.23     (2) the average number of children in placement under 
458.24  sections 257.071 and 393.07, subdivisions 1 and 2, on the last 
458.25  day of each month is equal to or less than one child per 1,000 
458.26  children in the county or reservation. 
458.27     (d) For the purposes of this section, child welfare 
458.28  preventive services are those services directed toward a 
458.29  specific child or family that further the goals of section 
458.30  256F.01 and include assessments, family preservation services, 
458.31  service coordination, community-based treatment, crisis nursery 
458.32  services when the parents retain custody and there is no 
458.33  voluntary placement agreement with a child-placing agency, 
458.34  respite care except when it is provided under a medical 
458.35  assistance waiver, home-based services, and other related 
458.36  services.  For the purposes of this section, child welfare 
459.1   preventive services shall not include shelter care placements 
459.2   under the authority of the court or public agency to address an 
459.3   emergency, residential services except for respite care, child 
459.4   care for the purposes of employment and training, adult 
459.5   services, services other than child welfare targeted case 
459.6   management when they are provided under medical assistance, 
459.7   placement services, or activities not directed toward a specific 
459.8   child or family.  Respite care must be planned, routine care to 
459.9   support the continuing residence of the child with its family or 
459.10  long-term primary caretaker and must not be provided to address 
459.11  an emergency. 
459.12     (e) For the counties and tribal social services beginning 
459.13  to claim federal reimbursement for services under this section 
459.14  and section 256B.094, the base year is the calendar year ending 
459.15  at least two calendar quarters before the first calendar quarter 
459.16  in which the county provider begins claiming reimbursement.  For 
459.17  the purposes of this section, the base level of expenditures is 
459.18  the level of county or tribal social services expenditures in 
459.19  the base year for eligible child welfare preventive services 
459.20  described in this subdivision. 
459.21     Sec. 11.  Minnesota Statutes 1998, section 256F.10, 
459.22  subdivision 8, is amended to read: 
459.23     Subd. 8.  [PROVIDER RESPONSIBILITIES.] (a) Notwithstanding 
459.24  section 256B.19, subdivision 1, for the purposes of child 
459.25  welfare targeted case management under section 256B.094 and this 
459.26  section, the nonfederal share of costs shall be provided by the 
459.27  provider of child welfare targeted case management from sources 
459.28  other than federal funds or funds used to match other federal 
459.29  funds except when allowed by federal law or agreement. 
459.30     (b) Provider expenditures eligible for federal 
459.31  reimbursement under this section must not be made from federal 
459.32  funds or funds used to match other federal funds except when 
459.33  allowed by federal law or agreement. 
459.34     (c) The commissioner may suspend, reduce, or terminate the 
459.35  federal reimbursement to a provider that does not meet the 
459.36  reporting or other requirements of section 256B.094 and this 
460.1   section.  The county or reservation is responsible for any 
460.2   federal disallowances.  The county or reservation may share this 
460.3   responsibility with its contracted vendors. 
460.4      Sec. 12.  Minnesota Statutes 1998, section 256F.10, 
460.5   subdivision 10, is amended to read: 
460.6      Subd. 10.  [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 
460.7   PAYMENTS.] Notwithstanding section 256B.041, county provider 
460.8   payments for the cost of child welfare targeted case management 
460.9   services shall not be made to the state treasurer.  For the 
460.10  purposes of child welfare targeted case management services 
460.11  under section 256B.094 and this section, the centralized 
460.12  disbursement of payments to providers under section 256B.041 
460.13  consists only of federal earnings from services provided under 
460.14  section 256B.094 and this section. 
460.15     Sec. 13.  Minnesota Statutes 1998, section 257.071, 
460.16  subdivision 1, is amended to read: 
460.17     Subdivision 1.  [PLACEMENT; PLAN.] (a) A case plan shall be 
460.18  prepared within 30 days after any child is placed in a 
460.19  residential facility by court order or by the voluntary release 
460.20  of the child by the parent or parents.  
460.21     For purposes of this section, a residential facility means 
460.22  any group home, family foster home or other publicly supported 
460.23  out-of-home residential facility, including any out-of-home 
460.24  residential facility under contract with the state, county or 
460.25  other political subdivision, or any agency thereof, to provide 
460.26  those services or foster care as defined in section 260.015, 
460.27  subdivision 7.  
460.28     (b) When a child is in placement, the responsible local 
460.29  social services agency shall make diligent efforts to identify, 
460.30  locate, and, where appropriate, offer services to both parents 
460.31  of the child.  If a noncustodial or nonadjudicated parent is 
460.32  willing and capable of providing for the day-to-day care of the 
460.33  child, the local social services agency may seek authority from 
460.34  the custodial parent or the court to have that parent assume 
460.35  day-to-day care of the child.  If a parent is not an adjudicated 
460.36  parent, the local social services agency shall require the 
461.1   nonadjudicated parent to cooperate with paternity establishment 
461.2   procedures as part of the case plan. 
461.3      (c) If, after assessment, the local social services agency 
461.4   determines that the child cannot be in the day-to-day care of 
461.5   either parent, the agency shall prepare a case plan addressing 
461.6   the conditions that each parent must mitigate before the child 
461.7   could be in that parent's day-to-day care. 
461.8      (d) If, after the provision of services following a case 
461.9   plan under this section and ordered by the juvenile court, the 
461.10  child cannot return to the care of the parent from whom the 
461.11  child was removed or who had legal custody at the time the child 
461.12  was placed in foster care, the agency may petition on behalf of 
461.13  a noncustodial parent to establish legal custody with that 
461.14  parent under section 260.191, subdivision 3b.  If paternity has 
461.15  not already been established, it may be established in the same 
461.16  proceeding in the manner provided for under this chapter. 
461.17     The responsible social services agency may be relieved of 
461.18  the requirement to locate and offer services to both parents by 
461.19  the juvenile court upon a finding of good cause after the filing 
461.20  of a petition under section 260.131. 
461.21     (e) For the purposes of this section, a case plan means a 
461.22  written document which is ordered by the court or which is 
461.23  prepared by the social service services agency responsible for 
461.24  the residential facility placement and is signed by the parent 
461.25  or parents, or other custodian, of the child, the child's legal 
461.26  guardian, the social service services agency responsible for the 
461.27  residential facility placement, and, if possible, the child.  
461.28  The document shall be explained to all persons involved in its 
461.29  implementation, including the child who has signed the document, 
461.30  and shall set forth: 
461.31     (1) the specific reasons for the placement of the child in 
461.32  a residential facility, including a description of the problems 
461.33  or conditions in the home of the parent or parents which 
461.34  necessitated removal of the child from home; 
461.35     (2) the specific actions to be taken by the parent or 
461.36  parents of the child to eliminate or correct the problems or 
462.1   conditions identified in clause (1), and the time period during 
462.2   which the actions are to be taken; 
462.3      (3) the financial responsibilities and obligations, if any, 
462.4   of the parents for the support of the child during the period 
462.5   the child is in the residential facility; 
462.6      (4) the visitation rights and obligations of the parent or 
462.7   parents or other relatives as defined in section 260.181, if 
462.8   such visitation is consistent with the best interest of the 
462.9   child, during the period the child is in the residential 
462.10  facility; 
462.11     (5) the social and other supportive services to be provided 
462.12  to the parent or parents of the child, the child, and the 
462.13  residential facility during the period the child is in the 
462.14  residential facility; 
462.15     (6) the date on which the child is expected to be returned 
462.16  to and safely maintained in the home of the parent or parents or 
462.17  placed for adoption or otherwise permanently removed from the 
462.18  care of the parent by court order; 
462.19     (7) the nature of the effort to be made by the social 
462.20  service services agency responsible for the placement to reunite 
462.21  the family; and 
462.22     (8) notice to the parent or parents: 
462.23     (i) that placement of the child in foster care may result 
462.24  in termination of parental rights but only after notice and a 
462.25  hearing as provided in chapter 260.; and 
462.26     (ii) in cases where the agency has determined that both 
462.27  reasonable efforts to reunify the child with the parents, and 
462.28  reasonable efforts to place the child in a permanent home away 
462.29  from the parent that may become legally permanent are 
462.30  appropriate, notice of: 
462.31     (A) time limits on the length of placement and of 
462.32  reunification services; 
462.33     (B) the nature of the services available to the parent; 
462.34     (C) the consequences to the parent and the child if the 
462.35  parent fails or is unable to use services to correct the 
462.36  circumstances that led to the child's placement; 
463.1      (D) the first consideration for relative placement; and 
463.2      (E) the benefit to the child in getting the child out of 
463.3   residential care as soon as possible, preferably by returning 
463.4   the child home, but if that is not possible, through legally 
463.5   permanent placement of the child away from the parent; 
463.6      (9) a permanency hearing under section 260.191, subdivision 
463.7   3b, or a termination of parental rights hearing under sections 
463.8   260.221 to 260.245, where the agency asks the court to find that 
463.9   the child should be permanently placed away from the parent and 
463.10  includes documentation of the steps taken by the responsible 
463.11  social services agency to find an adoptive family or other 
463.12  legally permanent living arrangement for the child, to place the 
463.13  child with an adoptive family, a fit and willing relative 
463.14  through an award of permanent legal and physical custody, or in 
463.15  another planned and legally permanent living arrangement.  The 
463.16  documentation must include child-specific recruitment efforts; 
463.17  and 
463.18     (10) if the court has issued an order terminating the 
463.19  rights of both parents of the child or of the only known, living 
463.20  parent of the child, documentation of steps to finalize the 
463.21  adoption or legal guardianship of the child. 
463.22     (f) The parent or parents and the child each shall have the 
463.23  right to legal counsel in the preparation of the case plan and 
463.24  shall be informed of the right at the time of placement of the 
463.25  child.  The child shall also have the right to a guardian ad 
463.26  litem.  If unable to employ counsel from their own resources, 
463.27  the court shall appoint counsel upon the request of the parent 
463.28  or parents or the child or the child's legal guardian.  The 
463.29  parent or parents may also receive assistance from any person or 
463.30  social service services agency in preparation of the case plan. 
463.31     After the plan has been agreed upon by the parties 
463.32  involved, the foster parents shall be fully informed of the 
463.33  provisions of the case plan and shall be provided a copy of the 
463.34  plan. 
463.35     (g) When an agency accepts a child for placement, the 
463.36  agency shall determine whether the child has had a physical 
464.1   examination by or under the direction of a licensed physician 
464.2   within the 12 months immediately preceding the date when the 
464.3   child came into the agency's care.  If there is documentation 
464.4   that the child has had such an examination within the last 12 
464.5   months, the agency is responsible for seeing that the child has 
464.6   another physical examination within one year of the documented 
464.7   examination and annually in subsequent years.  If the agency 
464.8   determines that the child has not had a physical examination 
464.9   within the 12 months immediately preceding placement, the agency 
464.10  shall ensure that the child has the examination within 30 days 
464.11  of coming into the agency's care and once a year in subsequent 
464.12  years. 
464.13     Sec. 14.  Minnesota Statutes 1998, section 257.071, 
464.14  subdivision 1d, is amended to read: 
464.15     Subd. 1d.  [RELATIVE SEARCH; NATURE.] (a) As soon as 
464.16  possible, but in any event within six months after a child is 
464.17  initially placed in a residential facility, the local social 
464.18  services agency shall identify any relatives of the child and 
464.19  notify them of the need for a foster care home for the child and 
464.20  of the possibility of the need for a permanent out-of-home 
464.21  placement of the child.  Relatives should also be notified that 
464.22  a decision not to be a placement resource at the beginning of 
464.23  the case may affect the relative being considered for placement 
464.24  of the child with that relative later.  The relatives must be 
464.25  notified that they must keep the local social services agency 
464.26  informed of their current address in order to receive notice 
464.27  that a permanent placement is being sought for the child.  A 
464.28  relative who fails to provide a current address to the local 
464.29  social services agency forfeits the right to notice of the 
464.30  possibility of permanent placement.  If the child's parent 
464.31  refuses to give the responsible social services agency 
464.32  information sufficient to identify relatives of the child, the 
464.33  agency shall determine whether the parent's refusal is in the 
464.34  child's best interests.  If the agency determines the parent's 
464.35  refusal is not in the child's best interests, the agency shall 
464.36  file a petition under section 260.131, and shall ask the 
465.1   juvenile court to order the parent to provide the necessary 
465.2   information. 
465.3      (b) Unless required under the Indian Child Welfare Act or 
465.4   relieved of this duty by the court because the child is placed 
465.5   with an appropriate relative who wishes to provide a permanent 
465.6   home for the child or the child is placed with a foster home 
465.7   that has committed to being the legally permanent placement for 
465.8   the child and the responsible social services agency approves of 
465.9   that foster home for permanent placement of the child, when the 
465.10  agency determines that it is necessary to prepare for the 
465.11  permanent placement determination hearing, or in anticipation of 
465.12  filing a termination of parental rights petition, the agency 
465.13  shall send notice to the relatives, any adult with whom the 
465.14  child is currently residing, any adult with whom the child has 
465.15  resided for one year or longer in the past, and any adults who 
465.16  have maintained a relationship or exercised visitation with the 
465.17  child as identified in the agency case plan.  The notice must 
465.18  state that a permanent home is sought for the child and that the 
465.19  individuals receiving the notice may indicate to the agency 
465.20  their interest in providing a permanent home.  The notice must 
465.21  state that within 30 days of receipt of the notice an individual 
465.22  receiving the notice must indicate to the agency the 
465.23  individual's interest in providing a permanent home for the 
465.24  child or that the individual may lose the opportunity to be 
465.25  considered for a permanent placement.  This notice need not be 
465.26  sent if the child is placed with an appropriate relative who 
465.27  wishes to provide a permanent home for the child. 
465.28     Sec. 15.  Minnesota Statutes 1998, section 257.071, 
465.29  subdivision 4, is amended to read: 
465.30     Subd. 4.  [REVIEW OF DEVELOPMENTALLY DISABLED AND 
465.31  EMOTIONALLY HANDICAPPED CHILD PLACEMENTS.] If a developmentally 
465.32  disabled child, as that term is defined in United States Code, 
465.33  title 42, section 6001 (7), as amended through December 31, 
465.34  1979, or a child diagnosed with an emotional handicap as defined 
465.35  in section 252.27, subdivision 1a, has been placed in a 
465.36  residential facility pursuant to a voluntary release by the 
466.1   child's parent or parents because of the child's handicapping 
466.2   conditions or need for long-term residential treatment or 
466.3   supervision, the social service services agency responsible for 
466.4   the placement shall bring a petition for review of the child's 
466.5   foster care status, pursuant to section 260.131, subdivision 1a, 
466.6   rather than a after the child has been in placement for six 
466.7   months.  If a child is in placement due solely to the child's 
466.8   handicapping condition and custody of the child is not 
466.9   transferred to the responsible social services agency under 
466.10  section 260.191, subdivision 1, paragraph (a), clause (2), no 
466.11  petition as is required by section 260.191, subdivision 3b, 
466.12  after the child has been in foster care for six months or, in 
466.13  the case of a child with an emotional handicap, after the child 
466.14  has been in a residential facility for six months.  Whenever a 
466.15  petition for review is brought pursuant to this subdivision, a 
466.16  guardian ad litem shall be appointed for the child. 
466.17     Sec. 16.  Minnesota Statutes 1998, section 257.85, 
466.18  subdivision 2, is amended to read: 
466.19     Subd. 2.  [SCOPE.] The provisions of this section apply to 
466.20  those situations in which the legal and physical custody of a 
466.21  child is established with a relative or important friend with 
466.22  whom the child has resided or had significant contact according 
466.23  to section 260.191, subdivision 3b, by a court order issued on 
466.24  or after July 1, 1997.  
466.25     Sec. 17.  Minnesota Statutes 1998, section 257.85, 
466.26  subdivision 3, is amended to read: 
466.27     Subd. 3.  [DEFINITIONS.] For purposes of this section, the 
466.28  terms defined in this subdivision have the meanings given them. 
466.29     (a) "AFDC or MFIP standard" means the monthly standard of 
466.30  need used to calculate assistance under the AFDC program, the 
466.31  transitional standard used to calculate assistance under the 
466.32  MFIP-S program, or, if neither of those is applicable permanent 
466.33  legal and physical custody of the child is given to a relative 
466.34  custodian residing outside of Minnesota, the analogous 
466.35  transitional standard or standard of need used to calculate 
466.36  assistance under the MFIP or MFIP-R programs TANF program of the 
467.1   state where the relative custodian lives. 
467.2      (b) "Local agency" means the local social service services 
467.3   agency with legal custody of a child prior to the transfer of 
467.4   permanent legal and physical custody to a relative. 
467.5      (c) "Permanent legal and physical custody" means permanent 
467.6   legal and physical custody ordered by a Minnesota juvenile court 
467.7   under section 260.191, subdivision 3b. 
467.8      (d) "Relative" means an individual, other than a parent, 
467.9   who is related to a child by blood, marriage, or adoption has 
467.10  the meaning given in section 260.015, subdivision 13. 
467.11     (e) "Relative custodian" means a relative of a child for 
467.12  whom the relative person who has permanent legal and physical 
467.13  custody of a child.  When siblings, including half-siblings and 
467.14  step siblings, are placed together in the permanent legal and 
467.15  physical custody of a relative of one of the siblings, the 
467.16  person receiving permanent legal and physical custody of the 
467.17  siblings is considered a relative custodian of all of the 
467.18  siblings for purposes of this section. 
467.19     (f) "Relative custody assistance agreement" means an 
467.20  agreement entered into between a local agency and the relative 
467.21  of a child person who has been or will be awarded permanent 
467.22  legal and physical custody of the a child. 
467.23     (g) "Relative custody assistance payment" means a monthly 
467.24  cash grant made to a relative custodian pursuant to a relative 
467.25  custody assistance agreement and in an amount calculated under 
467.26  subdivision 7. 
467.27     (h) "Remains in the physical custody of the relative 
467.28  custodian" means that the relative custodian is providing 
467.29  day-to-day care for the child and that the child lives with the 
467.30  relative custodian; absence from the relative custodian's home 
467.31  for a period of more than 120 days raises a presumption that the 
467.32  child no longer remains in the physical custody of the relative 
467.33  custodian. 
467.34     Sec. 18.  Minnesota Statutes 1998, section 257.85, 
467.35  subdivision 7, is amended to read: 
467.36     Subd. 7.  [AMOUNT OF RELATIVE CUSTODY ASSISTANCE PAYMENTS.] 
468.1   (a) The amount of a monthly relative custody assistance payment 
468.2   shall be determined according to the provisions of this 
468.3   paragraph. 
468.4      (1) The total maximum assistance rate is equal to the base 
468.5   assistance rate plus, if applicable, the supplemental assistance 
468.6   rate. 
468.7      (i) The base assistance rate is equal to the maximum amount 
468.8   that could be received as basic maintenance for a child of the 
468.9   same age under the adoption assistance program. 
468.10     (ii) The local agency shall determine whether the child has 
468.11  physical, mental, emotional, or behavioral disabilities that 
468.12  require care, supervision, or structure beyond that ordinarily 
468.13  provided in a family setting to children of the same age such 
468.14  that the child would be eligible for supplemental maintenance 
468.15  payments under the adoption assistance program if an adoption 
468.16  assistance agreement were entered on the child's behalf.  If the 
468.17  local agency determines that the child has such a disability, 
468.18  the supplemental assistance rate shall be the maximum amount of 
468.19  monthly supplemental maintenance payment that could be received 
468.20  on behalf of a child of the same age, disabilities, and 
468.21  circumstances under the adoption assistance program. 
468.22     (2) The net maximum assistance rate is equal to the total 
468.23  maximum assistance rate from clause (1) less the following 
468.24  offsets: 
468.25     (i) if the child is or will be part of an assistance unit 
468.26  receiving an AFDC, MFIP-S, or other MFIP grant or a grant from a 
468.27  similar program of another state, the portion of the AFDC or 
468.28  MFIP standard relating to the child as calculated under 
468.29  paragraph (b), clause (2); 
468.30     (ii) Supplemental Security Income payments received by or 
468.31  on behalf of the child; 
468.32     (iii) veteran's benefits received by or on behalf of the 
468.33  child; and 
468.34     (iv) any other income of the child, including child support 
468.35  payments made on behalf of the child. 
468.36     (3) The relative custody assistance payment to be made to 
469.1   the relative custodian shall be a percentage of the net maximum 
469.2   assistance rate calculated in clause (2) based upon the gross 
469.3   income of the relative custodian's family, including the child 
469.4   for whom the relative custodian has permanent legal and physical 
469.5   custody.  In no case shall the amount of the relative custody 
469.6   assistance payment exceed that which the child could qualify for 
469.7   under the adoption assistance program if an adoption assistance 
469.8   agreement were entered on the child's behalf.  The relative 
469.9   custody assistance payment shall be calculated as follows: 
469.10     (i) if the relative custodian's gross family income is less 
469.11  than or equal to 200 percent of federal poverty guidelines, the 
469.12  relative custody assistance payment shall be the full amount of 
469.13  the net maximum assistance rate; 
469.14     (ii) if the relative custodian's gross family income is 
469.15  greater than 200 percent and less than or equal to 225 percent 
469.16  of federal poverty guidelines, the relative custody assistance 
469.17  payment shall be 80 percent of the net maximum assistance rate; 
469.18     (iii) if the relative custodian's gross family income is 
469.19  greater than 225 percent and less than or equal to 250 percent 
469.20  of federal poverty guidelines, the relative custody assistance 
469.21  payment shall be 60 percent of the net maximum assistance rate; 
469.22     (iv) if the relative custodian's gross family income is 
469.23  greater than 250 percent and less than or equal to 275 percent 
469.24  of federal poverty guidelines, the relative custody assistance 
469.25  payment shall be 40 percent of the net maximum assistance rate; 
469.26     (v) if the relative custodian's gross family income is 
469.27  greater than 275 percent and less than or equal to 300 percent 
469.28  of federal poverty guidelines, the relative custody assistance 
469.29  payment shall be 20 percent of the net maximum assistance rate; 
469.30  or 
469.31     (vi) if the relative custodian's gross family income is 
469.32  greater than 300 percent of federal poverty guidelines, no 
469.33  relative custody assistance payment shall be made. 
469.34     (b) This paragraph specifies the provisions pertaining to 
469.35  the relationship between relative custody assistance and AFDC, 
469.36  MFIP-S, or other MFIP programs The following provisions cover 
470.1   the relationship between relative custody assistance and 
470.2   assistance programs: 
470.3      (1) The relative custodian of a child for whom the relative 
470.4   custodian is receiving relative custody assistance is expected 
470.5   to seek whatever assistance is available for the child 
470.6   through the AFDC, MFIP-S, or other MFIP, if the relative 
470.7   custodian resides in a state other than Minnesota, or similar 
470.8   programs of that state.  If a relative custodian fails to apply 
470.9   for assistance through AFDC, MFIP-S, or other MFIP program for 
470.10  which the child is eligible, the child's portion of the AFDC or 
470.11  MFIP standard will be calculated as if application had been made 
470.12  and assistance received;. 
470.13     (2) The portion of the AFDC or MFIP standard relating to 
470.14  each child for whom relative custody assistance is being 
470.15  received shall be calculated as follows: 
470.16     (i) determine the total AFDC or MFIP standard for the 
470.17  assistance unit; 
470.18     (ii) determine the amount that the AFDC or MFIP standard 
470.19  would have been if the assistance unit had not included the 
470.20  children for whom relative custody assistance is being received; 
470.21     (iii) subtract the amount determined in item (ii) from the 
470.22  amount determined in item (i); and 
470.23     (iv) divide the result in item (iii) by the number of 
470.24  children for whom relative custody assistance is being received 
470.25  that are part of the assistance unit; or. 
470.26     (3) If a child for whom relative custody assistance is 
470.27  being received is not eligible for assistance through the AFDC, 
470.28  MFIP-S, or other MFIP similar programs of another state, the 
470.29  portion of AFDC or MFIP standard relating to that child shall be 
470.30  equal to zero. 
470.31     Sec. 19.  Minnesota Statutes 1998, section 257.85, 
470.32  subdivision 9, is amended to read: 
470.33     Subd. 9.  [RIGHT OF APPEAL.] A relative custodian who 
470.34  enters or seeks to enter into a relative custody assistance 
470.35  agreement with a local agency has the right to appeal to the 
470.36  commissioner according to section 256.045 when the local agency 
471.1   establishes, denies, terminates, or modifies the agreement.  
471.2   Upon appeal, the commissioner may review only: 
471.3      (1) whether the local agency has met the legal requirements 
471.4   imposed by this chapter for establishing, denying, terminating, 
471.5   or modifying the agreement; 
471.6      (2) whether the amount of the relative custody assistance 
471.7   payment was correctly calculated under the method in subdivision 
471.8   7; 
471.9      (3) whether the local agency paid for correct time periods 
471.10  under the relative custody assistance agreement; 
471.11     (4) whether the child remains in the physical custody of 
471.12  the relative custodian; 
471.13     (5) whether the local agency correctly calculated modified 
471.14  the amount of the supplemental assistance rate based on a change 
471.15  in the child's physical, mental, emotional, or behavioral needs, 
471.16  or based on the relative custodian's failure to document provide 
471.17  documentation, after the local agency has requested such 
471.18  documentation, that the continuing need for the supplemental 
471.19  assistance rate after the local agency has requested such 
471.20  documentation child continues to have physical, mental, 
471.21  emotional, or behavioral needs that support the current amount 
471.22  of relative custody assistance; and 
471.23     (6) whether the local agency correctly calculated modified 
471.24  or terminated the amount of relative custody assistance based on 
471.25  a change in the gross income of the relative custodian's family 
471.26  or based on the relative custodian's failure to provide 
471.27  documentation of the gross income of the relative custodian's 
471.28  family after the local agency has requested such documentation. 
471.29     Sec. 20.  Minnesota Statutes 1998, section 257.85, 
471.30  subdivision 11, is amended to read: 
471.31     Subd. 11.  [FINANCIAL CONSIDERATIONS.] (a) Payment of 
471.32  relative custody assistance under a relative custody assistance 
471.33  agreement is subject to the availability of state funds and 
471.34  payments may be reduced or suspended on order of the 
471.35  commissioner if insufficient funds are available. 
471.36     (b) Upon receipt from a local agency of a claim for 
472.1   reimbursement, the commissioner shall reimburse the local agency 
472.2   in an amount equal to 100 percent of the relative custody 
472.3   assistance payments provided to relative custodians.  The local 
472.4   agency may not seek and the commissioner shall not provide 
472.5   reimbursement for the administrative costs associated with 
472.6   performing the duties described in subdivision 4. 
472.7      (c) For the purposes of determining eligibility or payment 
472.8   amounts under the AFDC, MFIP-S, and other MFIP programs, 
472.9   relative custody assistance payments shall be considered 
472.10  excluded in determining the family's available income. 
472.11     Sec. 21.  Minnesota Statutes 1998, section 259.29, 
472.12  subdivision 2, is amended to read: 
472.13     Subd. 2.  [PLACEMENT WITH RELATIVE OR, FRIEND, OR MARRIED 
472.14  COUPLE.] The authorized child-placing agency shall consider 
472.15  placement, consistent with the child's best interests and in the 
472.16  following order, with (1) a relative or relatives of the 
472.17  child, or (2) an important friend with whom the child has 
472.18  resided or had significant contact, or (3) a married couple.  In 
472.19  implementing this section, an authorized child-placing agency 
472.20  may disclose private or confidential data, as defined in section 
472.21  13.02, to relatives of the child for the purpose of locating a 
472.22  suitable adoptive home.  The agency shall disclose only data 
472.23  that is necessary to facilitate implementing the preference.  
472.24     If the child's birth parent or parents explicitly request 
472.25  that placement with relatives or important friends not be 
472.26  considered, the authorized child-placing agency shall honor that 
472.27  request consistent with the best interests of the child. 
472.28     If the child's birth parent or parents express a preference 
472.29  for placing the child in an adoptive home of the same or a 
472.30  similar religious background to that of the birth parent or 
472.31  parents, the agency shall place the child with a family that 
472.32  meets the birth parent's religious preference.  
472.33     This subdivision does not affect the Indian Child Welfare 
472.34  Act, United States Code, title 25, sections 1901 to 1923, and 
472.35  the Minnesota Indian Family Preservation Act, sections 257.35 to 
472.36  257.3579. 
473.1      Sec. 22.  Minnesota Statutes 1998, section 259.67, 
473.2   subdivision 6, is amended to read: 
473.3      Subd. 6.  [RIGHT OF APPEAL.] (a) The adoptive parents have 
473.4   the right to appeal to the commissioner pursuant to section 
473.5   256.045, when the commissioner denies, discontinues, or modifies 
473.6   the agreement.  
473.7      (b) Adoptive parents who believe that their adopted child 
473.8   was incorrectly denied adoption assistance, or who did not seek 
473.9   adoption assistance on the child's behalf because of being 
473.10  provided with inaccurate or insufficient information about the 
473.11  child or the adoption assistance program, may request a hearing 
473.12  under section 256.045.  Notwithstanding subdivision 2, the 
473.13  purpose of the hearing shall be to determine whether, under 
473.14  standards established by the federal Department of Health and 
473.15  Human Services, the circumstances surrounding the child's 
473.16  adoption warrant making an adoption assistance agreement on 
473.17  behalf of the child after the final decree of adoption has been 
473.18  issued.  The commissioner shall enter into an adoption 
473.19  assistance agreement on the child's behalf if it is determined 
473.20  that: 
473.21     (1) at the time of the adoption and at the time the request 
473.22  for a hearing was submitted the child was eligible for adoption 
473.23  assistance under United States Code, title 42, chapter 7, 
473.24  subchapter IV, part E, sections 670 to 679a, at the time of the 
473.25  adoption and at the time the request for a hearing was submitted 
473.26  but, because of extenuating circumstances, did not receive or 
473.27  for state funded adoption assistance under subdivision 4; and 
473.28     (2) an adoption assistance agreement was not entered into 
473.29  on behalf of the child before the final decree of adoption 
473.30  because of extenuating circumstances as the term is used in the 
473.31  standards established by the federal Department of Health and 
473.32  Human Services.  An adoption assistance agreement made under 
473.33  this paragraph shall be effective the date the request for a 
473.34  hearing was received by the commissioner or the local agency. 
473.35     Sec. 23.  Minnesota Statutes 1998, section 259.67, 
473.36  subdivision 7, is amended to read: 
474.1      Subd. 7.  [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 
474.2   the commissioner, and the provisions of this subdivision 
474.3   a Minnesota-licensed child-placing agency licensed in Minnesota 
474.4   or any other state, or local social services agency shall 
474.5   receive a reimbursement from the commissioner equal to 100 
474.6   percent of the reasonable and appropriate cost of providing 
474.7   adoption services for a child certified as eligible for adoption 
474.8   assistance under subdivision 4.  Such assistance may include 
474.9   adoptive family recruitment, counseling, and special training 
474.10  when needed.  A Minnesota-licensed child-placing agency licensed 
474.11  in Minnesota or any other state shall receive reimbursement for 
474.12  adoption services it purchases for or directly provides to an 
474.13  eligible child.  A local social services agency shall receive 
474.14  such reimbursement only for adoption services it purchases for 
474.15  an eligible child. 
474.16     (b) A Minnesota-licensed child-placing agency licensed in 
474.17  Minnesota or any other state or local social services agency 
474.18  seeking reimbursement under this subdivision shall enter into a 
474.19  reimbursement agreement with the commissioner before providing 
474.20  adoption services for which reimbursement is sought.  No 
474.21  reimbursement under this subdivision shall be made to an agency 
474.22  for services provided prior to entering a reimbursement 
474.23  agreement.  Separate reimbursement agreements shall be made for 
474.24  each child and separate records shall be kept on each child for 
474.25  whom a reimbursement agreement is made.  Funds encumbered and 
474.26  obligated under such an agreement for the child remain available 
474.27  until the terms of the agreement are fulfilled or the agreement 
474.28  is terminated. 
474.29     (c) When a local social services agency uses a purchase of 
474.30  service agreement to provide services reimbursable under a 
474.31  reimbursement agreement, the commissioner may make reimbursement 
474.32  payments directly to the agency providing the service if direct 
474.33  reimbursement is specified by the purchase of service agreement, 
474.34  and if the request for reimbursement is submitted by the local 
474.35  social services agency along with a verification that the 
474.36  service was provided. 
475.1      Sec. 24.  Minnesota Statutes 1998, section 259.73, is 
475.2   amended to read: 
475.3      259.73 [REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.] 
475.4      The commissioner of human services shall provide 
475.5   reimbursement of up to $2,000 to the adoptive parent or parents 
475.6   for costs incurred in adopting a child with special needs.  The 
475.7   commissioner shall determine the child's eligibility for 
475.8   adoption expense reimbursement under title IV-E of the Social 
475.9   Security Act, United States Code, title 42, sections 670 to 
475.10  676.  To be reimbursed, costs must be reasonable, necessary, and 
475.11  directly related to the legal adoption of the child. 
475.12     Sec. 25.  Minnesota Statutes 1998, section 259.85, 
475.13  subdivision 2, is amended to read: 
475.14     Subd. 2.  [ELIGIBILITY CRITERIA.] A child may be certified 
475.15  by the local social service services agency as eligible for a 
475.16  postadoption service grant after a final decree of adoption and 
475.17  before the child's 18th birthday if: 
475.18     (a) (1) the child was a ward of the commissioner or a 
475.19  Minnesota licensed child-placing agency before adoption; 
475.20     (b) (2) the child had special needs at the time of adoption.
475.21  For the purposes of this section, "special needs" means a child 
475.22  who had a physical, mental, emotional, or behavioral disability 
475.23  at the time of an adoption or has a preadoption background to 
475.24  which the current development of such disabilities can be 
475.25  attributed; and 
475.26     (c) (3) the adoptive parents have exhausted all other 
475.27  available resources.  Available resources include public income 
475.28  support programs, medical assistance, health insurance coverage, 
475.29  services available through community resources, and any other 
475.30  private or public benefits or resources available to the family 
475.31  or to the child to meet the child's special needs; and 
475.32     (4) the child is under 18 years of age, or if the child is 
475.33  under 22 years of age and remains dependent on the adoptive 
475.34  parent or parents for care and financial support and is enrolled 
475.35  in a secondary education program as a full-time student.  
475.36     Sec. 26.  Minnesota Statutes 1998, section 259.85, 
476.1   subdivision 3, is amended to read: 
476.2      Subd. 3.  [CERTIFICATION STATEMENT.] The local social 
476.3   service services agency shall certify a child's eligibility for 
476.4   a postadoption service grant in writing to the commissioner.  
476.5   The certification statement shall include:  
476.6      (1) a description and history of the special needs upon 
476.7   which eligibility is based; and 
476.8      (2) separate certification for each of the eligibility 
476.9   criteria under subdivision 2, that the criteria are met; and 
476.10     (3) applicable supporting documentation including: 
476.11     (i) the child's individual service plan; 
476.12     (ii) medical, psychological, or special education 
476.13  evaluations; 
476.14     (iii) documentation that all other resources have been 
476.15  exhausted; and 
476.16     (iv) an estimate of the costs necessary to meet the special 
476.17  needs of the child.  
476.18     Sec. 27.  Minnesota Statutes 1998, section 259.85, 
476.19  subdivision 5, is amended to read: 
476.20     Subd. 5.  [GRANT PAYMENTS.] The amount of the postadoption 
476.21  service grant payment shall be based on the special needs of the 
476.22  child and the determination that other resources to meet those 
476.23  special needs are not available.  The amount of any grant 
476.24  payments shall be based on the severity of the child's 
476.25  disability and the effect of the disability on the family and 
476.26  must not exceed $10,000 annually.  Adoptive parents are eligible 
476.27  for grant payments until their child's 18th birthday, or if the 
476.28  child is under 22 years of age and remains dependent on the 
476.29  adoptive parent or parents for care and financial support and is 
476.30  enrolled in a secondary education program as a full-time student.
476.31     Permissible expenses that may be paid from grants shall be 
476.32  limited to:  
476.33     (1) medical expenses not covered by the family's health 
476.34  insurance or medical assistance; 
476.35     (2) therapeutic expenses, including individual and family 
476.36  therapy; and 
477.1      (3) nonmedical services, items, or equipment required to 
477.2   meet the special needs of the child.  
477.3      The grants under this section shall not be used for 
477.4   maintenance for out-of-home placement of the child in substitute 
477.5   care. 
477.6      Sec. 28.  Minnesota Statutes 1998, section 259.89, is 
477.7   amended by adding a subdivision to read: 
477.8      Subd. 6.  [DETERMINATION OF ELIGIBILITY FOR ENROLLMENT OR 
477.9   MEMBERSHIP IN A FEDERALLY RECOGNIZED AMERICAN INDIAN TRIBE.] The 
477.10  state registrar shall provide a copy of an adopted person's 
477.11  original birth certificate to an authorized representative of a 
477.12  federally recognized American Indian tribe for the sole purpose 
477.13  of determining the adopted person's eligibility for enrollment 
477.14  or membership in the tribe. 
477.15     Sec. 29.  Minnesota Statutes 1998, section 260.012, is 
477.16  amended to read: 
477.17     260.012 [DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 
477.18  REUNIFICATION; REASONABLE EFFORTS.] 
477.19     (a) If Once a child alleged to be in need of protection or 
477.20  services is under the court's jurisdiction, the court shall 
477.21  ensure that reasonable efforts including culturally appropriate 
477.22  services by the social service services agency are made to 
477.23  prevent placement or to eliminate the need for removal and to 
477.24  reunite the child with the child's family at the earliest 
477.25  possible time, consistent with the best interests, safety, and 
477.26  protection of the child.  The court may, upon motion and 
477.27  hearing, order the cessation of reasonable efforts if the court 
477.28  finds that provision of services or further services for the 
477.29  purpose of rehabilitation and reunification is futile and 
477.30  therefore unreasonable under the circumstances.  In determining 
477.31  reasonable efforts to be made with respect to a child and in 
477.32  making those reasonable efforts, the child's health and safety 
477.33  must be of paramount concern.  Reasonable efforts for 
477.34  rehabilitation and reunification are not required if upon a 
477.35  determination by the court determines that: 
477.36     (1) a termination of parental rights petition has been 
478.1   filed stating a prima facie case that: 
478.2      (i) the parent has subjected the a child to egregious harm 
478.3   as defined in section 260.015, subdivision 29, or; 
478.4      (ii) the parental rights of the parent to a sibling another 
478.5   child have been terminated involuntarily; or 
478.6      (iii) the child is an abandoned infant under section 
478.7   260.221, subdivision 1a, paragraph (a), clause (2); 
478.8      (2) the county attorney has filed a determination not to 
478.9   proceed with a termination of parental rights petition on these 
478.10  grounds was made under section 260.221, subdivision 1b, 
478.11  paragraph (b), and a permanency hearing is held within 30 days 
478.12  of the determination.; or 
478.13     (3) a termination of parental rights petition or other 
478.14  petition according to section 260.191, subdivision 3b, has been 
478.15  filed alleging a prima facie case that the provision of services 
478.16  or further services for the purpose of reunification is futile 
478.17  and therefore unreasonable under the circumstances. 
478.18     In the case of an Indian child, in proceedings under 
478.19  sections 260.172, 260.191, and 260.221 the juvenile court must 
478.20  make findings and conclusions consistent with the Indian Child 
478.21  Welfare Act of 1978, United States Code, title 25, section 1901 
478.22  et seq., as to the provision of active efforts.  If a child is 
478.23  under the court's delinquency jurisdiction, it shall be the duty 
478.24  of the court to ensure that reasonable efforts are made to 
478.25  reunite the child with the child's family at the earliest 
478.26  possible time, consistent with the best interests of the child 
478.27  and the safety of the public. 
478.28     (b) "Reasonable efforts" means the exercise of due 
478.29  diligence by the responsible social service services agency to 
478.30  use appropriate and available services to meet the needs of the 
478.31  child and the child's family in order to prevent removal of the 
478.32  child from the child's family; or upon removal, services to 
478.33  eliminate the need for removal and reunite the family.  
478.34     (1) Services may include those listed under section 
478.35  256F.07, subdivision 3, and other appropriate services available 
478.36  in the community.  
479.1      (2) At each stage of the proceedings where the court is 
479.2   required to review the appropriateness of the responsible social 
479.3   services agency's reasonable efforts, the social service 
479.4   services agency has the burden of demonstrating that it has made 
479.5   reasonable efforts, or that provision of services or further 
479.6   services for the purpose of rehabilitation and reunification is 
479.7   futile and therefore unreasonable under the circumstances. or 
479.8   that reasonable efforts aimed at reunification are not required 
479.9   under this section.  The agency may meet this burden by stating 
479.10  facts in a sworn petition filed under section 260.131, or by 
479.11  filing an affidavit summarizing the agency's reasonable efforts 
479.12  or facts the agency believes demonstrate there is no need for 
479.13  reasonable efforts to reunify the parent and child. 
479.14     (3) No reasonable efforts for reunification are required 
479.15  when the court makes a determination under paragraph (a) unless, 
479.16  after a hearing according to section 260.155, the court finds 
479.17  there is not clear and convincing evidence of the facts upon 
479.18  which the court based its prima facie determination.  In this 
479.19  case, the court may proceed under section 260.235.  
479.20  Reunification of a surviving child with a parent is not required 
479.21  if the parent has been convicted of: 
479.22     (1) (i) a violation of, or an attempt or conspiracy to 
479.23  commit a violation of, sections 609.185 to 609.20; 609.222, 
479.24  subdivision 2; or 609.223 in regard to another child of the 
479.25  parent; 
479.26     (2) (ii) a violation of section 609.222, subdivision 2; or 
479.27  609.223, in regard to the surviving child; or 
479.28     (3) (iii) a violation of, or an attempt or conspiracy to 
479.29  commit a violation of, United States Code, title 18, section 
479.30  1111(a) or 1112(a), in regard to another child of the parent. 
479.31     (c) The juvenile court, in proceedings under sections 
479.32  260.172, 260.191, and 260.221 shall make findings and 
479.33  conclusions as to the provision of reasonable efforts.  When 
479.34  determining whether reasonable efforts have been made, the court 
479.35  shall consider whether services to the child and family were: 
479.36     (1) relevant to the safety and protection of the child; 
480.1      (2) adequate to meet the needs of the child and family; 
480.2      (3) culturally appropriate; 
480.3      (4) available and accessible; 
480.4      (5) consistent and timely; and 
480.5      (6) realistic under the circumstances. 
480.6      In the alternative, the court may determine that provision 
480.7   of services or further services for the purpose of 
480.8   rehabilitation is futile and therefore unreasonable under the 
480.9   circumstances or that reasonable efforts are not required as 
480.10  provided in paragraph (a). 
480.11     (d) This section does not prevent out-of-home placement for 
480.12  treatment of a child with a mental disability when the child's 
480.13  diagnostic assessment or individual treatment plan indicates 
480.14  that appropriate and necessary treatment cannot be effectively 
480.15  provided outside of a residential or inpatient treatment program.
480.16     (e) If continuation of reasonable efforts described in 
480.17  paragraph (b) is determined by the court to be inconsistent with 
480.18  the permanency permanent plan for the child, or upon a 
480.19  determination under paragraph (a), reasonable efforts must be 
480.20  made to place the child in a timely manner in accordance with 
480.21  the permanency permanent plan ordered by the court and to 
480.22  complete whatever steps are necessary to finalize the permanency 
480.23  permanent plan for the child.  
480.24     (f) Reasonable efforts to place a child for adoption or in 
480.25  another permanent placement may be made concurrently with 
480.26  reasonable efforts as described in paragraphs (a) and (b).  When 
480.27  the responsible social services agency decides to concurrently 
480.28  make reasonable efforts for both reunification and permanent 
480.29  placement away from the parent under paragraphs (a) and (b), the 
480.30  agency shall disclose its decision and both plans for concurrent 
480.31  reasonable efforts to all parties and the court.  When the 
480.32  agency discloses its decision to proceed on both plans for 
480.33  reunification and permanent placement away from the parent, the 
480.34  court's review of the agency's reasonable efforts shall include 
480.35  the agency's efforts under paragraphs (a) and (b). 
480.36     Sec. 30.  Minnesota Statutes 1998, section 260.015, 
481.1   subdivision 13, is amended to read: 
481.2      Subd. 13.  [RELATIVE.] "Relative" means a parent, 
481.3   stepparent, grandparent, brother, sister, uncle, or aunt of the 
481.4   minor.  This relationship may be by blood or marriage.  For an 
481.5   Indian child, relative includes members of the extended family 
481.6   as defined by the law or custom of the Indian child's tribe or, 
481.7   in the absence of laws or custom, nieces, nephews, or first or 
481.8   second cousins, as provided in the Indian Child Welfare Act of 
481.9   1978, United States Code, title 25, section 1903.  For purposes 
481.10  of dispositions, relative has the meaning given in section 
481.11  260.181, subdivision 3. a child in need of protection or 
481.12  services proceedings, termination of parental rights 
481.13  proceedings, and permanency proceedings under section 260.191, 
481.14  subdivision 3b, relative means a person related to the child by 
481.15  blood, marriage, or adoption, or an individual who is an 
481.16  important friend with whom the child has resided or had 
481.17  significant contact. 
481.18     Sec. 31.  Minnesota Statutes 1998, section 260.015, 
481.19  subdivision 29, is amended to read: 
481.20     Subd. 29.  [EGREGIOUS HARM.] "Egregious harm" means the 
481.21  infliction of bodily harm to a child or neglect of a child which 
481.22  demonstrates a grossly inadequate ability to provide minimally 
481.23  adequate parental care.  The egregious harm need not have 
481.24  occurred in the state or in the county where a termination of 
481.25  parental rights action is otherwise properly venued.  Egregious 
481.26  harm includes, but is not limited to: 
481.27     (1) conduct towards a child that constitutes a violation of 
481.28  sections 609.185 to 609.21, 609.222, subdivision 2, 609.223, or 
481.29  any other similar law of any other state; 
481.30     (2) the infliction of "substantial bodily harm" to a child, 
481.31  as defined in section 609.02, subdivision 7a; 
481.32     (3) conduct towards a child that constitutes felony 
481.33  malicious punishment of a child under section 609.377; 
481.34     (4) conduct towards a child that constitutes felony 
481.35  unreasonable restraint of a child under section 609.255, 
481.36  subdivision 3; 
482.1      (5) conduct towards a child that constitutes felony neglect 
482.2   or endangerment of a child under section 609.378; 
482.3      (6) conduct towards a child that constitutes assault under 
482.4   section 609.221, 609.222, or 609.223; 
482.5      (7) conduct towards a child that constitutes solicitation, 
482.6   inducement, or promotion of, or receiving profit derived from 
482.7   prostitution under section 609.322; 
482.8      (8) conduct toward a child that constitutes murder or 
482.9   voluntary manslaughter as defined by United States Code, title 
482.10  18, section 1111(a) or 1112(a); or 
482.11     (9) conduct toward a child that constitutes aiding or 
482.12  abetting, attempting, conspiring, or soliciting to commit a 
482.13  murder or voluntary manslaughter that constitutes a violation of 
482.14  United States Code, title 18, section 1111(a) or 1112(a); or 
482.15     (10) conduct toward a child that constitutes criminal 
482.16  sexual conduct under sections 609.342 to 609.345. 
482.17     Sec. 32.  Minnesota Statutes 1998, section 260.131, 
482.18  subdivision 1a, is amended to read: 
482.19     Subd. 1a.  [REVIEW OF FOSTER CARE STATUS.] The social 
482.20  service services agency responsible for the placement of a child 
482.21  in a residential facility, as defined in section 257.071, 
482.22  subdivision 1, pursuant to a voluntary release by the child's 
482.23  parent or parents may bring a petition in juvenile court to 
482.24  review the foster care status of the child in the manner 
482.25  provided in this section.  The responsible social services 
482.26  agency shall file either a petition alleging the child to be in 
482.27  need of protection or services or a petition to terminate 
482.28  parental rights or other permanency petition under section 
482.29  260.191, subdivision 3b. 
482.30     (a) In the case of a child in voluntary placement according 
482.31  to section 257.071, subdivision 3, the petition shall be filed 
482.32  within 90 days of the date of the voluntary placement agreement 
482.33  and shall state the reasons why the child is in placement, the 
482.34  progress on the case plan required under section 257.071, 
482.35  subdivision 1, and the statutory basis for the petition under 
482.36  section 260.015, subdivision 2a, 260.191, subdivision 3b, or 
483.1   260.221. 
483.2      (1) In the case of a petition filed under this paragraph, 
483.3   if all parties agree and the court finds it is in the best 
483.4   interests of the child, the court may find the petition states a 
483.5   prima facie case that: 
483.6      (i) the child's needs are being met; 
483.7      (ii) the placement of the child in foster care is in the 
483.8   best interests of the child; and 
483.9      (iii) the child will be returned home in the next six 
483.10  months. 
483.11     (2) If the court makes findings under paragraph (a), clause 
483.12  (1), the court shall approve the voluntary arrangement and 
483.13  continue the matter for up to six more months to ensure the 
483.14  child returns to the parents' home.  The responsible social 
483.15  services agency shall: 
483.16     (i) report to the court when the child returns home and the 
483.17  progress made by the parent on the case plan required under 
483.18  section 257.071, in which case the court shall dismiss 
483.19  jurisdiction; 
483.20     (ii) report to the court that the child has not returned 
483.21  home, in which case the matter shall be returned to the court 
483.22  for further proceedings under section 260.155; or 
483.23     (iii) if any party does not agree to continue the matter 
483.24  under paragraph (a), clause (1), and this paragraph, the matter 
483.25  shall proceed under section 260.155. 
483.26     (b) In the case of a child in voluntary placement according 
483.27  to section 257.071, subdivision 4, the petition shall be filed 
483.28  within six months of the date of the voluntary placement 
483.29  agreement and shall state the date of the voluntary placement 
483.30  agreement, the nature of the child's developmental delay or 
483.31  emotional handicap, the plan for the ongoing care of the child, 
483.32  the parents' participation in the plan, and the statutory basis 
483.33  for the petition. 
483.34     (1) In the case of petitions filed under this paragraph, 
483.35  the court may find, based on the contents of the sworn petition, 
483.36  and the agreement of all parties, including the child, where 
484.1   appropriate, that the voluntary arrangement is in the best 
484.2   interests of the child, approve the voluntary arrangement, and 
484.3   dismiss the matter from further jurisdiction.  The court shall 
484.4   give notice to the responsible social services agency that the 
484.5   matter must be returned to the court for further review if the 
484.6   child remains in placement after 12 months. 
484.7      (2) If any party, including the child, disagrees with the 
484.8   voluntary arrangement, the court shall proceed under section 
484.9   260.155. 
484.10     Sec. 33.  Minnesota Statutes 1998, section 260.133, 
484.11  subdivision 1, is amended to read: 
484.12     Subdivision 1.  [PETITION.] The local welfare agency may 
484.13  bring an emergency petition on behalf of minor family or 
484.14  household members seeking relief from acts of domestic child 
484.15  abuse.  The petition shall be brought according to section 
484.16  260.131 and shall allege the existence of or immediate and 
484.17  present danger of domestic child abuse, and shall be accompanied 
484.18  by an affidavit made under oath stating the specific facts and 
484.19  circumstances from which relief is sought.  The court has 
484.20  jurisdiction over the parties to a domestic child abuse matter 
484.21  notwithstanding that there is a parent in the child's household 
484.22  who is willing to enforce the court's order and accept services 
484.23  on behalf of the family. 
484.24     Sec. 34.  Minnesota Statutes 1998, section 260.135, is 
484.25  amended by adding a subdivision to read: 
484.26     Subd. 1a.  [NOTICE.] After a petition has been filed 
484.27  alleging a child to be in need of protection or services and 
484.28  unless the persons named in clauses (1) to (4) voluntarily 
484.29  appear or are summoned according to subdivision 1, the court 
484.30  shall issue a notice to: 
484.31     (1) an adjudicated or presumed father of the child; 
484.32     (2) an alleged father of the child; 
484.33     (3) a noncustodial mother; and 
484.34     (4) a grandparent with the right to participate under 
484.35  section 260.155, subdivision 1a. 
484.36     Sec. 35.  Minnesota Statutes 1998, section 260.155, 
485.1   subdivision 4, is amended to read: 
485.2      Subd. 4.  [GUARDIAN AD LITEM.] (a) The court shall appoint 
485.3   a guardian ad litem to protect the interests of the minor when 
485.4   it appears, at any stage of the proceedings, that the minor is 
485.5   without a parent or guardian, or that the minor's parent is a 
485.6   minor or incompetent, or that the parent or guardian is 
485.7   indifferent or hostile to the minor's interests, and in every 
485.8   proceeding alleging a child's need for protection or services 
485.9   under section 260.015, subdivision 2a.  In any other case the 
485.10  court may appoint a guardian ad litem to protect the interests 
485.11  of the minor when the court feels that such an appointment is 
485.12  desirable.  The court shall appoint the guardian ad litem on its 
485.13  own motion or in the manner provided for the appointment of a 
485.14  guardian ad litem in the district court.  The court may appoint 
485.15  separate counsel for the guardian ad litem if necessary.  
485.16     (b) A guardian ad litem shall carry out the following 
485.17  responsibilities: 
485.18     (1) conduct an independent investigation to determine the 
485.19  facts relevant to the situation of the child and the family, 
485.20  which must include, unless specifically excluded by the court, 
485.21  reviewing relevant documents; meeting with and observing the 
485.22  child in the home setting and considering the child's wishes, as 
485.23  appropriate; and interviewing parents, caregivers, and others 
485.24  with knowledge relevant to the case; 
485.25     (2) advocate for the child's best interests by 
485.26  participating in appropriate aspects of the case and advocating 
485.27  for appropriate community services when necessary; 
485.28     (3) maintain the confidentiality of information related to 
485.29  a case, with the exception of sharing information as permitted 
485.30  by law to promote cooperative solutions that are in the best 
485.31  interests of the child; 
485.32     (4) monitor the child's best interests throughout the 
485.33  judicial proceeding; and 
485.34     (5) present written reports on the child's best interests 
485.35  that include conclusions and recommendations and the facts upon 
485.36  which they are based. 
486.1      (c) Except in cases where the child is alleged to have been 
486.2   abused or neglected, the court may waive the appointment of a 
486.3   guardian ad litem pursuant to clause (a), whenever counsel has 
486.4   been appointed pursuant to subdivision 2 or is retained 
486.5   otherwise, and the court is satisfied that the interests of the 
486.6   minor are protected. 
486.7      (d) In appointing a guardian ad litem pursuant to clause 
486.8   (a), the court shall not appoint the party, or any agent or 
486.9   employee thereof, filing a petition pursuant to section 260.131. 
486.10     (e) The following factors shall be considered when 
486.11  appointing a guardian ad litem in a case involving an Indian or 
486.12  minority child: 
486.13     (1) whether a person is available who is the same racial or 
486.14  ethnic heritage as the child or, if that is not possible; 
486.15     (2) whether a person is available who knows and appreciates 
486.16  the child's racial or ethnic heritage. 
486.17     Sec. 36.  Minnesota Statutes 1998, section 260.155, 
486.18  subdivision 8, is amended to read: 
486.19     Subd. 8.  [WAIVER.] (a) Waiver of any right which a child 
486.20  has under this chapter must be an express waiver voluntarily and 
486.21  intelligently made by the child after the child has been fully 
486.22  and effectively informed of the right being waived.  If a child 
486.23  is not represented by counsel, any waiver must be given or any 
486.24  objection must be offered by the child's guardian ad litem. 
486.25     (b) Waiver of a child's right to be represented by counsel 
486.26  provided under the juvenile court rules must be an express 
486.27  waiver voluntarily and intelligently made by the child after the 
486.28  child has been fully and effectively informed of the right being 
486.29  waived.  In determining whether a child has voluntarily and 
486.30  intelligently waived the right to counsel, the court shall look 
486.31  to the totality of the circumstances which includes but is not 
486.32  limited to the child's age, maturity, intelligence, education, 
486.33  experience, and ability to comprehend, and the presence and 
486.34  competence of the child's parents, guardian, or guardian ad 
486.35  litem.  If the court accepts the child's waiver, it shall state 
486.36  on the record the findings and conclusions that form the basis 
487.1   for its decision to accept the waiver. 
487.2      Sec. 37.  Minnesota Statutes 1998, section 260.172, 
487.3   subdivision 1, is amended to read: 
487.4      Subdivision 1.  [HEARING AND RELEASE REQUIREMENTS.] (a) If 
487.5   a child was taken into custody under section 260.165, 
487.6   subdivision 1, clause (a) or (c)(2), the court shall hold a 
487.7   hearing within 72 hours of the time the child was taken into 
487.8   custody, excluding Saturdays, Sundays, and holidays, to 
487.9   determine whether the child should continue in custody.  
487.10     (b) In all other cases, the court shall hold a detention 
487.11  hearing: 
487.12     (1) within 36 hours of the time the child was taken into 
487.13  custody, excluding Saturdays, Sundays, and holidays, if the 
487.14  child is being held at a juvenile secure detention facility or 
487.15  shelter care facility; or 
487.16     (2) within 24 hours of the time the child was taken into 
487.17  custody, excluding Saturdays, Sundays, and holidays, if the 
487.18  child is being held at an adult jail or municipal lockup.  
487.19     (c) Unless there is reason to believe that the child would 
487.20  endanger self or others, not return for a court hearing, run 
487.21  away from the child's parent, guardian, or custodian or 
487.22  otherwise not remain in the care or control of the person to 
487.23  whose lawful custody the child is released, or that the child's 
487.24  health or welfare would be immediately endangered, the child 
487.25  shall be released to the custody of a parent, guardian, 
487.26  custodian, or other suitable person, subject to reasonable 
487.27  conditions of release including, but not limited to, a 
487.28  requirement that the child undergo a chemical use assessment as 
487.29  provided in section 260.151, subdivision 1.  In determining 
487.30  whether the child's health or welfare would be immediately 
487.31  endangered, the court shall consider whether the child would 
487.32  reside with a perpetrator of domestic child abuse.  In a 
487.33  proceeding regarding a child in need of protection or services, 
487.34  the court, before determining whether a child should continue in 
487.35  custody, shall also make a determination, consistent with 
487.36  section 260.012 as to whether reasonable efforts, or in the case 
488.1   of an Indian child, active efforts, according to the Indian 
488.2   Child Welfare Act of 1978, United States Code, title 25, section 
488.3   1912(d), were made to prevent placement or to reunite the child 
488.4   with the child's family, or that reasonable efforts were not 
488.5   possible.  The court shall also determine whether there are 
488.6   available services that would prevent the need for further 
488.7   detention. 
488.8      If the court finds the social services agency's preventive 
488.9   or reunification efforts have not been reasonable but further 
488.10  preventive or reunification efforts could not permit the child 
488.11  to safely remain at home, the court may nevertheless authorize 
488.12  or continue the removal of the child. 
488.13     The court may determine (d) At the detention hearing, or at 
488.14  any time prior to an adjudicatory hearing, that reasonable 
488.15  efforts are not required because the facts, if proved, will 
488.16  demonstrate that the parent has subjected the child to egregious 
488.17  harm as defined in section 260.015, subdivision 29, or the 
488.18  parental rights of the parent to a sibling of the child have 
488.19  been terminated involuntarily. and upon notice and request of 
488.20  the county attorney, the court shall make the following 
488.21  determinations: 
488.22     (1) whether a termination of parental rights petition has 
488.23  been filed stating a prima facie case that: 
488.24     (i) the parent has subjected a child to egregious harm as 
488.25  defined in section 260.015, subdivision 29; 
488.26     (ii) the parental rights of the parent to another child 
488.27  have been involuntarily terminated; or 
488.28     (iii) the child is an abandoned infant under section 
488.29  260.221, subdivision 1a, paragraph (a), clause (2); 
488.30     (2) that the county attorney has determined not to proceed 
488.31  with a termination of parental rights petition under section 
488.32  260.221, subdivision 1b; or 
488.33     (3) whether a termination of parental rights petition or 
488.34  other petition according to section 260.191, subdivision 3b, has 
488.35  been filed alleging a prima facie case that the provision of 
488.36  services or further services for the purpose of rehabilitation 
489.1   and reunification is futile and therefore unreasonable under the 
489.2   circumstances. 
489.3      If the court determines that the county attorney is not 
489.4   proceeding with a termination of parental rights petition under 
489.5   section 260.221, subdivision 1b, but is proceeding with a 
489.6   petition under section 260.191, subdivision 3b, the court shall 
489.7   schedule a permanency hearing within 30 days.  If the county 
489.8   attorney has filed a petition under section 260.221, subdivision 
489.9   1b, the court shall schedule a trial under section 260.155 
489.10  within 90 days of the filing of the petition except when the 
489.11  county attorney determines that the criminal case shall proceed 
489.12  to trial first under section 260.191, subdivision 1b. 
489.13     (e) If the court determines the child should be ordered 
489.14  into out-of-home placement and the child's parent refuses to 
489.15  give information to the responsible social services agency 
489.16  regarding the child's father or relatives of the child, the 
489.17  court may order the parent to disclose the names, addresses, 
489.18  telephone numbers, and other identifying information to the 
489.19  local social services agency for the purpose of complying with 
489.20  the requirements of sections 257.071, 257.072, and 260.135. 
489.21     Sec. 38.  Minnesota Statutes 1998, section 260.172, is 
489.22  amended by adding a subdivision to read: 
489.23     Subd. 5.  [CASE PLAN.] (a) A case plan required under 
489.24  section 257.071 shall be filed with the court within 30 days of 
489.25  the filing of a petition alleging the child to be in need of 
489.26  protection or services under section 260.131. 
489.27     (b) Upon the filing of the case plan, the court may approve 
489.28  the case plan based on the allegations contained in the 
489.29  petition.  A parent may agree to comply with the terms of the 
489.30  case plan filed with the court. 
489.31     (c) Upon notice and motion by a parent who agrees to comply 
489.32  with the terms of a case plan, the court may modify the case and 
489.33  order the responsible social services agency to provide other or 
489.34  additional services for reunification, if reunification efforts 
489.35  are required, and the court determines the agency's case plan 
489.36  inadequate under section 260.012. 
490.1      (d) Unless the parent agrees to comply with the terms of 
490.2   the case plan, the court may not order a parent to comply with 
490.3   the provisions of the case plan until the court makes a 
490.4   determination under section 260.191, subdivision 1. 
490.5      Sec. 39.  Minnesota Statutes 1998, section 260.181, 
490.6   subdivision 3, is amended to read: 
490.7      Subd. 3.  [PROTECTION OF CHILD'S BEST INTERESTS.] (a) The 
490.8   policy of the state is to ensure that the best interests of 
490.9   children are met by requiring individualized determinations of 
490.10  the needs of the child and of how the selected placement will 
490.11  serve the needs of the child in foster care placements.  
490.12     (b) Among the factors to be considered in determining the 
490.13  needs of the child are:  
490.14     (1) the child's current functioning and behaviors; 
490.15     (2) the medical, educational, and developmental needs of 
490.16  the child; 
490.17     (3) the child's history and past experience; 
490.18     (4) the child's religious and cultural needs; 
490.19     (5) the child's connection with a community, school, and 
490.20  church; 
490.21     (6) the child's interests and talents; 
490.22     (7) the child's relationship to current caretakers, 
490.23  parents, siblings, and relatives; and 
490.24     (8) the reasonable preference of the child, if the court, 
490.25  or in the case of a voluntary placement the child-placing 
490.26  agency, deems the child to be of sufficient age to express 
490.27  preferences.  
490.28     (c) The court, in transferring legal custody of any child 
490.29  or appointing a guardian for the child under the laws relating 
490.30  to juvenile courts, shall consider placement, consistent with 
490.31  the child's best interests and in the following order, in the 
490.32  legal custody or guardianship of an individual who (1) is 
490.33  related to the child by blood, marriage, or adoption, or (2) is 
490.34  an important friend with whom the child has resided or had 
490.35  significant contact, or (3) a married couple.  Placement of a 
490.36  child cannot be delayed or denied based on race, color, or 
491.1   national origin of the foster parent or the child.  Whenever 
491.2   possible, siblings should be placed together unless it is 
491.3   determined not to be in the best interests of a sibling. 
491.4      (d) If the child's birth parent or parents explicitly 
491.5   request that a relative or important friend not be considered, 
491.6   the court shall honor that request if it is consistent with the 
491.7   best interests of the child. 
491.8      If the child's birth parent or parents express a preference 
491.9   for placing the child in a foster or adoptive home of the same 
491.10  or a similar religious background to that of the birth parent or 
491.11  parents, the court shall order placement of the child with an 
491.12  individual who meets the birth parent's religious preference.  
491.13     (e) This subdivision does not affect the Indian Child 
491.14  Welfare Act, United States Code, title 25, sections 1901 to 
491.15  1923, and the Minnesota Indian Family Preservation Act, sections 
491.16  257.35 to 257.3579. 
491.17     Sec. 40.  Minnesota Statutes 1998, section 260.191, 
491.18  subdivision 1, is amended to read: 
491.19     Subdivision 1.  [DISPOSITIONS.] (a) If the court finds that 
491.20  the child is in need of protection or services or neglected and 
491.21  in foster care, it shall enter an order making any of the 
491.22  following dispositions of the case: 
491.23     (1) place the child under the protective supervision of the 
491.24  local social services agency or child-placing agency in the 
491.25  child's own home of a parent of the child under conditions 
491.26  prescribed by the court directed to the correction of the 
491.27  child's need for protection or services;, or: 
491.28     (i) the court may order the child into the home of a parent 
491.29  who does not otherwise have legal custody of the child, however, 
491.30  an order under this section does not confer legal custody on 
491.31  that parent; 
491.32     (ii) if the court orders the child into the home of a 
491.33  father who is not adjudicated, he must cooperate with paternity 
491.34  establishment proceedings regarding the child in the appropriate 
491.35  jurisdiction as one of the conditions prescribed by the court 
491.36  for the child to continue in his home; 
492.1      (iii) the court may order the child into the home of a 
492.2   noncustodial parent with conditions and may also order both the 
492.3   noncustodial and the custodial parent to comply with the 
492.4   requirements of a case plan under subdivision 1a; 
492.5      (2) transfer legal custody to one of the following: 
492.6      (i) a child-placing agency; or 
492.7      (ii) the local social services agency. 
492.8      In placing a child whose custody has been transferred under 
492.9   this paragraph, the agencies shall follow the order of 
492.10  preference stated in requirements of section 260.181, 
492.11  subdivision 3; 
492.12     (3) if the child is in need of special treatment and care 
492.13  for reasons of physical or mental health, the court may order 
492.14  the child's parent, guardian, or custodian to provide it.  If 
492.15  the parent, guardian, or custodian fails or is unable to provide 
492.16  this treatment or care, the court may order it provided.  The 
492.17  court shall not transfer legal custody of the child for the 
492.18  purpose of obtaining special treatment or care solely because 
492.19  the parent is unable to provide the treatment or care.  If the 
492.20  court's order for mental health treatment is based on a 
492.21  diagnosis made by a treatment professional, the court may order 
492.22  that the diagnosing professional not provide the treatment to 
492.23  the child if it finds that such an order is in the child's best 
492.24  interests; or 
492.25     (4) if the court believes that the child has sufficient 
492.26  maturity and judgment and that it is in the best interests of 
492.27  the child, the court may order a child 16 years old or older to 
492.28  be allowed to live independently, either alone or with others as 
492.29  approved by the court under supervision the court considers 
492.30  appropriate, if the county board, after consultation with the 
492.31  court, has specifically authorized this dispositional 
492.32  alternative for a child. 
492.33     (b) If the child was adjudicated in need of protection or 
492.34  services because the child is a runaway or habitual truant, the 
492.35  court may order any of the following dispositions in addition to 
492.36  or as alternatives to the dispositions authorized under 
493.1   paragraph (a): 
493.2      (1) counsel the child or the child's parents, guardian, or 
493.3   custodian; 
493.4      (2) place the child under the supervision of a probation 
493.5   officer or other suitable person in the child's own home under 
493.6   conditions prescribed by the court, including reasonable rules 
493.7   for the child's conduct and the conduct of the parents, 
493.8   guardian, or custodian, designed for the physical, mental, and 
493.9   moral well-being and behavior of the child; or with the consent 
493.10  of the commissioner of corrections, place the child in a group 
493.11  foster care facility which is under the commissioner's 
493.12  management and supervision; 
493.13     (3) subject to the court's supervision, transfer legal 
493.14  custody of the child to one of the following: 
493.15     (i) a reputable person of good moral character.  No person 
493.16  may receive custody of two or more unrelated children unless 
493.17  licensed to operate a residential program under sections 245A.01 
493.18  to 245A.16; or 
493.19     (ii) a county probation officer for placement in a group 
493.20  foster home established under the direction of the juvenile 
493.21  court and licensed pursuant to section 241.021; 
493.22     (4) require the child to pay a fine of up to $100.  The 
493.23  court shall order payment of the fine in a manner that will not 
493.24  impose undue financial hardship upon the child; 
493.25     (5) require the child to participate in a community service 
493.26  project; 
493.27     (6) order the child to undergo a chemical dependency 
493.28  evaluation and, if warranted by the evaluation, order 
493.29  participation by the child in a drug awareness program or an 
493.30  inpatient or outpatient chemical dependency treatment program; 
493.31     (7) if the court believes that it is in the best interests 
493.32  of the child and of public safety that the child's driver's 
493.33  license or instruction permit be canceled, the court may order 
493.34  the commissioner of public safety to cancel the child's license 
493.35  or permit for any period up to the child's 18th birthday.  If 
493.36  the child does not have a driver's license or permit, the court 
494.1   may order a denial of driving privileges for any period up to 
494.2   the child's 18th birthday.  The court shall forward an order 
494.3   issued under this clause to the commissioner, who shall cancel 
494.4   the license or permit or deny driving privileges without a 
494.5   hearing for the period specified by the court.  At any time 
494.6   before the expiration of the period of cancellation or denial, 
494.7   the court may, for good cause, order the commissioner of public 
494.8   safety to allow the child to apply for a license or permit, and 
494.9   the commissioner shall so authorize; 
494.10     (8) order that the child's parent or legal guardian deliver 
494.11  the child to school at the beginning of each school day for a 
494.12  period of time specified by the court; or 
494.13     (9) require the child to perform any other activities or 
494.14  participate in any other treatment programs deemed appropriate 
494.15  by the court.  
494.16     To the extent practicable, the court shall enter a 
494.17  disposition order the same day it makes a finding that a child 
494.18  is in need of protection or services or neglected and in foster 
494.19  care, but in no event more than 15 days after the finding unless 
494.20  the court finds that the best interests of the child will be 
494.21  served by granting a delay.  If the child was under eight years 
494.22  of age at the time the petition was filed, the disposition order 
494.23  must be entered within ten days of the finding and the court may 
494.24  not grant a delay unless good cause is shown and the court finds 
494.25  the best interests of the child will be served by the delay. 
494.26     (c) If a child who is 14 years of age or older is 
494.27  adjudicated in need of protection or services because the child 
494.28  is a habitual truant and truancy procedures involving the child 
494.29  were previously dealt with by a school attendance review board 
494.30  or county attorney mediation program under section 260A.06 or 
494.31  260A.07, the court shall order a cancellation or denial of 
494.32  driving privileges under paragraph (b), clause (7), for any 
494.33  period up to the child's 18th birthday. 
494.34     (d) In the case of a child adjudicated in need of 
494.35  protection or services because the child has committed domestic 
494.36  abuse and been ordered excluded from the child's parent's home, 
495.1   the court shall dismiss jurisdiction if the court, at any time, 
495.2   finds the parent is able or willing to provide an alternative 
495.3   safe living arrangement for the child, as defined in Laws 1997, 
495.4   chapter 239, article 10, section 2. 
495.5      Sec. 41.  Minnesota Statutes 1998, section 260.191, 
495.6   subdivision 3b, is amended to read: 
495.7      Subd. 3b.  [REVIEW OF COURT ORDERED PLACEMENTS; PERMANENT 
495.8   PLACEMENT DETERMINATION.] (a) Except for cases where the child 
495.9   is in placement due solely to the child's status as 
495.10  developmentally delayed under United States Code, title 42, 
495.11  section 6001(7), or emotionally handicapped under section 
495.12  252.27, and where custody has not been transferred to the 
495.13  responsible social services agency, the court shall conduct a 
495.14  hearing to determine the permanent status of a child not later 
495.15  than 12 months after the child is placed out of the home of the 
495.16  parent, except that if the child was under eight years of age at 
495.17  the time the petition was filed, the hearing must be conducted 
495.18  no later than six months after the child is placed out of the 
495.19  home of the parent. 
495.20     For purposes of this subdivision, the date of the child's 
495.21  placement out of the home of the parent is the earlier of the 
495.22  first court-ordered placement or 60 days after the date on which 
495.23  the child has been voluntarily placed out of the home. 
495.24     For purposes of this subdivision, 12 months is calculated 
495.25  as follows: 
495.26     (1) during the pendency of a petition alleging that a child 
495.27  is in need of protection or services, all time periods when a 
495.28  child is placed out of the home of the parent are cumulated; 
495.29     (2) if a child has been placed out of the home of the 
495.30  parent within the previous five years in connection with one or 
495.31  more prior petitions for a child in need of protection or 
495.32  services, the lengths of all prior time periods when the child 
495.33  was placed out of the home within the previous five years and 
495.34  under the current petition, are cumulated.  If a child under 
495.35  this clause has been out of the home for 12 months or more, the 
495.36  court, if it is in the best interests of the child and for 
496.1   compelling reasons, may extend the total time the child may 
496.2   continue out of the home under the current petition up to an 
496.3   additional six months before making a permanency determination.  
496.4      (b) Unless the responsible social services agency 
496.5   recommends return of the child to the custodial parent or 
496.6   parents, not later than ten 30 days prior to this hearing, the 
496.7   responsible social service services agency shall file pleadings 
496.8   in juvenile court to establish the basis for the juvenile court 
496.9   to order permanent placement determination of the child 
496.10  according to paragraph (d).  Notice of the hearing and copies of 
496.11  the pleadings must be provided pursuant to section 260.141.  If 
496.12  a termination of parental rights petition is filed before the 
496.13  date required for the permanency planning determination, and 
496.14  there is a trial under section 260.155 scheduled on that 
496.15  petition within 90 days of the filing of the petition, no 
496.16  hearing need be conducted under this subdivision. 
496.17     (c) At the conclusion of the hearing, the court shall 
496.18  determine whether order the child is to be returned home or, if 
496.19  not, what order a permanent placement is consistent with in the 
496.20  child's best interests.  The "best interests of the child" means 
496.21  all relevant factors to be considered and evaluated. 
496.22     (c) (d) At a hearing under this subdivision, if the child 
496.23  was under eight years of age at the time the petition was filed 
496.24  alleging the child in need of protection or services, the court 
496.25  shall review the progress of the case and the case plan, 
496.26  including the provision of services.  The court may order the 
496.27  local social service services agency to show cause why it should 
496.28  not file a termination of parental rights petition.  Cause may 
496.29  include, but is not limited to, the following conditions: 
496.30     (1) the parents or guardians have maintained regular 
496.31  contact with the child, the parents are complying with the 
496.32  court-ordered case plan, and the child would benefit from 
496.33  continuing this relationship; 
496.34     (2) grounds for termination under section 260.221 do not 
496.35  exist; or 
496.36     (3) the permanent plan for the child is transfer of 
497.1   permanent legal and physical custody to a relative.  When the 
497.2   permanent plan for the child is transfer of permanent legal and 
497.3   physical custody to a relative, a petition supporting the plan 
497.4   shall be filed in juvenile court within 30 days of the hearing 
497.5   required under this subdivision and a hearing on the petition 
497.6   held within 30 days of the filing of the pleadings. 
497.7      (d) (e) If the child is not returned to the home, the court 
497.8   must order one of the following dispositions available for 
497.9   permanent placement determination are: 
497.10     (1) permanent legal and physical custody to a relative in 
497.11  the best interests of the child.  In transferring permanent 
497.12  legal and physical custody to a relative, the juvenile court 
497.13  shall follow the standards and procedures applicable under 
497.14  chapter 257 or 518.  An order establishing permanent legal or 
497.15  physical custody under this subdivision must be filed with the 
497.16  family court.  A transfer of legal and physical custody includes 
497.17  responsibility for the protection, education, care, and control 
497.18  of the child and decision making on behalf of the child.  The 
497.19  social service services agency may petition on behalf of the 
497.20  proposed custodian; 
497.21     (2) termination of parental rights and adoption; unless the 
497.22  social service services agency shall file has already filed a 
497.23  petition for termination of parental rights under section 
497.24  260.231, the court may order such a petition filed and all the 
497.25  requirements of sections 260.221 to 260.245 remain applicable.  
497.26  An adoption completed subsequent to a determination under this 
497.27  subdivision may include an agreement for communication or 
497.28  contact under section 259.58; or 
497.29     (3) long-term foster care; transfer of legal custody and 
497.30  adoption are preferred permanency options for a child who cannot 
497.31  return home.  The court may order a child into long-term foster 
497.32  care only if it finds that neither an award of legal and 
497.33  physical custody to a relative, nor termination of parental 
497.34  rights nor adoption is in the child's best interests.  Further, 
497.35  the court may only order long-term foster care for the child 
497.36  under this section if it finds the following: 
498.1      (i) the child has reached age 12 and reasonable efforts by 
498.2   the responsible social service services agency have failed to 
498.3   locate an adoptive family for the child; or 
498.4      (ii) the child is a sibling of a child described in clause 
498.5   (i) and the siblings have a significant positive relationship 
498.6   and are ordered into the same long-term foster care home; or 
498.7      (4) foster care for a specified period of time may be 
498.8   ordered only if: 
498.9      (i) the sole basis for an adjudication that a the child is 
498.10  in need of protection or services is that the child is a 
498.11  runaway, is an habitual truant, or committed a delinquent act 
498.12  before age ten the child's behavior; and 
498.13     (ii) the court finds that foster care for a specified 
498.14  period of time is in the best interests of the child. 
498.15     (e) In ordering a permanent placement of a child, the court 
498.16  must be governed by the best interests of the child, including a 
498.17  review of the relationship between the child and relatives and 
498.18  the child and other important persons with whom the child has 
498.19  resided or had significant contact. 
498.20     (f) Once a permanent placement determination has been made 
498.21  and permanent placement has been established, further court 
498.22  reviews and dispositional hearings are only necessary if the 
498.23  placement is made under paragraph (d), clause (4), review is 
498.24  otherwise required by federal law, an adoption has not yet been 
498.25  finalized, or there is a disruption of the permanent or 
498.26  long-term placement.  
498.27     (g) An order under this subdivision must include the 
498.28  following detailed findings: 
498.29     (1) how the child's best interests are served by the order; 
498.30     (2) the nature and extent of the responsible social service 
498.31  services agency's reasonable efforts, or, in the case of an 
498.32  Indian child, active efforts, to reunify the child with the 
498.33  parent or parents; 
498.34     (3) the parent's or parents' efforts and ability to use 
498.35  services to correct the conditions which led to the out-of-home 
498.36  placement; and 
499.1      (4) whether the conditions which led to the out-of-home 
499.2   placement have been corrected so that the child can return home; 
499.3   and 
499.4      (5) if the child cannot be returned home, whether there is 
499.5   a substantial probability of the child being able to return home 
499.6   in the next six months.  
499.7      (h) An order for permanent legal and physical custody of a 
499.8   child may be modified under sections 518.18 and 518.185.  The 
499.9   social service services agency is a party to the proceeding and 
499.10  must receive notice.  An order for long-term foster care is 
499.11  reviewable upon motion and a showing by the parent of a 
499.12  substantial change in the parent's circumstances such that the 
499.13  parent could provide appropriate care for the child and that 
499.14  removal of the child from the child's permanent placement and 
499.15  the return to the parent's care would be in the best interest of 
499.16  the child. 
499.17     (i) The court shall issue an order required under this 
499.18  section within 15 days of the close of the proceedings.  The 
499.19  court may extend issuing the order an additional 15 days when 
499.20  necessary in the interests of justice and the best interests of 
499.21  the child. 
499.22     Sec. 42.  Minnesota Statutes 1998, section 260.192, is 
499.23  amended to read: 
499.24     260.192 [DISPOSITIONS; VOLUNTARY FOSTER CARE PLACEMENTS.] 
499.25     Unless the court disposes of the petition under section 
499.26  260.131, subdivision 1a, upon a petition for review of the 
499.27  foster care status of a child, the court may:  
499.28     (a) In the case of a petition required to be filed under 
499.29  section 257.071, subdivision 3, find that the child's needs are 
499.30  being met, that the child's placement in foster care is in the 
499.31  best interests of the child, and that the child will be returned 
499.32  home in the next six months, in which case the court shall 
499.33  approve the voluntary arrangement and continue the matter for 
499.34  six months to assure the child returns to the parent's home.  
499.35     (b) In the case of a petition required to be filed under 
499.36  section 257.071, subdivision 4, find that the child's needs are 
500.1   being met and that the child's placement in foster care is in 
500.2   the best interests of the child, in which case the court shall 
500.3   approve the voluntary arrangement.  The court shall order the 
500.4   social service agency responsible for the placement to bring a 
500.5   petition under section 260.131, subdivision 1 or 1a, as 
500.6   appropriate, within 12 months. 
500.7      (c) Find that the child's needs are not being met, in which 
500.8   case the court shall order the social service services agency or 
500.9   the parents to take whatever action is necessary and feasible to 
500.10  meet the child's needs, including, when appropriate, the 
500.11  provision by the social service services agency of services to 
500.12  the parents which would enable the child to live at home, and 
500.13  order a disposition under section 260.191. 
500.14     (d) (b) Find that the child has been abandoned by parents 
500.15  financially or emotionally, or that the developmentally disabled 
500.16  child does not require out-of-home care because of the 
500.17  handicapping condition, in which case the court shall order the 
500.18  social service services agency to file an appropriate petition 
500.19  pursuant to sections 260.131, subdivision 1, or 260.231. 
500.20     Nothing in this section shall be construed to prohibit 
500.21  bringing a petition pursuant to section 260.131, subdivision 1 
500.22  or 2, sooner than required by court order pursuant to this 
500.23  section. 
500.24     Sec. 43.  Minnesota Statutes 1998, section 260.221, 
500.25  subdivision 1, is amended to read: 
500.26     Subdivision 1.  [VOLUNTARY AND INVOLUNTARY.] The juvenile 
500.27  court may upon petition, terminate all rights of a parent to a 
500.28  child: 
500.29     (a) with the written consent of a parent who for good cause 
500.30  desires to terminate parental rights; or 
500.31     (b) if it finds that one or more of the following 
500.32  conditions exist: 
500.33     (1) that the parent has abandoned the child; 
500.34     (2) that the parent has substantially, continuously, or 
500.35  repeatedly refused or neglected to comply with the duties 
500.36  imposed upon that parent by the parent and child relationship, 
501.1   including but not limited to providing the child with necessary 
501.2   food, clothing, shelter, education, and other care and control 
501.3   necessary for the child's physical, mental, or emotional health 
501.4   and development, if the parent is physically and financially 
501.5   able, and either reasonable efforts by the social service 
501.6   services agency have failed to correct the conditions that 
501.7   formed the basis of the petition or reasonable efforts would be 
501.8   futile and therefore unreasonable; 
501.9      (3) that a parent has been ordered to contribute to the 
501.10  support of the child or financially aid in the child's birth and 
501.11  has continuously failed to do so without good cause.  This 
501.12  clause shall not be construed to state a grounds for termination 
501.13  of parental rights of a noncustodial parent if that parent has 
501.14  not been ordered to or cannot financially contribute to the 
501.15  support of the child or aid in the child's birth; 
501.16     (4) that a parent is palpably unfit to be a party to the 
501.17  parent and child relationship because of a consistent pattern of 
501.18  specific conduct before the child or of specific conditions 
501.19  directly relating to the parent and child relationship either of 
501.20  which are determined by the court to be of a duration or nature 
501.21  that renders the parent unable, for the reasonably foreseeable 
501.22  future, to care appropriately for the ongoing physical, mental, 
501.23  or emotional needs of the child.  It is presumed that a parent 
501.24  is palpably unfit to be a party to the parent and child 
501.25  relationship upon a showing that: 
501.26     (i) the child was adjudicated in need of protection or 
501.27  services due to circumstances described in section 260.015, 
501.28  subdivision 2a, clause (1), (2), (3), (5), or (8); and 
501.29     (ii) the parent's parental rights to one or more other 
501.30  children were involuntarily terminated under clause (1), (2), 
501.31  (4), or (7), or under clause (5) if the child was initially 
501.32  determined to be in need of protection or services due to 
501.33  circumstances described in section 260.015, subdivision 2a, 
501.34  clause (1), (2), (3), (5), or (8); 
501.35     (5) that following upon a determination of neglect or 
501.36  dependency, or of a child's need for protection or services the 
502.1   child's placement out of the home, reasonable efforts, under the 
502.2   direction of the court, have failed to correct the conditions 
502.3   leading to the determination child's placement.  It is presumed 
502.4   that reasonable efforts under this clause have failed upon a 
502.5   showing that: 
502.6      (i) a child has resided out of the parental home under 
502.7   court order for a cumulative period of more than one year within 
502.8   a five-year period following an adjudication of dependency, 
502.9   neglect, need for protection or services under section 260.015, 
502.10  subdivision 2a, clause (1), (2), (3), (6), (8), or (9), or 
502.11  neglected and in foster care, and an order for disposition under 
502.12  section 260.191, including adoption of the case plan required by 
502.13  section 257.071; 12 months within the preceding 22 months.  In 
502.14  the case of a child under age eight at the time the petition was 
502.15  filed alleging the child to be in need of protection or 
502.16  services, the presumption arises when the child has resided out 
502.17  of the parental home under court order for six months unless the 
502.18  parent has maintained regular contact with the child and the 
502.19  parent is complying with the case plan; 
502.20     (ii) the court has approved a case plan required under 
502.21  section 257.071 and filed with the court under section 260.172; 
502.22     (iii) conditions leading to the determination 
502.23  will out-of-home placement have not be been corrected within 
502.24  the reasonably foreseeable future.  It is presumed that 
502.25  conditions leading to a child's out-of-home placement will have 
502.26  not be been corrected in the reasonably foreseeable future upon 
502.27  a showing that the parent or parents have not substantially 
502.28  complied with the court's orders and a reasonable case plan, and 
502.29  the conditions which led to the out-of-home placement have not 
502.30  been corrected; and 
502.31     (iii) (iv) reasonable efforts have been made by the social 
502.32  service services agency to rehabilitate the parent and reunite 
502.33  the family. 
502.34     This clause does not prohibit the termination of parental 
502.35  rights prior to one year, or in the case of a child under age 
502.36  eight, within six months after a child has been placed out of 
503.1   the home. 
503.2      It is also presumed that reasonable efforts have failed 
503.3   under this clause upon a showing that: 
503.4      (i) (A) the parent has been diagnosed as chemically 
503.5   dependent by a professional certified to make the diagnosis; 
503.6      (ii) (B) the parent has been required by a case plan to 
503.7   participate in a chemical dependency treatment program; 
503.8      (iii) (C) the treatment programs offered to the parent were 
503.9   culturally, linguistically, and clinically appropriate; 
503.10     (iv) (D) the parent has either failed two or more times to 
503.11  successfully complete a treatment program or has refused at two 
503.12  or more separate meetings with a caseworker to participate in a 
503.13  treatment program; and 
503.14     (v) (E) the parent continues to abuse chemicals.  
503.15  Provided, that this presumption applies only to parents required 
503.16  by a case plan to participate in a chemical dependency treatment 
503.17  program on or after July 1, 1990; 
503.18     (6) that a child has experienced egregious harm in the 
503.19  parent's care which is of a nature, duration, or chronicity that 
503.20  indicates a lack of regard for the child's well-being, such that 
503.21  a reasonable person would believe it contrary to the best 
503.22  interest of the child or of any child to be in the parent's 
503.23  care; 
503.24     (7) that in the case of a child born to a mother who was 
503.25  not married to the child's father when the child was conceived 
503.26  nor when the child was born the person is not entitled to notice 
503.27  of an adoption hearing under section 259.49 and the person has 
503.28  not registered with the fathers' adoption registry under section 
503.29  259.52; 
503.30     (8) that the child is neglected and in foster care; or 
503.31     (9) that the parent has been convicted of a crime listed in 
503.32  section 260.012, paragraph (b), clauses (1) to (3). 
503.33     In an action involving an American Indian child, sections 
503.34  257.35 to 257.3579 and the Indian Child Welfare Act, United 
503.35  States Code, title 25, sections 1901 to 1923, control to the 
503.36  extent that the provisions of this section are inconsistent with 
504.1   those laws. 
504.2      Sec. 44.  Minnesota Statutes 1998, section 260.221, 
504.3   subdivision 1b, is amended to read: 
504.4      Subd. 1b.  [REQUIRED TERMINATION OF PARENTAL RIGHTS.] (a) 
504.5   The county attorney shall file a termination of parental rights 
504.6   petition within 30 days of the responsible social services 
504.7   agency determining that a child's placement in out-of-home care 
504.8   if the child has been subjected to egregious harm as defined in 
504.9   section 260.015, subdivision 29, is determined to be the sibling 
504.10  of another child of the parent who was subjected to egregious 
504.11  harm, or is an abandoned infant as defined in subdivision 1a, 
504.12  paragraph (a), clause (2).  The local social services agency 
504.13  shall concurrently identify, recruit, process, and approve an 
504.14  adoptive family for the child.  If a termination of parental 
504.15  rights petition has been filed by another party, the local 
504.16  social services agency shall be joined as a party to the 
504.17  petition.  If criminal charges have been filed against a parent 
504.18  arising out of the conduct alleged to constitute egregious harm, 
504.19  the county attorney shall determine which matter should proceed 
504.20  to trial first, consistent with the best interests of the child 
504.21  and subject to the defendant's right to a speedy trial. 
504.22     (b) This requirement does not apply if the county attorney 
504.23  determines and files with the court its determination that: 
504.24     (1) a petition for transfer of permanent legal and physical 
504.25  custody to a relative is in the best interests of the child or 
504.26  there is under section 260.191, subdivision 3b, including a 
504.27  determination that the transfer is in the best interests of the 
504.28  child; or 
504.29     (2) a petition alleging the child and, where appropriate, 
504.30  the child's siblings to be in need of protection or services 
504.31  accompanied by a case plan prepared by the responsible social 
504.32  services agency documenting a compelling reason documented by 
504.33  the local social services agency that why filing the a 
504.34  termination of parental rights petition would not be in the best 
504.35  interests of the child. 
504.36     Sec. 45.  Minnesota Statutes 1998, section 260.221, 
505.1   subdivision 1c, is amended to read: 
505.2      Subd. 1c.  [CURRENT FOSTER CARE CHILDREN.] Except for cases 
505.3   where the child is in placement due solely to the child's status 
505.4   as developmentally delayed under United States Code, title 42, 
505.5   section 6001(7), or emotionally handicapped under section 
505.6   252.27, and where custody has not been transferred to the 
505.7   responsible social services agency, the county attorney shall 
505.8   file a termination of parental rights petition or other a 
505.9   petition to support another permanent placement proceeding under 
505.10  section 260.191, subdivision 3b, for all children determined to 
505.11  be in need of protection or services who are placed in 
505.12  out-of-home care for reasons other than care or treatment of the 
505.13  child's disability, and who are in out-of-home placement on 
505.14  April 21, 1998, and have been in out-of-home care for 15 of the 
505.15  most recent 22 months.  This requirement does not apply if there 
505.16  is a compelling reason documented in a case plan filed with the 
505.17  court for determining that filing a termination of parental 
505.18  rights petition or other permanency petition would not be in the 
505.19  best interests of the child or if the responsible social 
505.20  services agency has not provided reasonable efforts necessary 
505.21  for the safe return of the child, if reasonable efforts are 
505.22  required.  
505.23     Sec. 46.  Minnesota Statutes 1998, section 260.221, 
505.24  subdivision 3, is amended to read: 
505.25     Subd. 3.  [WHEN PRIOR FINDING REQUIRED.] For purposes of 
505.26  subdivision 1, clause (b), no prior judicial finding of 
505.27  dependency, neglect, need for protection or services, or 
505.28  neglected and in foster care is required, except as provided in 
505.29  subdivision 1, clause (b), item (5). 
505.30     Sec. 47.  Minnesota Statutes 1998, section 260.221, 
505.31  subdivision 5, is amended to read: 
505.32     Subd. 5.  [FINDINGS REGARDING REASONABLE EFFORTS.] In any 
505.33  proceeding under this section, the court shall make specific 
505.34  findings: 
505.35     (1) regarding the nature and extent of efforts made by the 
505.36  social service services agency to rehabilitate the parent and 
506.1   reunite the family; or 
506.2      (2) that provision of services or further services for the 
506.3   purpose of rehabilitation and reunification is futile and 
506.4   therefore unreasonable under the circumstances; or 
506.5      (3) that reasonable efforts at reunification are not 
506.6   required as provided under section 260.012. 
506.7                              ARTICLE 10
506.8              OTHER HEALTH AND HUMAN SERVICES PROVISIONS
506.9      Section 1.  Minnesota Statutes 1998, section 256.485, is 
506.10  amended to read: 
506.11     256.485 [CHILD WELFARE SERVICES TO MINOR REFUGEES.] 
506.12     Subdivision 1.  [SPECIAL PROJECTS.] The commissioner of 
506.13  human services shall establish a grant program to provide 
506.14  specialized child welfare services to Asian and Amerasian 
506.15  refugees under the age of 18 who reside in Minnesota.  
506.16     Subd. 2.  [DEFINITIONS.] For the purpose of this section, 
506.17  the following terms have the meanings given them:  
506.18     (a) "Refugee" means refugee or asylee status granted by the 
506.19  United States Immigration and Naturalization Service. 
506.20     (b) "Child welfare services" means treatment or services, 
506.21  including workshops or training regarding independent living 
506.22  skills, coping skills, and responsible parenting, and family or 
506.23  individual counseling regarding career planning, 
506.24  intergenerational relationships and communications, and 
506.25  emotional or psychological stress. 
506.26     Subd. 3.  [PROJECT SELECTION.] The commissioner shall 
506.27  select projects for funding under this section.  Projects 
506.28  selected must be administered by service providers who have 
506.29  experience in providing child welfare services to minor Asian 
506.30  and Amerasian refugees. 
506.31     Subd. 4.  [PROJECT DESIGN.] Project proposals selected 
506.32  under this section must: 
506.33     (1) use existing resources when possible; 
506.34     (2) provide bilingual services; 
506.35     (3) clearly specify program goals and timetables for 
506.36  project operation; 
507.1      (4) identify support services, social services, and 
507.2   referral procedures to be used; and 
507.3      (5) identify the training and experience that enable 
507.4   project staff to provide services to targeted refugees, as well 
507.5   as the number of staff with bilingual service expertise. 
507.6      Subd. 5.  [ANNUAL REPORT.] Selected service providers must 
507.7   report to the commissioner by June 30 of each year on the number 
507.8   of refugees served, the average cost per refugee served, the 
507.9   number and percentage of refugees who are successfully assisted 
507.10  through child welfare services, and recommendations for 
507.11  modifications in service delivery for the upcoming year.  
507.12     Subd. 6.  [EXPIRATION.] This section expires June 30, 2001. 
507.13     Sec. 2.  [REPEALER.] 
507.14     Minnesota Statutes 1998, section 256.973, is repealed. 
507.15                             ARTICLE 11 
507.16                   HEALTH PLAN COMPANY REGULATION 
507.17     Section 1.  Minnesota Statutes 1998, section 62D.11, 
507.18  subdivision 1, is amended to read: 
507.19     Subdivision 1.  [ENROLLEE COMPLAINT SYSTEM.] Every health 
507.20  maintenance organization shall establish and maintain a 
507.21  complaint system, as required under section 62Q.105 sections 
507.22  62Q.68 to 62Q.72 to provide reasonable procedures for the 
507.23  resolution of written complaints initiated by or on behalf of 
507.24  enrollees concerning the provision of health care 
507.25  services.  "Provision of health services" includes, but is not 
507.26  limited to, questions of the scope of coverage, quality of care, 
507.27  and administrative operations.  The health maintenance 
507.28  organization must inform enrollees that they may choose to use 
507.29  arbitration to appeal a health maintenance organization's 
507.30  internal appeal decision.  The health maintenance organization 
507.31  must also inform enrollees that they have the right to use 
507.32  arbitration to appeal a health maintenance organization's 
507.33  internal appeal decision not to certify an admission, procedure, 
507.34  service, or extension of stay under section 62M.06.  If an 
507.35  enrollee chooses to use arbitration, the health maintenance 
507.36  organization must participate. 
508.1      (Effective Date:  Section 1 (62D.11, subdivision 1) is 
508.2   effective January 1, 2000.) 
508.3      Sec. 2.  Minnesota Statutes 1998, section 62M.01, is 
508.4   amended to read: 
508.5      62M.01 [CITATION, JURISDICTION, AND SCOPE.] 
508.6      Subdivision 1.  [POPULAR NAME.] Sections 62M.01 to 62M.16 
508.7   may be cited as the "Minnesota Utilization Review Act of 1992." 
508.8      Subd. 2.  [JURISDICTION.] Sections 62M.01 to 62M.16 apply 
508.9   to any insurance company licensed under chapter 60A to offer, 
508.10  sell, or issue a policy of accident and sickness insurance as 
508.11  defined in section 62A.01; a health service plan licensed under 
508.12  chapter 62C; a health maintenance organization licensed under 
508.13  chapter 62D; a community integrated service network licensed 
508.14  under chapter 62N; an accountable provider network operating 
508.15  under chapter 62T; a fraternal benefit society operating under 
508.16  chapter 64B; a joint self-insurance employee health plan 
508.17  operating under chapter 62H; a multiple employer welfare 
508.18  arrangement, as defined in section 3 of the Employee Retirement 
508.19  Income Security Act of 1974 (ERISA), United States Code, title 
508.20  29, section 1103, as amended; a third party administrator 
508.21  licensed under section 60A.23, subdivision 8, that provides 
508.22  utilization review services for the administration of benefits 
508.23  under a health benefit plan as defined in section 62M.02; or any 
508.24  entity performing utilization review on behalf of a business 
508.25  entity in this state pursuant to a health benefit plan covering 
508.26  a Minnesota resident. 
508.27     Subd. 3.  [SCOPE.] Sections 62M.02, 62M.07, and 62M.09, 
508.28  subdivision 4, apply to prior authorization of services.  
508.29  Nothing in sections 62M.01 to 62M.16 applies to review of claims 
508.30  after submission to determine eligibility for benefits under a 
508.31  health benefit plan.  The appeal procedure described in section 
508.32  62M.06 applies to any complaint as defined under section 62Q.68, 
508.33  subdivision 2, that requires a medical determination in its 
508.34  resolution.  
508.35     (Effective Date:  Section 2 (62M.01, subdivisions 2 and 3) 
508.36  are effective January 1, 2000.) 
509.1      Sec. 3.  Minnesota Statutes 1998, section 62M.02, 
509.2   subdivision 3, is amended to read: 
509.3      Subd. 3.  [ATTENDING DENTIST.] "Attending dentist" means 
509.4   the dentist with primary responsibility for the dental care 
509.5   provided to a patient an enrollee. 
509.6      (Effective Date:  Section 3 (62M.02, subdivision 3) is 
509.7   effective January 1, 2000.) 
509.8      Sec. 4.  Minnesota Statutes 1998, section 62M.02, 
509.9   subdivision 4, is amended to read: 
509.10     Subd. 4.  [ATTENDING PHYSICIAN HEALTH CARE PROFESSIONAL.] 
509.11  "Attending physician health care professional" means 
509.12  the physician health care professional with primary 
509.13  responsibility for the care provided to a patient in a hospital 
509.14  or other health care facility an enrollee. 
509.15     (Effective Date:  Section 4 (62M.02, subdivision 4) is 
509.16  effective January 1, 2000.) 
509.17     Sec. 5.  Minnesota Statutes 1998, section 62M.02, 
509.18  subdivision 5, is amended to read: 
509.19     Subd. 5.  [CERTIFICATION.] "Certification" means a 
509.20  determination by a utilization review organization that an 
509.21  admission, extension of stay, or other health care service has 
509.22  been reviewed and that it, based on the information provided, 
509.23  meets the utilization review requirements of the applicable 
509.24  health plan and the health carrier plan company will then pay 
509.25  for the covered benefit, provided the preexisting limitation 
509.26  provisions, the general exclusion provisions, and any 
509.27  deductible, copayment, coinsurance, or other policy requirements 
509.28  have been met. 
509.29     (Effective Date:  Section 5 (62M.02, subdivision 5) is 
509.30  effective January 1, 2000.) 
509.31     Sec. 6.  Minnesota Statutes 1998, section 62M.02, 
509.32  subdivision 6, is amended to read: 
509.33     Subd. 6.  [CLAIMS ADMINISTRATOR.] "Claims administrator" 
509.34  means an entity that reviews and determines whether to pay 
509.35  claims to enrollees, physicians, hospitals, or others or 
509.36  providers based on the contract provisions of the health plan 
510.1   contract.  Claims administrators may include insurance companies 
510.2   licensed under chapter 60A to offer, sell, or issue a policy of 
510.3   accident and sickness insurance as defined in section 62A.01; a 
510.4   health service plan licensed under chapter 62C; a health 
510.5   maintenance organization licensed under chapter 62D; a community 
510.6   integrated service network licensed under chapter 62N; an 
510.7   accountable provider network operating under chapter 62T; a 
510.8   fraternal benefit society operating under chapter 64B; a 
510.9   multiple employer welfare arrangement, as defined in section 3 
510.10  of the Employee Retirement Income Security Act of 1974 (ERISA), 
510.11  United States Code, title 29, section 1103, as amended. 
510.12     (Effective Date:  Section 6 (62M.02, subdivision 6) is 
510.13  effective January 1, 2000.) 
510.14     Sec. 7.  Minnesota Statutes 1998, section 62M.02, 
510.15  subdivision 7, is amended to read: 
510.16     Subd. 7.  [CLAIMANT.] "Claimant" means the enrollee or 
510.17  covered person who files a claim for benefits or a provider of 
510.18  services who, pursuant to a contract with a claims 
510.19  administrator, files a claim on behalf of an enrollee or covered 
510.20  person. 
510.21     (Effective Date:  Section 7 (62M.02, subdivision 7) is 
510.22  effective January 1, 2000.) 
510.23     Sec. 8.  Minnesota Statutes 1998, section 62M.02, 
510.24  subdivision 9, is amended to read: 
510.25     Subd. 9.  [CONCURRENT REVIEW.] "Concurrent review" means 
510.26  utilization review conducted during a patient's an enrollee's 
510.27  hospital stay or course of treatment and has the same meaning as 
510.28  continued stay review. 
510.29     (Effective Date:  Section 8 (62M.02, subdivision 9) is 
510.30  effective January 1, 2000.) 
510.31     Sec. 9.  Minnesota Statutes 1998, section 62M.02, 
510.32  subdivision 10, is amended to read: 
510.33     Subd. 10.  [DISCHARGE PLANNING.] "Discharge planning" means 
510.34  the process that assesses a patient's an enrollee's need for 
510.35  treatment after hospitalization in order to help arrange for the 
510.36  necessary services and resources to effect an appropriate and 
511.1   timely discharge. 
511.2      (Effective Date:  Section 9 (62M.02, subdivision 10) is 
511.3   effective January 1, 2000.) 
511.4      Sec. 10.  Minnesota Statutes 1998, section 62M.02, 
511.5   subdivision 11, is amended to read: 
511.6      Subd. 11.  [ENROLLEE.] "Enrollee" means an individual who 
511.7   has elected to contract for, or participate in, a health benefit 
511.8   plan for enrollee coverage or for dependent coverage covered by 
511.9   a health benefit plan and includes an insured policyholder, 
511.10  subscriber contract holder, member, covered person, or 
511.11  certificate holder. 
511.12     (Effective Date:  Section 10 (62M.02, subdivision 11) is 
511.13  effective January 1, 2000.) 
511.14     Sec. 11.  Minnesota Statutes 1998, section 62M.02, 
511.15  subdivision 12, is amended to read: 
511.16     Subd. 12.  [HEALTH BENEFIT PLAN.] "Health benefit plan" 
511.17  means a policy, contract, or certificate issued by a health 
511.18  carrier to an employer or individual plan company for the 
511.19  coverage of medical, dental, or hospital benefits.  A health 
511.20  benefit plan does not include coverage that is: 
511.21     (1) limited to disability or income protection coverage; 
511.22     (2) automobile medical payment coverage; 
511.23     (3) supplemental to liability insurance; 
511.24     (4) designed solely to provide payments on a per diem, 
511.25  fixed indemnity, or nonexpense incurred basis; 
511.26     (5) credit accident and health insurance issued under 
511.27  chapter 62B; 
511.28     (6) blanket accident and sickness insurance as defined in 
511.29  section 62A.11; 
511.30     (7) accident only coverage issued by a licensed and tested 
511.31  insurance agent; or 
511.32     (8) workers' compensation. 
511.33     (Effective Date:  Section 11 (62M.02, subdivision 12) is 
511.34  effective January 1, 2000.) 
511.35     Sec. 12.  Minnesota Statutes 1998, section 62M.02, is 
511.36  amended by adding a subdivision to read: 
512.1      Subd. 12a.  [HEALTH PLAN COMPANY.] "Health plan company" 
512.2   means a health plan company as defined in section 62Q.01, 
512.3   subdivision 4, and includes an accountable provider network 
512.4   operating under chapter 62T. 
512.5      (Effective Date:  Section 12 (62M.02, subdivision 12a) is 
512.6   effective January 1, 2000.) 
512.7      Sec. 13.  Minnesota Statutes 1998, section 62M.02, 
512.8   subdivision 17, is amended to read: 
512.9      Subd. 17.  [PROVIDER.] "Provider" means a licensed health 
512.10  care facility, physician, or other health care professional that 
512.11  delivers health care services to an enrollee or covered person. 
512.12     (Effective Date:  Section 13 (62M.02, subdivision 17) is 
512.13  effective January 1, 2000.) 
512.14     Sec. 14.  Minnesota Statutes 1998, section 62M.02, 
512.15  subdivision 20, is amended to read: 
512.16     Subd. 20.  [UTILIZATION REVIEW.] "Utilization review" means 
512.17  the evaluation of the necessity, appropriateness, and efficacy 
512.18  of the use of health care services, procedures, and facilities, 
512.19  by a person or entity other than the attending physician health 
512.20  care professional, for the purpose of determining the medical 
512.21  necessity of the service or admission.  Utilization review also 
512.22  includes review conducted after the admission of the enrollee.  
512.23  It includes situations where the enrollee is unconscious or 
512.24  otherwise unable to provide advance notification.  Utilization 
512.25  review does not include the imposition of a requirement that 
512.26  services be received by or upon referral from a participating 
512.27  provider. 
512.28     (Effective Date:  Section 14 (62M.02, subdivision 20) is 
512.29  effective January 1, 2000.) 
512.30     Sec. 15.  Minnesota Statutes 1998, section 62M.02, 
512.31  subdivision 21, is amended to read: 
512.32     Subd. 21.  [UTILIZATION REVIEW ORGANIZATION.] "Utilization 
512.33  review organization" means an entity including but not limited 
512.34  to an insurance company licensed under chapter 60A to offer, 
512.35  sell, or issue a policy of accident and sickness insurance as 
512.36  defined in section 62A.01; a health service plan licensed under 
513.1   chapter 62C; a health maintenance organization licensed under 
513.2   chapter 62D; a community integrated service network licensed 
513.3   under chapter 62N; an accountable provider network operating 
513.4   under chapter 62T; a fraternal benefit society operating under 
513.5   chapter 64B; a joint self-insurance employee health plan 
513.6   operating under chapter 62H; a multiple employer welfare 
513.7   arrangement, as defined in section 3 of the Employee Retirement 
513.8   Income Security Act of 1974 (ERISA), United States Code, title 
513.9   29, section 1103, as amended; a third party administrator 
513.10  licensed under section 60A.23, subdivision 8, which conducts 
513.11  utilization review and determines certification of an admission, 
513.12  extension of stay, or other health care services for a Minnesota 
513.13  resident; or any entity performing utilization review that is 
513.14  affiliated with, under contract with, or conducting utilization 
513.15  review on behalf of, a business entity in this state. 
513.16     (Effective Date:  Section 15 (62M.02, subdivision 21) is 
513.17  effective January 1, 2000.) 
513.18     Sec. 16.  Minnesota Statutes 1998, section 62M.03, 
513.19  subdivision 1, is amended to read: 
513.20     Subdivision 1.  [LICENSED UTILIZATION REVIEW ORGANIZATION.] 
513.21  Beginning January 1, 1993, any organization that meets the 
513.22  definition of utilization review organization in section 62M.02, 
513.23  subdivision 21, must be licensed under chapter 60A, 62C, 62D, 
513.24  62N, 62T, or 64B, or registered under this chapter and must 
513.25  comply with sections 62M.01 to 62M.16 and section 72A.201, 
513.26  subdivisions 8 and 8a.  Each licensed community integrated 
513.27  service network or health maintenance organization that has an 
513.28  employed staff model of providing health care services shall 
513.29  comply with sections 62M.01 to 62M.16 and section 72A.201, 
513.30  subdivisions 8 and 8a, for any services provided by providers 
513.31  under contract. 
513.32     (Effective Date:  Section 16 (62M.03, subdivision 1) is 
513.33  effective January 1, 2000.) 
513.34     Sec. 17.  Minnesota Statutes 1998, section 62M.03, 
513.35  subdivision 3, is amended to read: 
513.36     Subd. 3.  [PENALTIES AND ENFORCEMENTS.] If a utilization 
514.1   review organization fails to comply with sections 62M.01 to 
514.2   62M.16, the organization may not provide utilization review 
514.3   services for any Minnesota resident.  The commissioner of 
514.4   commerce may issue a cease and desist order under section 
514.5   45.027, subdivision 5, to enforce this provision.  The cease and 
514.6   desist order is subject to appeal under chapter 14.  A 
514.7   nonlicensed utilization review organization that fails to comply 
514.8   with the provisions of sections 62M.01 to 62M.16 is subject to 
514.9   all applicable penalty and enforcement provisions of section 
514.10  72A.201.  Each utilization review organization licensed under 
514.11  chapter 60A, 62C, 62D, 62N, 62T, or 64B shall comply with 
514.12  sections 62M.01 to 62M.16 as a condition of licensure. 
514.13     (Effective Date:  Section 17 (62M.03, subdivision 3) is 
514.14  effective January 1, 2000.) 
514.15     Sec. 18.  Minnesota Statutes 1998, section 62M.04, 
514.16  subdivision 1, is amended to read: 
514.17     Subdivision 1.  [RESPONSIBILITY FOR OBTAINING 
514.18  CERTIFICATION.] A health benefit plan that includes utilization 
514.19  review requirements must specify the process for notifying the 
514.20  utilization review organization in a timely manner and obtaining 
514.21  certification for health care services.  Each health plan 
514.22  company must provide a clear and concise description of this 
514.23  process to an enrollee as part of the policy, subscriber 
514.24  contract, or certificate of coverage.  In addition to the 
514.25  enrollee, the utilization review organization must allow any 
514.26  licensed hospital, physician or the physician's provider or 
514.27  provider's designee, or responsible patient representative, 
514.28  including a family member, to fulfill the obligations under the 
514.29  health plan. 
514.30     A claims administrator that contracts directly with 
514.31  providers for the provision of health care services to enrollees 
514.32  may, through contract, require the provider to notify the review 
514.33  organization in a timely manner and obtain certification for 
514.34  health care services. 
514.35     (Effective Date:  Section 18 (62M.04, subdivision 1) is 
514.36  effective January 1, 2000.) 
515.1      Sec. 19.  Minnesota Statutes 1998, section 62M.04, 
515.2   subdivision 2, is amended to read: 
515.3      Subd. 2.  [INFORMATION UPON WHICH UTILIZATION REVIEW IS 
515.4   CONDUCTED.] If the utilization review organization is conducting 
515.5   routine prospective and concurrent utilization review, 
515.6   utilization review organizations must collect only the 
515.7   information necessary to certify the admission, procedure of 
515.8   treatment, and length of stay. 
515.9      (a) Utilization review organizations may request, but may 
515.10  not require, hospitals, physicians, or other providers to supply 
515.11  numerically encoded diagnoses or procedures as part of the 
515.12  certification process. 
515.13     (b) Utilization review organizations must not routinely 
515.14  request copies of medical records for all patients reviewed.  In 
515.15  performing prospective and concurrent review, copies of the 
515.16  pertinent portion of the medical record should be required only 
515.17  when a difficulty develops in certifying the medical necessity 
515.18  or appropriateness of the admission or extension of stay. 
515.19     (c) Utilization review organizations may request copies of 
515.20  medical records retrospectively for a number of purposes, 
515.21  including auditing the services provided, quality assurance 
515.22  review, ensuring compliance with the terms of either the health 
515.23  benefit plan or the provider contract, and compliance with 
515.24  utilization review activities.  Except for reviewing medical 
515.25  records associated with an appeal or with an investigation or 
515.26  audit of data discrepancies, health care providers must be 
515.27  reimbursed for the reasonable costs of duplicating records 
515.28  requested by the utilization review organization for 
515.29  retrospective review unless otherwise provided under the terms 
515.30  of the provider contract. 
515.31     (Effective Date:  Section 19 (62M.04, subdivision 2) is 
515.32  effective January 1, 2000.) 
515.33     Sec. 20.  Minnesota Statutes 1998, section 62M.04, 
515.34  subdivision 3, is amended to read: 
515.35     Subd. 3.  [DATA ELEMENTS.] Except as otherwise provided in 
515.36  sections 62M.01 to 62M.16, for purposes of certification a 
516.1   utilization review organization must limit its data requirements 
516.2   to the following elements: 
516.3      (a) Patient information that includes the following: 
516.4      (1) name; 
516.5      (2) address; 
516.6      (3) date of birth; 
516.7      (4) sex; 
516.8      (5) social security number or patient identification 
516.9   number; 
516.10     (6) name of health carrier plan company or health plan; and 
516.11     (7) plan identification number. 
516.12     (b) Enrollee information that includes the following: 
516.13     (1) name; 
516.14     (2) address; 
516.15     (3) social security number or employee identification 
516.16  number; 
516.17     (4) relation to patient; 
516.18     (5) employer; 
516.19     (6) health benefit plan; 
516.20     (7) group number or plan identification number; and 
516.21     (8) availability of other coverage. 
516.22     (c) Attending physician or provider health care 
516.23  professional information that includes the following: 
516.24     (1) name; 
516.25     (2) address; 
516.26     (3) telephone numbers; 
516.27     (4) degree and license; 
516.28     (5) specialty or board certification status; and 
516.29     (6) tax identification number or other identification 
516.30  number. 
516.31     (d) Diagnosis and treatment information that includes the 
516.32  following: 
516.33     (1) primary diagnosis with associated ICD or DSM coding, if 
516.34  available; 
516.35     (2) secondary diagnosis with associated ICD or DSM coding, 
516.36  if available; 
517.1      (3) tertiary diagnoses with associated ICD or DSM coding, 
517.2   if available; 
517.3      (4) proposed procedures or treatments with ICD or 
517.4   associated CPT codes, if available; 
517.5      (5) surgical assistant requirement; 
517.6      (6) anesthesia requirement; 
517.7      (7) proposed admission or service dates; 
517.8      (8) proposed procedure date; and 
517.9      (9) proposed length of stay. 
517.10     (e) Clinical information that includes the following: 
517.11     (1) support and documentation of appropriateness and level 
517.12  of service proposed; and 
517.13     (2) identification of contact person for detailed clinical 
517.14  information. 
517.15     (f) Facility information that includes the following:  
517.16     (1) type; 
517.17     (2) licensure and certification status and DRG exempt 
517.18  status; 
517.19     (3) name; 
517.20     (4) address; 
517.21     (5) telephone number; and 
517.22     (6) tax identification number or other identification 
517.23  number. 
517.24     (g) Concurrent or continued stay review information that 
517.25  includes the following: 
517.26     (1) additional days, services, or procedures proposed; 
517.27     (2) reasons for extension, including clinical information 
517.28  sufficient for support of appropriateness and level of service 
517.29  proposed; and 
517.30     (3) diagnosis status. 
517.31     (h) For admissions to facilities other than acute medical 
517.32  or surgical hospitals, additional information that includes the 
517.33  following: 
517.34     (1) history of present illness; 
517.35     (2) patient treatment plan and goals; 
517.36     (3) prognosis; 
518.1      (4) staff qualifications; and 
518.2      (5) 24-hour availability of staff. 
518.3      Additional information may be required for other specific 
518.4   review functions such as discharge planning or catastrophic case 
518.5   management.  Second opinion information may also be required, 
518.6   when applicable, to support benefit plan requirements. 
518.7      (Effective Date:  Section 20 (62M.04, subdivision 3) is 
518.8   effective January 1, 2000.) 
518.9      Sec. 21.  Minnesota Statutes 1998, section 62M.04, 
518.10  subdivision 4, is amended to read: 
518.11     Subd. 4.  [ADDITIONAL INFORMATION.] A utilization review 
518.12  organization may request information in addition to that 
518.13  described in subdivision 3 when there is significant lack of 
518.14  agreement between the utilization review organization and the 
518.15  health care provider regarding the appropriateness of 
518.16  certification during the review or appeal process.  For purposes 
518.17  of this subdivision, "significant lack of agreement" means that 
518.18  the utilization review organization has: 
518.19     (1) tentatively determined through its professional staff 
518.20  that a service cannot be certified; 
518.21     (2) referred the case to a physician for review; and 
518.22     (3) talked to or attempted to talk to the attending 
518.23  physician health care professional for further information. 
518.24     Nothing in sections 62M.01 to 62M.16 prohibits a 
518.25  utilization review organization from requiring submission of 
518.26  data necessary to comply with the quality assurance and 
518.27  utilization review requirements of chapter 62D or other 
518.28  appropriate data or outcome analyses. 
518.29     (Effective Date:  Section 21 (62M.04, subdivision 4) is 
518.30  effective January 1, 2000.) 
518.31     Sec. 22.  Minnesota Statutes 1998, section 62M.05, is 
518.32  amended to read: 
518.33     62M.05 [PROCEDURES FOR REVIEW DETERMINATION.] 
518.34     Subdivision 1.  [WRITTEN PROCEDURES.] A utilization review 
518.35  organization must have written procedures to ensure that reviews 
518.36  are conducted in accordance with the requirements of this 
519.1   chapter and section 72A.201, subdivision 4a. 
519.2      Subd. 2.  [CONCURRENT REVIEW.] A utilization review 
519.3   organization may review ongoing inpatient stays based on the 
519.4   severity or complexity of the patient's enrollee's condition or 
519.5   on necessary treatment or discharge planning activities.  Such 
519.6   review must not be consistently conducted on a daily basis. 
519.7      Subd. 3.  [NOTIFICATION OF DETERMINATIONS.] A utilization 
519.8   review organization must have written procedures for providing 
519.9   notification of its determinations on all certifications in 
519.10  accordance with the following: this section. 
519.11     Subd. 3a.  [STANDARD REVIEW DETERMINATION.] (a) 
519.12  Notwithstanding subdivision 3b, an initial determination on all 
519.13  requests for utilization review must be communicated to the 
519.14  provider and enrollee in accordance with this subdivision within 
519.15  ten business days of the request, provided that all information 
519.16  reasonably necessary to make a determination on the request has 
519.17  been made available to the utilization review organization.  
519.18     (b) When an initial determination is made to certify, 
519.19  notification must be provided promptly by telephone to the 
519.20  provider.  The utilization review organization shall send 
519.21  written notification to the hospital, attending physician, or 
519.22  applicable service provider within ten business days of the 
519.23  determination in accordance with section 72A.201, subdivision 
519.24  4a, provider or shall maintain an audit trail of the 
519.25  determination and telephone notification.  For purposes of this 
519.26  subdivision, "audit trail" includes documentation of the 
519.27  telephone notification, including the date; the name of the 
519.28  person spoken to; the enrollee or patient; the service, 
519.29  procedure, or admission certified; and the date of the service, 
519.30  procedure, or admission.  If the utilization review organization 
519.31  indicates certification by use of a number, the number must be 
519.32  called the "certification number." 
519.33     (b) (c) When a an initial determination is made not to 
519.34  certify a hospital or surgical facility admission or extension 
519.35  of a hospital stay, or other service requiring review 
519.36  determination, notification must be provided by telephone within 
520.1   one working day after making the decision determination to the 
520.2   attending physician health care professional and hospital must 
520.3   be notified by telephone and a written notification must be sent 
520.4   to the hospital, attending physician health care professional, 
520.5   and enrollee or patient.  The written notification must include 
520.6   the principal reason or reasons for the determination and the 
520.7   process for initiating an appeal of the determination.  Upon 
520.8   request, the utilization review organization shall provide 
520.9   the attending physician or provider or enrollee with the 
520.10  criteria used to determine the necessity, appropriateness, and 
520.11  efficacy of the health care service and identify the database, 
520.12  professional treatment parameter, or other basis for the 
520.13  criteria.  Reasons for a determination not to certify may 
520.14  include, among other things, the lack of adequate information to 
520.15  certify after a reasonable attempt has been made to contact 
520.16  the attending physician provider or enrollee. 
520.17     (d) When an initial determination is made not to certify, 
520.18  the written notification must inform the enrollee and the 
520.19  attending health care professional of the right to submit an 
520.20  appeal to the internal appeal process described in section 
520.21  62M.06 and the procedure for initiating the internal appeal. 
520.22     Subd. 3b.  [EXPEDITED REVIEW DETERMINATION.] (a) An 
520.23  expedited initial determination must be utilized if the 
520.24  attending health care professional believes that an expedited 
520.25  determination is warranted. 
520.26     (b) Notification of an expedited initial determination to 
520.27  either certify or not to certify must be provided to the 
520.28  hospital, the attending health care professional, and the 
520.29  enrollee as expeditiously as the enrollee's medical condition 
520.30  requires, but no later than 72 hours from the initial request.  
520.31  When an expedited initial determination is made not to certify, 
520.32  the utilization review organization must also notify the 
520.33  enrollee and the attending health care professional of the right 
520.34  to submit an appeal to the expedited internal appeal as 
520.35  described in section 62M.06 and the procedure for initiating an 
520.36  internal expedited appeal. 
521.1      Subd. 4.  [FAILURE TO PROVIDE NECESSARY INFORMATION.] A 
521.2   utilization review organization must have written procedures to 
521.3   address the failure of a health care provider, patient, or 
521.4   representative of either or enrollee to provide the necessary 
521.5   information for review.  If the patient enrollee or provider 
521.6   will not release the necessary information to the utilization 
521.7   review organization, the utilization review organization may 
521.8   deny certification in accordance with its own policy or the 
521.9   policy described in the health benefit plan. 
521.10     Subd. 5.  [NOTIFICATION TO CLAIMS ADMINISTRATOR.] If the 
521.11  utilization review organization and the claims administrator are 
521.12  separate entities, the utilization review organization must 
521.13  forward, electronically or in writing, a notification of 
521.14  certification or determination not to certify to the appropriate 
521.15  claims administrator for the health benefit plan. 
521.16     (Effective Date:  Section 22 (62M.05, subdivisions 1 to 5) 
521.17  are effective January 1, 2000.) 
521.18     Sec. 23.  Minnesota Statutes 1998, section 62M.06, is 
521.19  amended to read: 
521.20     62M.06 [APPEALS OF DETERMINATIONS NOT TO CERTIFY.] 
521.21     Subdivision 1.  [PROCEDURES FOR APPEAL.] A utilization 
521.22  review organization must have written procedures for appeals of 
521.23  determinations not to certify an admission, procedure, service, 
521.24  or extension of stay.  The right to appeal must be available to 
521.25  the enrollee or designee and to the attending physician health 
521.26  care professional.  The right of appeal must be communicated to 
521.27  the enrollee or designee or to the attending physician, whomever 
521.28  initiated the original certification request, at the time that 
521.29  the original determination is communicated. 
521.30     Subd. 2.  [EXPEDITED APPEAL.] (a) When an initial 
521.31  determination not to certify a health care service is made prior 
521.32  to or during an ongoing service requiring review, and the 
521.33  attending physician health care professional believes that the 
521.34  determination warrants immediate an expedited appeal, the 
521.35  utilization review organization must ensure that the enrollee 
521.36  and the attending physician, enrollee, or designee has health 
522.1   care professional have an opportunity to appeal the 
522.2   determination over the telephone on an expedited basis.  In such 
522.3   an appeal, the utilization review organization must ensure 
522.4   reasonable access to its consulting physician or health care 
522.5   provider.  Expedited appeals that are not resolved may be 
522.6   resubmitted through the standard appeal process. 
522.7      (b) The utilization review organization shall notify the 
522.8   enrollee and attending health care professional by telephone of 
522.9   its determination on the expedited appeal as expeditiously as 
522.10  the enrollee's medical condition requires, but no later than 72 
522.11  hours after receiving the expedited appeal. 
522.12     (c) If the determination not to certify is not reversed 
522.13  through the expedited appeal, the utilization review 
522.14  organization must include in its notification the right to 
522.15  submit the appeal to the external appeal process described in 
522.16  section 62Q.73 and the procedure for initiating the process.  
522.17  This information must be provided in writing to the enrollee and 
522.18  the attending health care professional as soon as practical. 
522.19     Subd. 3.  [STANDARD APPEAL.] The utilization review 
522.20  organization must establish procedures for appeals to be made 
522.21  either in writing or by telephone. 
522.22     (a) Each A utilization review organization shall notify in 
522.23  writing the enrollee or patient, attending physician health care 
522.24  professional, and claims administrator of its determination on 
522.25  the appeal as soon as practical, but in no case later than 45 
522.26  days after receiving the required documentation on the 
522.27  appeal within 30 days upon receipt of the notice of appeal.  
522.28     (b) The documentation required by the utilization review 
522.29  organization may include copies of part or all of the medical 
522.30  record and a written statement from the attending health care 
522.31  provider professional. 
522.32     (c) Prior to upholding the original decision initial 
522.33  determination not to certify for clinical reasons, the 
522.34  utilization review organization shall conduct a review of the 
522.35  documentation by a physician who did not make the original 
522.36  initial determination not to certify. 
523.1      (d) The process established by a utilization review 
523.2   organization may include defining a period within which an 
523.3   appeal must be filed to be considered.  The time period must be 
523.4   communicated to the patient, enrollee, or and attending 
523.5   physician health care professional when the initial 
523.6   determination is made. 
523.7      (e) An attending physician health care professional or 
523.8   enrollee who has been unsuccessful in an attempt to reverse a 
523.9   determination not to certify shall, consistent with section 
523.10  72A.285, be provided the following: 
523.11     (1) a complete summary of the review findings; 
523.12     (2) qualifications of the reviewers, including any license, 
523.13  certification, or specialty designation; and 
523.14     (3) the relationship between the enrollee's diagnosis and 
523.15  the review criteria used as the basis for the decision, 
523.16  including the specific rationale for the reviewer's decision. 
523.17     (f) In cases of appeal to reverse a determination not to 
523.18  certify for clinical reasons, the utilization review 
523.19  organization must, upon request of the attending physician 
523.20  health care professional, ensure that a physician of the 
523.21  utilization review organization's choice in the same or a 
523.22  similar general specialty as typically manages the medical 
523.23  condition, procedure, or treatment under discussion is 
523.24  reasonably available to review the case. 
523.25     (g) If the initial determination is not reversed on appeal, 
523.26  the utilization review organization must include in its 
523.27  notification the right to submit the appeal to the external 
523.28  review process described in section 62Q.73 and the procedure for 
523.29  initiating the external process. 
523.30     Subd. 4.  [NOTIFICATION TO CLAIMS ADMINISTRATOR.] If the 
523.31  utilization review organization and the claims administrator are 
523.32  separate entities, the utilization review organization 
523.33  must forward notify, either electronically or in writing, a 
523.34  notification of certification or determination not to certify to 
523.35  the appropriate claims administrator for the health benefit plan 
523.36  of any determination not to certify that is reversed on appeal. 
524.1      (Effective Date:  Section 23 (62M.06, subdivisions 1 to 4) 
524.2   are effective January 1, 2000.) 
524.3      Sec. 24.  Minnesota Statutes 1998, section 62M.07, is 
524.4   amended to read: 
524.5      62M.07 [PRIOR AUTHORIZATION OF SERVICES.] 
524.6      (a) Utilization review organizations conducting prior 
524.7   authorization of services must have written standards that meet 
524.8   at a minimum the following requirements: 
524.9      (1) written procedures and criteria used to determine 
524.10  whether care is appropriate, reasonable, or medically necessary; 
524.11     (2) a system for providing prompt notification of its 
524.12  determinations to enrollees and providers and for notifying the 
524.13  provider, enrollee, or enrollee's designee of appeal procedures 
524.14  under clause (4); 
524.15     (3) compliance with section 72A.201 62M.05, subdivision 4a 
524.16  3, regarding time frames for approving and disapproving prior 
524.17  authorization requests; 
524.18     (4) written procedures for appeals of denials of prior 
524.19  authorization which specify the responsibilities of the enrollee 
524.20  and provider, and which meet the requirements of section 
524.21  sections 62M.06 and 72A.285, regarding release of summary review 
524.22  findings; and 
524.23     (5) procedures to ensure confidentiality of 
524.24  patient-specific information, consistent with applicable law. 
524.25     (b) No utilization review organization, health plan 
524.26  company, or claims administrator may conduct or require prior 
524.27  authorization of emergency confinement or emergency treatment.  
524.28  The enrollee or the enrollee's authorized representative may be 
524.29  required to notify the health plan company, claims 
524.30  administrator, or utilization review organization as soon after 
524.31  the beginning of the emergency confinement or emergency 
524.32  treatment as reasonably possible. 
524.33     (Effective Date:  Section 24 (62M.07) is effective January 
524.34  1, 2000.) 
524.35     Sec. 25.  Minnesota Statutes 1998, section 62M.09, 
524.36  subdivision 3, is amended to read: 
525.1      Subd. 3.  [PHYSICIAN REVIEWER INVOLVEMENT.] A physician 
525.2   must review all cases in which the utilization review 
525.3   organization has concluded that a determination not to certify 
525.4   for clinical reasons is appropriate.  The physician should be 
525.5   reasonably available by telephone to discuss the determination 
525.6   with the attending physician health care professional.  This 
525.7   subdivision does not apply to outpatient mental health or 
525.8   substance abuse services governed by subdivision 3a.  
525.9      (Effective Date:  Section 25 (62M.09, subdivision 3) is 
525.10  effective January 1, 2000.) 
525.11     Sec. 26.  Minnesota Statutes 1998, section 62M.10, 
525.12  subdivision 2, is amended to read: 
525.13     Subd. 2.  [REVIEWS DURING NORMAL BUSINESS HOURS.] A 
525.14  utilization review organization must conduct its telephone 
525.15  reviews, on-site reviews, and hospital communications during 
525.16  hospitals' and physicians' reasonable and normal business hours, 
525.17  unless otherwise mutually agreed. 
525.18     (Effective Date:  Section 26 (62M.10, subdivision 2) is 
525.19  effective January 1, 2000.) 
525.20     Sec. 27.  Minnesota Statutes 1998, section 62M.10, 
525.21  subdivision 5, is amended to read: 
525.22     Subd. 5.  [ORAL REQUESTS FOR INFORMATION.] Utilization 
525.23  review organizations shall orally inform, upon request, 
525.24  designated hospital personnel or the attending physician health 
525.25  care professional of the utilization review requirements of the 
525.26  specific health benefit plan and the general type of criteria 
525.27  used by the review agent.  Utilization review organizations 
525.28  should also orally inform, upon request, hospitals, physicians, 
525.29  and other health care professionals a provider of the 
525.30  operational procedures in order to facilitate the review process.
525.31     (Effective Date:  Section 27 (62M.10, subdivision 5) is 
525.32  effective January 1, 2000.) 
525.33     Sec. 28.  Minnesota Statutes 1998, section 62M.10, 
525.34  subdivision 7, is amended to read: 
525.35     Subd. 7.  [AVAILABILITY OF CRITERIA.] Upon request, a 
525.36  utilization review organization shall provide to an enrollee or 
526.1   to an attending physician or a provider the criteria used for a 
526.2   specific procedure to determine the necessity, appropriateness, 
526.3   and efficacy of that procedure and identify the database, 
526.4   professional treatment guideline, or other basis for the 
526.5   criteria. 
526.6      (Effective Date:  Section 28 (62M.10, subdivision 7) is 
526.7   effective January 1, 2000.) 
526.8      Sec. 29.  Minnesota Statutes 1998, section 62M.12, is 
526.9   amended to read: 
526.10     62M.12 [PROHIBITION OF INAPPROPRIATE INCENTIVES.] 
526.11     No individual who is performing utilization review may 
526.12  receive any financial incentive based on the number of denials 
526.13  of certifications made by such individual, provided that 
526.14  utilization review organizations may establish medically 
526.15  appropriate performance standards.  This prohibition does not 
526.16  apply to financial incentives established between health plans 
526.17  plan companies and their providers. 
526.18     (Effective Date:  Section 29 (62M.12) is effective January 
526.19  1, 2000.) 
526.20     Sec. 30.  Minnesota Statutes 1998, section 62M.15, is 
526.21  amended to read: 
526.22     62M.15 [APPLICABILITY OF OTHER CHAPTER REQUIREMENTS.] 
526.23     The requirements of this chapter regarding the conduct of 
526.24  utilization review are in addition to any specific requirements 
526.25  contained in chapter 62A, 62C, 62D, 62Q, or 72A. 
526.26     (Effective Date:  Section 30 (62M.15) is effective January 
526.27  1, 2000.) 
526.28     Sec. 31.  Minnesota Statutes 1998, section 62Q.106, is 
526.29  amended to read: 
526.30     62Q.106 [DISPUTE RESOLUTION BY COMMISSIONER.] 
526.31     A complainant may at any time submit a complaint to the 
526.32  appropriate commissioner to investigate.  After investigating a 
526.33  complaint, or reviewing a company's decision, the appropriate 
526.34  commissioner may order a remedy as authorized under section 
526.35  62Q.30 or chapter 45, 60A, or 62D.  
526.36     (Effective Date:  Section 31 (62Q.106) is effective January 
527.1   1, 2000.) 
527.2      Sec. 32.  Minnesota Statutes 1998, section 62Q.19, 
527.3   subdivision 5a, is amended to read: 
527.4      Subd. 5a.  [COOPERATION.] Each health plan company and 
527.5   essential community provider shall cooperate to facilitate the 
527.6   use of the essential community provider by the high risk and 
527.7   special needs populations.  This includes cooperation on the 
527.8   submission and processing of claims, sharing of all pertinent 
527.9   records and data, including performance indicators and specific 
527.10  outcomes data, and the use of all dispute resolution methods as 
527.11  defined in section 62Q.11, subdivision 1. 
527.12     (Effective Date:  Section 32 (62Q.19, subdivision 5a) is 
527.13  effective January 1, 2000.) 
527.14     Sec. 33.  [62Q.68] [DEFINITIONS.] 
527.15     Subdivision 1.  [APPLICATION.] For purposes of sections 
527.16  62Q.68 to 62Q.72, the terms defined in this section have the 
527.17  meanings given them.  For purposes of sections 62Q.69 and 
527.18  62Q.70, the term "health plan company" does not include an 
527.19  insurance company licensed under chapter 60A to offer, sell, or 
527.20  issue a policy of accident and sickness insurance as defined in 
527.21  section 62A.01. 
527.22     Subd. 2.  [COMPLAINT.] "Complaint" means any grievance 
527.23  against a health plan company that is not the subject of 
527.24  litigation and that has been submitted by a complainant to a 
527.25  health plan company regarding the provision of health services 
527.26  including, but not limited to, the scope of coverage for health 
527.27  care services; retrospective denials or limitations of payment 
527.28  for services; eligibility issues; denials, cancellations, or 
527.29  nonrenewals of coverage; administrative operations; and the 
527.30  quality, timeliness, and appropriateness of health care services 
527.31  rendered.  If the complaint is from an applicant, the complaint 
527.32  must relate to the application.  If the complaint is from a 
527.33  former enrollee, the complaint must relate to services received 
527.34  during the period of time the individual was an enrollee.  Any 
527.35  grievance requiring a medical determination in its resolution 
527.36  must be processed under the appeal procedure described in 
528.1   section 62M.06. 
528.2      Subd. 3.  [COMPLAINANT.] "Complainant" means an enrollee, 
528.3   applicant, or former enrollee, or anyone acting on behalf of an 
528.4   enrollee, applicant, or former enrollee who submits a complaint. 
528.5      (Effective Date:  Section 33 (62Q.68, subdivisions 1 to 3) 
528.6   are effective January 1, 2000.) 
528.7      Sec. 34.  [62Q.69] [COMPLAINT RESOLUTION.] 
528.8      Subdivision 1.  [ESTABLISHMENT.] Each health plan company 
528.9   must establish and maintain an internal complaint resolution 
528.10  process that meets the requirements of this section to provide 
528.11  for the resolution of a complaint initiated by a complainant. 
528.12     Subd. 2.  [PROCEDURES FOR FILING A COMPLAINT.] (a) A 
528.13  complainant may submit a complaint to a health plan company 
528.14  either by telephone or in writing.  If a complaint is submitted 
528.15  orally and the resolution of the complaint is partially or 
528.16  wholly adverse to the complainant, or the oral complaint is not 
528.17  resolved by the health plan company within ten days of receiving 
528.18  the complaint, the health plan company must inform the 
528.19  complainant that the complaint may be submitted in writing and 
528.20  must promptly mail a complaint form to the complainant.  The 
528.21  complaint form must include the following information: 
528.22     (1) the telephone number of the office of health care 
528.23  consumer assistance, advocacy, and information, and the health 
528.24  plan company member services or other departments or persons 
528.25  equipped to advise complainants on complaint resolution; 
528.26     (2) the address to which the form must be sent; 
528.27     (3) a description of the health plan company's internal 
528.28  complaint procedure and the applicable time limits; and 
528.29     (4) the toll-free telephone number of either the 
528.30  commissioner of health or commerce and notification that the 
528.31  complainant has the right to submit the complaint at any time to 
528.32  the appropriate commissioner for investigation. 
528.33     (b) Upon receipt of a written complaint, the health plan 
528.34  company must notify the complainant within ten business days 
528.35  that the complaint was received, unless the complaint is 
528.36  resolved to the satisfaction of the complainant within the ten 
529.1   business days. 
529.2      (c) At the complainant's request, a health plan company 
529.3   must provide a complainant with any assistance needed to file a 
529.4   written complaint. 
529.5      (d) Each health plan company must provide, in the member 
529.6   handbook, subscriber contract, or certification of coverage, a 
529.7   clear and concise description of how to submit a complaint and a 
529.8   statement that, upon request, assistance in submitting a written 
529.9   complaint is available from the health plan company. 
529.10     Subd. 3.  [NOTIFICATION OF COMPLAINT DECISIONS.] (a) The 
529.11  health plan company must notify the complainant in writing of 
529.12  its decision and the reasons for it as soon as practical but in 
529.13  no case later than 30 days after receipt of a written complaint. 
529.14     (b) If the decision is partially or wholly adverse to the 
529.15  complainant, the notification must inform the complainant of the 
529.16  right to appeal the decision to the health plan company's 
529.17  internal appeal process described in section 62Q.70 and the 
529.18  procedure for initiating an appeal.  
529.19     (c) The notification must also inform the complainant of 
529.20  the right to submit the complaint at any time to either the 
529.21  commissioner of health or commerce for investigation and the 
529.22  toll-free telephone number of the appropriate commissioner. 
529.23     (Effective Date:  Section 34 (62Q.69, subdivisions 1 to 3) 
529.24  are effective January 1, 2000.) 
529.25     Sec. 35.  [62Q.70] [APPEAL OF THE COMPLAINT DECISION.] 
529.26     Subdivision 1.  [ESTABLISHMENT.] (a) Each health plan 
529.27  company shall establish an internal appeal process for reviewing 
529.28  a health plan company's decision regarding a complaint filed in 
529.29  accordance with section 62Q.69.  The appeal process must meet 
529.30  the requirements of this section.  
529.31     (b) The person or persons with authority to resolve or 
529.32  recommend the resolution of the internal appeal must not be 
529.33  solely the same person or persons who made the complaint 
529.34  decision under section 62Q.69. 
529.35     (c) The internal appeal process must permit the receipt of 
529.36  testimony, correspondence, explanations, or other information 
530.1   from the complainant, staff persons, administrators, providers, 
530.2   or other persons as deemed necessary by the person or persons 
530.3   investigating or presiding over the appeal. 
530.4      Subd. 2.  [PROCEDURES FOR FILING AN APPEAL.] If a 
530.5   complainant notifies the health plan company of the 
530.6   complainant's desire to appeal the health plan company's 
530.7   decision regarding the complaint through the internal appeal 
530.8   process, the health plan company must provide the complainant 
530.9   the option for the appeal to occur either in writing or by 
530.10  hearing. 
530.11     Subd. 3.  [NOTIFICATION OF APPEAL DECISIONS.] (a) Written 
530.12  notice of the appeal decision and all key findings must be given 
530.13  to the complainant within 30 days of the health plan company's 
530.14  receipt of the complainant's written notice of appeal. 
530.15     (b) If the appeal decision is partially or wholly adverse 
530.16  to the complainant, the notice must advise the complainant of 
530.17  the right to submit the appeal decision to the external review 
530.18  process described in section 62Q.73 and the procedure for 
530.19  initiating the external process. 
530.20     (c) Upon the request of the complainant, the health plan 
530.21  company must provide the complainant with a complete summary of 
530.22  the appeal decision.  
530.23     (Effective Date:  Section 35 (62Q.70, subdivisions 1 to 3) 
530.24  are effective January 1, 2000.) 
530.25     Sec. 36.  [62Q.71] [NOTICE TO ENROLLEES.] 
530.26     Each health plan company shall provide to enrollees a clear 
530.27  and concise description of their complaint resolution procedure 
530.28  and the procedure used for utilization review as defined under 
530.29  chapter 62M as part of the member handbook, subscriber contract, 
530.30  or certificate of coverage.  The description must specifically 
530.31  inform enrollees:  
530.32     (1) how to submit a complaint to the health plan company; 
530.33     (2) if the health plan includes utilization review 
530.34  requirements, how to notify the utilization review organization 
530.35  in a timely manner and how to obtain certification for health 
530.36  care services; 
531.1      (3) how to request an appeal either through the procedures 
531.2   described in sections 62Q.69 and 62Q.70 or through the 
531.3   procedures described in chapter 62M; 
531.4      (4) of the right to file a complaint with either the 
531.5   commissioner of health or commerce at any time during the 
531.6   complaint and appeal process; 
531.7      (5) the toll-free telephone number of the appropriate 
531.8   commissioner; 
531.9      (6) the telephone number of the office of consumer 
531.10  assistance, advocacy, and information; and 
531.11     (7) of the right to obtain an external review under section 
531.12  62Q.73 and a description of when and how that right may be 
531.13  exercised. 
531.14     (Effective Date:  Section 36 (62Q.71) is effective January 
531.15  1, 2000.) 
531.16     Sec. 37.  [62Q.72] [RECORDKEEPING; REPORTING.] 
531.17     Subdivision 1.  [RECORDKEEPING.] Each health plan company 
531.18  shall maintain records of all enrollee complaints and their 
531.19  resolutions.  These records shall be retained for five years and 
531.20  shall be made available to the appropriate commissioner upon 
531.21  request. 
531.22     Subd. 2.  [REPORTING.] Each health plan company shall 
531.23  submit to the appropriate commissioner, as part of the company's 
531.24  annual filing, data on the number and type of complaints that 
531.25  are not resolved within 30 days.  A health plan company shall 
531.26  also make this information available to the public upon request. 
531.27     (Effective Date:  Section 37 (62Q.72, subdivisions 1 and 2) 
531.28  are effective January 1, 2000.) 
531.29     Sec. 38.  [62Q.73] [EXTERNAL REVIEW OF ADVERSE 
531.30  DETERMINATIONS.] 
531.31     Subdivision 1.  [DEFINITIONS.] (a) For purposes of this 
531.32  section, the term defined in this subdivision has the meaning 
531.33  given it. 
531.34     (b) An adverse determination means:  
531.35     (1) a complaint decision relating to a health care service 
531.36  or claim that has been appealed in accordance with section 
532.1   62Q.70 and the appeal decision is partially or wholly adverse to 
532.2   the complainant; or 
532.3      (2) any initial determination not to certify that has been 
532.4   appealed in accordance with section 62M.06 and the appeal did 
532.5   not reverse the initial determination not to certify. 
532.6   An adverse determination does not include complaints relating to 
532.7   fraudulent marketing practices or agent misrepresentation. 
532.8      Subd. 2.  [RIGHT TO EXTERNAL REVIEW.] (a) Any enrollee or 
532.9   anyone acting on behalf of an enrollee who has received an 
532.10  adverse determination may submit a written request for an 
532.11  external review of the adverse determination to the commissioner 
532.12  of health if the request involves a health plan company 
532.13  regulated by that commissioner or to the commissioner of 
532.14  commerce if the request involves a health plan company regulated 
532.15  by that commissioner.  The written request must be accompanied 
532.16  by a filing fee of $25.  The fee may be waived by the 
532.17  commissioner of health or commerce in cases of financial 
532.18  hardship. 
532.19     (b) Nothing in this section requires the commissioner of 
532.20  health or commerce to independently investigate an adverse 
532.21  determination referred for independent external review. 
532.22     (c) If an enrollee requests an external review, the health 
532.23  plan company must participate in the external review.  The cost 
532.24  of the external review in excess of the filing fee described in 
532.25  paragraph (a) shall be borne by the health plan company.  
532.26     Subd. 3.  [CONTRACT.] Pursuant to a request for proposal, 
532.27  the commissioner of administration, in consultation with the 
532.28  commissioners of health and commerce, shall contract with an 
532.29  organization or business entity to provide independent external 
532.30  reviews of all adverse determinations submitted for external 
532.31  review.  The contract shall ensure that the fees for services 
532.32  rendered in connection with the reviews be reasonable. 
532.33     Subd. 4.  [CRITERIA.] The request for proposal must require 
532.34  that the entity be affiliated with an institution of higher 
532.35  learning and demonstrate: 
532.36     (1) no conflicts of interest in that it is not owned, a 
533.1   subsidiary of, or affiliated with a health plan company or 
533.2   utilization review organization; 
533.3      (2) an expertise in dispute resolution; 
533.4      (3) an expertise in health related law; 
533.5      (4) an ability to conduct reviews using a variety of 
533.6   procedures depending upon the nature of the dispute; 
533.7      (5) an ability to provide data to the commissioners of 
533.8   health and commerce on reviews conducted; and 
533.9      (6) an ability to ensure confidentiality of medical records 
533.10  and other enrollee information. 
533.11     Subd. 5.  [PROCESS.] (a) Upon receiving a request for an 
533.12  external review, the external review entity must provide 
533.13  immediate notice of the review to the enrollee and to the health 
533.14  plan company.  Within ten business days of receiving notice of 
533.15  the review the health plan company and the enrollee must provide 
533.16  the external review entity with any information that they wish 
533.17  to be considered.  Each party shall be provided an opportunity 
533.18  to present its version of the facts and arguments.  An enrollee 
533.19  may be assisted or represented by a person of the enrollee's 
533.20  choice. 
533.21     (b) As part of the external review process, an independent 
533.22  medical opinion may be sought as necessary.  A medical review 
533.23  panel may be used to provide additional technical expertise when 
533.24  the issue presented is complex and clinical guidelines are 
533.25  absent, ambiguous, unclear, or conflicting. 
533.26     (c) An external review shall be made as soon as practical 
533.27  but in no case later than 40 days after receiving the request 
533.28  for an external review and must promptly send written notice of 
533.29  the decision and the reasons for it to the enrollee, the health 
533.30  plan company, and to the commissioner who is responsible for 
533.31  regulating the health plan company. 
533.32     Subd. 6.  [EFFECTS OF EXTERNAL REVIEW.] A decision rendered 
533.33  under this section shall be nonbinding on the enrollee and 
533.34  binding on the health plan company.  The health plan company may 
533.35  seek judicial review of the decision on the grounds that the 
533.36  decision was arbitrary and capricious or involved an abuse of 
534.1   discretion. 
534.2      Subd. 7.  [IMMUNITY FROM CIVIL LIABILITY.] A person who 
534.3   participates in an external review by investigating, reviewing 
534.4   materials, providing technical expertise, or rendering a 
534.5   decision shall not be civilly liable for any action that is 
534.6   taken in good faith, that is within the scope of the person's 
534.7   duties, and that does not constitute willful or reckless 
534.8   misconduct. 
534.9      Subd. 8.  [DATA REPORTING.] The commissioners shall make 
534.10  available to the public, upon request, summary data on the 
534.11  decisions rendered under this section, including the number of 
534.12  reviews heard and decided and the final outcomes.  Any data 
534.13  released to the public must not individually identify the 
534.14  enrollee initiating the request for external review.  
534.15     (Effective Date:  Section 38 (62Q.73, subdivisions 1 to 8) 
534.16  are effective January 1, 2000.) 
534.17     Sec. 39.  Minnesota Statutes 1998, section 62T.04, is 
534.18  amended to read: 
534.19     62T.04 [COMPLAINT SYSTEM.] 
534.20     Accountable provider networks must establish and maintain 
534.21  an enrollee complaint system as required under section 
534.22  62Q.105 sections 62Q.68 to 62Q.72.  The accountable provider 
534.23  network may contract with the health care purchasing alliance or 
534.24  a vendor for operation of this system. 
534.25     (Effective Date:  Section 39 (62T.04) is effective January 
534.26  1, 2000.) 
534.27     Sec. 40.  Minnesota Statutes 1998, section 72A.201, 
534.28  subdivision 4a, is amended to read: 
534.29     Subd. 4a.  [STANDARDS FOR PREAUTHORIZATION APPROVAL.] If a 
534.30  policy of accident and sickness insurance or a subscriber 
534.31  contract requires preauthorization approval for any nonemergency 
534.32  services or benefits, the decision to approve or disapprove the 
534.33  requested services or benefits must be communicated to the 
534.34  insured or the insured's health care provider within ten 
534.35  business days of the preauthorization request provided that all 
534.36  information reasonably necessary to make a decision on the 
535.1   request has been made available to the insurer processed 
535.2   according to section 62M.07. 
535.3      (Effective Date:  Section 40 (72A.201, subdivision 4a) is 
535.4   effective January 1, 2000.) 
535.5      Sec. 41.  Minnesota Statutes 1998, section 256B.692, 
535.6   subdivision 2, is amended to read: 
535.7      Subd. 2.  [DUTIES OF THE COMMISSIONER OF HEALTH.] 
535.8   Notwithstanding chapters 62D and 62N, a county that elects to 
535.9   purchase medical assistance and general assistance medical care 
535.10  in return for a fixed sum without regard to the frequency or 
535.11  extent of services furnished to any particular enrollee is not 
535.12  required to obtain a certificate of authority under chapter 62D 
535.13  or 62N.  A county that elects to purchase medical assistance and 
535.14  general assistance medical care services under this section must 
535.15  satisfy the commissioner of health that the requirements of 
535.16  chapter 62D, applicable to health maintenance organizations, or 
535.17  chapter 62N, applicable to community integrated service 
535.18  networks, will be met.  A county must also assure the 
535.19  commissioner of health that the requirements of sections 
535.20  62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 
535.21  applicable provisions of chapter 62Q, including sections 62Q.07; 
535.22  62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 
535.23  62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 
535.24  62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; 62Q.68 to 
535.25  62Q.72; and 72A.201 will be met.  All enforcement and rulemaking 
535.26  powers available under chapters 62D, 62J, 62M, 62N, and 62Q are 
535.27  hereby granted to the commissioner of health with respect to 
535.28  counties that purchase medical assistance and general assistance 
535.29  medical care services under this section. 
535.30     (Effective Date:  Section 41 (256B.692, subdivision 2) is 
535.31  effective January 1, 2000.) 
535.32     Sec. 42.  [REPEALER.] 
535.33     (a) Minnesota Statutes 1998, sections 62D.11, subdivisions 
535.34  1b and 2; and 62Q.11, are repealed effective January 1, 2000. 
535.35     (b) Minnesota Statutes 1998, sections 62Q.105 and 62Q.30, 
535.36  are repealed effective July 1, 1999. 
536.1      (c) Minnesota Rules, parts 4685.0100, subparts 4 and 4a; 
536.2   and 4685.1700, are repealed effective January 1, 2000. 
536.3      Sec. 43.  [EFFECTIVE DATE.] 
536.4      When preparing the health and human services conference 
536.5   committee report for adoption by the legislature, the revisor 
536.6   shall combine all the effective date notations into this 
536.7   effective date section.