2nd Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; modifying provisions in 1.3 health care programs; requiring a study of group 1.4 residential housing; clarifying medical assistance 1.5 coverage for employed persons with disabilities; 1.6 amending Minnesota Statutes 1998, sections 62Q.19, 1.7 subdivisions 2 and 6; and 256B.69, subdivision 23; 1.8 Minnesota Statutes 1999 Supplement, sections 256B.057, 1.9 subdivision 9; 256B.0945, subdivisions 1, 2, 4, 5, 6, 1.10 7, 8, and 9; 256B.69, subdivision 6b; 256D.03, 1.11 subdivision 3; and 256L.03, subdivision 5; Laws 1999, 1.12 chapter 245, article 8, section 84; repealing Laws 1.13 1998, chapter 407, article 5, section 44. 1.14 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.15 Section 1. Minnesota Statutes 1998, section 62Q.19, 1.16 subdivision 2, is amended to read: 1.17 Subd. 2. [APPLICATION.] (a) Any provider may apply to the 1.18 commissioner for designation as an essential community provider 1.19 by submitting an application form developed by the 1.20 commissioner. Except as provided in paragraph (d), applications 1.21 must be accepted within two years after the effective date of 1.22 the rules adopted by the commissioner to implement this section. 1.23 (b) Each application submitted must be accompanied by an 1.24 application fee in an amount determined by the commissioner. 1.25 The fee shall be no more than what is needed to cover the 1.26 administrative costs of processing the application. 1.27 (c) The name, address, contact person, and the date by 1.28 which the commissioner's decision is expected to be made shall 1.29 be classified as public data under section 13.41. All other 2.1 information contained in the application form shall be 2.2 classified as private data under section 13.41 until the 2.3 application has been approved, approved as modified, or denied 2.4 by the commissioner. Once the decision has been made, all 2.5 information shall be classified as public data unless the 2.6 applicant designates and the commissioner determines that the 2.7 information contains trade secret information. 2.8 (d) The commissioner shall accept an application for 2.9 designation as an essential community provider until June 30, 2.10 2001, from: 2.11 (1) one applicant that is a nonprofit community health care 2.12 facility, certified as a medical assistance provider effective 2.13 April 1, 1998, that provides culturally competent health care to 2.14 an underserved Southeast Asian immigrant and refugee population 2.15 residing in the immediate neighborhood of the facility; 2.16 (2) one applicant that is a nonprofit home health care 2.17 provider, certified as a Medicare and a medical assistance 2.18 provider that provides culturally competent home health care 2.19 services to a low-income culturally diverse population; 2.20 (3) up to five applicants that are nonprofit community 2.21 mental health centers certified as medical assistance providers 2.22 that provide mental health services to children with serious 2.23 emotional disturbance and their families or to adults with 2.24 serious and persistent mental illness; and 2.25 (4) one applicant that is a nonprofit provider certified as 2.26 a medical assistance provider that provides mental health, child 2.27 development, and family services to children with physical and 2.28 mental health disorders and their families. 2.29 Sec. 2. Minnesota Statutes 1998, section 62Q.19, 2.30 subdivision 6, is amended to read: 2.31 Subd. 6. [TERMINATION OR RENEWAL OF DESIGNATION; 2.32 COMMISSIONER REVIEW.] The designation as an essential community 2.33 provider
terminatesshall be valid for a five-year period from 2.34 the date of designation. Five years after itthe designation of 2.35 essential community provider is granted , or when universal2.36 coverage as defined under section 62Q.165 is achieved, whichever3.1 is laterto a provider, the commissioner shall review the need 3.2 for and appropriateness of continuing the designation for that 3.3 provider. The commissioner may require a provider whose 3.4 designation is to be reviewed to submit an application to the 3.5 commissioner for renewal of the designation and may require an 3.6 application fee to be submitted with the application to cover 3.7 the administrative costs of processing the application. Based 3.8 on that review, the commissioner may renew a provider's 3.9 essential community provider designation for an additional 3.10 five-year period or terminate the designation. Once the 3.11 designation terminates, the former essential community provider 3.12 has no rights or privileges beyond those of any other health 3.13 care provider. The commissioner shall make a recommendation to3.14 the legislature on whether an essential community provider3.15 designation should be longer than five years.3.16 Sec. 3. Minnesota Statutes 1999 Supplement, section 3.17 256B.057, subdivision 9, is amended to read: 3.18 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 3.19 assistance may be paid for a person who is employed and who: 3.20 (1) meets the definition of disabled under the supplemental 3.21 security income program; 3.22 (2) is at least 16 but less than 65 years of age; 3.23 (3) meets the asset limits in paragraph (b); and 3.24 (3)(4) pays a premium, if required, under paragraph (c). 3.25 Any spousal income or assets shall be disregarded for purposes 3.26 of eligibility and premium determinations. 3.27 (b) For purposes of determining eligibility under this 3.28 subdivision, a person's assets must not exceed $20,000, 3.29 excluding: 3.30 (1) all assets excluded under section 256B.056; 3.31 (2) retirement accounts, including individual accounts, 3.32 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 3.33 (3) medical expense accounts set up through the person's 3.34 employer. 3.35 (c) A person whose earned and unearned income is greater 3.36 than 200 percent of federal poverty guidelines for the 4.1 applicable family size must pay a premium to be eligible for 4.2 medical assistance. The premium shall be equal to ten percent 4.3 of the person's gross earned and unearned income above 200 4.4 percent of federal poverty guidelines for the applicable family 4.5 size up to the cost of coverage. 4.6 (d) A person's eligibility and premium shall be determined 4.7 by the local county agency. Premiums must be paid to the 4.8 commissioner. All premiums are dedicated to the commissioner. 4.9 (e) Any required premium shall be determined at application 4.10 and redetermined annually at recertification or when a change in 4.11 income ofor family size occurs. 4.12 (f) Premium payment is due upon notification from the 4.13 commissioner of the premium amount required. Premiums may be 4.14 paid in installments at the discretion of the commissioner. 4.15 (g) Nonpayment of the premium shall result in denial or 4.16 termination of medical assistance unless the person demonstrates 4.17 good cause for nonpayment. Good cause exists if the 4.18 requirements specified in Minnesota Rules, part 9506.0040, 4.19 subpart 7, items B to D, are met. Nonpayment shall include 4.20 payment with a returned, refused, or dishonored instrument. The 4.21 commissioner may require a guaranteed form of payment as the 4.22 only means to replace a returned, refused, or dishonored 4.23 instrument. 4.24 Sec. 4. Minnesota Statutes 1999 Supplement, section 4.25 256B.0945, subdivision 1, is amended to read: 4.26 Subdivision 1. [PROVIDER QUALIFICATIONS.] Counties must 4.27 arrange to provide residential services for children with severe 4.28 emotional disturbance according to sectionsections 245.4882, 4.29 245.4885, and this section. Services must be provided by a 4.30 facility that is licensed according to section 245.4882 and 4.31 administrative rules promulgated thereunder, and under contract 4.32 with the county. Facilities providing services under subdivision 4.33 2, paragraph (a), must be accredited as a psychiatric facility 4.34 by the Joint Commission on Accreditation of Healthcare 4.35 Organizations, the Commission on Accreditation of Rehabilitation 4.36 Facilities, or the Council on Accreditation. Accreditation is 5.1 not required for facilities providing services under subdivision 5.2 2, paragraph (b). 5.3 Sec. 5. Minnesota Statutes 1999 Supplement, section 5.4 256B.0945, subdivision 2, is amended to read: 5.5 Subd. 2. [COVERED SERVICES.] All services must be included 5.6 in a child's individualized treatment or collaborative family5.7 servicemultiagency plan of care as defined in chapter 245. 5.8 (a) For facilities that are institutions for mental 5.9 diseases according to statute and regulation or are not 5.10 institutions for mental diseases but chooseare approved by the 5.11 commissioner to provide services under this paragraph, medical 5.12 assistance covers the full contract rate, including room and 5.13 board if the services meet the requirements of Code of Federal 5.14 Regulations, title 42, section 440.160. 5.15 (b) For facilities that are not institutions for mental 5.16 diseases according to federal statute and regulation and are not 5.17 providing services under paragraph (a), medical assistance 5.18 covers mental health related services that are required to be 5.19 provided by a residential facility under section 245.4882 and 5.20 administrative rules promulgated thereunder, except for room and 5.21 board. 5.22 Sec. 6. Minnesota Statutes 1999 Supplement, section 5.23 256B.0945, subdivision 4, is amended to read: 5.24 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 5.25 256.025, subdivision 2; 256B.19; and 256B.041, payments to 5.26 counties for residential services provided by a residential 5.27 facility shall only be made of federal earnings for services 5.28 provided under this section, and the nonfederal share of costs 5.29 for services provided under this section shall be paid by the 5.30 county from sources other than federal funds or funds used to 5.31 match other federal funds. Total annual payments for federal5.32 earnings shall not exceed the federal medical assistance5.33 percentage matching rate multiplied by the total county5.34 expenditures for services provided under section 245.4882 for5.35 either (1) the calendar year 1999 or (2) the average annual5.36 expenditures for the calendar years 1995 to 1999, whichever is6.1 greater.Payment to counties for services provided according to 6.2 subdivision 2, paragraph (a), shall be the federal share of the 6.3 contract rate. Payment to counties for services provided 6.4 according to subdivision 2, paragraph (b), shall be a proportion 6.5 of the per day contract rate that relates to rehabilitative 6.6 mental health services and shall not include payment for costs 6.7 or services that are billed to the IV-E program as room and 6.8 board. 6.9 (b) Annual earnings that exceed a county's limit as6.10 established under paragraph (a) shall be retained by the6.11 commissioner and managed as grants for community-based6.12 children's mental health services under section 245.4886. The6.13 commissioner may target these grant funds as necessary to reduce6.14 reliance on residential treatment of children with severe6.15 emotional disturbance.6.16 (c)(b) The commissioner shall set aside a portion not to 6.17 exceed five percent of the federal funds earned under this 6.18 section to cover the state costs of two staff positions and6.19 support costs necessary inadministering this section. Any 6.20 unexpended funds from the set-aside shall be distributed to the 6.21 counties in proportion to their earnings under this section. 6.22 Sec. 7. Minnesota Statutes 1999 Supplement, section 6.23 256B.0945, subdivision 5, is amended to read: 6.24 Subd. 5. [QUALITY MEASURES.] Counties must collect and 6.25 report to the commissioner information on outcomes for services 6.26 provided under this section using standardized tools that 6.27 measure the impact of residential treatment programs on child 6.28 functioning and/or behavior, living stability, and parent and 6.29 child satisfaction consistent with the goals of sections 6.30 245.4876, subdivision 1, and 256F.01. The commissioner shall 6.31 designate standardized tools to be used and shall collect and 6.32 analyze individualized outcome data on a statewide basis and 6.33 report to the legislature by December 1, 2003. The commissioner 6.34 shall provide standardized tools that measure child and 6.35 adolescent functional assessment for intake and discharge, child6.36 behavior, residential living environment andfunctionality, 7.1 placement stability, and satisfaction for youth and family 7.2 members. 7.3 Sec. 8. Minnesota Statutes 1999 Supplement, section 7.4 256B.0945, subdivision 6, is amended to read: 7.5 Subd. 6. [FEDERAL EARNINGS.] Use of new federal funding 7.6 earned from services provided under this section is limited to: 7.7 (1) increasing prevention and early intervention and 7.8 supportive services to meet the mental health and child welfare 7.9 needs of the children and families in the system of care; 7.10 (2) replacing reductions in federal IV-E reimbursement 7.11 resulting from new medical assistance coverage; and7.12 (3) paying the nonfederal share of additional provider 7.13 costs due to accreditation and new program standards necessary 7.14 for Medicaid reimbursement; and 7.15 (4) paying for the costs of complying with the data 7.16 collection and reporting requirements contained in subdivision 5. 7.17 For purposes of this section, prevention, early intervention, 7.18 and supportive services for children and families include 7.19 alternative responses to child maltreatment reports under 7.20 chapter 626 and nonresidential children's mental health services 7.21 outlined in sectionssection 245.4875, subdivision 2, children's7.22 mental health,and family preservation services outlined in 7.23 section 256F.05, subdivision 8 , family preservation services. 7.24 Sec. 9. Minnesota Statutes 1999 Supplement, section 7.25 256B.0945, subdivision 7, is amended to read: 7.26 Subd. 7. [MAINTENANCE OF EFFORT.] (a) Counties that 7.27 receive payment under this section must maintain a level of 7.28 expenditures such that each year's county expenditures 7.29 for prevention, early intervention, and supportive services for 7.30 children and families is at least equal to that county's average 7.31 expenditures for those services for calendar years 1998 and 7.32 1999. For purposes of this section, "county expenditures" are7.33 the total expenditures for those services minus the state and7.34 federal revenues specifically designated for these services.7.35 (b) The commissioner may waive the requirements in 7.36 paragraph (a) if any of the conditions specified in section 8.1 256F.13, subdivision 1, paragraph (a), clause (4), items (i) to 8.2 (iv), are met. 8.3 Sec. 10. Minnesota Statutes 1999 Supplement, section 8.4 256B.0945, subdivision 8, is amended to read: 8.5 Subd. 8. [REPORTS.] The commissioner shall review county 8.6 expenditures annually using reports required under sections 8.7 245.482; 256.01, subdivision 2, clause (17); and 256E.08, 8.8 subdivision 8, to ensure that counties meet their obligation 8.9 under subdivision 7, and that the base level of expenditures for 8.10 mental health and child welfareprevention, early intervention, 8.11 and family supportsupportive services for children and families 8.12 and children's mental health residential treatment is continued 8.13 from sources other than federal funds earned under this section. 8.14 Sec. 11. Minnesota Statutes 1999 Supplement, section 8.15 256B.0945, subdivision 9, is amended to read: 8.16 Subd. 9. [SANCTIONS.] The commissioner may suspend, 8.17 reduce, or terminate the federal reimbursementfunds for 8.18 prevention, early intervention, and supportive services for 8.19 children and families up to the limit of federal revenue earned 8.20 under this section to a county that does not meet one or all of 8.21 the requirements of this section. If the commissioner finds 8.22 evidence of children placed in residential treatment who do not 8.23 meet the criteria outlined in section 245.4885, subdivision 1, 8.24 the commissioner may take action to limit inappropriate 8.25 placements in residential treatment. 8.26 Sec. 12. Minnesota Statutes 1999 Supplement, section 8.27 256B.69, subdivision 6b, is amended to read: 8.28 Subd. 6b. [HOME AND COMMUNITY-BASED WAIVER SERVICES.] (a) 8.29 For individuals enrolled in the Minnesota senior health options 8.30 project authorized under subdivision 23, elderly waiver services 8.31 shall be covered according to the terms and conditions of the 8.32 federal agreement governing that demonstration project. 8.33 (b) For individuals under age 65 with physical disabilities8.34 but without a primary diagnosis of mental illness or8.35 developmental disabilities, except for related conditions,8.36 enrolled in the Minnesota senior health options project9.1 demonstrations authorized under subdivision 23, home and 9.2 community-based waiver services shall be covered according to 9.3 the terms and conditions of the federal agreement governing that 9.4 demonstration project. 9.5 Sec. 13. Minnesota Statutes 1998, section 256B.69, 9.6 subdivision 23, is amended to read: 9.7 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 9.8 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 9.9 implement demonstration projects to create alternative 9.10 integrated delivery systems for acute and long-term care 9.11 services to elderly persons and disabledpersons with 9.12 disabilities as defined in section 256B.77, subdivision 7a, that 9.13 provide increased coordination, improve access to quality 9.14 services, and mitigate future cost increases. The commissioner 9.15 may seek federal authority to combine Medicare and Medicaid 9.16 capitation payments for the purpose of such demonstrations. 9.17 Medicare funds and services shall be administered according to 9.18 the terms and conditions of the federal waiver and demonstration 9.19 provisions. For the purpose of administering medical assistance 9.20 funds, demonstrations under this subdivision are subject to 9.21 subdivisions 1 to 1722. The provisions of Minnesota Rules, 9.22 parts 9500.1450 to 9500.1464, apply to these demonstrations, 9.23 with the exceptions of parts 9500.1452, subpart 2, item B; and 9.24 9500.1457, subpart 1, items B and C, which do not apply 9.25 to elderlypersons enrolling in demonstrations under this 9.26 section. An initial open enrollment period may be provided. 9.27 Persons who disenroll from demonstrations under this subdivision 9.28 remain subject to Minnesota Rules, parts 9500.1450 to 9.29 9500.1464. When a person is enrolled in a health plan under 9.30 these demonstrations and the health plan's participation is 9.31 subsequently terminated for any reason, the person shall be 9.32 provided an opportunity to select a new health plan and shall 9.33 have the right to change health plans within the first 60 days 9.34 of enrollment in the second health plan. Persons required to 9.35 participate in health plans under this section who fail to make 9.36 a choice of health plan shall not be randomly assigned to health 10.1 plans under these demonstrations. Notwithstanding section 10.2 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 10.3 subpart 1, item A, if adopted, for the purpose of demonstrations 10.4 under this subdivision, the commissioner may contract with 10.5 managed care organizations, including counties, to serve only 10.6 elderly persons eligible for medical assistance, elderly and 10.7 disabled persons, or disabled persons only. For persons with 10.8 primary diagnoses of mental retardation or a related condition, 10.9 serious and persistent mental illness, or serious emotional 10.10 disturbance, the commissioner must ensure that the county 10.11 authority has approved the demonstration and contracting 10.12 design. Enrollment in these projects shall be voluntary until 10.13 July 1, 2001. The commissioner shall not implement any 10.14 demonstration project under this subdivision for persons with 10.15 primary diagnoses of mental retardation or a related condition, 10.16 serious and persistent mental illness, or serious emotional 10.17 disturbance, without approval of the county board of the county 10.18 in which the demonstration is being implemented. 10.19 Before implementation of a demonstration project for 10.20 disabled persons, the commissioner must provide information to 10.21 appropriate committees of the house of representatives and 10.22 senate and must involve representatives of affected disability 10.23 groups in the design of the demonstration projects. 10.24 (b) A nursing facility reimbursed under the alternative 10.25 reimbursement methodology in section 256B.434 may, in 10.26 collaboration with a hospital, clinic, or other health care 10.27 entity provide services under paragraph (a). The commissioner 10.28 shall amend the state plan and seek any federal waivers 10.29 necessary to implement this paragraph. 10.30 Sec. 14. Minnesota Statutes 1999 Supplement, section 10.31 256D.03, subdivision 3, is amended to read: 10.32 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 10.33 (a) General assistance medical care may be paid for any person 10.34 who is not eligible for medical assistance under chapter 256B, 10.35 including eligibility for medical assistance based on a 10.36 spenddown of excess income according to section 256B.056, 11.1 subdivision 5, or MinnesotaCare as defined in paragraph (b), 11.2 except as provided in paragraph (c); and: 11.3 (1) who is receiving assistance under section 256D.05, 11.4 except for families with children who are eligible under 11.5 Minnesota family investment program-statewide (MFIP-S), who is 11.6 having a payment made on the person's behalf under sections 11.7 256I.01 to 256I.06, or who resides in group residential housing 11.8 as defined in chapter 256I and can meet a spenddown using the 11.9 cost of remedial services received through group residential 11.10 housing; or 11.11 (2)(i) who is a resident of Minnesota; and whose equity in 11.12 assets is not in excess of $1,000 per assistance unit. Exempt 11.13 assets, the reduction of excess assets, and the waiver of excess 11.14 assets must conform to the medical assistance program in chapter 11.15 256B, with the following exception: the maximum amount of 11.16 undistributed funds in a trust that could be distributed to or 11.17 on behalf of the beneficiary by the trustee, assuming the full 11.18 exercise of the trustee's discretion under the terms of the 11.19 trust, must be applied toward the asset maximum; and 11.20 (ii) who has countable income not in excess of the 11.21 assistance standards established in section 256B.056, 11.22 subdivision 4, or whose excess income is spent down according to 11.23 section 256B.056, subdivision 5, using a six-month budget 11.24 period. The method for calculating earned income disregards and 11.25 deductions for a person who resides with a dependent child under 11.26 age 21 shall follow section 256B.056, subdivision 1a. However, 11.27 if a disregard of $30 and one-third of the remainder has been 11.28 applied to the wage earner's income, the disregard shall not be 11.29 applied again until the wage earner's income has not been 11.30 considered in an eligibility determination for general 11.31 assistance, general assistance medical care, medical assistance, 11.32 or MFIP-S for 12 consecutive months. The earned income and work 11.33 expense deductions for a person who does not reside with a 11.34 dependent child under age 21 shall be the same as the method 11.35 used to determine eligibility for a person under section 11.36 256D.06, subdivision 1, except the disregard of the first $50 of 12.1 earned income is not allowed; 12.2 (3) who would be eligible for medical assistance except 12.3 that the person resides in a facility that is determined by the 12.4 commissioner or the federal Health Care Financing Administration 12.5 to be an institution for mental diseases; or 12.6 (4) who is ineligible for medical assistance under chapter 12.7 256B or general assistance medical care under any other 12.8 provision of this section, and is receiving care and 12.9 rehabilitation services from a nonprofit center established to 12.10 serve victims of torture. These individuals are eligible for 12.11 general assistance medical care only for the period during which 12.12 they are receiving services from the center. During this period 12.13 of eligibility, individuals eligible under this clause shall not 12.14 be required to participate in prepaid general assistance medical 12.15 care. 12.16 (b) Beginning January 1, 2000, applicants or recipients who 12.17 meet all eligibility requirements of MinnesotaCare as defined in 12.18 sections 256L.01 to 256L.16, and are: 12.19 (i) adults with dependent children under 21 whose gross 12.20 family income is equal to or less than 275 percent of the 12.21 federal poverty guidelines; or 12.22 (ii) adults without children with earned income and whose 12.23 family gross income is between 75 percent of the federal poverty 12.24 guidelines and the amount set by section 256L.04, subdivision 7, 12.25 shall be terminated from general assistance medical care upon 12.26 enrollment in MinnesotaCare. 12.27 (c) For services rendered on or after July 1, 1997, 12.28 eligibility is limited to one month prior to application if the 12.29 person is determined eligible in the prior month. A 12.30 redetermination of eligibility must occur every 12 months. 12.31 Beginning January 1, 2000, Minnesota health care program 12.32 applications completed by recipients and applicants who are 12.33 persons described in paragraph (b), may be returned to the 12.34 county agency to be forwarded to the department of human 12.35 services or sent directly to the department of human services 12.36 for enrollment in MinnesotaCare. If all other eligibility 13.1 requirements of this subdivision are met, eligibility for 13.2 general assistance medical care shall be available in any month 13.3 during which a MinnesotaCare eligibility determination and 13.4 enrollment are pending. Upon notification of eligibility for 13.5 MinnesotaCare, notice of termination for eligibility for general 13.6 assistance medical care shall be sent to an applicant or 13.7 recipient. If all other eligibility requirements of this 13.8 subdivision are met, eligibility for general assistance medical 13.9 care shall be available until enrollment in MinnesotaCare 13.10 subject to the provisions of paragraph (e). 13.11 (d) The date of an initial Minnesota health care program 13.12 application necessary to begin a determination of eligibility 13.13 shall be the date the applicant has provided a name, address, 13.14 and social security number, signed and dated, to the county 13.15 agency or the department of human services. If the applicant is 13.16 unable to provide an initial application when health care is 13.17 delivered due to a medical condition or disability, a health 13.18 care provider may act on the person's behalf to complete the 13.19 initial application. The applicant must complete the remainder 13.20 of the application and provide necessary verification before 13.21 eligibility can be determined. The county agency must assist 13.22 the applicant in obtaining verification if necessary. On the 13.23 basis of information provided on the completed application, an 13.24 applicant who meets the following criteria shall be determined 13.25 eligible beginning in the month of application: 13.26 (1) has gross income less than 90 percent of the applicable 13.27 income standard; 13.28 (2) has liquid assets that total within $300 of the asset 13.29 standard; 13.30 (3) does not reside in a long-term care facility; and 13.31 (4) meets all other eligibility requirements. 13.32 The applicant must provide all required verifications within 30 13.33 days' notice of the eligibility determination or eligibility 13.34 shall be terminated. 13.35 (e) County agencies are authorized to use all automated 13.36 databases containing information regarding recipients' or 14.1 applicants' income in order to determine eligibility for general 14.2 assistance medical care or MinnesotaCare. Such use shall be 14.3 considered sufficient in order to determine eligibility and 14.4 premium payments by the county agency. 14.5 (f) General assistance medical care is not available for a 14.6 person in a correctional facility unless the person is detained 14.7 by law for less than one year in a county correctional or 14.8 detention facility as a person accused or convicted of a crime, 14.9 or admitted as an inpatient to a hospital on a criminal hold 14.10 order, and the person is a recipient of general assistance 14.11 medical care at the time the person is detained by law or 14.12 admitted on a criminal hold order and as long as the person 14.13 continues to meet other eligibility requirements of this 14.14 subdivision. 14.15 (g) General assistance medical care is not available for 14.16 applicants or recipients who do not cooperate with the county 14.17 agency to meet the requirements of medical assistance. General 14.18 assistance medical care is limited to payment of emergency 14.19 services only for applicants or recipients as described in 14.20 paragraph (b), whose MinnesotaCare coverage is denied or 14.21 terminated for nonpayment of premiums as required by sections 14.22 256L.06 and 256L.07. 14.23 (h) In determining the amount of assets of an individual, 14.24 there shall be included any asset or interest in an asset, 14.25 including an asset excluded under paragraph (a), that was given 14.26 away, sold, or disposed of for less than fair market value 14.27 within the 60 months preceding application for general 14.28 assistance medical care or during the period of eligibility. 14.29 Any transfer described in this paragraph shall be presumed to 14.30 have been for the purpose of establishing eligibility for 14.31 general assistance medical care, unless the individual furnishes 14.32 convincing evidence to establish that the transaction was 14.33 exclusively for another purpose. For purposes of this 14.34 paragraph, the value of the asset or interest shall be the fair 14.35 market value at the time it was given away, sold, or disposed 14.36 of, less the amount of compensation received. For any 15.1 uncompensated transfer, the number of months of ineligibility, 15.2 including partial months, shall be calculated by dividing the 15.3 uncompensated transfer amount by the average monthly per person 15.4 payment made by the medical assistance program to skilled 15.5 nursing facilities for the previous calendar year. The 15.6 individual shall remain ineligible until this fixed period has 15.7 expired. The period of ineligibility may exceed 30 months, and 15.8 a reapplication for benefits after 30 months from the date of 15.9 the transfer shall not result in eligibility unless and until 15.10 the period of ineligibility has expired. The period of 15.11 ineligibility begins in the month the transfer was reported to 15.12 the county agency, or if the transfer was not reported, the 15.13 month in which the county agency discovered the transfer, 15.14 whichever comes first. For applicants, the period of 15.15 ineligibility begins on the date of the first approved 15.16 application. 15.17 (i) When determining eligibility for any state benefits 15.18 under this subdivision, the income and resources of all 15.19 noncitizens shall be deemed to include their sponsor's income 15.20 and resources as defined in the Personal Responsibility and Work 15.21 Opportunity Reconciliation Act of 1996, title IV, Public Law 15.22 Number 104-193, sections 421 and 422, and subsequently set out 15.23 in federal rules. 15.24 (j)(1) An undocumented noncitizen or a nonimmigrant is 15.25 ineligible for general assistance medical care other than 15.26 emergency services. For purposes of this subdivision, a 15.27 nonimmigrant is an individual in one or more of the classes 15.28 listed in United States Code, title 8, section 1101(a)(15), and 15.29 an undocumented noncitizen is an individual who resides in the 15.30 United States without the approval or acquiescence of the 15.31 Immigration and Naturalization Service. 15.32 (2) This paragraph does not apply to a child under age 18, 15.33 to a Cuban or Haitian entrant as defined in Public Law Number 15.34 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 15.35 aged, blind, or disabled as defined in Code of Federal 15.36 Regulations, title 42, sections 435.520, 435.530, 435.531, 16.1 435.540, and 435.541, or effective October 1, 1998, to an 16.2 individual eligible for general assistance medical care under 16.3 paragraph (a), clause (4), who cooperates with the Immigration 16.4 and Naturalization Service to pursue any applicable immigration 16.5 status, including citizenship, that would qualify the individual 16.6 for medical assistance with federal financial participation. 16.7 (3)(k) For purposes of this paragraphparagraphs (g) and 16.8 (j), "emergency services" has the meaning given in Code of 16.9 Federal Regulations, title 42, section 440.255(b)(1), except 16.10 that it also means services rendered because of suspected or 16.11 actual pesticide poisoning. 16.12 (k)(l) Notwithstanding any other provision of law, a 16.13 noncitizen who is ineligible for medical assistance due to the 16.14 deeming of a sponsor's income and resources, is ineligible for 16.15 general assistance medical care. 16.16 Sec. 15. Minnesota Statutes 1999 Supplement, section 16.17 256L.03, subdivision 5, is amended to read: 16.18 Subd. 5. [COPAYMENTS AND COINSURANCE.] (a) Except as 16.19 provided in paragraphs (b) and (c), the MinnesotaCare benefit 16.20 plan shall include the following copayments and coinsurance 16.21 requirements for all enrollees except parents and relative16.22 caretakers of children under the age of 21 in households with16.23 income at or below 175 percent of the federal poverty guidelines16.24 and pregnant women and children under the age of 21: 16.25 (1) ten percent of the paid charges for inpatient hospital 16.26 services for adult enrollees, subject to an annual inpatient 16.27 out-of-pocket maximum of $1,000 per individual and $3,000 per 16.28 family; 16.29 (2) $3 per prescription for adult enrollees; 16.30 (3) $25 for eyeglasses for adult enrollees; and 16.31 (4) effective July 1, 1998,50 percent of the 16.32 fee-for-service rate for adult dental care services other than 16.33 preventive care services for persons eligible under section 16.34 256L.04, subdivisions 1 to 7, with income equal to or less than 16.35 175 percent of the federal poverty guidelines. 16.36 The exceptions described in this paragraph shall only be17.1 implemented if required to obtain federal Medicaid funding for17.2 these individuals and shall expire July 1, 2000.17.3 (b) Effective July 1, 1997,Paragraph (a), clause (1), does 17.4 not apply to parents and relative caretakers of children under 17.5 the age of 21 in households with family income equal to or less 17.6 than 175 percent of the federal poverty guidelines. Paragraph 17.7 (a), clause (1), does not apply to parents and relative 17.8 caretakers of children under the age of 21 in households with 17.9 family income greater than 175 percent of the federal poverty 17.10 guidelines for inpatient hospital admissions occurring on or 17.11 after January 1, 2001. 17.12 (c) Paragraph (a), clauses (1) to (4), do not apply to 17.13 pregnant women and children under the age of 21. 17.14 (d) Adult enrollees with family gross income that exceeds 17.15 175 percent of the federal poverty guidelines and who are not 17.16 pregnant shall be financially responsible for the coinsurance 17.17 amount, if applicable, and amounts which exceed the $10,000 17.18 inpatient hospital benefit limit. 17.19 (c)(e) When a MinnesotaCare enrollee becomes a member of a 17.20 prepaid health plan, or changes from one prepaid health plan to 17.21 another during a calendar year, any charges submitted towards 17.22 the $10,000 annual inpatient benefit limit, and any 17.23 out-of-pocket expenses incurred by the enrollee for inpatient 17.24 services, that were submitted or incurred prior to enrollment, 17.25 or prior to the change in health plans, shall be disregarded. 17.26 Sec. 16. Laws 1999, chapter 245, article 8, section 84, is 17.27 amended to read: 17.28 Sec. 84. [RECOMMENDATIONS TO THE LEGISLATURE.] 17.29 The commissioner of human services shall submit to the 17.30 legislature design and implementation recommendations for the 17.31 proposals required in sections 82 and 83, including draft 17.32 legislation, by January 15, 20002001, for implementation 17.33 by July 1, 2000January 1, 2002, with respect to the proposal in 17.34 section 82 only. The proposals shall not include requirements 17.35 for maintenance of effort and expanded expenditures concerning 17.36 federal reimbursements earned in these programs. 18.1 Sec. 17. [OBSOLETE RULES.] 18.2 The commissioner shall amend or repeal obsolete provisions 18.3 of Minnesota Rules, parts 9505.0010 to 9505.0150, governing 18.4 eligibility for the medical assistance program, under the 18.5 expedited process of Minnesota Statutes, section 14.389, to 18.6 bring them into conformance with state and federal law. 18.7 Sec. 18. [GROUP RESIDENTIAL HOUSING REVIEW.] 18.8 The commissioner of human services, in consultation with 18.9 representatives of affected providers, consumers, and counties, 18.10 shall review group residential housing (GRH) expenditures that 18.11 may be eligible for reimbursement under the home and 18.12 community-based waiver services program for persons with mental 18.13 retardation or related conditions (MR/RC waiver). The review 18.14 may include: 18.15 (1) an assessment of consumer access to housing as a result 18.16 of the limits on GRH supplementary room and board rates adopted 18.17 in Laws 1999, chapter 245, article 3, section 40; 18.18 (2) an analysis of market rate housing costs for families 18.19 of comparable size to those funded under the GRH program; 18.20 (3) an analysis of the impact on GRH costs of providing 18.21 services and housing to persons with developmental disabilities, 18.22 including: 18.23 (i) a breakdown by level of client disability of GRH 18.24 expenditures for housing costs for persons with developmental 18.25 disabilities; 18.26 (ii) a breakdown by level of client disability of GRH 18.27 expenditures for service costs for persons with developmental 18.28 disabilities; 18.29 (iii) an analysis of differences in GRH expenditures for 18.30 persons with developmental disabilities compared to other GRH 18.31 residents; and 18.32 (iv) a determination of GRH expenditures that are a direct 18.33 result of a resident's disability; 18.34 (4) a determination of which services now paid for by the 18.35 GRH program may be eligible under the MR/RC waiver, and an 18.36 estimate of GRH costs that could be paid by the federal 19.1 government under the MR/RC waiver. The commissioner may begin 19.2 the process of seeking federal approval to fund current group 19.3 residential housing services under the MR/RC waiver; 19.4 (5) an assessment of the utilization of the food stamp 19.5 program and other federal benefit programs by GRH residents; 19.6 (6) an analysis of the methods other states utilize to 19.7 reimburse comparable room and board costs and service costs; and 19.8 (7) a compilation of current MR/RC waiver caps in Minnesota 19.9 counties, compared with actual MR/RC spending. 19.10 Sec. 19. [ALTERNATIVE CARE PILOT PROJECTS.] 19.11 (a) Expenditures for housing with services and adult foster 19.12 care shall be excluded when determining average monthly 19.13 expenditures per client for alternative care pilot projects 19.14 authorized in Laws 1993, First Special Session chapter 1, 19.15 article 5, section 133. 19.16 (b) Alternative care pilot projects shall not expire on 19.17 June 30, 2001, but shall continue until June 30, 2005. 19.18 Sec. 20. [REPEALER.] 19.19 Laws 1998, chapter 407, article 5, section 44, is repealed. 19.20 Sec. 21. [EFFECTIVE DATE.] 19.21 Sections 1 (62Q.19, s.2), 15, and 17 are effective the day 19.22 following final enactment.