HF 3222B

Conference Committee Report - 85th Legislature (2007 - 2008) Posted on 01/15/2013 08:28pm

1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 3222

1.2A bill for an act

1.3relating to human services; amending health care services provisions;
1.4making changes to general assistance medical care, medical assistance, and
1.5MinnesotaCare; modifying claims, liens, and treatment of assets; establishing a
1.6statewide information exchange;amending Minnesota Statutes 2006, sections
1.7256B.056, subdivisions 2, 4a, 11, by adding a subdivision; 256B.057, subdivision
1.81; 256B.0571, subdivisions 8, 9, 15, by adding a subdivision; 256B.058;
1.9256B.059, subdivisions 1, 1a; 256B.0594; 256B.0595, subdivisions 1, 2, 3, 4,
1.10by adding subdivisions; 256B.0625, subdivision 13g; 256B.075, subdivision 2;
1.11256B.15, subdivision 4; 256B.69, subdivisions 6, 27; 524.3-803; Minnesota
1.12Statutes 2007 Supplement, sections 256B.055, subdivision 14; 256B.0625,
1.13subdivision 49; 256D.03, subdivision 3; proposing coding for new law in
1.14Minnesota Statutes, chapter 256B.
1.15May 7, 2008
1.16The Honorable Margaret Anderson Kelliher
1.17Speaker of the House of Representatives
1.18The Honorable James P. Metzen
1.19President of the Senate
1.20We, the undersigned conferees for H. F. No. 3222 report that we have agreed upon
1.21the items in dispute and recommend as follows:
1.22That the Senate recede from its amendments and that H. F. No. 3222 be further
1.23amended as follows:
1.24Delete everything after the enacting clause and insert:

1.25"ARTICLE 1

1.26HEALTH CARE

1.27    Section 1. Minnesota Statutes 2006, section 125A.02, subdivision 1, is amended to
1.28read:
1.29    Subdivision 1. Child with a disability. Every child who has a hearing impairment,
1.30blindness, visual disability, speech or language impairment, physical disability, other
1.31health impairment, mental disability, emotional/behavioral disorder, specific learning
2.1disability, autism, traumatic brain injury, multiple disabilities, or deaf/blind disability and
2.2needs special instruction and services, as determined by the standards of the commissioner,
2.3is a child with a disability. A licensed physician, an advanced practice nurse, or a licensed
2.4psychologist is qualified to make a diagnosis and determination of attention deficit
2.5disorder or attention deficit hyperactivity disorder for purposes of identifying a child
2.6with a disability. In addition, every child under age three, and at local district discretion
2.7from age three to age seven, who needs special instruction and services, as determined
2.8by the standards of the commissioner, because the child has a substantial delay or has
2.9an identifiable physical or mental condition known to hinder normal development is
2.10a child with a disability.
2.11EFFECTIVE DATE.This section is effective the day following final enactment.

2.12    Sec. 2. Minnesota Statutes 2006, section 144A.45, subdivision 1, is amended to read:
2.13    Subdivision 1. Rules. The commissioner shall adopt rules for the regulation of
2.14home care providers pursuant to sections 144A.43 to 144A.47. The rules shall include
2.15the following:
2.16    (a) (1) provisions to assure, to the extent possible, the health, safety and well-being,
2.17and appropriate treatment of persons who receive home care services;
2.18    (b) (2) requirements that home care providers furnish the commissioner with
2.19specified information necessary to implement sections 144A.43 to 144A.47;
2.20    (c) (3) standards of training of home care provider personnel, which may vary
2.21according to the nature of the services provided or the health status of the consumer;
2.22    (d) (4) standards for medication management which may vary according to the
2.23nature of the services provided, the setting in which the services are provided, or the
2.24status of the consumer. Medication management includes the central storage, handling,
2.25distribution, and administration of medications;
2.26    (e) (5) standards for supervision of home care services requiring supervision by a
2.27registered nurse or other appropriate health care professional which must occur on site
2.28at least every 62 days, or more frequently if indicated by a clinical assessment, and in
2.29accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that,
2.30notwithstanding the provisions of Minnesota Rules, part 4668.0110, subpart 5, item B,
2.31supervision of a person performing home care aide tasks for a class B licensee providing
2.32paraprofessional services must occur only every 180 days, or more frequently if indicated
2.33by a clinical assessment;
2.34    (f) (6) standards for client evaluation or assessment which may vary according to the
2.35nature of the services provided or the status of the consumer;
3.1    (g) (7) requirements for the involvement of a consumer's physician, the
3.2documentation of physicians' orders, if required, and the consumer's treatment plan, and
3.3the maintenance of accurate, current clinical records;
3.4    (h) (8) the establishment of different classes of licenses for different types of
3.5providers and different standards and requirements for different kinds of home care
3.6services; and
3.7    (i) (9) operating procedures required to implement the home care bill of rights.

3.8    Sec. 3. Minnesota Statutes 2006, section 144A.45, is amended by adding a subdivision
3.9to read:
3.10    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
3.11Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
3.12toileting, transfers, and ambulation if the client is ambulatory and if the client has no
3.13serious acute illness or infectious disease.

3.14    Sec. 4. [145.1622] POLICY FOR NOTIFICATION OF DISPOSITION OPTIONS.
3.15    Hospitals, clinics, and medical facilities must have in place by January 15, 2009, a
3.16policy for informing a woman of available options for fetal disposition when the woman
3.17experiences a miscarriage or is expected to experience a miscarriage.

3.18    Sec. 5. Minnesota Statutes 2006, section 150A.06, is amended by adding a subdivision
3.19to read:
3.20    Subd. 9. Graduates of nonaccredited dental programs. A graduate of a
3.21nonaccredited dental program who successfully completes the clinical licensure
3.22examination, and meets all other applicant requirements of the board shall be licensed to
3.23practice dentistry and granted a limited general dentist license by the board. The board
3.24shall place limitations on the licensee's authority to practice by requiring the licensee to
3.25practice under the general supervision of a Minnesota-licensed dentist approved by the
3.26board. A person licensed under this subdivision must practice for three consecutive years
3.27in Minnesota pursuant to a written agreement, approved by the board, between the licensee
3.28and a Minnesota-licensed dentist who may limit the types of services authorized. At the
3.29conclusion of the three-year period, the board shall grant an unlimited license without
3.30further restrictions if all supervising dentists who had entered into written agreements with
3.31the licensee during any part of the three-year period recommend unlimited licensure, and if
3.32no corrective action or disciplinary action has been taken by the board against the licensee.

4.1    Sec. 6. Minnesota Statutes 2006, section 214.40, is amended by adding a subdivision
4.2to read:
4.3    Subd. 8. Fee adjustment. The administrative services unit shall apportion between
4.4the Board of Medical Practice, the Board of Dentistry, and the Board of Nursing an
4.5amount to be raised through fees by the respective board. The amount apportioned to each
4.6board shall be the total amount expended on medical professional liability insurance
4.7coverage purchased for the providers regulated by the respective board. The respective
4.8board may adjust the fees which the board is required to collect to compensate for the
4.9amount apportioned to the board by the administrative services unit.

4.10    Sec. 7. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
4.11to read:
4.12    Subd. 27. Statewide health information exchange. (a) The commissioner has the
4.13authority to join and participate as a member in a legal entity developing and operating a
4.14statewide health information exchange that shall meet the following criteria:
4.15    (1) the legal entity must meet all constitutional and statutory requirements to allow
4.16the commissioner to participate; and
4.17    (2) the commissioner or the commissioner's designated representative must have
4.18the right to participate in the governance of the legal entity under the same terms and
4.19conditions and subject to the same requirements as any other member in the legal entity
4.20and in that role shall act to advance state interests and lessen the burdens of government.
4.21    (b) Notwithstanding chapter 16C, the commissioner may pay the state's prorated
4.22share of development-related expenses of the legal entity retroactively from October 29,
4.232007, regardless of the date the commissioner joins the legal entity as a member.

4.24    Sec. 8. Minnesota Statutes 2007 Supplement, section 256B.055, subdivision 14,
4.25is amended to read:
4.26    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
4.27inmate of a correctional facility who is conditionally released as authorized under section
4.28241.26 , 244.065, or 631.425, if the individual does not require the security of a public
4.29detention facility and is housed in a halfway house or community correction center, or
4.30under house arrest and monitored by electronic surveillance in a residence approved
4.31by the commissioner of corrections, and if the individual meets the other eligibility
4.32requirements of this chapter.
4.33    (b) An individual who is enrolled in medical assistance, and who is charged with a
4.34crime and incarcerated for less than 12 months shall be suspended from eligibility at the
5.1time of incarceration until the individual is released. Upon release, medical assistance
5.2eligibility is reinstated without reapplication using a reinstatement process and form, if the
5.3individual is otherwise eligible.
5.4    (c) An individual, regardless of age, who is considered an inmate of a public
5.5institution as defined in Code of Federal Regulations, title 42, section 435.1009 435.1010,
5.6is not eligible for medical assistance.

5.7    Sec. 9. Minnesota Statutes 2006, section 256B.056, subdivision 2, is amended to read:
5.8    Subd. 2. Homestead exclusion and homestead equity limit for institutionalized
5.9persons residing in a long-term care facility. (a) The homestead shall be excluded
5.10for the first six calendar months of a person's stay in a long-term care facility and shall
5.11continue to be excluded for as long as the recipient can be reasonably expected to return to
5.12the homestead. For purposes of this subdivision, "reasonably expected to return to the
5.13homestead" means the recipient's attending physician has certified that the expectation
5.14is reasonable, and the recipient can show that the cost of care upon returning home will
5.15be met through medical assistance or other sources. The homestead shall continue to
5.16be excluded for persons residing in a long-term care facility if it is used as a primary
5.17residence by one of the following individuals:
5.18    (1) the spouse;
5.19    (2) a child under age 21;
5.20    (3) a child of any age who is blind or permanently and totally disabled as defined in
5.21the supplemental security income program;
5.22    (4) a sibling who has equity interest in the home and who resided in the home for at
5.23least one year immediately before the date of the person's admission to the facility; or
5.24    (5) a child of any age, or, subject to federal approval, a grandchild of any age, who
5.25resided in the home for at least two years immediately before the date of the person's
5.26admission to the facility, and who provided care to the person that permitted the person to
5.27reside at home rather than in an institution.
5.28    (b) Effective for applications filed on or after July 1, 2006, and for renewals after
5.29July 1, 2006, for persons who first applied for payment of long-term care services on
5.30or after January 2, 2006, the equity interest in the homestead of an individual whose
5.31eligibility for long-term care services is determined on or after January 1, 2006, shall not
5.32exceed $500,000, unless it is the lawful residence of the individual's spouse or child
5.33who is under age 21, blind, or disabled. The amount specified in this paragraph shall be
5.34increased beginning in year 2011, from year to year based on the percentage increase in
5.35the Consumer Price Index for all urban consumers (all items; United States city average),
6.1rounded to the nearest $1,000. This provision may be waived in the case of demonstrated
6.2hardship by a process to be determined by the secretary of health and human services
6.3pursuant to section 6014 of the Deficit Reduction Act of 2005, Public Law 109-171.

6.4    Sec. 10. Minnesota Statutes 2006, section 256B.056, is amended by adding a
6.5subdivision to read:
6.6    Subd. 2a. Home equity limit for medical assistance payment of long-term
6.7care services. (a) Effective for requests of medical assistance payment of long-term
6.8care services filed on or after July 1, 2006, and for renewals on or after July 1, 2006,
6.9for persons who received payment of long-term care services under a request filed on
6.10or after January 1, 2006, the equity interest in the home of a person whose eligibility
6.11for long-term care services is determined on or after January 1, 2006, shall not exceed
6.12$500,000, unless it is the lawful residence of the person's spouse or child who is under
6.13age 21, or a child of any age who is blind or permanently and totally disabled as defined
6.14in the Supplemental Security Income program. The amount specified in this paragraph
6.15shall be increased beginning in year 2011, from year to year based on the percentage
6.16increase in the Consumer Price Index for all urban consumers (all items; United States city
6.17average), rounded to the nearest $1,000.
6.18    (b) For purposes of this subdivision, a "home" means any real or personal property
6.19interest, including an interest in an agricultural homestead as defined under section
6.20273.124, subdivision 1, that, at the time of the request for medical assistance payment of
6.21long-term care services, is the primary dwelling of the person or was the primary dwelling
6.22of the person before receipt of long-term care services began outside of the home.
6.23    (c) A person denied or terminated from medical assistance payment of long-term
6.24care services because the person's home equity exceeds the home equity limit may seek
6.25a waiver based upon a hardship by filing a written request with the county agency.
6.26Hardship is an imminent threat to the person's health and well-being that is demonstrated
6.27by documentation of no alternatives for payment of long-term care services. The county
6.28agency shall make a decision regarding the written request to waive the home equity limit
6.29within 30 days if all necessary information has been provided. The county agency shall
6.30send the person and the person's representative a written notice of decision on the request
6.31for a demonstrated hardship waiver that also advises the person of appeal rights under the
6.32fair hearing process of section 256.045.

6.33    Sec. 11. Minnesota Statutes 2006, section 256B.056, subdivision 4a, is amended to
6.34read:
7.1    Subd. 4a. Asset verification. For purposes of verification, the value of an individual
7.2is not required to make a good faith effort to sell a life estate that is not excluded under
7.3subdivision 2 and the life estate shall be considered deemed not salable unless the owner
7.4of the remainder interest intends to purchase the life estate, or the owner of the life estate
7.5and the owner of the remainder sell the entire property. This subdivision applies only for
7.6the purpose of determining eligibility for medical assistance, and does not apply to the
7.7valuation of assets owned by either the institutional spouse or the community spouse
7.8under section 256B.059, subdivision 2.

7.9    Sec. 12. Minnesota Statutes 2006, section 256B.056, subdivision 11, is amended to
7.10read:
7.11    Subd. 11. Treatment of annuities. (a) Any individual applying for or seeking
7.12recertification of eligibility for person requesting medical assistance payment of long-term
7.13care services shall provide a complete description of any interest either the individual
7.14person or the individual's person's spouse has in annuities on a form designated by the
7.15department. The form shall include a statement that the state becomes a preferred
7.16remainder beneficiary of annuities or similar financial instruments by virtue of the receipt
7.17of medical assistance payment of long-term care services. The individual person and the
7.18individual's person's spouse shall furnish the agency responsible for determining eligibility
7.19with complete current copies of their annuities and related documents for review as part
7.20of the application process on disclosure forms provided by the department as part of
7.21their application and complete the form designating the state as the preferred remainder
7.22beneficiary for each annuity in which the person or the person's spouse has an interest.
7.23    (b) The disclosure form shall include a statement that the department becomes the
7.24remainder beneficiary under the annuity or similar financial instrument by virtue of the
7.25receipt of medical assistance. The disclosure form department shall include a provide
7.26notice to the issuer of the department's right under this section as a preferred remainder
7.27beneficiary under the annuity or similar financial instrument for medical assistance
7.28furnished to the individual person or the individual's person's spouse, and require the
7.29issuer to provide confirmation that a remainder beneficiary designation has been made
7.30and to notify the county agency when there is a change in the amount of the income or
7.31principal being withdrawn from the annuity or other similar financial instrument at the
7.32time of the most recent disclosure required under this section. The individual and the
7.33individual's spouse shall execute separate disclosure forms for each annuity or similar
7.34financial instrument that they are required to disclose under this section and in which they
7.35have an interest provide notice of the issuer's responsibilities as provided in paragraph (c).
8.1    (c) An issuer of an annuity or similar financial instrument who receives notice
8.2on a disclosure form of the state's right to be named a preferred remainder beneficiary
8.3as described in paragraph (b) shall provide confirmation to the requesting agency that
8.4a remainder beneficiary designating the state has been made and a preferred remainder
8.5beneficiary. The issuer shall also notify the county agency when there is a change in the
8.6amount of income or principal being withdrawn from the annuity or other similar financial
8.7instrument or a change in the state's preferred remainder beneficiary designation under
8.8the annuity or other similar financial instrument occurs. The county agency shall provide
8.9the issuer with the name, address, and telephone number of a unit within the department
8.10that the issuer can contact to comply with this paragraph.
8.11    (d) "Preferred remainder beneficiary" for purposes of this subdivision and sections
8.12256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position in
8.13an amount equal to the amount of medical assistance paid on behalf of the institutionalized
8.14person, or is a remainder beneficiary in the second position if the institutionalized person
8.15designates and is survived by a remainder beneficiary who is (1) a spouse who does not
8.16reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or
8.17permanently and totally disabled as defined in the Supplemental Security Income program.
8.18Notwithstanding this paragraph, the state is the remainder beneficiary in the first position
8.19if the spouse or child disposes of the remainder for less than fair market value.
8.20    (e) For purposes of this subdivision, "institutionalized person" and "long-term care
8.21services" have the meanings given in section 256B.0595, subdivision 1, paragraph (h).
8.22    (f) For purposes of this subdivision, "medical institution" means a skilled
8.23nursing facility, intermediate care facility, intermediate care facility for persons with
8.24developmental disabilities, nursing facility, or inpatient hospital.

8.25    Sec. 13. Minnesota Statutes 2006, section 256B.057, subdivision 1, is amended to read:
8.26    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year of
8.27age or a pregnant woman who has written verification of a positive pregnancy test from a
8.28physician or licensed registered nurse is eligible for medical assistance if countable family
8.29income is equal to or less than 275 percent of the federal poverty guideline for the same
8.30family size. A pregnant woman who has written verification of a positive pregnancy test
8.31from a physician or licensed registered nurse is eligible for medical assistance if countable
8.32family income is equal to or less than 200 percent of the federal poverty guideline for the
8.33same family size. For purposes of this subdivision, "countable family income" means the
8.34amount of income considered available using the methodology of the AFDC program
8.35under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility
9.1and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193,
9.2except for the earned income disregard and employment deductions.
9.3    (2) For applications processed within one calendar month prior to the effective date,
9.4eligibility shall be determined by applying the income standards and methodologies in
9.5effect prior to the effective date for any months in the six-month budget period before
9.6that date and the income standards and methodologies in effect on the effective date for
9.7any months in the six-month budget period on or after that date. The income standards
9.8for each month shall be added together and compared to the applicant's total countable
9.9income for the six-month budget period to determine eligibility.
9.10    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
9.11    (2) For applications processed within one calendar month prior to July 1, 2003,
9.12eligibility shall be determined by applying the income standards and methodologies in
9.13effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
9.142003, and the income standards and methodologies in effect on the expiration date for any
9.15months in the six-month budget period on or after July 1, 2003. The income standards
9.16for each month shall be added together and compared to the applicant's total countable
9.17income for the six-month budget period to determine eligibility.
9.18    (3) An amount equal to the amount of earned income exceeding 275 percent of
9.19the federal poverty guideline, up to a maximum of the amount by which the combined
9.20total of 185 percent of the federal poverty guideline plus the earned income disregards
9.21and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
9.22by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
9.23Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
9.24pregnant women and infants less than one year of age.
9.25    (c) Dependent care and child support paid under court order shall be deducted from
9.26the countable income of pregnant women.
9.27    (d) An infant born on or after January 1, 1991, to a woman who was eligible for and
9.28receiving medical assistance on the date of the child's birth shall continue to be eligible for
9.29medical assistance without redetermination until the child's first birthday, as long as the
9.30child remains in the woman's household.

9.31    Sec. 14. Minnesota Statutes 2006, section 256B.0571, subdivision 6, is amended to
9.32read:
9.33    Subd. 6. Partnership policy. "Partnership policy" means a long-term care insurance
9.34policy that meets the requirements under subdivision 10 and was issued on or after the
9.35effective date of the state plan amendment implementing the partnership program in
10.1Minnesota. Policies that are exchanged or that have riders or endorsements added on or
10.2after the effective date of the state plan amendment as authorized by the commissioner of
10.3commerce qualify as a partnership policy.

10.4    Sec. 15. Minnesota Statutes 2006, section 256B.0571, subdivision 8, is amended to
10.5read:
10.6    Subd. 8. Program established. (a) The commissioner, in cooperation with the
10.7commissioner of commerce, shall establish the Minnesota partnership for long-term care
10.8program to provide for the financing of long-term care through a combination of private
10.9insurance and medical assistance.
10.10    (b) An individual who meets the requirements in this paragraph is eligible to
10.11participate in the partnership program. The individual must:
10.12    (1) meet one of the following criteria:
10.13    (i) be a beneficiary of, and a Minnesota resident at the time coverage first became
10.14effective under the a partnership policy;
10.15    (2) be a beneficiary of a partnership policy that (i) either is issued on or after the
10.16effective date of the state plan amendment implementing the partnership program in
10.17Minnesota, or (ii) qualifies as a partnership policy under the provisions of subdivision 8a
10.18as authorized by the commissioner of commerce under subdivision 6; and or
10.19    (ii) be a beneficiary of a policy recognized under subdivision 17; and
10.20    (3) (2) have exhausted all of the benefits under the partnership policy as described
10.21in this section. Benefits received under a long-term care insurance policy before July 1,
10.222006, do not count toward the exhaustion of benefits required in this subdivision.

10.23    Sec. 16. Minnesota Statutes 2006, section 256B.0571, subdivision 9, is amended to
10.24read:
10.25    Subd. 9. Medical assistance eligibility. (a) Upon application request for medical
10.26assistance program payment of long-term care services by an individual who meets the
10.27requirements described in subdivision 8, the commissioner shall determine the individual's
10.28eligibility for medical assistance according to paragraphs (b) to (i).
10.29    (b) After determining assets subject to the asset limit under section 256B.056,
10.30subdivision 3 or 3c, or 256B.057, subdivision 9 or 10, the commissioner shall allow
10.31the individual to designate assets to be protected from recovery under subdivisions 13
10.32and 15 up to the dollar amount of the benefits utilized under the partnership policy.
10.33Designated assets shall be disregarded for purposes of determining eligibility for payment
10.34of long-term care services.
11.1    (c) The individual shall identify the designated assets and the full fair market value
11.2of those assets and designate them as assets to be protected at the time of initial application
11.3for medical assistance. The full fair market value of real property or interests in real
11.4property shall be based on the most recent full assessed value for property tax purposes
11.5for the real property, unless the individual provides a complete professional appraisal by
11.6a licensed appraiser to establish the full fair market value. The extent of a life estate in
11.7real property shall be determined using the life estate table in the health care program's
11.8manual. Ownership of any asset in joint tenancy shall be treated as ownership as tenants
11.9in common for purposes of its designation as a disregarded asset. The unprotected value
11.10of any protected asset is subject to estate recovery according to subdivisions 13 and 15.
11.11    (d) The right to designate assets to be protected is personal to the individual and
11.12ends when the individual dies, except as otherwise provided in subdivisions 13 and
11.1315. It does not include the increase in the value of the protected asset and the income,
11.14dividends, or profits from the asset. It may be exercised by the individual or by anyone
11.15with the legal authority to do so on the individual's behalf. It shall not be sold, assigned,
11.16transferred, or given away.
11.17    (e) If the dollar amount of the benefits utilized under a partnership policy is greater
11.18than the full fair market value of all assets protected at the time of the application for
11.19medical assistance long-term care services, the individual may designate additional assets
11.20that become available during the individual's lifetime for protection under this section.
11.21The individual must make the designation in writing to the county agency no later than
11.22the last date on which the individual must report a change in circumstances to the county
11.23agency, as provided for under the medical assistance program ten days from the date the
11.24designation is requested by the county agency. Any excess used for this purpose shall not
11.25be available to the individual's estate to protect assets in the estate from recovery under
11.26section 256B.15 or 524.3-1202, or otherwise.
11.27    (f) This section applies only to estate recovery under United States Code, title 42,
11.28section 1396p, subsections (a) and (b), and does not apply to recovery authorized by other
11.29provisions of federal law, including, but not limited to, recovery from trusts under United
11.30States Code, title 42, section 1396p, subsection (d)(4)(A) and (C), or to recovery from
11.31annuities, or similar legal instruments, subject to section 6012, subsections (a) and (b), of
11.32the Deficit Reduction Act of 2005, Public Law 109-171.
11.33    (g) An individual's protected assets owned by the individual's spouse who applies
11.34for payment of medical assistance long-term care services shall not be protected assets or
11.35disregarded for purposes of eligibility of the individual's spouse solely because they were
11.36protected assets of the individual.
12.1    (h) Assets designated under this subdivision shall not be subject to penalty under
12.2section 256B.0595.
12.3    (i) The commissioner shall otherwise determine the individual's eligibility
12.4for payment of long-term care services according to medical assistance eligibility
12.5requirements.

12.6    Sec. 17. Minnesota Statutes 2006, section 256B.0571, subdivision 15, is amended to
12.7read:
12.8    Subd. 15. Limitation on liens. (a) An individual's interest in real property shall not
12.9be subject to a medical assistance lien under sections 514.980 to 514.985 or a notice of
12.10potential claim lien arising under section 256B.15 while and to the extent it is protected
12.11under subdivision 9. An individual's interest in real property that exceeds the value
12.12protected under subdivision 9 is subject to a lien for recovery.
12.13    (b) Medical assistance liens under sections 514.980 to 514.985 or liens arising
12.14under notices of potential claims section 256B.15 against an individual's interests in real
12.15property in the individual's estate that are designated as protected under subdivision 13,
12.16paragraph (b), shall be released to the extent of the dollar value of the protection applied
12.17to the interest.
12.18    (c) If an interest in real property is protected from a lien for recovery of medical
12.19assistance paid on behalf of the individual under paragraph (a) or (b), no lien for recovery
12.20of medical assistance paid on behalf of that individual shall be filed against the protected
12.21interest in real property after it is distributed to the individual's heirs or devisees.

12.22    Sec. 18. Minnesota Statutes 2006, section 256B.0571, is amended by adding a
12.23subdivision to read:
12.24    Subd. 17. Reciprocal agreements. The commissioner may enter into an agreement
12.25with any other state with a partnership program under United States Code, title 42,
12.26section 1396p(b)(1)(C), for reciprocal recognition of qualified long-term care insurance
12.27policies purchased under each state's partnership program. The commissioner shall notify
12.28the secretary of the United States Department of Health and Human Services if the
12.29commissioner declines to enter into a national reciprocal agreement.

12.30    Sec. 19. Minnesota Statutes 2006, section 256B.058, is amended to read:
12.31256B.058 TREATMENT OF INCOME OF INSTITUTIONALIZED SPOUSE.
12.32    Subdivision 1. Income not available. The income described in subdivisions 2
12.33and 3 shall be deducted from an institutionalized spouse's monthly income and is not
13.1considered available for payment of the monthly costs of an institutionalized person in
13.2the institution spouse after the person has been the institutionalized spouse has been
13.3determined eligible for medical assistance.
13.4    Subd. 2. Monthly income allowance for community spouse. (a) For an
13.5institutionalized spouse with a spouse residing in the community, monthly income may be
13.6allocated to the community spouse as a monthly income allowance for the community
13.7spouse. Beginning with the first full calendar month the institutionalized spouse is
13.8in the institution, the monthly income allowance is not considered available to the
13.9institutionalized spouse for monthly payment of costs of care in the institution as long as
13.10the income is made available to the community spouse.
13.11    (b) The monthly income allowance is the amount by which the community spouse's
13.12monthly maintenance needs allowance under paragraphs (c) and (d) exceeds the amount
13.13of monthly income otherwise available to the community spouse.
13.14    (c) The community spouse's monthly maintenance needs allowance is the lesser of
13.15$1,500 or 122 percent of the monthly federal poverty guideline for a family of two plus
13.16an excess shelter allowance. The excess shelter allowance is for the amount of shelter
13.17expenses that exceed 30 percent of 122 percent of the federal poverty guideline line for a
13.18family of two. Shelter expenses are the community spouse's expenses for rent, mortgage
13.19payments including principal and interest, taxes, insurance, required maintenance charges
13.20for a cooperative or condominium that is the community spouse's principal residence,
13.21and the standard utility allowance under section 5(e) of the federal Food Stamp Act of
13.221977. If the community spouse has a required maintenance charge for a cooperative or
13.23condominium, the standard utility allowance must be reduced by the amount of utility
13.24expenses included in the required maintenance charge.
13.25    If the community or institutionalized spouse establishes that the community spouse
13.26needs income greater than the monthly maintenance needs allowance determined in this
13.27paragraph due to exceptional circumstances resulting in significant financial duress, the
13.28monthly maintenance needs allowance may be increased to an amount that provides
13.29needed additional income.
13.30    (d) The percentage of the federal poverty guideline used to determine the monthly
13.31maintenance needs allowance in paragraph (c) is increased to 133 percent on July 1,
13.321991, and to 150 percent on July 1, 1992. Adjustments in the income limits due to annual
13.33changes in the federal poverty guidelines shall be implemented the first day of July
13.34following publication of the annual changes. The $1,500 maximum must be adjusted
13.35January 1, 1990, and every January 1 after that by the same percentage increase in the
14.1Consumer Price Index for all urban consumers (all items; United States city average)
14.2between the two previous Septembers.
14.3    (e) If a court has entered an order against an institutionalized spouse for monthly
14.4income for support of the community spouse, the community spouse's monthly income
14.5allowance under this subdivision shall not be less than the amount of the monthly income
14.6ordered.
14.7    Subd. 3. Family allowance. (a) A family allowance determined under paragraph
14.8(b) is not considered available to the institutionalized spouse for monthly payment of costs
14.9of care in the institution.
14.10    (b) The family allowance is equal to one-third of the amount by which 122 percent
14.11of the monthly federal poverty guideline for a family of two exceeds the monthly income
14.12for that family member.
14.13    (c) For purposes of this subdivision, the term family member only includes a
14.14minor or dependent child as defined in the Internal Revenue Code, dependent parent, or
14.15dependent sibling of the institutionalized or community spouse if the sibling resides with
14.16the community spouse.
14.17    (d) The percentage of the federal poverty guideline used to determine the family
14.18allowance in paragraph (b) is increased to 133 percent on July 1, 1991, and to 150 percent
14.19on July 1, 1992. Adjustments in the income limits due to annual changes in the federal
14.20poverty guidelines shall be implemented the first day of July following publication of
14.21the annual changes.
14.22    Subd. 4. Treatment of income. (a) No income of the community spouse will
14.23be considered available to an eligible institutionalized spouse, beginning the first full
14.24calendar month of institutionalization, except as provided in this subdivision.
14.25    (b) In determining the income of an institutionalized spouse or community spouse,
14.26after the institutionalized spouse has been determined eligible for medical assistance,
14.27the following rules apply.
14.28    (1) For income that is not from a trust, availability is determined according to items
14.29(i) to (v), unless the instrument providing the income otherwise specifically provides:
14.30    (i) if payment is made solely in the name of one spouse, the income is considered
14.31available only to that spouse;
14.32    (ii) if payment is made in the names of both spouses, one-half of the income is
14.33considered available to each;
14.34    (iii) if payment is made in the names of one or both spouses together with one or
14.35more other persons, the income is considered available to each spouse according to the
15.1spouse's interest, or one-half of the joint interest is considered available to each spouse
15.2if each spouse's interest is not specified;
15.3    (iv) if there is no instrument that establishes ownership, one-half of the income is
15.4considered available to each spouse; and
15.5    (v) either spouse may rebut the determination of availability of income by showing
15.6by a preponderance of the evidence that ownership interests are different than provided
15.7above.
15.8    (2) For income from a trust, income is considered available to each spouse as
15.9provided in the trust. If the trust does not specify an amount available to either or both
15.10spouses, availability will be determined according to items (i) to (iii):
15.11    (i) if payment of income is made only to one spouse, the income is considered
15.12available only to that spouse;
15.13    (ii) if payment of income is made to both spouses, one-half is considered available to
15.14each; and
15.15    (iii) if payment is made to either or both spouses and one or more other persons,
15.16the income is considered available to each spouse in proportion to each spouse's interest,
15.17or if no such interest is specified, one-half of the joint interest is considered available
15.18to each spouse.

15.19    Sec. 20. Minnesota Statutes 2006, section 256B.059, subdivision 1, is amended to read:
15.20    Subdivision 1. Definitions. (a) For purposes of this section and section sections
15.21256B.058 and 256B.0595, the terms defined in this subdivision have the meanings given
15.22them.
15.23    (b) "Community spouse" means the spouse of an institutionalized spouse.
15.24    (c) "Spousal share" means one-half of the total value of all assets, to the extent that
15.25either the institutionalized spouse or the community spouse had an ownership interest at
15.26the time of the first continuous period of institutionalization.
15.27    (d) "Assets otherwise available to the community spouse" means assets individually
15.28or jointly owned by the community spouse, other than assets excluded by subdivision 5,
15.29paragraph (c).
15.30    (e) "Community spouse asset allowance" is the value of assets that can be transferred
15.31under subdivision 3.
15.32    (f) "Institutionalized spouse" means a person who is:
15.33    (1) in a hospital, nursing facility, or intermediate care facility for persons with
15.34developmental disabilities, or receiving home and community-based services under
16.1section 256B.0915 or 256B.49, and is expected to remain in the facility or institution or
16.2receive the home and community-based services for at least 30 consecutive days; and
16.3    (2) married to a person who is not in a hospital, nursing facility, or intermediate
16.4care facility for persons with developmental disabilities, and is not receiving home and
16.5community-based services under section 256B.0915, 256B.092, or 256B.49.
16.6    (g) "For the sole benefit of" means no other individual or entity can benefit in any
16.7way from the assets or income at the time of a transfer or at any time in the future.
16.8    (h) "Continuous period of institutionalization" means a 30-consecutive-day period
16.9of time in which a person is expected to stay in a medical or long-term care facility,
16.10or receive home and community-based services that would qualify for coverage under
16.11the elderly waiver (EW) or alternative care (AC) programs. For a stay in a facility, the
16.1230-consecutive-day period begins on the date of entry into a medical or long-term care
16.13facility. For receipt of home and community-based services, the 30-consecutive-day
16.14period begins on the date that the following conditions are met:
16.15    (1) the person is receiving services that meet the nursing facility level of care
16.16determined by a long-term care consultation;
16.17    (2) the person has received the long-term care consultation within the past 60 days;
16.18    (3) the services are paid by the EW program under section 256B.0915 or the AC
16.19program under section 256B.0913 or would qualify for payment under the EW or AC
16.20programs if the person were otherwise eligible for either program, and but for the receipt
16.21of such services the person would have resided in a nursing facility; and
16.22    (4) the services are provided by a licensed provider qualified to provide home and
16.23community-based services.

16.24    Sec. 21. Minnesota Statutes 2006, section 256B.059, subdivision 1a, is amended to
16.25read:
16.26    Subd. 1a. Institutionalized spouse. The provisions of this section apply only
16.27when a spouse is institutionalized for a begins the first continuous period beginning of
16.28institutionalization on or after October 1, 1989.

16.29    Sec. 22. Minnesota Statutes 2006, section 256B.0594, is amended to read:
16.30256B.0594 PAYMENT OF BENEFITS FROM AN ANNUITY.
16.31    When payment becomes due under an annuity that names the department a
16.32remainder beneficiary as described in section 256B.056, subdivision 11, the issuer shall
16.33request and the department shall, within 45 days after receipt of the request, provide
16.34a written statement of the total amount of the medical assistance paid or confirmation
17.1that any family member designated as a remainder beneficiary meets requirements for
17.2qualification as a beneficiary in the first position. Upon timely receipt of the written
17.3statement of the amount of medical assistance paid, the issuer shall pay the department an
17.4amount equal to the lesser of the amount due the department under the annuity or the total
17.5amount of medical assistance paid on behalf of the individual or the individual's spouse.
17.6Any amounts remaining after the issuer's payment to the department shall be payable
17.7according to the terms of the annuity or similar financial instrument. The county agency
17.8or the department shall provide the issuer with the name, address, and telephone number
17.9of a unit within the department the issuer can contact to comply with this section. The
17.10requirements of section 72A.201, subdivision 4, clause (3), shall not apply to payments
17.11made under this section until the issuer has received final payment information from the
17.12department, if the issuer has notified the beneficiary of the requirements of this section at
17.13the time it initially requests payment information from the department.

17.14    Sec. 23. Minnesota Statutes 2006, section 256B.0595, subdivision 1, is amended to
17.15read:
17.16    Subdivision 1. Prohibited transfers. (a) For transfers of assets made on or before
17.17August 10, 1993, if a an institutionalized person or the institutionalized person's spouse
17.18has given away, sold, or disposed of, for less than fair market value, any asset or interest
17.19therein, except assets other than the homestead that are excluded under the supplemental
17.20security program, within 30 months before or any time after the date of institutionalization
17.21if the person has been determined eligible for medical assistance, or within 30 months
17.22before or any time after the date of the first approved application for medical assistance
17.23if the person has not yet been determined eligible for medical assistance, the person is
17.24ineligible for long-term care services for the period of time determined under subdivision
17.252.
17.26    (b) Effective for transfers made after August 10, 1993, a an institutionalized person,
17.27a an institutionalized person's spouse, or any person, court, or administrative body with
17.28legal authority to act in place of, on behalf of, at the direction of, or upon the request of the
17.29institutionalized person or institutionalized person's spouse, may not give away, sell, or
17.30dispose of, for less than fair market value, any asset or interest therein, except assets other
17.31than the homestead that are excluded under the supplemental security income program,
17.32for the purpose of establishing or maintaining medical assistance eligibility. This applies
17.33to all transfers, including those made by a community spouse after the month in which
17.34the institutionalized spouse is determined eligible for medical assistance. For purposes of
17.35determining eligibility for long-term care services, any transfer of such assets within 36
18.1months before or any time after an institutionalized person applies for requests medical
18.2assistance payment of long-term care services, or 36 months before or any time after a
18.3medical assistance recipient becomes an institutionalized person, for less than fair market
18.4value may be considered. Any such transfer is presumed to have been made for the purpose
18.5of establishing or maintaining medical assistance eligibility and the institutionalized
18.6person is ineligible for long-term care services for the period of time determined under
18.7subdivision 2, unless the institutionalized person furnishes convincing evidence to
18.8establish that the transaction was exclusively for another purpose, or unless the transfer is
18.9permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a
18.10trust that are considered transfers of assets under federal law, or in the case of any other
18.11disposal of assets made on or after February 8, 2006, any transfers made within 60 months
18.12before or any time after an institutionalized person applies for requests medical assistance
18.13payment of long-term care services and within 60 months before or any time after a
18.14medical assistance recipient becomes an institutionalized person, may be considered.
18.15    (c) This section applies to transfers, for less than fair market value, of income
18.16or assets, including assets that are considered income in the month received, such as
18.17inheritances, court settlements, and retroactive benefit payments or income to which the
18.18institutionalized person or the institutionalized person's spouse is entitled but does not
18.19receive due to action by the institutionalized person, the institutionalized person's spouse,
18.20or any person, court, or administrative body with legal authority to act in place of, on
18.21behalf of, at the direction of, or upon the request of the institutionalized person or the
18.22institutionalized person's spouse.
18.23    (d) This section applies to payments for care or personal services provided by a
18.24relative, unless the compensation was stipulated in a notarized, written agreement which
18.25was in existence when the service was performed, the care or services directly benefited
18.26the person, and the payments made represented reasonable compensation for the care
18.27or services provided. A notarized written agreement is not required if payment for the
18.28services was made within 60 days after the service was provided.
18.29    (e) This section applies to the portion of any asset or interest that a an institutionalized
18.30person, a an institutionalized person's spouse, or any person, court, or administrative body
18.31with legal authority to act in place of, on behalf of, at the direction of, or upon the request
18.32of the institutionalized person or the institutionalized person's spouse, transfers to any
18.33annuity that exceeds the value of the benefit likely to be returned to the institutionalized
18.34person or institutionalized person's spouse while alive, based on estimated life expectancy
18.35using the life expectancy tables employed by the supplemental security income program
18.36to determine the value of an agreement for services for life as determined according to the
19.1current actuarial tables published by the Office of the Chief Actuary of the Social Security
19.2Administration. The commissioner may adopt rules reducing life expectancies based on
19.3the need for long-term care. This section applies to an annuity described in this paragraph
19.4purchased on or after March 1, 2002, that:
19.5    (1) is not purchased from an insurance company or financial institution that is
19.6subject to licensing or regulation by the Minnesota Department of Commerce or a similar
19.7regulatory agency of another state;
19.8    (2) does not pay out principal and interest in equal monthly installments; or
19.9    (3) does not begin payment at the earliest possible date after annuitization.
19.10    (f) Effective for transactions, including the purchase of an annuity, occurring on
19.11or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
19.12institutionalized person who has applied for or is receiving long-term care services or the
19.13individual's institutionalized person's spouse shall be treated as the disposal of an asset for
19.14less than fair market value unless the department is named as the a preferred remainder
19.15beneficiary in first position for an amount equal to at least the total amount of medical
19.16assistance paid on behalf of the individual or the individual's spouse; or the department
19.17is named as the remainder beneficiary in second position for an amount equal to at least
19.18the total amount of medical assistance paid on behalf of the individual or the individual's
19.19spouse after the individual's community spouse or minor or disabled child and is named as
19.20the remainder beneficiary in the first position if the community spouse or a representative
19.21of the minor or disabled child disposes of the remainder for less than fair market value as
19.22described in section 256B.056, subdivision 11. Any subsequent change to the designation
19.23of the department as a preferred remainder beneficiary shall result in the annuity being
19.24treated as a disposal of assets for less than fair market value. The amount of such transfer
19.25shall be the maximum amount the individual institutionalized person or the individual's
19.26institutionalized person's spouse could receive from the annuity or similar financial
19.27instrument. Any change in the amount of the income or principal being withdrawn
19.28from the annuity or other similar financial instrument at the time of the most recent
19.29disclosure shall be deemed to be a transfer of assets for less than fair market value unless
19.30the individual institutionalized person or the individual's institutionalized person's spouse
19.31demonstrates that the transaction was for fair market value. In the event a distribution
19.32of income or principal has been improperly distributed or disbursed from an annuity or
19.33other retirement planning instrument of an institutionalized person or the institutionalized
19.34person's spouse, a cause of action exists against the individual receiving the improper
19.35distribution for the cost of medical assistance services provided or the amount of the
19.36improper distribution, whichever is less.
20.1    (g) Effective for transactions, including the purchase of an annuity, occurring on
20.2or after February 8, 2006, the purchase of an annuity by or on behalf of an individual
20.3institutionalized person applying for or receiving long-term care services shall be treated
20.4as a disposal of assets for less than fair market value unless it is:
20.5    (i) an annuity described in subsection (b) or (q) of section 408 of the Internal
20.6Revenue Code of 1986; or
20.7    (ii) purchased with proceeds from:
20.8    (A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
20.9Internal Revenue Code;
20.10    (B) a simplified employee pension within the meaning of section 408(k) of the
20.11Internal Revenue Code; or
20.12    (C) a Roth IRA described in section 408A of the Internal Revenue Code; or
20.13    (iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
20.14determined in accordance with actuarial publications of the Office of the Chief Actuary of
20.15the Social Security Administration; and provides for payments in equal amounts during
20.16the term of the annuity, with no deferral and no balloon payments made.
20.17     (h) For purposes of this section, long-term care services include services in a nursing
20.18facility, services that are eligible for payment according to section 256B.0625, subdivision
20.192 , because they are provided in a swing bed, intermediate care facility for persons with
20.20developmental disabilities, and home and community-based services provided pursuant
20.21to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and
20.22subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient
20.23in a nursing facility or in a swing bed, or intermediate care facility for persons with
20.24developmental disabilities or who is receiving home and community-based services under
20.25sections 256B.0915, 256B.092, and 256B.49.
20.26    (i) This section applies to funds used to purchase a promissory note, loan, or
20.27mortgage unless the note, loan, or mortgage:
20.28    (1) has a repayment term that is actuarially sound;
20.29    (2) provides for payments to be made in equal amounts during the term of the loan,
20.30with no deferral and no balloon payments made; and
20.31    (3) prohibits the cancellation of the balance upon the death of the lender.
20.32    In the case of a promissory note, loan, or mortgage that does not meet an exception
20.33in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
20.34balance due as of the date of the individual's application institutionalized person's request
20.35for medical assistance payment of long-term care services.
21.1    (j) This section applies to the purchase of a life estate interest in another individual's
21.2person's home unless the purchaser resides in the home for a period of at least one year
21.3after the date of purchase.

21.4    Sec. 24. Minnesota Statutes 2006, section 256B.0595, subdivision 2, is amended to
21.5read:
21.6    Subd. 2. Period of ineligibility. (a) For any uncompensated transfer occurring on or
21.7before August 10, 1993, the number of months of ineligibility for long-term care services
21.8shall be the lesser of 30 months, or the uncompensated transfer amount divided by the
21.9average medical assistance rate for nursing facility services in the state in effect on the
21.10date of application. The amount used to calculate the average medical assistance payment
21.11rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year.
21.12The period of ineligibility begins with the month in which the assets were transferred.
21.13If the transfer was not reported to the local agency at the time of application, and the
21.14applicant received long-term care services during what would have been the period of
21.15ineligibility if the transfer had been reported, a cause of action exists against the transferee
21.16for the cost of long-term care services provided during the period of ineligibility, or for the
21.17uncompensated amount of the transfer, whichever is less. The action may be brought by
21.18the state or the local agency responsible for providing medical assistance under chapter
21.19256G. The uncompensated transfer amount is the fair market value of the asset at the time
21.20it was given away, sold, or disposed of, less the amount of compensation received.
21.21    (b) For uncompensated transfers made after August 10, 1993, the number of months
21.22of ineligibility for long-term care services shall be the total uncompensated value of the
21.23resources transferred divided by the average medical assistance rate for nursing facility
21.24services in the state in effect on the date of application. The amount used to calculate the
21.25average medical assistance payment rate shall be adjusted each July 1 to reflect payment
21.26rates for the previous calendar year. The period of ineligibility begins with the first day
21.27of the month after the month in which the assets were transferred except that if one or
21.28more uncompensated transfers are made during a period of ineligibility, the total assets
21.29transferred during the ineligibility period shall be combined and a penalty period calculated
21.30to begin on the first day of the month after the month in which the first uncompensated
21.31transfer was made. If the transfer was reported to the local agency after the date that
21.32advance notice of a period of ineligibility that affects the next month could be provided to
21.33the recipient and the recipient received medical assistance services or the transfer was not
21.34reported to the local agency, and the applicant or recipient received medical assistance
21.35services during what would have been the period of ineligibility if the transfer had been
22.1reported, a cause of action exists against the transferee for the cost of medical assistance
22.2that portion of long-term care services provided during the period of ineligibility, or for
22.3the uncompensated amount of the transfer, whichever is less. The action may be brought
22.4by the state or the local agency responsible for providing medical assistance under chapter
22.5256G. The uncompensated transfer amount is the fair market value of the asset at the
22.6time it was given away, sold, or disposed of, less the amount of compensation received.
22.7Effective for transfers made on or after March 1, 1996, involving persons who apply for
22.8medical assistance on or after April 13, 1996, no cause of action exists for a transfer unless:
22.9    (1) the transferee knew or should have known that the transfer was being made by a
22.10person who was a resident of a long-term care facility or was receiving that level of care in
22.11the community at the time of the transfer;
22.12    (2) the transferee knew or should have known that the transfer was being made to
22.13assist the person to qualify for or retain medical assistance eligibility; or
22.14    (3) the transferee actively solicited the transfer with intent to assist the person to
22.15qualify for or retain eligibility for medical assistance.
22.16    (c) For uncompensated transfers made on or after February 8, 2006, the period
22.17of ineligibility:
22.18    (1) for uncompensated transfers by or on behalf of individuals receiving medical
22.19assistance payment of long-term care services, begins on the first day of the month
22.20in which following advance notice can be given following of the penalty period, but no
22.21later than the first day of the month in which assets have been transferred for less than
22.22fair market value, that follows three full calendar months from the date of the report
22.23or discovery of the transfer; or
22.24    (2) for uncompensated transfers by individuals requesting medical assistance
22.25payment of long-term care services, begins the date on which the individual is eligible
22.26for medical assistance under the Medicaid state plan and would otherwise be receiving
22.27long-term care services based on an approved application for such care but for the
22.28application of the penalty period, whichever is later,; and which does not occur
22.29    (3) cannot begin during any other period of ineligibility.
22.30    (d) If a calculation of a penalty period results in a partial month, payments for
22.31long-term care services shall be reduced in an amount equal to the fraction.
22.32    (e) In the case of multiple fractional transfers of assets in more than one month for
22.33less than fair market value on or after February 8, 2006, the period of ineligibility is
22.34calculated by treating the total, cumulative, uncompensated value of all assets transferred
22.35during all months on or after February 8, 2006, as one transfer.

23.1    Sec. 25. Minnesota Statutes 2006, section 256B.0595, subdivision 3, is amended to
23.2read:
23.3    Subd. 3. Homestead exception to transfer prohibition. (a) An institutionalized
23.4person is not ineligible for long-term care services due to a transfer of assets for less than
23.5fair market value if the asset transferred was a homestead and:
23.6    (1) title to the homestead was transferred to the individual's:
23.7    (i) spouse;
23.8    (ii) child who is under age 21;
23.9    (iii) blind or permanently and totally disabled child as defined in the supplemental
23.10security income program;
23.11    (iv) sibling who has equity interest in the home and who was residing in the home
23.12for a period of at least one year immediately before the date of the individual's admission
23.13to the facility; or
23.14    (v) son or daughter who was residing in the individual's home for a period of at least
23.15two years immediately before the date of the individual's admission to the facility the
23.16individual became an institutionalized person, and who provided care to the individual
23.17that, as certified by the individual's attending physician, permitted the individual to reside
23.18at home rather than receive care in an institution or facility;
23.19    (2) a satisfactory showing is made that the individual intended to dispose of the
23.20homestead at fair market value or for other valuable consideration; or
23.21    (3) the local agency grants a waiver of a penalty resulting from a transfer for less
23.22than fair market value because denial of eligibility would cause undue hardship for the
23.23individual, based on imminent threat to the individual's health and well-being. Whenever
23.24an applicant or recipient is denied eligibility because of a transfer for less than fair market
23.25value, the local agency shall notify the applicant or recipient that the applicant or recipient
23.26may request a waiver of the penalty if the denial of eligibility will cause undue hardship.
23.27With the written consent of the individual or the personal representative of the individual,
23.28a long-term care facility in which an individual is residing may file an undue hardship
23.29waiver request, on behalf of the individual who is denied eligibility for long-term care
23.30services on or after July 1, 2006, due to a period of ineligibility resulting from a transfer on
23.31or after February 8, 2006. In evaluating a waiver, the local agency shall take into account
23.32whether the individual was the victim of financial exploitation, whether the individual has
23.33made reasonable efforts to recover the transferred property or resource, and other factors
23.34relevant to a determination of hardship. If the local agency does not approve a hardship
23.35waiver, the local agency shall issue a written notice to the individual stating the reasons
23.36for the denial and the process for appealing the local agency's decision.
24.1    (b) When a waiver is granted under paragraph (a), clause (3), a cause of action exists
24.2against the person to whom the homestead was transferred for that portion of long-term
24.3care services granted provided within:
24.4    (1) 30 months of a transfer made on or before August 10, 1993;
24.5    (2) 60 months if the homestead was transferred after August 10, 1993, to a trust or
24.6portion of a trust that is considered a transfer of assets under federal law;
24.7    (3) 36 months if transferred in any other manner after August 10, 1993, but prior
24.8to February 8, 2006; or
24.9    (4) 60 months if the homestead was transferred on or after February 8, 2006,
24.10or the amount of the uncompensated transfer, whichever is less, together with the
24.11costs incurred due to the action. The action shall be brought by the state unless the
24.12state delegates this responsibility to the local agency responsible for providing medical
24.13assistance under chapter 256G.

24.14    Sec. 26. Minnesota Statutes 2006, section 256B.0595, subdivision 4, is amended to
24.15read:
24.16    Subd. 4. Other exceptions to transfer prohibition. An institutionalized person
24.17who has made, or whose spouse has made a transfer prohibited by subdivision 1, is not
24.18ineligible for long-term care services if one of the following conditions applies:
24.19    (1) the assets were transferred to the individual's spouse or to another for the sole
24.20benefit of the spouse; or
24.21    (2) the institutionalized spouse, prior to being institutionalized, transferred assets
24.22to a spouse, provided that the spouse to whom the assets were transferred does not then
24.23transfer those assets to another person for less than fair market value. (At the time when
24.24one spouse is institutionalized, assets must be allocated between the spouses as provided
24.25under section 256B.059); or
24.26    (3) the assets were transferred to the individual's child who is blind or permanently
24.27and totally disabled as determined in the supplemental security income program; or
24.28    (4) a satisfactory showing is made that the individual intended to dispose of the
24.29assets either at fair market value or for other valuable consideration; or
24.30    (5) the local agency determines that denial of eligibility for long-term care services
24.31would work an undue hardship and grants a waiver of a penalty resulting from a transfer
24.32for less than fair market value based on an imminent threat to the individual's health
24.33and well-being. Whenever an applicant or recipient is denied eligibility because of a
24.34transfer for less than fair market value, the local agency shall notify the applicant or
24.35recipient that the applicant or recipient may request a waiver of the penalty if the denial of
25.1eligibility will cause undue hardship. With the written consent of the individual or the
25.2personal representative of the individual, a long-term care facility in which an individual
25.3is residing may file an undue hardship waiver request, on behalf of the individual who
25.4is denied eligibility for long-term care services on or after July 1, 2006, due to a period
25.5of ineligibility resulting from a transfer on or after February 8, 2006. In evaluating a
25.6waiver, the local agency shall take into account whether the individual was the victim of
25.7financial exploitation, whether the individual has made reasonable efforts to recover the
25.8transferred property or resource, whether the individual has taken any action to prevent
25.9the designation of the department as a remainder beneficiary on an annuity as described
25.10in section 256B.056, subdivision 11, and other factors relevant to a determination of
25.11hardship. The local agency shall make a determination within 30 days of the receipt of all
25.12necessary information needed to make such a determination. If the local agency does not
25.13approve a hardship waiver, the local agency shall issue a written notice to the individual
25.14stating the reasons for the denial and the process for appealing the local agency's decision.
25.15When a waiver is granted, a cause of action exists against the person to whom the assets
25.16were transferred for that portion of long-term care services granted provided within:
25.17    (i) 30 months of a transfer made on or before August 10, 1993;
25.18    (ii) 60 months of a transfer if the assets were transferred after August 30, 1993, to a
25.19trust or portion of a trust that is considered a transfer of assets under federal law;
25.20    (iii) 36 months of a transfer if transferred in any other manner after August 10, 1993,
25.21but prior to February 8, 2006; or
25.22    (iv) 60 months of any transfer made on or after February 8, 2006,
25.23or the amount of the uncompensated transfer, whichever is less, together with the
25.24costs incurred due to the action. The action shall be brought by the state unless the
25.25state delegates this responsibility to the local agency responsible for providing medical
25.26assistance under this chapter; or
25.27    (6) for transfers occurring after August 10, 1993, the assets were transferred by
25.28the person or person's spouse: (i) into a trust established for the sole benefit of a son or
25.29daughter of any age who is blind or disabled as defined by the Supplemental Security
25.30Income program; or (ii) into a trust established for the sole benefit of an individual who is
25.31under 65 years of age who is disabled as defined by the Supplemental Security Income
25.32program.
25.33    "For the sole benefit of" has the meaning found in section 256B.059, subdivision 1.

25.34    Sec. 27. Minnesota Statutes 2006, section 256B.0595, is amended by adding a
25.35subdivision to read:
26.1    Subd. 8. Cause of action; transfer prior to death. (a) A cause of action exists
26.2against a transferee who receives assets for less than fair market value, either:
26.3    (1) from a person who was a recipient of medical assistance and who made an
26.4uncompensated transfer that was known to the county agency but a penalty period could
26.5not be implemented under this section due to the death of the person; or
26.6    (2) from a person who was a recipient of medical assistance who made an
26.7uncompensated transfer that was not known to the county agency and the transfer was
26.8made with the intent to hinder, delay, or defraud the state or local agency from recovering
26.9as allowed under section 256B.15. In determining intent under this clause consideration
26.10may be given, among other factors, to whether:
26.11    (i) the transfer was to a family member;
26.12    (ii) the transferor retained possession or control of the property after the transfer;
26.13    (iii) the transfer was concealed;
26.14    (iv) the transfer included the majority of the transferor's assets;
26.15    (v) the value of the consideration received was not reasonably equivalent to the fair
26.16market value of the property; and
26.17    (vi) the transfer occurred shortly before the death of the transferor.
26.18    (b) No cause of action exists under this subdivision unless:
26.19    (1) the transferee knew or should have known that the transfer was being made by a
26.20person who was receiving medical assistance as described in section 256B.15, subdivision
26.211, paragraph (b); and
26.22    (2) the transferee received the asset without providing a reasonable equivalent fair
26.23market value in exchange for the transfer.
26.24    (c) The cause of action is for the uncompensated amount of the transfer or the
26.25amount of medical assistance paid on behalf of the person, whichever is less. The
26.26uncompensated transfer amount is the fair market value of the asset at the time it was
26.27given away, sold, or disposed of, less the amount of the compensation received.

26.28    Sec. 28. Minnesota Statutes 2006, section 256B.0595, is amended by adding a
26.29subdivision to read:
26.30    Subd. 9. Filing cause of action; limitation. (a) The county of financial
26.31responsibility under chapter 256G may bring a cause of action under any or all of the
26.32following:
26.33    (1) subdivision 1, paragraph (f);
26.34    (2) subdivision 2, paragraphs (a) and (b);
26.35    (3) subdivision 3, paragraph (b);
27.1    (4) subdivision 4, clause (5); and
27.2    (5) subdivision 8
27.3on behalf of the claimant who must be the commissioner.
27.4    (b) Notwithstanding any other law to the contrary, a cause of action under
27.5subdivision 2, paragraph (a) or (b), or 8, must be commenced within six years of the date
27.6the local agency determines that a transfer was made for less than fair market value.
27.7Notwithstanding any other law to the contrary, a cause of action under subdivision 3,
27.8paragraph (b), or 4, clause (5), must be commenced within six years of the date of
27.9approval of a waiver of the penalty period for a transfer for less than fair market value
27.10based on undue hardship.

27.11    Sec. 29. Minnesota Statutes 2006, section 256B.0625, subdivision 3c, is amended to
27.12read:
27.13    Subd. 3c. Health Services Policy Committee. The commissioner, after receiving
27.14recommendations from professional physician associations, professional associations
27.15representing licensed nonphysician health care professionals, and consumer groups, shall
27.16establish a 13-member Health Services Policy Committee, which consists of 12 voting
27.17members and one nonvoting member. The Health Services Policy Committee shall advise
27.18the commissioner regarding health services pertaining to the administration of health
27.19care benefits covered under the medical assistance, general assistance medical care, and
27.20MinnesotaCare programs. The Health Services Policy Committee shall meet at least
27.21quarterly. The Health Services Policy Committee shall annually elect a physician chair
27.22from among its members, who shall work directly with the commissioner's medical
27.23director, to establish the agenda for each meeting. The Health Services Policy Committee
27.24shall also recommend criteria for verifying centers of excellence for specific aspects of
27.25medical care where a specific set of combined services, a volume of patients necessary to
27.26maintain a high level of competency, or a specific level of technical capacity is associated
27.27with improved health outcomes.

27.28    Sec. 30. Minnesota Statutes 2006, section 256B.0625, subdivision 13g, is amended to
27.29read:
27.30    Subd. 13g. Preferred drug list. (a) The commissioner shall adopt and implement a
27.31preferred drug list by January 1, 2004. The commissioner may enter into a contract with
27.32a vendor or one or more states for the purpose of participating in a multistate preferred
27.33drug list and supplemental rebate program. The commissioner shall ensure that any
27.34contract meets all federal requirements and maximizes federal financial participation. The
28.1commissioner shall publish the preferred drug list annually in the State Register and shall
28.2maintain an accurate and up-to-date list on the agency Web site.
28.3    (b) The commissioner may add to, delete from, and otherwise modify the preferred
28.4drug list, after consulting with the Formulary Committee and appropriate medical
28.5specialists and providing public notice and the opportunity for public comment.
28.6    (c) The commissioner shall adopt and administer the preferred drug list as part of the
28.7administration of the supplemental drug rebate program. Reimbursement for prescription
28.8drugs not on the preferred drug list may be subject to prior authorization, unless the drug
28.9manufacturer signs a supplemental rebate contract.
28.10    (d) For purposes of this subdivision, "preferred drug list" means a list of prescription
28.11drugs within designated therapeutic classes selected by the commissioner, for which prior
28.12authorization based on the identity of the drug or class is not required.
28.13    (e) The commissioner shall seek any federal waivers or approvals necessary to
28.14implement this subdivision.

28.15    Sec. 31. Minnesota Statutes 2006, section 256B.0625, subdivision 13h, is amended to
28.16read:
28.17    Subd. 13h. Medication therapy management services. (a) Medical assistance
28.18and general assistance medical care cover medication therapy management services for
28.19a recipient taking four or more prescriptions to treat or prevent two or more chronic
28.20medical conditions, or a recipient with a drug therapy problem that is identified or prior
28.21authorized by the commissioner that has resulted or is likely to result in significant
28.22nondrug program costs. The commissioner may cover medical therapy management
28.23services under MinnesotaCare if the commissioner determines this is cost-effective. For
28.24purposes of this subdivision, "medication therapy management" means the provision
28.25of the following pharmaceutical care services by a licensed pharmacist to optimize the
28.26therapeutic outcomes of the patient's medications:
28.27    (1) performing or obtaining necessary assessments of the patient's health status;
28.28    (2) formulating a medication treatment plan;
28.29    (3) monitoring and evaluating the patient's response to therapy, including safety
28.30and effectiveness;
28.31    (4) performing a comprehensive medication review to identify, resolve, and prevent
28.32medication-related problems, including adverse drug events;
28.33    (5) documenting the care delivered and communicating essential information to
28.34the patient's other primary care providers;
29.1    (6) providing verbal education and training designed to enhance patient
29.2understanding and appropriate use of the patient's medications;
29.3    (7) providing information, support services, and resources designed to enhance
29.4patient adherence with the patient's therapeutic regimens; and
29.5    (8) coordinating and integrating medication therapy management services within the
29.6broader health care management services being provided to the patient.
29.7Nothing in this subdivision shall be construed to expand or modify the scope of practice of
29.8the pharmacist as defined in section 151.01, subdivision 27.
29.9    (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
29.10must meet the following requirements:
29.11    (1) have a valid license issued under chapter 151;
29.12    (2) have graduated from an accredited college of pharmacy on or after May 1996, or
29.13completed a structured and comprehensive education program approved by the Board of
29.14Pharmacy and the American Council of Pharmaceutical Education for the provision and
29.15documentation of pharmaceutical care management services that has both clinical and
29.16didactic elements;
29.17    (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
29.18have developed a structured patient care process that is offered in a private or semiprivate
29.19patient care area that is separate from the commercial business that also occurs in the
29.20setting, or in home settings, excluding long-term care and group homes, if the service is
29.21ordered by the provider-directed care coordination team; and
29.22    (4) make use of an electronic patient record system that meets state standards.
29.23    (c) For purposes of reimbursement for medication therapy management services,
29.24the commissioner may enroll individual pharmacists as medical assistance and general
29.25assistance medical care providers. The commissioner may also establish contact
29.26requirements between the pharmacist and recipient, including limiting the number of
29.27reimbursable consultations per recipient.
29.28    (d) The commissioner, after receiving recommendations from professional medical
29.29associations, professional pharmacy associations, and consumer groups, shall convene
29.30an 11-member Medication Therapy Management Advisory Committee to advise
29.31the commissioner on the implementation and administration of medication therapy
29.32management services. The committee shall be comprised of: two licensed physicians;
29.33two licensed pharmacists; two consumer representatives; two health plan company
29.34representatives; and three members with expertise in the area of medication therapy
29.35management, who may be licensed physicians or licensed pharmacists. The committee is
30.1governed by section 15.059, except that committee members do not receive compensation
30.2or reimbursement for expenses. The advisory committee expires on June 30, 2007.
30.3    (e) The commissioner shall evaluate the effect of medication therapy management
30.4on quality of care, patient outcomes, and program costs, and shall include a description
30.5of any savings generated in the medical assistance and general assistance medical care
30.6programs that can be attributable to this coverage. The evaluation shall be submitted to
30.7the legislature by December 15, 2007. The commissioner may contract with a vendor
30.8or an academic institution that has expertise in evaluating health care outcomes for the
30.9purpose of completing the evaluation.

30.10    Sec. 32. Minnesota Statutes 2007 Supplement, section 256B.0625, subdivision 49,
30.11is amended to read:
30.12    Subd. 49. Community health worker. (a) Medical assistance covers the care
30.13coordination and patient education services provided by a community health worker if
30.14the community health worker has:
30.15    (1) received a certificate from the Minnesota State Colleges and Universities System
30.16approved community health worker curriculum; or
30.17    (2) at least five years of supervised experience with an enrolled physician, registered
30.18nurse, or advanced practice registered nurse, or dentist, or at least five years of supervised
30.19experience by a certified public health nurse operating under the direct authority of an
30.20enrolled unit of government.
30.21Community health workers eligible for payment under clause (2) must complete the
30.22certification program by January 1, 2010, to continue to be eligible for payment.
30.23    (b) Community health workers must work under the supervision of a medical
30.24assistance enrolled physician, registered nurse, or advanced practice registered nurse, or
30.25dentist, or work under the supervision of a certified public health nurse operating under
30.26the direct authority of an enrolled unit of government.
30.27    (c) Care coordination and patient education services covered under this subdivision
30.28include, but are not limited to, services relating to oral health and dental care.

30.29    Sec. 33. Minnesota Statutes 2006, section 256B.075, subdivision 2, is amended to read:
30.30    Subd. 2. Fee-for-service. (a) The commissioner shall develop and implement
30.31a disease management program for medical assistance and general assistance medical
30.32care recipients who are not enrolled in the prepaid medical assistance or prepaid general
30.33assistance medical care programs and who are receiving services on a fee-for-service basis.
30.34The commissioner may contract with an outside organization to provide these services.
31.1    (b) The commissioner shall seek any federal approval necessary to implement this
31.2section and to obtain federal matching funds.
31.3    (c) The commissioner shall develop and implement a pilot intensive care
31.4management program for medical assistance children with complex and chronic medical
31.5issues who are not able to participate in the metro-based U Special Kids program due
31.6to geographic distance.

31.7    Sec. 34. Minnesota Statutes 2006, section 256B.15, subdivision 4, is amended to read:
31.8    Subd. 4. Other survivors. (a) If the decedent who was single or the surviving
31.9spouse of a married couple is survived by one of the following persons, a claim exists
31.10against the estate payable first from the value of the nonhomestead property included in
31.11the estate and the personal representative shall make, execute, and deliver to the county
31.12agency a lien against the homestead property in the estate for any unpaid balance of the
31.13claim to the claimant as provided under this section:
31.14    (a) (1) a sibling who resided in the decedent medical assistance recipient's home at
31.15least one year before the decedent's institutionalization and continuously since the date
31.16of institutionalization; or
31.17    (b) (2) a son or daughter or a grandchild who resided in the decedent medical
31.18assistance recipient's home for at least two years immediately before the parent's or
31.19grandparent's institutionalization and continuously since the date of institutionalization,
31.20and who establishes by a preponderance of the evidence having provided care to the
31.21parent or grandparent who received medical assistance, that the care was provided before
31.22institutionalization, and that the care permitted the parent or grandparent to reside at
31.23home rather than in an institution.
31.24    (b) For purposes of this subdivision, "institutionalization" means receiving care:
31.25    (1) in a nursing facility or swing bed, or intermediate care facility for persons with
31.26developmental disabilities; or
31.27    (2) through home and community-based services under section 256B.0915,
31.28256B.092, or 256B.49.

31.29    Sec. 35. Minnesota Statutes 2006, section 256B.69, subdivision 3a, is amended to read:
31.30    Subd. 3a. County authority. (a) The commissioner, when implementing the general
31.31assistance medical care, or medical assistance prepayment program within a county,
31.32must include the county board in the process of development, approval, and issuance of
31.33the request for proposals to provide services to eligible individuals within the proposed
31.34county. County boards must be given reasonable opportunity to make recommendations
32.1regarding the development, issuance, review of responses, and changes needed in the
32.2request for proposals. The commissioner must provide county boards the opportunity to
32.3review each proposal based on the identification of community needs under chapters 145A
32.4and 256E and county advocacy activities. If a county board finds that a proposal does not
32.5address certain community needs, the county board and commissioner shall continue
32.6efforts for improving the proposal and network prior to the approval of the contract. The
32.7county board shall make recommendations regarding the approval of local networks
32.8and their operations to ensure adequate availability and access to covered services. The
32.9provider or health plan must respond directly to county advocates and the state prepaid
32.10medical assistance ombudsperson regarding service delivery and must be accountable to
32.11the state regarding contracts with medical assistance and general assistance medical care
32.12funds. The county board may recommend a maximum number of participating health
32.13plans after considering the size of the enrolling population; ensuring adequate access and
32.14capacity; considering the client and county administrative complexity; and considering
32.15the need to promote the viability of locally developed health plans. The county board
32.16or a single entity representing a group of county boards and the commissioner shall
32.17mutually select health plans for participation at the time of initial implementation of the
32.18prepaid medical assistance program in that county or group of counties and at the time
32.19of contract renewal. The commissioner shall also seek input for contract requirements
32.20from the county or single entity representing a group of county boards at each contract
32.21renewal and incorporate those recommendations into the contract negotiation process.
32.22The commissioner, in conjunction with the county board, shall actively seek to develop
32.23a mutually agreeable timetable prior to the development of the request for proposal, but
32.24counties must agree to initial enrollment beginning on or before January 1, 1999, in
32.25either the prepaid medical assistance and general assistance medical care programs or
32.26county-based purchasing under section 256B.692. At least 90 days before enrollment in
32.27the medical assistance and general assistance medical care prepaid programs begins in
32.28a county in which the prepaid programs have not been established, the commissioner
32.29shall provide a report to the chairs of senate and house committees having jurisdiction
32.30over state health care programs which verifies that the commissioner complied with the
32.31requirements for county involvement that are specified in this subdivision.
32.32    (b) At the option of the county board, the board may develop contract requirements
32.33related to the achievement of local public health goals to meet the health needs of medical
32.34assistance and general assistance medical care enrollees. These requirements must be
32.35reasonably related to the performance of health plan functions and within the scope of the
32.36medical assistance and general assistance medical care benefit sets. If the county board
33.1and the commissioner mutually agree to such requirements, the department shall include
33.2such requirements in all health plan contracts governing the prepaid medical assistance
33.3and general assistance medical care programs in that county at initial implementation of
33.4the program in that county and at the time of contract renewal. The county board may
33.5participate in the enforcement of the contract provisions related to local public health goals.
33.6    (c) For counties in which prepaid medical assistance and general assistance medical
33.7care programs have not been established, the commissioner shall not implement those
33.8programs if a county board submits acceptable and timely preliminary and final proposals
33.9under section 256B.692, until county-based purchasing is no longer operational in that
33.10county. For counties in which prepaid medical assistance and general assistance medical
33.11care programs are in existence on or after September 1, 1997, the commissioner must
33.12terminate contracts with health plans according to section 256B.692, subdivision 5, if
33.13the county board submits and the commissioner accepts preliminary and final proposals
33.14according to that subdivision. The commissioner is not required to terminate contracts that
33.15begin on or after September 1, 1997, according to section 256B.692 until two years have
33.16elapsed from the date of initial enrollment.
33.17    (d) In the event that a county board or a single entity representing a group of county
33.18boards and the commissioner cannot reach agreement regarding: (i) the selection of
33.19participating health plans in that county; (ii) contract requirements; or (iii) implementation
33.20and enforcement of county requirements including provisions regarding local public
33.21health goals, the commissioner shall resolve all disputes after taking into account the
33.22recommendations of a three-person mediation panel. The panel shall be composed of one
33.23designee of the president of the association of Minnesota counties, one designee of the
33.24commissioner of human services, and one designee of the commissioner of health person
33.25selected jointly by the designee of the commissioner of human services and the designee
33.26of the Association of Minnesota Counties. Within a reasonable period of time before
33.27the hearing, the panelists must be provided all documents and information relevant to
33.28the mediation. The parties to the mediation must be given 30 days' notice of a hearing
33.29before the mediation panel.
33.30    (e) If a county which elects to implement county-based purchasing ceases to
33.31implement county-based purchasing, it is prohibited from assuming the responsibility of
33.32county-based purchasing for a period of five years from the date it discontinues purchasing.
33.33    (f) Notwithstanding the requirement in this subdivision that a county must agree to
33.34initial enrollment on or before January 1, 1999, the commissioner shall grant a delay in
33.35the implementation of the county-based purchasing authorized in section 256B.692 until
33.36federal waiver authority and approval has been granted, if the county or group of counties
34.1has submitted a preliminary proposal for county-based purchasing by September 1, 1997,
34.2has not already implemented the prepaid medical assistance program before January 1,
34.31998, and has submitted a written request for the delay to the commissioner by July
34.41, 1998. In order for the delay to be continued, the county or group of counties must
34.5also submit to the commissioner the following information by December 1, 1998. The
34.6information must:
34.7    (1) identify the proposed date of implementation, as determined under section
34.8256B.692, subdivision 5;
34.9    (2) include copies of the county board resolutions which demonstrate the continued
34.10commitment to the implementation of county-based purchasing by the proposed date.
34.11County board authorization may remain contingent on the submission of a final proposal
34.12which meets the requirements of section 256B.692, subdivision 5, paragraph (b);
34.13    (3) demonstrate actions taken for the establishment of a governance structure
34.14between the participating counties and describe how the fiduciary responsibilities of
34.15county-based purchasing will be allocated between the counties, if more than one county
34.16is involved in the proposal;
34.17    (4) describe how the risk of a deficit will be managed in the event expenditures are
34.18greater than total capitation payments. This description must identify how any of the
34.19following strategies will be used:
34.20    (i) risk contracts with licensed health plans;
34.21    (ii) risk arrangements with providers who are not licensed health plans;
34.22    (iii) risk arrangements with other licensed insurance entities; and
34.23    (iv) funding from other county resources;
34.24    (5) include, if county-based purchasing will not contract with licensed health plans
34.25or provider networks, letters of interest from local providers in at least the categories of
34.26hospital, physician, mental health, and pharmacy which express interest in contracting
34.27for services. These letters must recognize any risk transfer identified in clause (4), item
34.28(ii); and
34.29    (6) describe the options being considered to obtain the administrative services
34.30required in section 256B.692, subdivision 3, clauses (3) and (5).
34.31    (g) For counties which receive a delay under this subdivision, the final proposals
34.32required under section 256B.692, subdivision 5, paragraph (b), must be submitted at
34.33least six months prior to the requested implementation date. Authority to implement
34.34county-based purchasing remains contingent on approval of the final proposal as required
34.35under section 256B.692.
35.1    (h) If the commissioner is unable to provide county-specific, individual-level
35.2fee-for-service claims to counties by June 4, 1998, the commissioner shall grant a delay
35.3under paragraph (f) of up to 12 months in the implementation of county-based purchasing,
35.4and shall require implementation not later than January 1, 2000. In order to receive an
35.5extension of the proposed date of implementation under this paragraph, a county or group
35.6of counties must submit a written request for the extension to the commissioner by August
35.71, 1998, must submit the information required under paragraph (f) by December 1, 1998,
35.8and must submit a final proposal as provided under paragraph (g).
35.9    (i) Notwithstanding other requirements of this subdivision, the commissioner
35.10shall not require the implementation of the county-based purchasing authorized in
35.11section 256B.692 until six months after federal waiver approval has been obtained for
35.12county-based purchasing, if the county or counties have submitted the final plan as
35.13required in section 256B.692, subdivision 5. The commissioner shall allow the county or
35.14counties which submitted information under section 256B.692, subdivision 5, to submit
35.15supplemental or additional information which was not possible to submit by April 1, 1999.
35.16A county or counties shall continue to submit the required information and substantive
35.17detail necessary to obtain a prompt response and waiver approval. If amendments to
35.18the final plan are necessary due to the terms and conditions of the waiver approval, the
35.19commissioner shall allow the county or group of counties 60 days to make the necessary
35.20amendments to the final plan and shall not require implementation of the county-based
35.21purchasing until six months after the revised final plan has been submitted.
35.22    (f) The commissioner shall not require that contractual disputes between
35.23county-based purchasing entities and the commissioner be mediated by a panel that
35.24includes a representative of the Minnesota Council of Health Plans.
35.25    (g) At the request of a county-purchasing entity, the commissioner shall adopt a
35.26contract reprocurement or renewal schedule under which all counties included in the
35.27entity's service area are reprocured or renewed at the same time.
35.28    (h) The commissioner shall provide a written report under section 3.195 to the chairs
35.29of the legislative committees having jurisdiction over human services in the senate and the
35.30house of representatives describing in detail the activities undertaken by the commissioner
35.31to ensure full compliance with this section. The report must also provide an explanation
35.32for any decisions of the commissioner not to accept the recommendations of a county or
35.33group of counties required to be consulted under this section. The report must be provided
35.34at least 30 days prior to the effective date of a new or renewed prepaid or managed care
35.35contract in a county.

36.1    Sec. 36. Minnesota Statutes 2006, section 256B.69, subdivision 6, is amended to read:
36.2    Subd. 6. Service delivery. (a) Each demonstration provider shall be responsible for
36.3the health care coordination for eligible individuals. Demonstration providers:
36.4    (1) shall authorize and arrange for the provision of all needed health services
36.5including but not limited to the full range of services listed in sections 256B.02,
36.6subdivision 8 , and 256B.0625 in order to ensure appropriate health care is delivered
36.7to enrollees; notwithstanding section 256B.0621, demonstration providers that provide
36.8nursing home and community-based services under this section shall provide relocation
36.9service coordination to enrolled persons age 65 and over;
36.10    (2) shall accept the prospective, per capita payment from the commissioner in return
36.11for the provision of comprehensive and coordinated health care services for eligible
36.12individuals enrolled in the program;
36.13    (3) may contract with other health care and social service practitioners to provide
36.14services to enrollees; and
36.15    (4) shall institute recipient grievance procedures according to the method established
36.16by the project, utilizing applicable requirements of chapter 62D. Disputes not resolved
36.17through this process shall be appealable to the commissioner as provided in subdivision 11.
36.18    (b) Demonstration providers must comply with the standards for claims settlement
36.19under section 72A.201, subdivisions 4, 5, 7, and 8, when contracting with other health
36.20care and social service practitioners to provide services to enrollees. A demonstration
36.21provider must pay a clean claim, as defined in Code of Federal Regulations, title 42,
36.22section 447.45(b), within 30 business days of the date of acceptance of the claim.

36.23    Sec. 37. Minnesota Statutes 2006, section 256B.69, subdivision 27, is amended to read:
36.24    Subd. 27. Information for persons with limited English-language proficiency.
36.25    Managed care contracts entered into under this section and sections 256D.03, subdivision
36.264 , paragraph (c), and 256L.12 must require demonstration providers to inform enrollees
36.27that upon request the enrollee can obtain a certificate of coverage in the following
36.28languages: Spanish, Hmong, Laotian, Russian, Somali, Vietnamese, or Cambodian.
36.29Upon request, the demonstration provider must provide the enrollee with a certificate of
36.30coverage in the specified language of preference provide language assistance to enrollees
36.31that ensures meaningful access to its programs and services according to Title VI of the
36.32Civil Rights Act and federal regulations adopted under that law or any guidance from the
36.33United States Department of Health and Human Services.

36.34    Sec. 38. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to read:
37.1    Subd. 28. Medicare special needs plans; medical assistance basic health care.
37.2    (a) The commissioner may contract with qualified Medicare-approved special needs
37.3plans to provide medical assistance basic health care services to persons with disabilities,
37.4including those with developmental disabilities. Basic health care services include:
37.5    (1) those services covered by the medical assistance state plan except for ICF/MR
37.6services, home and community-based waiver services, case management for persons with
37.7developmental disabilities under section 256B.0625, subdivision 20a, and personal care
37.8and certain home care services defined by the commissioner in consultation with the
37.9stakeholder group established under paragraph (d); and
37.10    (2) basic health care services may also include risk for up to 100 days of nursing
37.11facility services for persons who reside in a noninstitutional setting and home health
37.12services related to rehabilitation as defined by the commissioner after consultation with
37.13the stakeholder group.
37.14    The commissioner may exclude other medical assistance services from the basic
37.15health care benefit set. Enrollees in these plans can access any excluded services on the
37.16same basis as other medical assistance recipients who have not enrolled.
37.17    Unless a person is otherwise required to enroll in managed care, enrollment in these
37.18plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
37.19enrollment with an option to opt out is not voluntary enrollment.
37.20    (b) Beginning January 1, 2007, the commissioner may contract with qualified
37.21Medicare special needs plans to provide basic health care services under medical
37.22assistance to persons who are dually eligible for both Medicare and Medicaid and those
37.23Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
37.24The commissioner shall consult with the stakeholder group under paragraph (d) in
37.25developing program specifications for these services. The commissioner shall report to
37.26the chairs of the house and senate committees with jurisdiction over health and human
37.27services policy and finance by February 1, 2007, on implementation of these programs and
37.28the need for increased funding for the ombudsman for managed care and other consumer
37.29assistance and protections needed due to enrollment in managed care of persons with
37.30disabilities. Payment for Medicaid services provided under this subdivision for the months
37.31of May and June will be made no earlier than July 1 of the same calendar year.
37.32    (c) Beginning January 1, 2008, the commissioner may expand contracting under this
37.33subdivision to all persons with disabilities not otherwise required to enroll in managed
37.34care.
37.35    (d) The commissioner shall establish a state-level stakeholder group to provide
37.36advice on managed care programs for persons with disabilities, including both MnDHO
38.1and contracts with special needs plans that provide basic health care services as described
38.2in paragraphs (a) and (b). The stakeholder group shall provide advice on program
38.3expansions under this subdivision and subdivision 23, including:
38.4    (1) implementation efforts;
38.5    (2) consumer protections; and
38.6    (3) program specifications such as quality assurance measures, data collection and
38.7reporting, and evaluation of costs, quality, and results.
38.8    (e) Each plan under contract to provide medical assistance basic health care services
38.9shall establish a local or regional stakeholder group, including representatives of the
38.10counties covered by the plan, members, consumer advocates, and providers, for advice on
38.11issues that arise in the local or regional area.
38.12    (f) The commissioner is prohibited from providing the names of potential enrollees
38.13to health plans for marketing purposes. The commissioner may mail marketing materials
38.14to potential enrollees on behalf of health plans, in which case the health plans shall cover
38.15any costs incurred by the commissioner for mailing marketing materials.

38.16    Sec. 39. Minnesota Statutes 2006, section 256B.692, subdivision 7, is amended to read:
38.17    Subd. 7. Dispute resolution. In the event the commissioner rejects a proposal
38.18under subdivision 6, the county board may request the recommendation of a three-person
38.19mediation panel. The commissioner shall resolve all disputes after taking into account the
38.20recommendations of the mediation panel. The panel shall be composed of one designee of
38.21the president of the Association of Minnesota Counties, one designee of the commissioner
38.22of human services, and one designee of the commissioner of health person selected jointly
38.23by the designee of the commissioner of human services and the designee of the Association
38.24of Minnesota Counties. Within a reasonable period of time before the hearing, the panelists
38.25must be provided all documents and information relevant to the mediation. The parties to
38.26the mediation must be given 30 days' notice of a hearing before the mediation panel.

38.27    Sec. 40. Minnesota Statutes 2007 Supplement, section 256D.03, subdivision 3, is
38.28amended to read:
38.29    Subd. 3. General assistance medical care; eligibility. (a) General assistance
38.30medical care may be paid for any person who is not eligible for medical assistance under
38.31chapter 256B, including eligibility for medical assistance based on a spenddown of excess
38.32income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
38.33paragraph (b), except as provided in paragraph (c), and:
39.1    (1) who is receiving assistance under section 256D.05, except for families with
39.2children who are eligible under Minnesota family investment program (MFIP), or who is
39.3having a payment made on the person's behalf under sections 256I.01 to 256I.06; or
39.4    (2) who is a resident of Minnesota; and
39.5    (i) who has gross countable income not in excess of 75 percent of the federal poverty
39.6guidelines for the family size, using a six-month budget period and whose equity in assets
39.7is not in excess of $1,000 per assistance unit. General assistance medical care is not
39.8available for applicants or enrollees who are otherwise eligible for medical assistance but
39.9fail to verify their assets. Enrollees who become eligible for medical assistance shall be
39.10terminated and transferred to medical assistance. Exempt assets, the reduction of excess
39.11assets, and the waiver of excess assets must conform to the medical assistance program in
39.12section 256B.056, subdivision 3, with the following exception: the maximum amount of
39.13undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by
39.14the trustee, assuming the full exercise of the trustee's discretion under the terms of the
39.15trust, must be applied toward the asset maximum;
39.16    (ii) who has gross countable income above 75 percent of the federal poverty
39.17guidelines but not in excess of 175 percent of the federal poverty guidelines for the
39.18family size, using a six-month budget period, whose equity in assets is not in excess
39.19of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
39.20hospitalization; or
39.21    (iii) the commissioner shall adjust the income standards under this section each July
39.221 by the annual update of the federal poverty guidelines following publication by the
39.23United States Department of Health and Human Services.
39.24    (b) Effective for applications and renewals processed on or after September 1, 2006,
39.25general assistance medical care may not be paid for applicants or recipients who are adults
39.26with dependent children under 21 whose gross family income is equal to or less than 275
39.27percent of the federal poverty guidelines who are not described in paragraph (e).
39.28    (c) Effective for applications and renewals processed on or after September 1, 2006,
39.29general assistance medical care may be paid for applicants and recipients who meet all
39.30eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
39.31beginning the date of application. Immediately following approval of general assistance
39.32medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
39.33subdivision 7 , with covered services as provided in section 256L.03 for the rest of the
39.34six-month general assistance medical care eligibility period, until their six-month renewal.
40.1    (d) To be eligible for general assistance medical care following enrollment in
40.2MinnesotaCare as required by paragraph (c), an individual must complete a new
40.3application.
40.4    (e) Applicants and recipients eligible under paragraph (a), clause (1); who, are
40.5exempt from the MinnesotaCare enrollment requirements in this subdivision if they:
40.6    (1) have applied for and are awaiting a determination of blindness or disability by
40.7the state medical review team or a determination of eligibility for Supplemental Security
40.8Income or Social Security Disability Insurance by the Social Security Administration; who
40.9    (2) fail to meet the requirements of section 256L.09, subdivision 2; who
40.10    (3) are homeless as defined by United States Code, title 42, section 11301, et seq.;
40.11who
40.12    (4) are classified as end-stage renal disease beneficiaries in the Medicare program;
40.13who
40.14    (5) are enrolled in private health care coverage as defined in section 256B.02,
40.15subdivision 9; who
40.16    (6) are eligible under paragraph (j); or who
40.17    (7) receive treatment funded pursuant to section 254B.02 are exempt from the
40.18MinnesotaCare enrollment requirements of this subdivision; or
40.19    (8) reside in the Minnesota sex offender program defined in chapter 246B.
40.20    (f) For applications received on or after October 1, 2003, eligibility may begin no
40.21earlier than the date of application. For individuals eligible under paragraph (a), clause
40.22(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
40.23eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
40.24may reapply if there is a subsequent period of inpatient hospitalization.
40.25    (g) Beginning September 1, 2006, Minnesota health care program applications and
40.26renewals completed by recipients and applicants who are persons described in paragraph
40.27(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
40.28by the county agency. If all other eligibility requirements of this subdivision are met,
40.29eligibility for general assistance medical care shall be available in any month during which
40.30MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
40.31notice of termination for eligibility for general assistance medical care shall be sent to
40.32an applicant or recipient. If all other eligibility requirements of this subdivision are
40.33met, eligibility for general assistance medical care shall be available until enrollment in
40.34MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
40.35    (h) The date of an initial Minnesota health care program application necessary to
40.36begin a determination of eligibility shall be the date the applicant has provided a name,
41.1address, and Social Security number, signed and dated, to the county agency or the
41.2Department of Human Services. If the applicant is unable to provide a name, address,
41.3Social Security number, and signature when health care is delivered due to a medical
41.4condition or disability, a health care provider may act on an applicant's behalf to establish
41.5the date of an initial Minnesota health care program application by providing the county
41.6agency or Department of Human Services with provider identification and a temporary
41.7unique identifier for the applicant. The applicant must complete the remainder of the
41.8application and provide necessary verification before eligibility can be determined. The
41.9county agency must assist the applicant in obtaining verification if necessary.
41.10    (i) County agencies are authorized to use all automated databases containing
41.11information regarding recipients' or applicants' income in order to determine eligibility for
41.12general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
41.13in order to determine eligibility and premium payments by the county agency.
41.14    (j) General assistance medical care is not available for a person in a correctional
41.15facility unless the person is detained by law for less than one year in a county correctional
41.16or detention facility as a person accused or convicted of a crime, or admitted as an
41.17inpatient to a hospital on a criminal hold order, and the person is a recipient of general
41.18assistance medical care at the time the person is detained by law or admitted on a criminal
41.19hold order and as long as the person continues to meet other eligibility requirements
41.20of this subdivision.
41.21    (k) General assistance medical care is not available for applicants or recipients who
41.22do not cooperate with the county agency to meet the requirements of medical assistance.
41.23    (l) In determining the amount of assets of an individual eligible under paragraph
41.24(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
41.25an asset excluded under paragraph (a), that was given away, sold, or disposed of for
41.26less than fair market value within the 60 months preceding application for general
41.27assistance medical care or during the period of eligibility. Any transfer described in this
41.28paragraph shall be presumed to have been for the purpose of establishing eligibility for
41.29general assistance medical care, unless the individual furnishes convincing evidence to
41.30establish that the transaction was exclusively for another purpose. For purposes of this
41.31paragraph, the value of the asset or interest shall be the fair market value at the time it
41.32was given away, sold, or disposed of, less the amount of compensation received. For any
41.33uncompensated transfer, the number of months of ineligibility, including partial months,
41.34shall be calculated by dividing the uncompensated transfer amount by the average monthly
41.35per person payment made by the medical assistance program to skilled nursing facilities
41.36for the previous calendar year. The individual shall remain ineligible until this fixed period
42.1has expired. The period of ineligibility may exceed 30 months, and a reapplication for
42.2benefits after 30 months from the date of the transfer shall not result in eligibility unless
42.3and until the period of ineligibility has expired. The period of ineligibility begins in the
42.4month the transfer was reported to the county agency, or if the transfer was not reported,
42.5the month in which the county agency discovered the transfer, whichever comes first. For
42.6applicants, the period of ineligibility begins on the date of the first approved application.
42.7    (m) When determining eligibility for any state benefits under this subdivision,
42.8the income and resources of all noncitizens shall be deemed to include their sponsor's
42.9income and resources as defined in the Personal Responsibility and Work Opportunity
42.10Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
42.11subsequently set out in federal rules.
42.12    (n) Undocumented noncitizens and nonimmigrants are ineligible for general
42.13assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
42.14in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
42.15an undocumented noncitizen is an individual who resides in the United States without the
42.16approval or acquiescence of the United States Citizenship and Immigration Services.
42.17    (o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
42.18medical assistance due to the deeming of a sponsor's income and resources, is ineligible
42.19for general assistance medical care.
42.20    (p) Effective July 1, 2003, general assistance medical care emergency services end.
42.21EFFECTIVE DATE.This section is effective the day following final enactment.

42.22    Sec. 41. Minnesota Statutes 2006, section 524.3-803, is amended to read:
42.23524.3-803 LIMITATIONS ON PRESENTATION OF CLAIMS.
42.24    (a) All claims as defined in section 524.1-201(6), against a decedent's estate which
42.25arose before the death of the decedent, including claims of the state and any subdivision
42.26thereof, whether due or to become due, absolute or contingent, liquidated or unliquidated,
42.27if not barred earlier by other statute of limitations, are barred against the estate, the personal
42.28representative, and the heirs and devisees of the decedent, unless presented as follows:
42.29    (1) in the case of a creditor who is only entitled, under the United States Constitution
42.30and under the Minnesota Constitution, to notice by publication under section 524.3-801,
42.31within four months after the date of the court administrator's notice to creditors which
42.32is subsequently published pursuant to section 524.3-801;
42.33    (2) in the case of a creditor who was served with notice under section 524.3-801(c),
42.34within the later to expire of four months after the date of the first publication of notice to
42.35creditors or one month after the service;
43.1    (3) within the later to expire of one year after the decedent's death, or one year after
43.2June 16, 1989, whether or not notice to creditors has been published or served under
43.3section 524.3-801, provided, however, that in the case of a decedent who died before June
43.416, 1989, no claim which was then barred by any provision of law may be deemed to have
43.5been revived by the amendment of this section. Claims authorized by section 246.53,
43.6256B.15, or 256D.16 must not be barred after one year as provided in this clause.
43.7    (b) All claims against a decedent's estate which arise at or after the death of the
43.8decedent, including claims of the state and any subdivision thereof, whether due or to
43.9become due, absolute or contingent, liquidated or unliquidated, are barred against the
43.10estate, the personal representative, and the heirs and devisees of the decedent, unless
43.11presented as follows:
43.12    (1) a claim based on a contract with the personal representative, within four months
43.13after performance by the personal representative is due;
43.14    (2) any other claim, within four months after it arises.
43.15    (c) Nothing in this section affects or prevents:
43.16    (1) any proceeding to enforce any mortgage, pledge, or other lien upon property
43.17of the estate;
43.18    (2) any proceeding to establish liability of the decedent or the personal representative
43.19for which there is protection by liability insurance, to the limits of the insurance protection
43.20only;
43.21    (3) the presentment and payment at any time within one year after the decedent's
43.22death of any claim arising before the death of the decedent that is referred to in section
43.23524.3-715 , clause (18), although the same may be otherwise barred under this section; or
43.24    (4) the presentment and payment at any time before a petition is filed in compliance
43.25with section 524.3-1001 or 524.3-1002 or a closing statement is filed under section
43.26524.3-1003 , of:
43.27    (i) any claim arising after the death of the decedent that is referred to in section
43.28524.3-715 , clause (18), although the same may be otherwise barred hereunder;
43.29    (ii) any other claim, including claims subject to clause (3), which would otherwise be
43.30barred hereunder, upon allowance by the court upon petition of the personal representative
43.31or the claimant for cause shown on notice and hearing as the court may direct.

43.32    Sec. 42. NURSING FACILITY PENSION COSTS.
43.33    The commissioner of human services shall evaluate the extent to which the
43.34alternative payment system reimbursement methodology for pension costs leads to
43.35funding shortfalls for nursing facilities that convert from public to private ownership. The
44.1commissioner shall report to the legislature by January 15, 2009, recommendations for
44.2any changes to the alternative payment system reimbursement methodology for pension
44.3costs necessary to ensure the financial viability of nursing facilities. The commissioner
44.4shall pay for any costs related to this study using existing resources.

44.5    Sec. 43. NURSING FACILITY RATE DISPARITY REPORT.
44.6    The commissioner of human services shall study and make a report to the legislature
44.7by January 15, 2009, with recommendations to reduce rate disparities between nursing
44.8facilities in various regions of the state. The recommendations shall include cost estimates
44.9and may include a phase-in schedule. The study shall be accomplished using existing
44.10resources.

44.11    Sec. 44. HOME MODIFICATIONS.
44.12    Effective upon federal approval, the costs associated with home modifications
44.13that add to the square footage of an unlicensed private residence when necessary to
44.14complete a modification to configure a bathroom to accommodate a wheelchair may
44.15be allowed expenses for home and community-based waiver services provided under
44.16Minnesota Statutes, sections 256B.0916 and 256B.49, for persons with disabilities when
44.17the following conditions are met:
44.18    (1) the annual cost of the care and modifications for the waiver recipient does not
44.19exceed the cost of care that would otherwise be incurred for the recipient without the
44.20modification, as determined by the local lead agency;
44.21    (2) the modification is based on the assessed needs, goals, and best interest of the
44.22recipient as identified in the plan of care;
44.23    (3) the modification has been found to be the least costly appropriate alternative after
44.24other alternatives have been explored through an evaluation by the local lead agency; and
44.25    (4) the modification is reasonable given the value and size of the home.

44.26    Sec. 45. WAIVER AMENDMENT.
44.27    The commissioner of human services shall submit an amendment to the Centers for
44.28Medicare and Medicaid Services consistent with section 44 by October 1, 2008.
44.29EFFECTIVE DATE.This section is effective the day following final enactment.

44.30    Sec. 46. APPROPRIATION.
44.31    $65,000 is appropriated in the fiscal year beginning July 1, 2008, from the
44.32state government special revenue fund to the administrative services unit to pay for
44.33medical professional liability insurance coverage required under Minnesota Statutes,
45.1section 214.40. This appropriation shall become part of the base appropriation for
45.2the administrative services unit and shall be annually adjusted based on the cost of the
45.3coverage purchased to comply with Minnesota Statutes, section 214.40.

45.4    Sec. 47. REPEALER.
45.5(a) Minnesota Statutes 2006, section 256B.0571, subdivision 8a, is repealed.
45.6(b) Laws 2003, First Special Session chapter 5, section 11, is repealed.

45.7ARTICLE 2

45.8SEX OFFENDER PROGRAM

45.9    Section 1. Minnesota Statutes 2006, section 13.851, is amended by adding a
45.10subdivision to read:
45.11    Subd. 9. Civil commitment of sexual offenders. Data relating to the preparation
45.12of a petition to commit an individual as a sexual psychopathic personality or sexually
45.13dangerous person is governed by section 253B.185, subdivision 1b.

45.14    Sec. 2. Minnesota Statutes 2006, section 246B.02, is amended to read:
45.15246B.02 ESTABLISHMENT OF MINNESOTA SEX OFFENDER PROGRAM.
45.16    The commissioner of human services shall establish and maintain a secure facility
45.17located in Moose Lake. The facility shall be operated by the Minnesota sex offender
45.18program. The program shall provide care and treatment in secure treatment facilities
45.19to persons on a court-hold order and residing in a secure treatment facility or program
45.20pending commitment or committed by the courts as sexual psychopathic personalities
45.21or sexually dangerous persons, or persons admitted there with the consent of the
45.22commissioner of human services.

45.23    Sec. 3. [246B.06] ESTABLISHMENT OF MINNESOTA STATE INDUSTRIES.
45.24    Subdivision 1. Establishment; purpose. (a) The commissioner of human
45.25services may establish, equip, maintain, and operate the Minnesota State Industries at
45.26any Minnesota sex offender program facility under this chapter. The commissioner
45.27may establish industrial and commercial activities for sex offender treatment patients
45.28as the commissioner deems necessary and suitable to the profitable employment,
45.29educational training, and development of proper work habits of patients consistent with
45.30the requirements in section 246B.05. The industrial and commercial activities authorized
45.31by this section are designated Minnesota State Industries and must be for the primary
45.32purpose of sustaining and ensuring Minnesota State Industries' self-sufficiency, providing
46.1educational training, meaningful employment, and the teaching of proper work habits to
46.2the patients of the Minnesota sex offender program under this chapter, and not solely as
46.3competitive business ventures.
46.4    (b) The net profits from Minnesota State Industries must be used for the benefit
46.5of the patients as it relates to building education and self-sufficiency skills. Prior to
46.6the establishment of any industrial and commercial activity, the commissioner of
46.7human services shall consult with stakeholders including representatives of business,
46.8industry, organized labor, the commissioner of education, the state Apprenticeship
46.9Council, the commissioner of labor and industry, the commissioner of employment and
46.10economic development, the commissioner of administration, and other stakeholders the
46.11commissioner deems qualified. The purpose of the stakeholder consultation is to determine
46.12the quantity and nature of the goods, wares, merchandise, and services to be made or
46.13provided, and the types of processes to be used in their manufacture, processing, repair,
46.14and production consistent with the greatest opportunity for the reform and educational
46.15training of the patients, and with the best interests of the state, business, industry, and labor.
46.16    (c) The commissioner of human services shall, at all times in the conduct of any
46.17industrial or commercial activity authorized by this section, utilize patient labor to the
46.18greatest extent feasible, provided that the commissioner may employ all administrative,
46.19supervisory, and other skilled workers necessary to the proper instruction of the patients
46.20and the profitable and efficient operation of the industrial and commercial activities
46.21authorized by this section.
46.22    (d) The commissioner of human services may authorize the director of any
46.23Minnesota sex offender treatment facility under the commissioner's control to accept
46.24work projects from outside sources for processing, fabrication, or repair, provided that
46.25preference is given to the performance of work projects for state departments and agencies.
46.26    Subd. 2. Revolving fund. As described in section 246B.05, subdivision 2, there
46.27is established a Minnesota State Industries revolving fund under the control of the
46.28commissioner of human services. The revolving fund must be used for Minnesota State
46.29Industries authorized under this section, including, but not limited to, the purchase of
46.30equipment and raw materials, the payment of salaries and wages, and other necessary
46.31expenses as determined by the commissioner of human services. The purchase of
46.32services, materials, and commodities used in and held for resale are not subject to the
46.33competitive bidding procedures of section 16C.06, but are subject to all other provisions
46.34of chapters 16B and 16C. When practical, purchases must be made from small targeted
46.35group businesses designated under section 16C.16. Additionally, the expenses of patient
46.36educational training and self-sufficiency skills may be financed from the revolving fund
47.1in an amount to be determined by the commissioner or designee. The proceeds and
47.2income from all Minnesota State Industries conducted at the Minnesota sex offender
47.3treatment facilities must be deposited in the revolving fund subject to disbursement under
47.4subdivision 3. The commissioner of human services may request that money in the fund
47.5be invested pursuant to section 11A.25. Proceeds from the investment not currently
47.6needed must be accounted for separately and credited to the revolving fund.
47.7    Subd. 3. Disbursement from fund. The Minnesota State Industries revolving
47.8fund must be deposited in the state treasury and paid out only on proper vouchers as
47.9authorized and approved by the commissioner of human services, and in the same manner
47.10and under the same restrictions as are now provided by law for the disbursement of funds
47.11by the commissioner. An amount deposited in the state treasury equal to six months
47.12of net operating cash as determined by the prior 12 months of revenue and cash flow
47.13statements must be restricted for use only by Minnesota State Industries as described
47.14under subdivision 2. For purposes of this subdivision, "net operating cash" means net
47.15income, minus sales, plus cost of goods sold. Cost of goods sold include all direct costs
47.16of industry products attributable to the goods' production.
47.17    Subd. 4. Revolving fund; borrowing. The commissioner of human services is
47.18authorized to borrow sums of money as the commissioner deems necessary to meet
47.19current demands on the Minnesota State Industries revolving fund. The sums borrowed
47.20must not exceed, in any calendar year, six months of net operating cash as determined
47.21by the previous 12 months of the industries' revenue and cash flow statements. If the
47.22commissioner of human services determines that borrowing of funds is necessary, the
47.23commissioner of human services shall certify this need to the commissioner of finance.
47.24Funds may be borrowed from general fund appropriations to the Minnesota sex offender
47.25program with the authorization of the commissioner of finance. Upon authorization of the
47.26commissioner of finance, the transfer must be made and credited to the Minnesota State
47.27Industries revolving fund. The sum transferred to the Minnesota State Industries revolving
47.28fund must be repaid by the commissioner of human services from the revolving fund to
47.29the fund from which it was transferred in a time period specified by the commissioner
47.30of finance, but by no later than the end of the biennium, as defined in section 16A.011,
47.31in which the loan is made. When any transfer is made to the Minnesota State Industries
47.32revolving fund, the commissioner of finance shall notify the commissioner of human
47.33services of the amount transferred to the fund and the date the transfer is to be repaid.
47.34    Subd. 5. Federal grant fund transfers. Grants received by the commissioner of
47.35human services from the federal government for any vocational training program or for
48.1administration by the commissioner of human services must (1) be credited to a federal
48.2grant fund and then (2) be transferred from the federal grant fund to the credit of the
48.3commissioner of human services in the appropriate account upon certification by the
48.4commissioner of human services that the amounts requested to be transferred have been
48.5earned or are required for the purposes of this section. Funds received by the federal
48.6grant fund need not be budgeted as such, provided transfers from the fund are budgeted
48.7for allotment purposes in the appropriate appropriation.
48.8    Subd. 6. Wages. Notwithstanding section 177.24 or any other law to the
48.9contrary, wages paid to patients working within this program are at the discretion of the
48.10commissioner of human services.

48.11    Sec. 4. Minnesota Statutes 2006, section 253B.045, subdivision 1, is amended to read:
48.12    Subdivision 1. Restriction. Except when ordered by the court pursuant to a finding
48.13of necessity to protect the life of the proposed patient or others, or as provided under
48.14subdivision 1a, no person subject to the provisions of this chapter shall be confined in a
48.15jail or correctional institution, except pursuant to chapter 242 or 244.
48.16EFFECTIVE DATE.This section is effective the day following final enactment.

48.17    Sec. 5. Minnesota Statutes 2006, section 253B.045, is amended by adding a
48.18subdivision to read:
48.19    Subd. 1a. Exception. A person who is being petitioned for commitment
48.20under section 253B.185 and who is placed under a judicial hold order under section
48.21253B.07, subdivision 2b or 7, may be confined at a Department of Corrections or a
48.22county correctional or detention facility, rather than a secure treatment facility, until a
48.23determination of the commitment petition as specified in this subdivision.
48.24    (a) A court may order that a person who is being petitioned for commitment under
48.25section 253B.185 be confined in a Department of Corrections facility pursuant to the
48.26judicial hold order under the following circumstances and conditions:
48.27    (1) The person is currently serving a sentence in a Department of Corrections
48.28facility and the court determines that the person has made a knowing and voluntary (i)
48.29waiver of the right to be held in a secure treatment facility and (ii) election to be held in a
48.30Department of Corrections facility. The order confining the person in the Department of
48.31Corrections facility shall remain in effect until the court vacates the order or the person's
48.32criminal sentence and conditional release term expire.
49.1    In no case may the person be held in a Department of Corrections facility pursuant
49.2only to this subdivision, and not pursuant to any separate correctional authority, for more
49.3than 210 days.
49.4    (2) A person who has elected to be confined in a Department of Corrections facility
49.5under this subdivision may revoke the election by filing a written notice of intent to revoke
49.6the election with the court and serving the notice upon the Department of Corrections and
49.7the county attorney. The court shall order the person transferred to a secure treatment
49.8facility within 15 days of the date that the notice of revocation was filed with the court,
49.9except that, if the person has additional time to serve in prison at the end of the 15-day
49.10period, the person shall not be transferred to a secure treatment facility until the person's
49.11prison term expires. After a person has revoked an election to remain in a Department of
49.12Corrections facility under this subdivision, the court may not adopt another election to
49.13remain in a Department of Corrections facility without the agreement of both parties and
49.14the Department of Corrections.
49.15    (3) Upon petition by the commissioner of corrections, after notice to the parties
49.16and opportunity for hearing and for good cause shown, the court may order that the
49.17person's place of confinement be changed from the Department of Corrections to a secure
49.18treatment facility.
49.19    (4) While at a Department of Corrections facility pursuant to this subdivision, the
49.20person shall remain subject to all rules and practices applicable to correctional inmates
49.21in the facility in which the person is placed including, but not limited to, the powers and
49.22duties of the commissioner of corrections under section 241.01, powers relating to use of
49.23force under section 243.52, and the right of the commissioner of corrections to determine
49.24the place of confinement in a prison, reformatory, or other facility.
49.25    (5) A person may not be confined in a Department of Corrections facility under this
49.26provision beyond the end of the person's executed sentence or the end of any applicable
49.27conditional release period, whichever is later. If a person confined in a Department of
49.28Corrections facility pursuant to this provision reaches the person's supervised release
49.29date and is subject to a period of conditional release, the period of conditional release
49.30shall commence on the supervised release date even though the person remains in the
49.31Department of Corrections facility pursuant to this provision. At the end of the later of
49.32the executed sentence or any applicable conditional release period, the person shall be
49.33transferred to a secure treatment facility.
49.34    (6) Nothing in this section may be construed to establish a right of an inmate in a
49.35state correctional facility to participate in sex offender treatment. This section must be
49.36construed in a manner consistent with the provisions of section 244.03.
50.1    (b) The committing county may offer a person who is being petitioned for
50.2commitment under section 253B.185 and who is placed under a judicial hold order under
50.3section 253B.07, subdivision 2b or 7, the option to be held in a county correctional or
50.4detention facility rather than a secure treatment facility, under such terms as may be agreed
50.5to by the county, the commitment petitioner, and the commitment respondent. If a person
50.6makes such an election under this paragraph, the court hold order shall specify the terms
50.7of the agreement, including the conditions for revoking the election.
50.8EFFECTIVE DATE.This section is effective the day following final enactment.

50.9    Sec. 6. Minnesota Statutes 2006, section 253B.045, subdivision 2, is amended to read:
50.10    Subd. 2. Facilities. Each county or a group of counties shall maintain or provide
50.11by contract a facility for confinement of persons held temporarily for observation,
50.12evaluation, diagnosis, treatment, and care. When the temporary confinement is provided
50.13at a regional treatment center, the commissioner shall charge the county of financial
50.14responsibility for the costs of confinement of persons hospitalized under section 253B.05,
50.15subdivisions 1 and 2 , and section 253B.07, subdivision 2b, except that the commissioner
50.16shall bill the responsible health plan first. If the person has health plan coverage, but the
50.17hospitalization does not meet the criteria in subdivision 6 or section 62M.07, 62Q.53,
50.18or 62Q.535, the county is responsible. When a person is temporarily confined in a
50.19Department of Corrections facility solely under subdivision 1a, and not based on any
50.20separate correctional authority:
50.21    (1) the commissioner of corrections may charge the county of financial responsibility
50.22for the costs of confinement; and
50.23    (2) the Department of Human Services shall use existing appropriations to fund
50.24all remaining nonconfinement costs. The funds received by the commissioner for the
50.25confinement and nonconfinement costs are appropriated to the department for these
50.26purposes.
50.27"County of financial responsibility" means the county in which the person resides at the
50.28time of confinement or, if the person has no residence in this state, the county which
50.29initiated the confinement. The charge for confinement in a facility operated by the
50.30commissioner of human services shall be based on the commissioner's determination of
50.31the cost of care pursuant to section 246.50, subdivision 5. When there is a dispute as to
50.32which county is the county of financial responsibility, the county charged for the costs of
50.33confinement shall pay for them pending final determination of the dispute over financial
50.34responsibility. Disputes about the county of financial responsibility shall be submitted to
50.35the commissioner to be settled in the manner prescribed in section 256G.09.
51.1EFFECTIVE DATE.This section is effective the day following final enactment.

51.2    Sec. 7. Minnesota Statutes 2006, section 253B.18, subdivision 4c, is amended to read:
51.3    Subd. 4c. Special review board. (a) The commissioner shall establish one or more
51.4panels of a special review board for persons committed as mentally ill and dangerous to
51.5the public. The board shall consist of three members experienced in the field of mental
51.6illness. One member of each special review board panel shall be a psychiatrist and one
51.7member shall be an attorney. No member shall be affiliated with the Department of
51.8Human Services. The special review board shall meet at least every six months and at
51.9the call of the commissioner. It shall hear and consider all petitions for a reduction in
51.10custody or to appeal a revocation of provisional discharge. A "reduction in custody"
51.11means transfer from a secure treatment facility; all petitions for, discharge, and provisional
51.12discharge, and revocation of provisional discharge; and make recommendations to the
51.13commissioner concerning them. Patients may be transferred by the commissioner between
51.14secure treatment facilities without a special review board hearing.
51.15    (b) Members of the special review board shall receive compensation and
51.16reimbursement for expenses as established by the commissioner.
51.17    (b) A petition filed by a person committed as mentally ill and dangerous to the
51.18public under this section must be heard as provided in subdivision 5 and, as applicable,
51.19subdivision 13. A petition filed by a person committed as a sexual psychopathic
51.20personality or as a sexually dangerous person under section 253B.185, or committed
51.21as both mentally ill and dangerous to the public under this section and as a sexual
51.22psychopathic personality or as a sexually dangerous person must be heard as provided in
51.23section 253B.185, subdivision 9.

51.24    Sec. 8. Minnesota Statutes 2006, section 253B.18, subdivision 5, is amended to read:
51.25    Subd. 5. Petition; notice of hearing; attendance; order. (a) A petition for an
51.26order of transfer, discharge, provisional discharge, a reduction in custody or revocation of
51.27provisional discharge shall be filed with the commissioner and may be filed by the patient
51.28or by the head of the treatment facility. A patient may not petition the special review
51.29board for six months following commitment under subdivision 3 or following the final
51.30disposition of any previous petition and subsequent appeal by the patient. The medical
51.31director may petition at any time.
51.32    (b) Fourteen days prior to the hearing, the committing court, the county attorney of
51.33the county of commitment, the designated agency, interested person, the petitioner, and
51.34the petitioner's counsel shall be given written notice by the commissioner of the time and
52.1place of the hearing before the special review board. Only those entitled to statutory notice
52.2of the hearing or those administratively required to attend may be present at the hearing.
52.3The patient may designate interested persons to receive notice by providing the names
52.4and addresses to the commissioner at least 21 days before the hearing. The board shall
52.5provide the commissioner with written findings of fact and recommendations within 21
52.6days of the hearing. The commissioner shall issue an order no later than 14 days after
52.7receiving the recommendation of the special review board. A copy of the order shall be
52.8sent by certified mail mailed to every person entitled to statutory notice of the hearing
52.9within five days after it is signed. No order by the commissioner shall be effective sooner
52.10than 30 days after the order is signed, unless the county attorney, the patient, and the
52.11commissioner agree that it may become effective sooner.
52.12    (c) The special review board shall hold a hearing on each petition prior to making
52.13its recommendation to the commissioner. The special review board proceedings are not
52.14contested cases as defined in chapter 14. Any person or agency receiving notice that
52.15submits documentary evidence to the special review board prior to the hearing shall also
52.16provide copies to the patient, the patient's counsel, the county attorney of the county of
52.17commitment, the case manager, and the commissioner.
52.18    (d) Prior to the final decision by the commissioner, the special review board may be
52.19reconvened to consider events or circumstances that occurred subsequent to the hearing.
52.20    (e) In making their recommendations and order, the special review board and
52.21commissioner must consider any statements received from victims under subdivision 5a.

52.22    Sec. 9. Minnesota Statutes 2006, section 253B.18, subdivision 5a, is amended to read:
52.23    Subd. 5a. Victim notification of petition and release; right to submit statement.
52.24    (a) As used in this subdivision:
52.25    (1) "crime" has the meaning given to "violent crime" in section 609.1095, and
52.26includes criminal sexual conduct in the fifth degree and offenses within the definition of
52.27"crime against the person" in section 253B.02, subdivision 4a, and also includes offenses
52.28listed in section 253B.02, subdivision 7a, paragraph (b), regardless of whether they are
52.29sexually motivated;
52.30    (2) "victim" means a person who has incurred loss or harm as a result of a crime
52.31the behavior for which forms the basis for a commitment under this section or section
52.32253B.185 ; and
52.33    (3) "convicted" and "conviction" have the meanings given in section 609.02,
52.34subdivision 5 , and also include juvenile court adjudications, findings under Minnesota
52.35Rules of Criminal Procedure, Rule 20.02, that the elements of a crime have been proved,
53.1and findings in commitment cases under this section or section 253B.185 that an act or
53.2acts constituting a crime occurred.
53.3    (b) A county attorney who files a petition to commit a person under this section
53.4or section 253B.185 shall make a reasonable effort to provide prompt notice of filing
53.5the petition to any victim of a crime for which the person was convicted. In addition,
53.6the county attorney shall make a reasonable effort to promptly notify the victim of the
53.7resolution of the petition.
53.8    (c) Before provisionally discharging, discharging, granting pass-eligible status,
53.9approving a pass plan, or otherwise permanently or temporarily releasing a person
53.10committed under this section or section 253B.185 from a treatment facility, the head of the
53.11treatment facility shall make a reasonable effort to notify any victim of a crime for which
53.12the person was convicted that the person may be discharged or released and that the victim
53.13has a right to submit a written statement regarding decisions of the medical director,
53.14special review board, or commissioner with respect to the person. To the extent possible,
53.15the notice must be provided at least 14 days before any special review board hearing or
53.16before a determination on a pass plan. Notwithstanding section 611A.06, subdivision 4,
53.17the commissioner shall provide the judicial appeal panel with victim information in order
53.18to comply with the provisions of this section. The judicial appeal panel shall ensure that
53.19the data on victims remains private as provided for in section 611A.06, subdivision 4.
53.20    (d) This subdivision applies only to victims who have requested notification by
53.21contacting, in writing, the county attorney in the county where the conviction for the crime
53.22occurred. A county attorney who receives a request for notification under this paragraph
53.23shall promptly forward the request to the commissioner of human services.
53.24    (e) The rights under this subdivision are in addition to rights available to a victim
53.25under chapter 611A. This provision does not give a victim all the rights of a "notified
53.26person" or a person "entitled to statutory notice" under subdivision 4a, 4b, or 5.

53.27    Sec. 10. Minnesota Statutes 2007 Supplement, section 253B.185, subdivision 1b,
53.28is amended to read:
53.29    Subd. 1b. County attorney access to data. Notwithstanding sections 144.291
53.30to 144.298 ; 245.467, subdivision 6; 245.4876, subdivision 7; 260B.171; 260B.235,
53.31subdivision 8 ; 260C.171; and 609.749, subdivision 6, or any provision of chapter 13
53.32or other state law, prior to filing a petition for commitment as a sexual psychopathic
53.33personality or as a sexually dangerous person, and upon notice to the proposed patient,
53.34the county attorney or the county attorney's designee may move the court for an order
53.35granting access to any records or data, to the extent it relates to the proposed patient, for
54.1the purpose of determining whether good cause exists to file a petition and, if a petition
54.2is filed, to support the allegations set forth in the petition.
54.3    The court may grant the motion if: (1) the Department of Corrections refers the case
54.4for commitment as a sexual psychopathic personality or a sexually dangerous person; or
54.5(2) upon a showing that the requested category of data or records may be relevant to
54.6the determination by the county attorney or designee. The court shall decide a motion
54.7under this subdivision within 48 hours after a hearing on the motion. Notice to the
54.8proposed patient need not be given upon a showing that such notice may result in harm or
54.9harassment of interested persons or potential witnesses.
54.10    Notwithstanding any provision of chapter 13 or other state law, a county attorney
54.11considering the civil commitment of a person under this section may obtain records and
54.12data from the Department of Corrections or any probation or parole agency in this state
54.13upon request, without a court order, for the purpose of determining whether good cause
54.14exists to file a petition and, if a petition is filed, to support the allegations set forth in the
54.15petition. At the time of the request for the records, the county attorney shall provide notice
54.16of the request to the person who is the subject of the records.
54.17    Data collected pursuant to this subdivision shall retain their original status and, if not
54.18public, are inadmissible in any court proceeding unrelated to civil commitment, unless
54.19otherwise permitted.
54.20EFFECTIVE DATE.This section is effective the day following final enactment.

54.21    Sec. 11. Minnesota Statutes 2006, section 253B.185, subdivision 5, is amended to read:
54.22    Subd. 5. Financial responsibility. (a) For purposes of this subdivision, "state
54.23facility" has the meaning given in section 246.50 and also includes a Department of
54.24Corrections facility when the proposed patient is confined in such a facility pursuant to
54.25section 253B.045, subdivision 1a.
54.26    (b) Notwithstanding sections 246.54, 253B.045, and any other law to the contrary,
54.27when a petition is filed for commitment under this section pursuant to the notice required
54.28in section 244.05, subdivision 7, the state and county are each responsible for 50 percent of
54.29the cost of the person's confinement at a state facility or county jail, prior to commitment.
54.30    (c) The county shall submit an invoice to the state court administrator for
54.31reimbursement of the state's share of the cost of confinement.
54.32    (d) Notwithstanding paragraph (b), the state's responsibility for reimbursement is
54.33limited to the amount appropriated for this purpose.
54.34EFFECTIVE DATE.This section is effective the day following final enactment.

55.1    Sec. 12. Minnesota Statutes 2006, section 253B.185, is amended by adding a
55.2subdivision to read:
55.3    Subd. 9. Petition for reduction in custody. (a) This subdivision applies only
55.4to committed persons as defined in paragraph (b). The procedures in section 253B.18,
55.5subdivision 5a, for victim notification and right to submit a statement under section
55.6253B.18 apply to petitions filed and reductions in custody recommended under this
55.7subdivision.
55.8    (b) As used in this subdivision:
55.9    (1) "committed person" means an individual committed under this section, or under
55.10this section and under section 253B.18, as mentally ill and dangerous. It does not include
55.11persons committed only as mentally ill and dangerous under section 253B.18; and
55.12    (2) "reduction in custody" means transfer out of a secure treatment facility, a
55.13provisional discharge, or a discharge from commitment. A reduction in custody is
55.14considered to be a commitment proceeding under section 8.01.
55.15    (c) A petition for a reduction in custody or an appeal of a revocation of provisional
55.16discharge may be filed by either the committed person or by the head of the treatment
55.17facility and must be filed with and considered by the special review board. A committed
55.18person may not petition the special review board any sooner than six months following
55.19either:
55.20    (1) the entry of judgment in the district court of the order for commitment issued
55.21under section 253B.18, subdivision 3, or upon the exhaustion of all related appeal rights
55.22in state court relating to that order, whichever is later; or
55.23    (2) any recommendation of the special review board or order of the judicial appeal
55.24panel, or upon the exhaustion of all appeal rights in state court, whichever is later. The
55.25medical director may petition at any time. The special review board proceedings are not
55.26contested cases as defined in chapter 14.
55.27    (d) The special review board shall hold a hearing on each petition before issuing a
55.28recommendation under paragraph (f). Fourteen days before the hearing, the committing
55.29court, the county attorney of the county of commitment, the designated agency, an
55.30interested person, the petitioner and the petitioner's counsel, and the committed person
55.31and the committed person's counsel must be given written notice by the commissioner of
55.32the time and place of the hearing before the special review board. Only those entitled to
55.33statutory notice of the hearing or those administratively required to attend may be present
55.34at the hearing. The patient may designate interested persons to receive notice by providing
55.35the names and addresses to the commissioner at least 21 days before the hearing.
56.1    (e) A person or agency receiving notice that submits documentary evidence to the
56.2special review board before the hearing must also provide copies to the committed person,
56.3the committed person's counsel, the county attorney of the county of commitment, the case
56.4manager, and the commissioner. The special review board must consider any statements
56.5received from victims under section 253B.18, subdivision 5a.
56.6    (f) Within 30 days of the hearing, the special review board shall issue written
56.7findings of fact and shall recommend denial or approval of the petition to the judicial
56.8appeal panel established under section 253B.19. The commissioner shall forward the
56.9recommendation of the special review board to the judicial appeal panel and to every
56.10person entitled to statutory notice. No reduction in custody or reversal of a revocation
56.11of provisional discharge recommended by the special review board is effective until it
56.12has been reviewed by the judicial appeal panel and until 15 days after an order from the
56.13judicial appeal panel affirming, modifying, or denying the recommendation.

56.14    Sec. 13. Minnesota Statutes 2006, section 253B.19, subdivision 2, is amended to read:
56.15    Subd. 2. Petition; hearing. The committed person or the county attorney of the
56.16county from which a patient was committed as a person who is mentally ill and dangerous
56.17to the public, or as a sexual psychopathic personality or as a sexually dangerous person
56.18may petition the appeal panel for a rehearing and reconsideration of a decision by the
56.19commissioner. The petition shall be filed with the Supreme Court within 30 days after the
56.20decision of the commissioner is signed. The Supreme Court shall refer the petition to the
56.21chief judge of the appeal panel. (a) A person committed as mentally ill and dangerous to
56.22the public under section 253B.18, or the county attorney of the county from which the
56.23person was committed or the county of financial responsibility, may petition the judicial
56.24appeal panel for a rehearing and reconsideration of a decision by the commissioner under
56.25section 253B.18, subdivision 5. The judicial appeal panel must not consider petitions for
56.26relief other than those considered by the commissioner from which the appeal is taken.
56.27The petition must be filed with the Supreme Court within 30 days after the decision of
56.28the commissioner is signed. The hearing must be held within 45 days of the filing of the
56.29petition unless an extension is granted for good cause.
56.30    (b) A person committed as a sexual psychopathic personality or as a sexually
56.31dangerous person under section 253B.185, or committed as both mentally ill and
56.32dangerous to the public under section 253B.18 and as a sexual psychopathic personality or
56.33as a sexually dangerous person under section 253B.185; the county attorney of the county
56.34from which the person was committed or the county of financial responsibility; or the
56.35commissioner may petition the judicial appeal panel for a rehearing and reconsideration
57.1of a decision of the special review board under section 253B.185, subdivision 9. The
57.2petition must be filed with the Supreme Court within 30 days after the decision is mailed
57.3by the commissioner as required in section 253B.185, subdivision 9, paragraph (f). The
57.4hearing must be held within 180 days of the filing of the petition unless an extension is
57.5granted for good cause. If no party petitions the judicial appeal panel for a rehearing
57.6or reconsideration within 30 days, the judicial appeal panel shall either issue an order
57.7adopting the recommendations of the special review board or set the matter on for a
57.8hearing pursuant to this paragraph.
57.9    (c) For an appeal under paragraph (a) or (b), the Supreme Court shall refer the
57.10petition to the chief judge of the judicial appeal panel. The chief judge shall notify the
57.11patient, the county attorney of the county of commitment, the designated agency, the
57.12commissioner, the head of the treatment facility, any interested person, and other persons
57.13the chief judge designates, of the time and place of the hearing on the petition. The notice
57.14shall be given at least 14 days prior to the date of the hearing. The hearing shall be within
57.1545 days of the filing of the petition unless an extension is granted for good cause.
57.16    (d) Any person may oppose the petition. The patient, the patient's counsel, the
57.17county attorney of the committing county or the county of financial responsibility, and the
57.18commissioner shall participate as parties to the proceeding pending before the judicial
57.19appeal panel and shall, no later than 20 days before the hearing on the petition, inform the
57.20judicial appeal panel and the opposing party in writing whether they support or oppose the
57.21petition and provide a summary of facts in support of their position. The judicial appeal
57.22panel may appoint examiners and may adjourn the hearing from time to time. It shall hear
57.23and receive all relevant testimony and evidence and make a record of all proceedings. The
57.24patient, the patient's counsel, and the county attorney of the committing county may
57.25or the county of financial responsibility have the right to be present and may present
57.26and cross-examine all witnesses and offer a factual and legal basis in support of their
57.27positions. The petitioning party bears the burden of going forward with the evidence. The
57.28party opposing discharge bears the burden of proof by clear and convincing evidence that
57.29the respondent is in need of commitment.

57.30    Sec. 14. Minnesota Statutes 2006, section 253B.19, subdivision 3, is amended to read:
57.31    Subd. 3. Decision. A majority of the judicial appeal panel shall rule upon the
57.32petition. The panel shall consider the petition de novo. The order of the judicial appeal
57.33panel shall supersede the an order of the commissioner in the cases under section 253B.18,
57.34subdivision 5. No order of the judicial appeal panel granting a transfer, discharge or
57.35provisional discharge shall be made effective sooner than 15 days after it is issued.
58.1The panel may not consider petitions for relief other than those considered by the
58.2commissioner or special review board from which the appeal is taken. The judicial appeal
58.3panel may not grant a transfer or provisional discharge on terms or conditions that were
58.4not presented to the commissioner or the special review board.

58.5    Sec. 15. Minnesota Statutes 2006, section 626.5572, subdivision 21, is amended to
58.6read:
58.7    Subd. 21. Vulnerable adult. "Vulnerable adult" means any person 18 years of
58.8age or older who:
58.9    (1) is a resident or inpatient of a facility;
58.10    (2) receives services at or from a facility required to be licensed to serve adults
58.11under sections 245A.01 to 245A.15, except that a person receiving outpatient services for
58.12treatment of chemical dependency or mental illness, or one who is served in the Minnesota
58.13sex offender program on a court-hold order for commitment, or is committed as a sexual
58.14psychopathic personality or as a sexually dangerous person under chapter 253B, is not
58.15considered a vulnerable adult unless the person meets the requirements of clause (4);
58.16    (3) receives services from a home care provider required to be licensed under section
58.17144A.46 ; or from a person or organization that exclusively offers, provides, or arranges
58.18for personal care assistant services under the medical assistance program as authorized
58.19under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, and
58.20256B.0653 to 256B.0656; or
58.21    (4) regardless of residence or whether any type of service is received, possesses a
58.22physical or mental infirmity or other physical, mental, or emotional dysfunction:
58.23    (i) that impairs the individual's ability to provide adequately for the individual's
58.24own care without assistance, including the provision of food, shelter, clothing, health
58.25care, or supervision; and
58.26    (ii) because of the dysfunction or infirmity and the need for assistance, the individual
58.27has an impaired ability to protect the individual from maltreatment.

58.28    Sec. 16. MINNESOTA SEX OFFENDER PROGRAM; OPERATING
58.29STANDARDS.
58.30    The commissioner of human services shall convene a working group of interested
58.31parties to develop standards and guidelines for the operations of the Minnesota sex
58.32offender program. The standards and guidelines shall include, but not be limited to:
58.33    (1) criteria to establish a sex offender treatment advisory board;
58.34    (2) criteria to ensure the necessary provision of health and dental care for patients;
59.1    (3) criteria to ensure the necessary provision of mental health care; and
59.2    (4) fire and safety criteria.
59.3    The standards and guidelines shall be developed by the commissioner in consultation
59.4with the working group members by February 1, 2009, and presented to the chairs of
59.5the policy and finance committees having jurisdiction over the Minnesota sex offender
59.6program for review.

59.7ARTICLE 3

59.8MFIP

59.9    Section 1. Minnesota Statutes 2007 Supplement, section 256J.49, subdivision 13,
59.10is amended to read:
59.11    Subd. 13. Work activity. "Work activity" means any activity in a participant's
59.12approved employment plan that leads to employment. For purposes of the MFIP program,
59.13this includes activities that meet the definition of work activity under the participation
59.14requirements of TANF. Work activity includes:
59.15    (1) unsubsidized employment, including work study and paid apprenticeships or
59.16internships;
59.17    (2) subsidized private sector or public sector employment, including grant diversion
59.18as specified in section 256J.69, on-the-job training as specified in section 256J.66,
59.19the self-employment investment demonstration program (SEID) as specified in section
59.20256J.65, paid work experience, and supported work when a wage subsidy is provided;
59.21    (3) unpaid work experience, including community service, volunteer work,
59.22the community work experience program as specified in section 256J.67, unpaid
59.23apprenticeships or internships, and supported work when a wage subsidy is not provided.
59.24Unpaid work experience is only an option if the participant has been unable to obtain or
59.25maintain paid employment in the competitive labor market, and no paid work experience
59.26programs are available to the participant. Prior to placing a participant in unpaid work,
59.27the county must inform the participant that the participant will be notified if a paid
59.28work experience or supported work position becomes available. Unless a participant
59.29consents in writing to participating participate in unpaid work experience, the participant's
59.30employment plan may only include unpaid work experience if including the unpaid work
59.31experience in the plan will meet the following criteria:
59.32    (i) the unpaid work experience will provide the participant specific skills or
59.33experience that cannot be obtained through other work activity options where the
59.34participant resides or is willing to reside; and
60.1    (ii) the skills or experience gained through the unpaid work experience will result
60.2in higher wages for the participant than the participant could earn without the unpaid
60.3work experience;
60.4    (4) job search including job readiness assistance, job clubs, job placement,
60.5job-related counseling, and job retention services;
60.6    (5) job readiness education, including English as a second language (ESL) or
60.7functional work literacy classes as limited by the provisions of section 256J.531,
60.8subdivision 2 , general educational development (GED) course work, high school
60.9completion, and adult basic education as limited by the provisions of section 256J.531,
60.10subdivision 1 ;
60.11    (6) job skills training directly related to employment, including education and
60.12training that can reasonably be expected to lead to employment, as limited by the
60.13provisions of section 256J.53;
60.14    (7) providing child care services to a participant who is working in a community
60.15service program;
60.16    (8) activities included in the employment plan that is developed under section
60.17256J.521, subdivision 3 ; and
60.18    (9) preemployment activities including chemical and mental health assessments,
60.19treatment, and services; learning disabilities services; child protective services; family
60.20stabilization services; or other programs designed to enhance employability.

60.21ARTICLE 4

60.22MANAGED CARE CONTRACT

60.23    Section 1. Laws 2005, First Special Session chapter 4, article 8, section 84, as amended
60.24by Laws 2006, chapter 264, section 15, is amended to read:
60.25    Sec. 84. SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
60.26CONTRACT.
60.27    (a) Notwithstanding Minnesota Statutes, section 256B.692, subdivision 6, clause
60.28(1), paragraph (c), the commissioner of human services shall approve a county-based
60.29purchasing health plan proposal, submitted on behalf of Cass, Crow Wing, Morrison,
60.30Todd, and Wadena Counties, that requires county-based purchasing on a single-plan basis
60.31contract if the implementation of the single-plan purchasing proposal does not limit an
60.32enrollee's provider choice or access to services and all other requirements applicable to
60.33health plan purchasing are satisfied. The commissioner shall continue single health plan
60.34purchasing arrangements with county-based purchasing entities in the service areas in
60.35existence on May 1, 2006, including arrangements for which a proposal was submitted by
61.1May 1, 2006, on behalf of Cass, Crow Wing, Morrison, Todd, and Wadena Counties, in
61.2response to a request for proposals issued by the commissioner. The commissioner shall
61.3continue to use single-health plan, county-based purchasing arrangements for medical
61.4assistance and general assistance medical care programs and products for the counties
61.5that were in single-health plan, county-based purchasing arrangements on March 1, 2008.
61.6This paragraph does not require the commissioner to terminate an existing contract with a
61.7noncounty-based purchasing plan that had enrollment in a medical assistance program
61.8or product in these counties on March 1, 2008. This paragraph expires on December 31,
61.92010, or the effective date of a new contract for medical assistance and general assistance
61.10medical care managed care programs entered into at the conclusion of the commissioner's
61.11next scheduled reprocurement process for the county-based purchasing entities covered by
61.12this paragraph, whichever is later.
61.13    (b) The commissioner shall consider, and may approve, contracting on a
61.14single-health plan basis with other county-based purchasing plans, or with other qualified
61.15health plans that have coordination arrangements with counties, to serve persons with a
61.16disability who voluntarily enroll, in order to promote better coordination or integration of
61.17health care services, social services and other community-based services, provided that all
61.18requirements applicable to health plan purchasing, including those in Minnesota Statutes,
61.19section 256B.69, subdivision 23, are satisfied. By January 15, 2007, the commissioner
61.20shall report to the chairs of the appropriate legislative committees in the house and senate
61.21an analysis of the advantages and disadvantages of using single-health plan purchasing
61.22to serve persons with a disability who are eligible for health care programs. The report
61.23shall include consideration of the impact of federal health care programs and policies for
61.24persons who are eligible for both federal and state health care programs and shall consider
61.25strategies to improve coordination between federal and state health care programs for
61.26those persons. Nothing in this paragraph supersedes or modifies the requirements in
61.27paragraph (a)."
61.28Delete the title and insert:

61.29"A bill for an act

61.30relating to human services; amending health care services provisions; making
61.31changes to a managed care contract provision; increasing a HMO renewal fee;
61.32changing provisions relating to sex offender program; changing a work activity
61.33provision under MFIP; requiring a report; appropriating money;amending
61.34Minnesota Statutes 2006, sections 13.851, by adding a subdivision; 125A.02,
61.35subdivision 1; 144A.45, subdivision 1, by adding a subdivision; 150A.06, by
61.36adding a subdivision; 214.40, by adding a subdivision; 246B.02; 253B.045,
61.37subdivisions 1, 2, by adding a subdivision; 253B.18, subdivisions 4c, 5, 5a;
61.38253B.185, subdivision 5, by adding a subdivision; 253B.19, subdivisions 2, 3;
61.39256.01, by adding a subdivision; 256B.056, subdivisions 2, 4a, 11, by adding
61.40a subdivision; 256B.057, subdivision 1; 256B.0571, subdivisions 6, 8, 9, 15,
62.1by adding a subdivision; 256B.058; 256B.059, subdivisions 1, 1a; 256B.0594;
62.2256B.0595, subdivisions 1, 2, 3, 4, by adding subdivisions; 256B.0625,
62.3subdivisions 3c, 13g, 13h; 256B.075, subdivision 2; 256B.15, subdivision 4;
62.4256B.69, subdivisions 3a, 6, 27, 28; 256B.692, subdivision 7; 524.3-803;
62.5626.5572, subdivision 21; Minnesota Statutes 2007 Supplement, sections
62.6253B.185, subdivision 1b; 256B.055, subdivision 14; 256B.0625, subdivision
62.749; 256D.03, subdivision 3; 256J.49, subdivision 13; Laws 2005, First Special
62.8Session chapter 4, article 8, section 84, as amended; proposing coding for new
62.9law in Minnesota Statutes, chapters 145; 246B; repealing Minnesota Statutes
62.102006, section 256B.0571, subdivision 8a; Laws 2003, First Special Session
62.11chapter 5, section 11."
We request the adoption of this report and repassage of the bill.House Conferees: (Signed) Thomas Huntley, Erin Murphy, Ron ErhardtSenate Conferees: (Signed) Linda Berglin, Tony Lourey, Paul E. Koering

63.1	We request the adoption of this report and repassage of the bill.
63.2	House Conferees:(Signed)
63.3	.....		.....
63.4	Thomas Huntley		Erin Murphy
63.5	.....
63.6	Ron Erhardt
63.7	Senate Conferees:(Signed)
63.8	.....		.....
63.9	Linda Berglin		Tony Lourey
63.10	.....
63.11	Paul E. Koering