2nd Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; making changes to 1.3 licensing programs and continuing care programs; 1.4 requiring certain activity for identification of a 1.5 deceased person; establishing a guest license category 1.6 for dentists, dental hygienists, and dental 1.7 assistants; changing provisions for prospective 1.8 reimbursement rates; clarifying county duties related 1.9 to poor relief; amending Minnesota Statutes 2000, 1.10 sections 144.05, by adding a subdivision; 150A.06, by 1.11 adding a subdivision; 245.462, subdivision 4; 1.12 245.4871, subdivision 4; 245.50, subdivisions 1, 2, 5; 1.13 245B.02, subdivision 10; 245B.05, subdivision 7; 1.14 245B.07, subdivision 1; 261.063; 626.557, subdivision 1.15 14; Minnesota Statutes 2001 Supplement, sections 1.16 149A.90, subdivision 1; 245A.04, subdivisions 3b, 3d; 1.17 256B.0627, subdivision 10; 256B.0911, subdivisions 4b, 1.18 4d; 256B.0913, subdivision 5; 256B.0915, subdivision 1.19 3; 256B.0924, subdivision 6; 256B.0951, subdivisions 1.20 7, 8; 256B.437, subdivision 6; 256B.69, subdivision 5b. 1.21 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.22 ARTICLE 1 1.23 CONTINUING CARE 1.24 Section 1. Minnesota Statutes 2000, section 245.462, 1.25 subdivision 4, is amended to read: 1.26 Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 1.27 management service provider" means a case manager or case 1.28 manager associate employed by the county or other entity 1.29 authorized by the county board to provide case management 1.30 services specified in section 245.4711. 1.31 (b) A case manager must: 1.32 (1) be skilled in the process of identifying and assessing 1.33 a wide range of client needs; 2.1 (2) be knowledgeable about local community resources and 2.2 how to use those resources for the benefit of the client; 2.3 (3) have a bachelor's degree in one of the behavioral 2.4 sciences or related fields including, but not limited to, social 2.5 work, psychology, or nursing from an accredited college or 2.6 university or meet the requirements of paragraph (c); and 2.7 (4) meet the supervision and continuing education 2.8 requirements described in paragraphs (d), (e), and (f), as 2.9 applicable. 2.10 (c) Case managers without a bachelor's degree must meet one 2.11 of the requirements in clauses (1) to (3): 2.12 (1) have three or four years of experience as a case 2.13 manager associate as defined in this section; 2.14 (2) be a registered nurse without a bachelor's degree and 2.15 have a combination of specialized training in psychiatry and 2.16 work experience consisting of community interaction and 2.17 involvement or community discharge planning in a mental health 2.18 setting totaling three years; or 2.19 (3) be a person who qualified as a case manager under the 2.20 1998 department of human service waiver provision and meet the 2.21 continuing education and mentoring requirements in this section. 2.22 (d) A case manager with at least 2,000 hours of supervised 2.23 experience in the delivery of services to adults with mental 2.24 illness must receive regular ongoing supervision and clinical 2.25 supervision totaling 38 hours per year of which at least one 2.26 hour per month must be clinical supervision regarding individual 2.27 service delivery with a case management supervisor. The 2.28 remaining 26 hours of supervision may be provided by a case 2.29 manager with two years of experience. Group supervision may not 2.30 constitute more than one-half of the required supervision 2.31 hours. Clinical supervision must be documented in the client 2.32 record. 2.33 (e) A case manager without 2,000 hours of supervised 2.34 experience in the delivery of services to adults with mental 2.35 illness must: 2.36 (1) receive clinical supervision regarding individual 3.1 service delivery from a mental health professional at least one 3.2 hour per week until the requirement of 2,000 hours of experience 3.3 is met; and 3.4 (2) complete 40 hours of training approved by the 3.5 commissioner in case management skills and the characteristics 3.6 and needs of adults with serious and persistent mental illness. 3.7 (f) A case manager who is not licensed, registered, or 3.8 certified by a health-related licensing board must receive 30 3.9 hours of continuing education and training in mental illness and 3.10 mental health servicesannuallyevery two years. 3.11 (g) A case manager associate (CMA) must: 3.12 (1) work under the direction of a case manager or case 3.13 management supervisor; 3.14 (2) be at least 21 years of age; 3.15 (3) have at least a high school diploma or its equivalent; 3.16 and 3.17 (4) meet one of the following criteria: 3.18 (i) have an associate of arts degree in one of the 3.19 behavioral sciences or human services; 3.20 (ii) be a registered nurse without a bachelor's degree; 3.21 (iii) within the previous ten years, have three years of 3.22 life experience with serious and persistent mental illness as 3.23 defined in section 245.462, subdivision 20; or as a child had 3.24 severe emotional disturbance as defined in section 245.4871, 3.25 subdivision 6; or have three years life experience as a primary 3.26 caregiver to an adult with serious and persistent mental illness 3.27 within the previous ten years; 3.28 (iv) have 6,000 hours work experience as a nondegreed state 3.29 hospital technician; or 3.30 (v) be a mental health practitioner as defined in section 3.31 245.462, subdivision 17, clause (2). 3.32 Individuals meeting one of the criteria in items (i) to 3.33 (iv), may qualify as a case manager after four years of 3.34 supervised work experience as a case manager associate. 3.35 Individuals meeting the criteria in item (v), may qualify as a 3.36 case manager after three years of supervised experience as a 4.1 case manager associate. 4.2 (h) A case management associate must meet the following 4.3 supervision, mentoring, and continuing education requirements: 4.4 (1) have 40 hours of preservice training described under 4.5 paragraph (e), clause (2); 4.6 (2) receive at least 40 hours of continuing education in 4.7 mental illness and mental health services annually; and 4.8 (3) receive at least five hours of mentoring per week from 4.9 a case management mentor. 4.10 A "case management mentor" means a qualified, practicing case 4.11 manager or case management supervisor who teaches or advises and 4.12 provides intensive training and clinical supervision to one or 4.13 more case manager associates. Mentoring may occur while 4.14 providing direct services to consumers in the office or in the 4.15 field and may be provided to individuals or groups of case 4.16 manager associates. At least two mentoring hours per week must 4.17 be individual and face-to-face. 4.18 (i) A case management supervisor must meet the criteria for 4.19 mental health professionals, as specified in section 245.462, 4.20 subdivision 18. 4.21 (j) An immigrant who does not have the qualifications 4.22 specified in this subdivision may provide case management 4.23 services to adult immigrants with serious and persistent mental 4.24 illness who are members of the same ethnic group as the case 4.25 manager if the person: 4.26 (1) is currently enrolled in and is actively pursuing 4.27 credits toward the completion of a bachelor's degree in one of 4.28 the behavioral sciences or a related field including, but not 4.29 limited to, social work, psychology, or nursing from an 4.30 accredited college or university; 4.31 (2) completes 40 hours of training as specified in this 4.32 subdivision; and 4.33 (3) receives clinical supervision at least once a week 4.34 until the requirements of this subdivision are met. 4.35 Sec. 2. Minnesota Statutes 2000, section 245.4871, 4.36 subdivision 4, is amended to read: 5.1 Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 5.2 management service provider" means a case manager or case 5.3 manager associate employed by the county or other entity 5.4 authorized by the county board to provide case management 5.5 services specified in subdivision 3 for the child with severe 5.6 emotional disturbance and the child's family. 5.7 (b) A case manager must: 5.8 (1) have experience and training in working with children; 5.9 (2) have at least a bachelor's degree in one of the 5.10 behavioral sciences or a related field including, but not 5.11 limited to, social work, psychology, or nursing from an 5.12 accredited college or university or meet the requirements of 5.13 paragraph (d); 5.14 (3) have experience and training in identifying and 5.15 assessing a wide range of children's needs; 5.16 (4) be knowledgeable about local community resources and 5.17 how to use those resources for the benefit of children and their 5.18 families; and 5.19 (5) meet the supervision and continuing education 5.20 requirements of paragraphs (e), (f), and (g), as applicable. 5.21 (c) A case manager may be a member of any professional 5.22 discipline that is part of the local system of care for children 5.23 established by the county board. 5.24 (d) A case manager without a bachelor's degree must meet 5.25 one of the requirements in clauses (1) to (3): 5.26 (1) have three or four years of experience as a case 5.27 manager associate; 5.28 (2) be a registered nurse without a bachelor's degree who 5.29 has a combination of specialized training in psychiatry and work 5.30 experience consisting of community interaction and involvement 5.31 or community discharge planning in a mental health setting 5.32 totaling three years; or 5.33 (3) be a person who qualified as a case manager under the 5.34 1998 department of human services waiver provision and meets the 5.35 continuing education, supervision, and mentoring requirements in 5.36 this section. 6.1 (e) A case manager with at least 2,000 hours of supervised 6.2 experience in the delivery of mental health services to children 6.3 must receive regular ongoing supervision and clinical 6.4 supervision totaling 38 hours per year, of which at least one 6.5 hour per month must be clinical supervision regarding individual 6.6 service delivery with a case management supervisor. The other 6.7 26 hours of supervision may be provided by a case manager with 6.8 two years of experience. Group supervision may not constitute 6.9 more than one-half of the required supervision hours. 6.10 (f) A case manager without 2,000 hours of supervised 6.11 experience in the delivery of mental health services to children 6.12 with emotional disturbance must: 6.13 (1) begin 40 hours of training approved by the commissioner 6.14 of human services in case management skills and in the 6.15 characteristics and needs of children with severe emotional 6.16 disturbance before beginning to provide case management 6.17 services; and 6.18 (2) receive clinical supervision regarding individual 6.19 service delivery from a mental health professional at least one 6.20 hour each week until the requirement of 2,000 hours of 6.21 experience is met. 6.22 (g) A case manager who is not licensed, registered, or 6.23 certified by a health-related licensing board must receive 30 6.24 hours of continuing education and training in severe emotional 6.25 disturbance and mental health servicesannuallyevery two years. 6.26 (h) Clinical supervision must be documented in the child's 6.27 record. When the case manager is not a mental health 6.28 professional, the county board must provide or contract for 6.29 needed clinical supervision. 6.30 (i) The county board must ensure that the case manager has 6.31 the freedom to access and coordinate the services within the 6.32 local system of care that are needed by the child. 6.33 (j) A case manager associate (CMA) must: 6.34 (1) work under the direction of a case manager or case 6.35 management supervisor; 6.36 (2) be at least 21 years of age; 7.1 (3) have at least a high school diploma or its equivalent; 7.2 and 7.3 (4) meet one of the following criteria: 7.4 (i) have an associate of arts degree in one of the 7.5 behavioral sciences or human services; 7.6 (ii) be a registered nurse without a bachelor's degree; 7.7 (iii) have three years of life experience as a primary 7.8 caregiver to a child with serious emotional disturbance as 7.9 defined in section 245.4871, subdivision 6, within the previous 7.10 ten years; 7.11 (iv) have 6,000 hours work experience as a nondegreed state 7.12 hospital technician; or 7.13 (v) be a mental health practitioner as defined in 7.14 subdivision 26, clause (2). 7.15 Individuals meeting one of the criteria in items (i) to 7.16 (iv) may qualify as a case manager after four years of 7.17 supervised work experience as a case manager associate. 7.18 Individuals meeting the criteria in item (v) may qualify as a 7.19 case manager after three years of supervised experience as a 7.20 case manager associate. 7.21 (k) Case manager associates must meet the following 7.22 supervision, mentoring, and continuing education requirements; 7.23 (1) have 40 hours of preservice training described under 7.24 paragraph (f), clause (1); 7.25 (2) receive at least 40 hours of continuing education in 7.26 severe emotional disturbance and mental health service annually; 7.27 and 7.28 (3) receive at least five hours of mentoring per week from 7.29 a case management mentor. A "case management mentor" means a 7.30 qualified, practicing case manager or case management supervisor 7.31 who teaches or advises and provides intensive training and 7.32 clinical supervision to one or more case manager associates. 7.33 Mentoring may occur while providing direct services to consumers 7.34 in the office or in the field and may be provided to individuals 7.35 or groups of case manager associates. At least two mentoring 7.36 hours per week must be individual and face-to-face. 8.1 (l) A case management supervisor must meet the criteria for 8.2 a mental health professional as specified in section 245.4871, 8.3 subdivision 27. 8.4 (m) An immigrant who does not have the qualifications 8.5 specified in this subdivision may provide case management 8.6 services to child immigrants with severe emotional disturbance 8.7 of the same ethnic group as the immigrant if the person: 8.8 (1) is currently enrolled in and is actively pursuing 8.9 credits toward the completion of a bachelor's degree in one of 8.10 the behavioral sciences or related fields at an accredited 8.11 college or university; 8.12 (2) completes 40 hours of training as specified in this 8.13 subdivision; and 8.14 (3) receives clinical supervision at least once a week 8.15 until the requirements of obtaining a bachelor's degree and 8.16 2,000 hours of supervised experience are met. 8.17 Sec. 3. Minnesota Statutes 2000, section 245.50, 8.18 subdivision 1, is amended to read: 8.19 Subdivision 1. [DEFINITIONS.] For purposes of this 8.20 section, the following terms have the meanings given them. 8.21 (a) "Bordering state" means Iowa, North Dakota, South 8.22 Dakota, or Wisconsin. 8.23 (b) "Receiving agencyor facility" means a public or 8.24 private hospital, mental health center, or other person or 8.25 organizationauthorized by a state to providewhich provides 8.26 mental health services under this section to individuals from a 8.27 state other than the state in which the agency is located. 8.28 (c) "Receiving state" means the state in which a receiving 8.29 agency is located. 8.30 (d) "Sending agency" means a state or county agency which 8.31 sends an individual to a bordering state for treatment under 8.32 this section. 8.33 (e) "Sending state" means the state in which the sending 8.34 agency is located. 8.35 Sec. 4. Minnesota Statutes 2000, section 245.50, 8.36 subdivision 2, is amended to read: 9.1 Subd. 2. [PURPOSE AND AUTHORITY.] (a) The purpose of this 9.2 section is to enable appropriate treatment to be provided to 9.3 individuals, across state lines from the individual's state of 9.4 residence, in qualified facilities that are closer to the homes 9.5 of individuals than are facilities available in the individual's 9.6 home state. 9.7 (b) Unless prohibited by another law and subject to the 9.8 exceptions listed in subdivision 3, a county board or the 9.9 commissioner of human services may contract with an agency or 9.10 facility in a bordering state for mental health services for 9.11 residents of Minnesota, and a Minnesota mental health agency or 9.12 facility may contract to provide services to residents of 9.13 bordering states. Except as provided in subdivision 5, a person 9.14 who receives services in another state under this section is 9.15 subject to the laws of the state in which services are 9.16 provided. A person who will receive services in another state 9.17 under this section must be informed of the consequences of 9.18 receiving services in another state, including the implications 9.19 of the differences in state laws, to the extent the individual 9.20 will be subject to the laws of the receiving state. 9.21 Sec. 5. Minnesota Statutes 2000, section 245.50, 9.22 subdivision 5, is amended to read: 9.23 Subd. 5. [SPECIAL CONTRACTS;WISCONSINBORDERING 9.24 STATES.]The commissioner of the Minnesota department of human9.25services must enter into negotiations with appropriate personnel9.26at the Wisconsin department of health and social services and9.27must develop an agreement that conforms to the requirements of9.28subdivision 4, to enable the placement in Minnesota of patients9.29who are on emergency holds or who have been involuntarily9.30committed as mentally ill or chemically dependent in Wisconsin9.31and to enable the temporary placement in Wisconsin of patients9.32who are on emergency holds in Minnesota under section 253B.05,9.33provided that the Minnesota courts retain jurisdiction over9.34Minnesota patients, and the state of Wisconsin affords to9.35Minnesota patients the rights under Minnesota law. Persons9.36committed by the Wisconsin courts and placed in Minnesota10.1facilities shall continue to be in the legal custody of10.2Wisconsin and Wisconsin's laws governing length of commitment,10.3reexaminations, and extension of commitment shall continue to10.4apply to these residents. In all other respects, Wisconsin10.5residents placed in Minnesota facilities are subject to10.6Minnesota laws. The agreement must specify that responsibility10.7for payment for the cost of care of Wisconsin residents shall10.8remain with the state of Wisconsin and the cost of care of10.9Minnesota residents shall remain with the state of Minnesota.10.10The commissioner shall be assisted by attorneys from the10.11Minnesota attorney general's office in negotiating and10.12finalizing this agreement. The agreement shall be completed so10.13as to permit placement of Wisconsin residents in Minnesota10.14facilities and Minnesota residents in Wisconsin facilities10.15beginning July 1, 1994.(a) An individual who is detained, 10.16 committed, or placed on an involuntary basis under chapter 253B 10.17 may be confined or treated in a bordering state pursuant to a 10.18 contract under this section. An individual who is detained, 10.19 committed, or placed on an involuntary basis under the civil law 10.20 of a bordering state may be confined or treated in Minnesota 10.21 pursuant to a contract under this section. A peace or health 10.22 officer who is acting under the authority of the sending state 10.23 may transport an individual to a receiving agency that provides 10.24 services pursuant to a contract under this section, and may 10.25 transport the individual back to the sending state under the 10.26 laws of the sending state. Court orders valid under the law of 10.27 the sending state are granted recognition and reciprocity in the 10.28 receiving state for individuals covered by a contract under this 10.29 section to the extent that the court orders relate to 10.30 confinement for treatment or care of mental illness. Such 10.31 treatment or care may address other conditions that may be 10.32 cooccurring with the mental illness. These court orders are not 10.33 subject to legal challenge in the courts of the receiving 10.34 state. Individuals who are detained, committed, or placed under 10.35 the law of a sending state and who are transferred to a 10.36 receiving state under this section continue to be in the legal 11.1 custody of the authority responsible for them under the law of 11.2 the sending state. Except in emergencies, those individuals may 11.3 not be transferred, removed, or furloughed from a receiving 11.4 agency without the specific approval of the authority 11.5 responsible for them under the law of the sending state. 11.6 (b) While in the receiving state pursuant to a contract 11.7 under this section, an individual shall be subject to the 11.8 sending state's laws and rules relating to length of 11.9 confinement, reexaminations, and extensions of confinement. No 11.10 individual may be sent to another state pursuant to a contract 11.11 under this section until the receiving state has enacted a law 11.12 recognizing the validity and applicability of this section. 11.13 (c) If an individual receiving services pursuant to a 11.14 contract under this section leaves the receiving agency without 11.15 permission and the individual is subject to involuntary 11.16 confinement under the law of the sending state, the receiving 11.17 agency shall use all reasonable means to return the individual 11.18 to the receiving agency. The receiving agency shall immediately 11.19 report the absence to the sending agency. The receiving state 11.20 has the primary responsibility for, and the authority to direct, 11.21 the return of these individuals within its borders and is liable 11.22 for the cost of the action to the extent that it would be liable 11.23 for costs of its own resident. 11.24 (d) Responsibility for payment for the cost of care remains 11.25 with the sending agency. 11.26 (e) This subdivision also applies to county contracts under 11.27 subdivision 2 which include emergency care and treatment 11.28 provided to a county resident in a bordering state. 11.29 Sec. 6. Minnesota Statutes 2001 Supplement, section 11.30 256B.0627, subdivision 10, is amended to read: 11.31 Subd. 10. [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 11.32 PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 11.33 allow a recipient of personal care assistant services to use a 11.34 fiscal intermediary to assist the recipient in paying and 11.35 accounting for medically necessary covered personal care 11.36 assistant services authorized in subdivision 4 and within the 12.1 payment parameters of subdivision 5. Unless otherwise provided 12.2 in this subdivision, all other statutory and regulatory 12.3 provisions relating to personal care assistant services apply to 12.4 a recipient using the fiscal intermediary option. 12.5 (b) The recipient or responsible party shall: 12.6 (1) recruit, hire, and terminate a qualified professional, 12.7 if a qualified professional is requested by the recipient or 12.8 responsible party; 12.9 (2) verify and document the credentials of the qualified 12.10 professional, if a qualified professional is requested by the 12.11 recipient or responsible party; 12.12 (3) develop a service plan based on physician orders and 12.13 public health nurse assessment with the assistance of a 12.14 qualified professional, if a qualified professional is requested 12.15 by the recipient or responsible party, that addresses the health 12.16 and safety of the recipient; 12.17 (4) recruit, hire, and terminate the personal care 12.18 assistant; 12.19 (5) orient and train the personal care assistant with 12.20 assistance as needed from the qualified professional; 12.21 (6) supervise and evaluate the personal care assistant with 12.22 assistance as needed from the recipient's physician or the 12.23 qualified professional; 12.24 (7) monitor and verify in writing and report to the fiscal 12.25 intermediary the number of hours worked by the personal care 12.26 assistant and the qualified professional; and 12.27 (8) enter into a written agreement, as specified in 12.28 paragraph (f). 12.29 (c) The duties of the fiscal intermediary shall be to: 12.30 (1) bill the medical assistance program for personal care 12.31 assistant and qualified professional services; 12.32 (2) request and secure background checks on personal care 12.33 assistants and qualified professionals according to section 12.34 245A.04; 12.35 (3) pay the personal care assistant and qualified 12.36 professional based on actual hours of services provided; 13.1 (4) withhold and pay all applicable federal and state 13.2 taxes; 13.3 (5) verify and keep records of hours worked by the personal 13.4 care assistant and qualified professional; 13.5 (6) make the arrangements and pay unemployment insurance, 13.6 taxes, workers' compensation, liability insurance, and other 13.7 benefits, if any; 13.8 (7) enroll in the medical assistance program as a fiscal 13.9 intermediary; and 13.10 (8) enter into a written agreement as specified in 13.11 paragraph (f) before services are provided. 13.12 (d) The fiscal intermediary: 13.13 (1) may not be related to the recipient, qualified 13.14 professional, or the personal care assistant; 13.15 (2) must ensure arm's length transactions with the 13.16 recipient and personal care assistant; and 13.17 (3) shall be considered a joint employer of the personal 13.18 care assistant and qualified professional to the extent 13.19 specified in this section. 13.20 The fiscal intermediary or owners of the entity that 13.21 provides fiscal intermediary services under this subdivision 13.22 must pass a criminal background check as required in section 13.23 256B.0627, subdivision 1, paragraph (e). 13.24 (e) If the recipient or responsible party requests a 13.25 qualified professional, the qualified professional providing 13.26 assistance to the recipient shall meet the qualifications 13.27 specified in section 256B.0625, subdivision 19c. The qualified 13.28 professional shall assist the recipient in developing and 13.29 revising a plan to meet the recipient's needs, as assessed by 13.30 the public health nurse. In performing this function, the 13.31 qualified professional must visit the recipient in the 13.32 recipient's home at least once annually. The qualified 13.33 professional must report any suspected abuse, neglect, or 13.34 financial exploitation of the recipient to the appropriate 13.35 authorities. 13.36 (f) The fiscal intermediary, recipient or responsible 14.1 party, personal care assistant, and qualified professional shall 14.2 enter into a written agreement before services are started. The 14.3 agreement shall include: 14.4 (1) the duties of the recipient, qualified professional, 14.5 personal care assistant, and fiscal agent based on paragraphs 14.6 (a) to (e); 14.7 (2) the salary and benefits for the personal care assistant 14.8 and the qualified professional; 14.9 (3) the administrative fee of the fiscal intermediary and 14.10 services paid for with that fee, including background check 14.11 fees; 14.12 (4) procedures to respond to billing or payment complaints; 14.13 and 14.14 (5) procedures for hiring and terminating the personal care 14.15 assistant and the qualified professional. 14.16 (g) The rates paid for personal care assistant 14.17 services, shared care services, qualified professional services, 14.18 and fiscal intermediary services under this subdivision shall be 14.19 the same rates paid for personal care assistant services and 14.20 qualified professional services under subdivision 2 14.21 respectively. Except for the administrative fee of the fiscal 14.22 intermediary specified in paragraph (f), the remainder of the 14.23 rates paid to the fiscal intermediary must be used to pay for 14.24 the salary and benefits for the personal care assistant or the 14.25 qualified professional. 14.26 (h) As part of the assessment defined in subdivision 1, the 14.27 following conditions must be met to use or continue use of a 14.28 fiscal intermediary: 14.29 (1) the recipient must be able to direct the recipient's 14.30 own care, or the responsible party for the recipient must be 14.31 readily available to direct the care of the personal care 14.32 assistant; 14.33 (2) the recipient or responsible party must be 14.34 knowledgeable of the health care needs of the recipient and be 14.35 able to effectively communicate those needs; 14.36 (3) a face-to-face assessment must be conducted by the 15.1 local county public health nurse at least annually, or when 15.2 there is a significant change in the recipient's condition or 15.3 change in the need for personal care assistant services; 15.4 (4) recipients who choose to use the shared care option as 15.5 specified in subdivision 8 must utilize the same fiscal 15.6 intermediary; and 15.7the recipient cannot select the shared services option as15.8specified in subdivision 8; and15.9 (5) parties must be in compliance with the written 15.10 agreement specified in paragraph (f). 15.11 (i) The commissioner shall deny, revoke, or suspend the 15.12 authorization to use the fiscal intermediary option if: 15.13 (1) it has been determined by the qualified professional or 15.14 local county public health nurse that the use of this option 15.15 jeopardizes the recipient's health and safety; 15.16 (2) the parties have failed to comply with the written 15.17 agreement specified in paragraph (f); or 15.18 (3) the use of the option has led to abusive or fraudulent 15.19 billing for personal care assistant services. 15.20 The recipient or responsible party may appeal the 15.21 commissioner's action according to section 256.045. The denial, 15.22 revocation, or suspension to use the fiscal intermediary option 15.23 shall not affect the recipient's authorized level of personal 15.24 care assistant services as determined in subdivision 5. 15.25 Sec. 7. Minnesota Statutes 2001 Supplement, section 15.26 256B.0911, subdivision 4b, is amended to read: 15.27 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 15.28 Exemptions from the federal screening requirements outlined in 15.29 subdivision 4a, paragraphs (b) and (c), are limited to: 15.30 (1) a person who, having entered an acute care facility 15.31 from a certified nursing facility, is returning to a certified 15.32 nursing facility;and15.33 (2) a person transferring from one certified nursing 15.34 facility in Minnesota to another certified nursing facility in 15.35 Minnesota; and 15.36 (3) a person, 21 years of age or older, who satisfies the 16.1 following criteria, as specified in Code of Federal Regulations, 16.2 title 42, section 483.106(b)(2): 16.3 (i) the person is admitted to a nursing facility directly 16.4 from a hospital after receiving acute inpatient care at the 16.5 hospital; 16.6 (ii) the person requires nursing facility services for the 16.7 same condition for which care was provided in the hospital; and 16.8 (iii) the attending physician has certified before the 16.9 nursing facility admission that the person is likely to receive 16.10 less than 30 days of nursing facility services. 16.11 (b) Persons who are exempt from preadmission screening for 16.12 purposes of level of care determination include: 16.13 (1) persons described in paragraph (a); 16.14 (2) an individual who has a contractual right to have 16.15 nursing facility care paid for indefinitely by the veterans' 16.16 administration; 16.17 (3) an individual enrolled in a demonstration project under 16.18 section 256B.69, subdivision 8, at the time of application to a 16.19 nursing facility; 16.20 (4) an individual currently being served under the 16.21 alternative care program or under a home and community-based 16.22 services waiver authorized under section 1915(c) of the federal 16.23 Social Security Act; and 16.24 (5) individuals admitted to a certified nursing facility 16.25 for a short-term stay, which is expected to be 14 days or less 16.26 in duration based upon a physician's certification, and who have 16.27 been assessed and approved for nursing facility admission within 16.28 the previous six months. This exemption applies only if the 16.29 consultation team member determines at the time of the initial 16.30 assessment of the six-month period that it is appropriate to use 16.31 the nursing facility for short-term stays and that there is an 16.32 adequate plan of care for return to the home or community-based 16.33 setting. If a stay exceeds 14 days, the individual must be 16.34 referred no later than the first county working day following 16.35 the 14th resident day for a screening, which must be completed 16.36 within five working days of the referral. The payment 17.1 limitations in subdivision 7 apply to an individual found at 17.2 screening to not meet the level of care criteria for admission 17.3 to a certified nursing facility. 17.4 (c) Persons admitted to a Medicaid-certified nursing 17.5 facility from the community on an emergency basis as described 17.6 in paragraph (d) or from an acute care facility on a nonworking 17.7 day must be screened the first working day after admission. 17.8 (d) Emergency admission to a nursing facility prior to 17.9 screening is permitted when all of the following conditions are 17.10 met: 17.11 (1) a person is admitted from the community to a certified 17.12 nursing or certified boarding care facility during county 17.13 nonworking hours; 17.14 (2) a physician has determined that delaying admission 17.15 until preadmission screening is completed would adversely affect 17.16 the person's health and safety; 17.17 (3) there is a recent precipitating event that precludes 17.18 the client from living safely in the community, such as 17.19 sustaining an injury, sudden onset of acute illness, or a 17.20 caregiver's inability to continue to provide care; 17.21 (4) the attending physician has authorized the emergency 17.22 placement and has documented the reason that the emergency 17.23 placement is recommended; and 17.24 (5) the county is contacted on the first working day 17.25 following the emergency admission. 17.26 Transfer of a patient from an acute care hospital to a nursing 17.27 facility is not considered an emergency except for a person who 17.28 has received hospital services in the following situations: 17.29 hospital admission for observation, care in an emergency room 17.30 without hospital admission, or following hospital 24-hour bed 17.31 care. 17.32 (e) A nursing facility must provide a written notice to 17.33 persons who satisfy the criteria in paragraph (a), clause (3), 17.34 regarding the person's right to request and receive long-term 17.35 care consultation services as defined in subdivision 1a. The 17.36 notice must be provided prior to the person's discharge from the 18.1 facility and in a format specified by the commissioner. 18.2 [EFFECTIVE DATE.] This section is effective the day 18.3 following final enactment. 18.4 Sec. 8. Minnesota Statutes 2001 Supplement, section 18.5 256B.0911, subdivision 4d, is amended to read: 18.6 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 18.7 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 18.8 ensure that individuals with disabilities or chronic illness are 18.9 served in the most integrated setting appropriate to their needs 18.10 and have the necessary information to make informed choices 18.11 about home and community-based service options. 18.12 (b) Individuals under 65 years of age who are admitted to a 18.13 nursing facility from a hospital must be screened prior to 18.14 admission as outlined in subdivisions 4a through 4c. 18.15 (c) Individuals under 65 years of age who are admitted to 18.16 nursing facilities with only a telephone screening must receive 18.17 a face-to-face assessment from the long-term care consultation 18.18 team member of the county in which the facility is located or 18.19 from the recipient's county case manager within 20 working days 18.20 of admission. 18.21 (d) Individuals under 65 years of age who are admitted to a 18.22 nursing facility without preadmission screening according to the 18.23 exemption described in subdivision 4b, paragraph (a), clause 18.24 (3), and who remain in the facility longer than 30 days must 18.25 receive a face-to-face assessment within 40 days of admission. 18.26 (e) At the face-to-face assessment, the long-term care 18.27 consultation team member or county case manager must perform the 18.28 activities required under subdivision 3b. 18.29(e)(f) For individuals under 21 years of age, a screening 18.30 interview which recommends nursing facility admission must be 18.31 face-to-face and approved by the commissioner before the 18.32 individual is admitted to the nursing facility. 18.33(f)(g) In the event that an individual under 65 years of 18.34 age is admitted to a nursing facility on an emergency basis, the 18.35 county must be notified of the admission on the next working 18.36 day, and a face-to-face assessment as described in paragraph (c) 19.1 must be conducted within 20 working days of admission. 19.2(g)(h) At the face-to-face assessment, the long-term care 19.3 consultation team member or the case manager must present 19.4 information about home and community-based options so the 19.5 individual can make informed choices. If the individual chooses 19.6 home and community-based services, the long-term care 19.7 consultation team member or case manager must complete a written 19.8 relocation plan within 20 working days of the visit. The plan 19.9 shall describe the services needed to move out of the facility 19.10 and a time line for the move which is designed to ensure a 19.11 smooth transition to the individual's home and community. 19.12(h)(i) An individual under 65 years of age residing in a 19.13 nursing facility shall receive a face-to-face assessment at 19.14 least every 12 months to review the person's service choices and 19.15 available alternatives unless the individual indicates, in 19.16 writing, that annual visits are not desired. In this case, the 19.17 individual must receive a face-to-face assessment at least once 19.18 every 36 months for the same purposes. 19.19(i)(j) Notwithstanding the provisions of subdivision 6, 19.20 the commissioner may pay county agencies directly for 19.21 face-to-face assessments for individuals under 65 years of age 19.22 who are being considered for placement or residing in a nursing 19.23 facility. 19.24 [EFFECTIVE DATE.] This section is effective the day 19.25 following final enactment. 19.26 Sec. 9. Minnesota Statutes 2001 Supplement, section 19.27 256B.0913, subdivision 5, is amended to read: 19.28 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 19.29 Alternative care funding may be used for payment of costs of: 19.30 (1) adult foster care; 19.31 (2) adult day care; 19.32 (3) home health aide; 19.33 (4) homemaker services; 19.34 (5) personal care; 19.35 (6) case management; 19.36 (7) respite care; 20.1 (8) assisted living; 20.2 (9) residential care services; 20.3 (10) care-related supplies and equipment; 20.4 (11) meals delivered to the home; 20.5 (12) transportation; 20.6 (13) skilled nursing; 20.7 (14) chore services; 20.8 (15) companion services; 20.9 (16) nutrition services; 20.10 (17) training for direct informal caregivers; 20.11 (18) telemedicine devices to monitor recipients in their 20.12 own homes as an alternative to hospital care, nursing home care, 20.13 or home visits; 20.14 (19) other services which includes discretionary funds and 20.15 direct cash payments to clients, following approval by the 20.16 commissioner, subject to the provisions of paragraph (j). Total 20.17 annual payments for "other services" for all clients within a 20.18 county may not exceedeither ten25 percent of that county's 20.19 annual alternative care program base allocationor $5,000,20.20whichever is greater. In no case shall this amount exceed the20.21county's total annual alternative care program base allocation; 20.22 and 20.23 (20) environmental modifications. 20.24 (b) The county agency must ensure that the funds are not 20.25 used to supplant services available through other public 20.26 assistance or services programs. 20.27 (c) Unless specified in statute, the service definitions 20.28 and standards for alternative care services shall be the same as 20.29 the service definitions and standards specified in the federally 20.30 approved elderly waiver plan. Except for the county agencies' 20.31 approval of direct cash payments to clients as described in 20.32 paragraph (j) or for a provider of supplies and equipment when 20.33 the monthly cost of the supplies and equipment is less than 20.34 $250, persons or agencies must be employed by or under a 20.35 contract with the county agency or the public health nursing 20.36 agency of the local board of health in order to receive funding 21.1 under the alternative care program. Supplies and equipment may 21.2 be purchased from a vendor not certified to participate in the 21.3 Medicaid program if the cost for the item is less than that of a 21.4 Medicaid vendor. 21.5 (d) The adult foster care rate shall be considered a 21.6 difficulty of care payment and shall not include room and 21.7 board. The adult foster care rate shall be negotiated between 21.8 the county agency and the foster care provider. The alternative 21.9 care payment for the foster care service in combination with the 21.10 payment for other alternative care services, including case 21.11 management, must not exceed the limit specified in subdivision 21.12 4, paragraph (a), clause (6). 21.13 (e) Personal care services must meet the service standards 21.14 defined in the federally approved elderly waiver plan, except 21.15 that a county agency may contract with a client's relative who 21.16 meets the relative hardship waiver requirement as defined in 21.17 section 256B.0627, subdivision 4, paragraph (b), clause (10), to 21.18 provide personal care services if the county agency ensures 21.19 supervision of this service by a registered nurse or mental 21.20 health practitioner. 21.21 (f) For purposes of this section, residential care services 21.22 are services which are provided to individuals living in 21.23 residential care homes. Residential care homes are currently 21.24 licensed as board and lodging establishments and are registered 21.25 with the department of health as providing special services 21.26 under section 157.17 and are not subject to registration under 21.27 chapter 144D. Residential care services are defined as 21.28 "supportive services" and "health-related services." 21.29 "Supportive services" means the provision of up to 24-hour 21.30 supervision and oversight. Supportive services includes: (1) 21.31 transportation, when provided by the residential care home only; 21.32 (2) socialization, when socialization is part of the plan of 21.33 care, has specific goals and outcomes established, and is not 21.34 diversional or recreational in nature; (3) assisting clients in 21.35 setting up meetings and appointments; (4) assisting clients in 21.36 setting up medical and social services; (5) providing assistance 22.1 with personal laundry, such as carrying the client's laundry to 22.2 the laundry room. Assistance with personal laundry does not 22.3 include any laundry, such as bed linen, that is included in the 22.4 room and board rate. "Health-related services" are limited to 22.5 minimal assistance with dressing, grooming, and bathing and 22.6 providing reminders to residents to take medications that are 22.7 self-administered or providing storage for medications, if 22.8 requested. Individuals receiving residential care services 22.9 cannot receive homemaking services funded under this section. 22.10 (g) For the purposes of this section, "assisted living" 22.11 refers to supportive services provided by a single vendor to 22.12 clients who reside in the same apartment building of three or 22.13 more units which are not subject to registration under chapter 22.14 144D and are licensed by the department of health as a class A 22.15 home care provider or a class E home care provider. Assisted 22.16 living services are defined as up to 24-hour supervision, and 22.17 oversight, supportive services as defined in clause (1), 22.18 individualized home care aide tasks as defined in clause (2), 22.19 and individualized home management tasks as defined in clause 22.20 (3) provided to residents of a residential center living in 22.21 their units or apartments with a full kitchen and bathroom. A 22.22 full kitchen includes a stove, oven, refrigerator, food 22.23 preparation counter space, and a kitchen utensil storage 22.24 compartment. Assisted living services must be provided by the 22.25 management of the residential center or by providers under 22.26 contract with the management or with the county. 22.27 (1) Supportive services include: 22.28 (i) socialization, when socialization is part of the plan 22.29 of care, has specific goals and outcomes established, and is not 22.30 diversional or recreational in nature; 22.31 (ii) assisting clients in setting up meetings and 22.32 appointments; and 22.33 (iii) providing transportation, when provided by the 22.34 residential center only. 22.35 (2) Home care aide tasks means: 22.36 (i) preparing modified diets, such as diabetic or low 23.1 sodium diets; 23.2 (ii) reminding residents to take regularly scheduled 23.3 medications or to perform exercises; 23.4 (iii) household chores in the presence of technically 23.5 sophisticated medical equipment or episodes of acute illness or 23.6 infectious disease; 23.7 (iv) household chores when the resident's care requires the 23.8 prevention of exposure to infectious disease or containment of 23.9 infectious disease; and 23.10 (v) assisting with dressing, oral hygiene, hair care, 23.11 grooming, and bathing, if the resident is ambulatory, and if the 23.12 resident has no serious acute illness or infectious disease. 23.13 Oral hygiene means care of teeth, gums, and oral prosthetic 23.14 devices. 23.15 (3) Home management tasks means: 23.16 (i) housekeeping; 23.17 (ii) laundry; 23.18 (iii) preparation of regular snacks and meals; and 23.19 (iv) shopping. 23.20 Individuals receiving assisted living services shall not 23.21 receive both assisted living services and homemaking services. 23.22 Individualized means services are chosen and designed 23.23 specifically for each resident's needs, rather than provided or 23.24 offered to all residents regardless of their illnesses, 23.25 disabilities, or physical conditions. Assisted living services 23.26 as defined in this section shall not be authorized in boarding 23.27 and lodging establishments licensed according to sections 23.28 157.011 and 157.15 to 157.22. 23.29 (h) For establishments registered under chapter 144D, 23.30 assisted living services under this section means either the 23.31 services described in paragraph (g) and delivered by a class E 23.32 home care provider licensed by the department of health or the 23.33 services described under section 144A.4605 and delivered by an 23.34 assisted living home care provider or a class A home care 23.35 provider licensed by the commissioner of health. 23.36 (i) Payment for assisted living services and residential 24.1 care services shall be a monthly rate negotiated and authorized 24.2 by the county agency based on an individualized service plan for 24.3 each resident and may not cover direct rent or food costs. 24.4 (1) The individualized monthly negotiated payment for 24.5 assisted living services as described in paragraph (g) or (h), 24.6 and residential care services as described in paragraph (f), 24.7 shall not exceed the nonfederal share in effect on July 1 of the 24.8 state fiscal year for which the rate limit is being calculated 24.9 of the greater of either the statewide or any of the geographic 24.10 groups' weighted average monthly nursing facility payment rate 24.11 of the case mix resident class to which the alternative care 24.12 eligible client would be assigned under Minnesota Rules, parts 24.13 9549.0050 to 9549.0059, less the maintenance needs allowance as 24.14 described in section 256B.0915, subdivision 1d, paragraph (a), 24.15 until the first day of the state fiscal year in which a resident 24.16 assessment system, under section 256B.437, of nursing home rate 24.17 determination is implemented. Effective on the first day of the 24.18 state fiscal year in which a resident assessment system, under 24.19 section 256B.437, of nursing home rate determination is 24.20 implemented and the first day of each subsequent state fiscal 24.21 year, the individualized monthly negotiated payment for the 24.22 services described in this clause shall not exceed the limit 24.23 described in this clause which was in effect on the last day of 24.24 the previous state fiscal year and which has been adjusted by 24.25 the greater of any legislatively adopted home and 24.26 community-based services cost-of-living percentage increase or 24.27 any legislatively adopted statewide percent rate increase for 24.28 nursing facilities. 24.29 (2) The individualized monthly negotiated payment for 24.30 assisted living services described under section 144A.4605 and 24.31 delivered by a provider licensed by the department of health as 24.32 a class A home care provider or an assisted living home care 24.33 provider and provided in a building that is registered as a 24.34 housing with services establishment under chapter 144D and that 24.35 provides 24-hour supervision in combination with the payment for 24.36 other alternative care services, including case management, must 25.1 not exceed the limit specified in subdivision 4, paragraph (a), 25.2 clause (6). 25.3 (j) A county agency may make payment from their alternative 25.4 care program allocation for "other services" which include use 25.5 of "discretionary funds" for services that are not otherwise 25.6 defined in this section and direct cash payments to the client 25.7 for the purpose of purchasing the services. The following 25.8 provisions apply to payments under this paragraph: 25.9 (1) a cash payment to a client under this provision cannot 25.10 exceed80 percent ofthe monthly payment limit for that client 25.11 as specified in subdivision 4, paragraph (a), clause (6); 25.12 (2) a county may not approve any cash payment for a client 25.13 who meets either of the following: 25.14 (i) has been assessed as having a dependency in 25.15 orientation, unless the client has an authorized 25.16 representative. An "authorized representative" means an 25.17 individual who is at least 18 years of age and is designated by 25.18 the person or the person's legal representative to act on the 25.19 person's behalf. This individual may be a family member, 25.20 guardian, representative payee, or other individual designated 25.21 by the person or the person's legal representative, if any, to 25.22 assist in purchasing and arranging for supports; or 25.23 (ii) is concurrently receiving adult foster care, 25.24 residential care, or assisted living services; 25.25 (3) cash payments to a person or a person's family will be 25.26 provided through a monthly payment and be in the form of cash, 25.27 voucher, or direct county payment to a vendor. Fees or premiums 25.28 assessed to the person for eligibility for health and human 25.29 services are not reimbursable through this service option. 25.30 Services and goods purchased through cash payments must be 25.31 identified in the person's individualized care plan and must 25.32 meet all of the following criteria: 25.33 (i) they must be over and above the normal cost of caring 25.34 for the person if the person did not have functional 25.35 limitations; 25.36 (ii) they must be directly attributable to the person's 26.1 functional limitations; 26.2 (iii) they must have the potential to be effective at 26.3 meeting the goals of the program; 26.4 (iv) they must be consistent with the needs identified in 26.5 the individualized service plan. The service plan shall specify 26.6 the needs of the person and family, the form and amount of 26.7 payment, the items and services to be reimbursed, and the 26.8 arrangements for management of the individual grant; and 26.9 (v) the person, the person's family, or the legal 26.10 representative shall be provided sufficient information to 26.11 ensure an informed choice of alternatives. The local agency 26.12 shall document this information in the person's care plan, 26.13 including the type and level of expenditures to be reimbursed; 26.14 (4) the county, lead agency under contract, or tribal 26.15 government under contract to administer the alternative care 26.16 program shall not be liable for damages, injuries, or 26.17 liabilities sustained through the purchase of direct supports or 26.18 goods by the person, the person's family, or the authorized 26.19 representative with funds received through the cash payments 26.20 under this section. Liabilities include, but are not limited 26.21 to, workers' compensation, the Federal Insurance Contributions 26.22 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 26.23 (5) persons receiving grants under this section shall have 26.24 the following responsibilities: 26.25 (i) spend the grant money in a manner consistent with their 26.26 individualized service plan with the local agency; 26.27 (ii) notify the local agency of any necessary changes in 26.28 the grant expenditures; 26.29 (iii) arrange and pay for supports; and 26.30 (iv) inform the local agency of areas where they have 26.31 experienced difficulty securing or maintaining supports; and 26.32 (6) the county shall report client outcomes, services, and 26.33 costs under this paragraph in a manner prescribed by the 26.34 commissioner. 26.35 (k) Upon implementation of direct cash payments to clients 26.36 under this section, any person determined eligible for the 27.1 alternative care program who chooses a cash payment approved by 27.2 the county agency shall receive the cash payment under this 27.3 section and not under section 256.476 unless the person was 27.4 receiving a consumer support grant under section 256.476 before 27.5 implementation of direct cash payments under this section. 27.6 Sec. 10. Minnesota Statutes 2001 Supplement, section 27.7 256B.0915, subdivision 3, is amended to read: 27.8 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND 27.9 FORECASTING.] (a) The number of medical assistance waiver 27.10 recipients that a county may serve must be allocated according 27.11 to the number of medical assistance waiver cases open on July 1 27.12 of each fiscal year. Additional recipients may be served with 27.13 the approval of the commissioner. 27.14 (b) The monthly limit for the cost of waivered services to 27.15 an individual elderly waiver client shall be the weighted 27.16 average monthly nursing facility rate of the case mix resident 27.17 class to which the elderly waiver client would be assigned under 27.18 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 27.19 recipient's maintenance needs allowance as described in 27.20 subdivision 1d, paragraph (a), until the first day of the state 27.21 fiscal year in which the resident assessment system as described 27.22 in section 256B.437 for nursing home rate determination is 27.23 implemented. Effective on the first day of the state fiscal 27.24 year in which the resident assessment system as described in 27.25 section 256B.437 for nursing home rate determination is 27.26 implemented and the first day of each subsequent state fiscal 27.27 year, the monthly limit for the cost of waivered services to an 27.28 individual elderly waiver client shall be the rate of the case 27.29 mix resident class to which the waiver client would be assigned 27.30 under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 27.31 on the last day of the previous state fiscal year, adjusted by 27.32 the greater of any legislatively adopted home and 27.33 community-based services cost-of-living percentage increase or 27.34 any legislatively adopted statewide percent rate increase for 27.35 nursing facilities. 27.36 (c) If extended medical supplies and equipment or 28.1 environmental modifications are or will be purchased for an 28.2 elderly waiver client, the costs may be prorated for up to 12 28.3 consecutive months beginning with the month of purchase. If the 28.4 monthly cost of a recipient's waivered services exceeds the 28.5 monthly limit established in paragraph (b), the annual cost of 28.6 all waivered services shall be determined. In this event, the 28.7 annual cost of all waivered services shall not exceed 12 times 28.8 the monthly limit of waivered services as described in paragraph 28.9 (b). 28.10 (d) For a person who is a nursing facility resident at the 28.11 time of requesting a determination of eligibility for elderly 28.12 waivered services, a monthly conversion limit for the cost of 28.13 elderly waivered services may be requested. The monthly 28.14 conversion limit for the cost of elderly waiver services shall 28.15 be the resident class assigned under Minnesota Rules, parts 28.16 9549.0050 to 9549.0059, for that resident in the nursing 28.17 facility where the resident currently resides until July 1 of 28.18 the state fiscal year in which the resident assessment system as 28.19 described in section 256B.437 for nursing home rate 28.20 determination is implemented. Effective on July 1 of the state 28.21 fiscal year in which the resident assessment system as described 28.22 in section 256B.437 for nursing home rate determination is 28.23 implemented, the monthly conversion limit for the cost of 28.24 elderly waiver services shall be the per diem nursing facility 28.25 rate as determined by the resident assessment system as 28.26 described in section 256B.437 for that resident in the nursing 28.27 facility where the resident currently resides multiplied by 365 28.28 and divided by 12, less the recipient's maintenance needs 28.29 allowance as described in subdivision 1d. The initially 28.30 approved conversion rate may be adjusted by the greater of any 28.31 subsequent legislatively adopted home and community-based 28.32 services cost-of-living percentage increase or any subsequent 28.33 legislatively adopted statewide percentage rate increase for 28.34 nursing facilities. The limit under this clause only applies to 28.35 persons discharged from a nursing facility after a minimum 28.36 30-day stay and found eligible for waivered services on or after 29.1 July 1, 1997. The following costs must be included in 29.2 determining the total monthly costs for the waiver client: 29.3 (1) cost of all waivered services, including extended 29.4 medical supplies and equipment and environmental modifications; 29.5 and 29.6 (2) cost of skilled nursing, home health aide, and personal 29.7 care services reimbursable by medical assistance. 29.8 (e) Medical assistance funding for skilled nursing 29.9 services, private duty nursing, home health aide, and personal 29.10 care services for waiver recipients must be approved by the case 29.11 manager and included in the individual care plan. 29.12 (f) A county is not required to contract with a provider of 29.13 supplies and equipment if the monthly cost of the supplies and 29.14 equipment is less than $250. 29.15 (g) The adult foster care rate shall be considered a 29.16 difficulty of care payment and shall not include room and 29.17 board. The adult foster care service rate shall be negotiated 29.18 between the county agency and the foster care provider. The 29.19 elderly waiver payment for the foster care service in 29.20 combination with the payment for all other elderly waiver 29.21 services, including case management, must not exceed the limit 29.22 specified in paragraph (b). 29.23 (h) Payment for assisted living service shall be a monthly 29.24 rate negotiated and authorized by the county agency based on an 29.25 individualized service plan for each resident and may not cover 29.26 direct rent or food costs. 29.27 (1) The individualized monthly negotiated payment for 29.28 assisted living services as described in section 256B.0913, 29.29 subdivision 5, paragraph (g) or (h), and residential care 29.30 services as described in section 256B.0913, subdivision 5, 29.31 paragraph (f), shall not exceed the nonfederal share, in effect 29.32 on July 1 of the state fiscal year for which the rate limit is 29.33 being calculated, of the greater of either the statewide or any 29.34 of the geographic groups' weighted average monthly nursing 29.35 facility rate of the case mix resident class to which the 29.36 elderly waiver eligible client would be assigned under Minnesota 30.1 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 30.2 allowance as described in subdivision 1d, paragraph (a), until 30.3 the July 1 of the state fiscal year in which the resident 30.4 assessment system as described in section 256B.437 for nursing 30.5 home rate determination is implemented. Effective on July 1 of 30.6 the state fiscal year in which the resident assessment system as 30.7 described in section 256B.437 for nursing home rate 30.8 determination is implemented and July 1 of each subsequent state 30.9 fiscal year, the individualized monthly negotiated payment for 30.10 the services described in this clause shall not exceed the limit 30.11 described in this clause which was in effect on June 30 of the 30.12 previous state fiscal year and which has been adjusted by the 30.13 greater of any legislatively adopted home and community-based 30.14 services cost-of-living percentage increase or any legislatively 30.15 adopted statewide percent rate increase for nursing facilities. 30.16 (2) The individualized monthly negotiated payment for 30.17 assisted living services described in section 144A.4605 and 30.18 delivered by a provider licensed by the department of health as 30.19 a class A home care provider or an assisted living home care 30.20 provider and provided in a building that is registered as a 30.21 housing with services establishment under chapter 144D and that 30.22 provides 24-hour supervision in combination with the payment for 30.23 other elderly waiver services, including case management, must 30.24 not exceed the limit specified in paragraph (b). 30.25 (i) The county shall negotiate individual service rates 30.26 with vendors and may authorize payment for actual costs up to 30.27 the county's current approved rate. Persons or agencies must be 30.28 employed by or under a contract with the county agency or the 30.29 public health nursing agency of the local board of health in 30.30 order to receive funding under the elderly waiver program, 30.31 except as a provider of supplies and equipment when the monthly 30.32 cost of the supplies and equipment is less than $250. 30.33 (j) Reimbursement for the medical assistance recipients 30.34 under the approved waiver shall be made from the medical 30.35 assistance account through the invoice processing procedures of 30.36 the department's Medicaid Management Information System (MMIS), 31.1 only with the approval of the client's case manager. The budget 31.2 for the state share of the Medicaid expenditures shall be 31.3 forecasted with the medical assistance budget, and shall be 31.4 consistent with the approved waiver. 31.5 (k) To improve access to community services and eliminate 31.6 payment disparities between the alternative care program and the 31.7 elderly waiver, the commissioner shall establish statewide 31.8 maximum service rate limits and eliminate county-specific 31.9 service rate limits. 31.10 (1) Effective July 1, 2001, for service rate limits, except 31.11 those described or defined in paragraphs (g) and (h), the rate 31.12 limit for each service shall be the greater of the alternative 31.13 care statewide maximum rate or the elderly waiver statewide 31.14 maximum rate. 31.15 (2) Counties may negotiate individual service rates with 31.16 vendors for actual costs up to the statewide maximum service 31.17 rate limit. 31.18 (l) Beginning July 1, 1991, the state shall reimburse 31.19 counties according to the payment schedule in section 256.025 31.20 for the county share of costs incurred under this subdivision on 31.21 or after January 1, 1991, for individuals who are receiving 31.22 medical assistance. 31.23 Sec. 11. Minnesota Statutes 2001 Supplement, section 31.24 256B.0924, subdivision 6, is amended to read: 31.25 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 31.26 Medical assistance and MinnesotaCare payment for targeted case 31.27 management shall be made on a monthly basis. In order to 31.28 receive payment for an eligible adult, the provider must 31.29 document at least one contact per month and not more than two 31.30 consecutive months without a face-to-face contact with the adult 31.31 or the adult's legal representative, family, primary caregiver, 31.32 or other relevant persons identified as necessary to the 31.33 development or implementation of the goals of the personal 31.34 service plan. 31.35 (b) Payment for targeted case management provided by county 31.36 staff under this subdivision shall be based on the monthly rate 32.1 methodology under section 256B.094, subdivision 6, paragraph 32.2 (b), calculated as one combined average rate together with adult 32.3 mental health case management under section 256B.0625, 32.4 subdivision 20, except for calendar year 2002. In calendar year 32.5 2002, the rate for case management under this section shall be 32.6 the same as the rate for adult mental health case management in 32.7 effect as of December 31, 2001. Billing and payment must 32.8 identify the recipient's primary population group to allow 32.9 tracking of revenues. 32.10 (c) Payment for targeted case management provided by 32.11 county-contracted vendors shall be based on a monthly rate 32.12 negotiated by the host county. The negotiated rate must not 32.13 exceed the rate charged by the vendor for the same service to 32.14 other payers. If the service is provided by a team of 32.15 contracted vendors, the county may negotiate a team rate with a 32.16 vendor who is a member of the team. The team shall determine 32.17 how to distribute the rate among its members. No reimbursement 32.18 received by contracted vendors shall be returned to the county, 32.19 except to reimburse the county for advance funding provided by 32.20 the county to the vendor. 32.21 (d) If the service is provided by a team that includes 32.22 contracted vendors and county staff, the costs for county staff 32.23 participation on the team shall be included in the rate for 32.24 county-provided services. In this case, the contracted vendor 32.25 and the county may each receive separate payment for services 32.26 provided by each entity in the same month. In order to prevent 32.27 duplication of services, the county must document, in the 32.28 recipient's file, the need for team targeted case management and 32.29 a description of the different roles of the team members. 32.30 (e) Notwithstanding section 256B.19, subdivision 1, the 32.31 nonfederal share of costs for targeted case management shall be 32.32 provided by the recipient's county of responsibility, as defined 32.33 in sections 256G.01 to 256G.12, from sources other than federal 32.34 funds or funds used to match other federal funds. 32.35 (f) The commissioner may suspend, reduce, or terminate 32.36 reimbursement to a provider that does not meet the reporting or 33.1 other requirements of this section. The county of 33.2 responsibility, as defined in sections 256G.01 to 256G.12, is 33.3 responsible for any federal disallowances. The county may share 33.4 this responsibility with its contracted vendors. 33.5 (g) The commissioner shall set aside five percent of the 33.6 federal funds received under this section for use in reimbursing 33.7 the state for costs of developing and implementing this section. 33.8 (h) Notwithstanding section 256.025, subdivision 2, 33.9 payments to counties for targeted case management expenditures 33.10 under this section shall only be made from federal earnings from 33.11 services provided under this section. Payments to contracted 33.12 vendors shall include both the federal earnings and the county 33.13 share. 33.14 (i) Notwithstanding section 256B.041, county payments for 33.15 the cost of case management services provided by county staff 33.16 shall not be made to the state treasurer. For the purposes of 33.17 targeted case management services provided by county staff under 33.18 this section, the centralized disbursement of payments to 33.19 counties under section 256B.041 consists only of federal 33.20 earnings from services provided under this section. 33.21 (j) If the recipient is a resident of a nursing facility, 33.22 intermediate care facility, or hospital, and the recipient's 33.23 institutional care is paid by medical assistance, payment for 33.24 targeted case management services under this subdivision is 33.25 limited to the last 180 days of the recipient's residency in 33.26 that facility and may not exceed more than six months in a 33.27 calendar year. 33.28 (k) Payment for targeted case management services under 33.29 this subdivision shall not duplicate payments made under other 33.30 program authorities for the same purpose. 33.31 (l) Any growth in targeted case management services and 33.32 cost increases under this section shall be the responsibility of 33.33 the counties. 33.34 Sec. 12. Minnesota Statutes 2001 Supplement, section 33.35 256B.0951, subdivision 7, is amended to read: 33.36 Subd. 7. [WAIVER OF RULES.] If a federal waiver is 34.1 approved under subdivision 8, the commissioner of health may 34.2 exempt residents of intermediate care facilities for persons 34.3 with mental retardation (ICFs/MR) who participate in the 34.4three-yearalternative quality assurancepilotproject 34.5 established in section 256B.095 from the requirements of 34.6 Minnesota Rules, chapter 4665, upon approval by the federal34.7government of a waiver of federal certification requirements for34.8ICFs/MR. 34.9 Sec. 13. Minnesota Statutes 2001 Supplement, section 34.10 256B.0951, subdivision 8, is amended to read: 34.11 Subd. 8. [FEDERAL WAIVER.] The commissioner of human 34.12 services shall seekfederal authority to waive provisions of34.13intermediate care facilities for persons with mental retardation34.14(ICFs/MR) regulations to enable the demonstration and evaluation34.15of the alternative quality assurance system for ICFs/MR under34.16the project. The commissioner of human services shall apply for34.17any necessary waivers as soon as practicable.a federal waiver 34.18 to allow intermediate care facilities for persons with mental 34.19 retardation (ICFs/MR) in Region 10 of Minnesota to participate 34.20 in the alternative licensing system. If it is necessary for 34.21 purposes of participation in this alternative licensing system 34.22 for a facility to be decertified as an ICF/MR facility according 34.23 to the terms of the federal waiver, when the facility seeks 34.24 recertification under the provisions of ICF/MR regulations at 34.25 the end of the demonstration project, it will not be considered 34.26 a new ICF/MR as defined under section 252.291 provided the 34.27 licensed capacity of the facility did not increase during its 34.28 participation in the alternative licensing system. The 34.29 provisions of sections 252.82, 252.292, and 256B.5011 to 34.30 256B.5015 will remain applicable for counties in Region 10 of 34.31 Minnesota and the ICFs/MR located within those counties 34.32 notwithstanding a county's participation in the alternative 34.33 licensing system. 34.34 Sec. 14. Minnesota Statutes 2001 Supplement, section 34.35 256B.437, subdivision 6, is amended to read: 34.36 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 35.1 commissioner of human services shall calculate the amount of the 35.2 planned closure rate adjustment available under subdivision 3, 35.3 paragraph (b), for up to 5,140 beds according to clauses (1) to 35.4 (4): 35.5 (1) the amount available is the net reduction of nursing 35.6 facility beds multiplied by $2,080; 35.7 (2) the total number of beds in the nursing facility or 35.8 facilities receiving the planned closure rate adjustment must be 35.9 identified; 35.10 (3) capacity days are determined by multiplying the number 35.11 determined under clause (2) by 365; and 35.12 (4) the planned closure rate adjustment is the amount 35.13 available in clause (1), divided by capacity days determined 35.14 under clause (3). 35.15 (b) A planned closure rate adjustment under this section is 35.16 effective on the first day of the month following completion of 35.17 closure of the facility designated for closure in the 35.18 application and becomes part of the nursing facility's total 35.19 operating payment rate. 35.20 (c) Applicants may use the planned closure rate adjustment 35.21 to allow for a property payment for a new nursing facility or an 35.22 addition to an existing nursing facility or as an operating 35.23 payment rate adjustment. Applications approved under this 35.24 subdivision are exempt from other requirements for moratorium 35.25 exceptions under section 144A.073, subdivisions 2 and 3. 35.26 (d) Upon the request of a closing facility, the 35.27 commissioner must allow the facility a closure rate adjustment 35.28 as provided under section 144A.161, subdivision 10. 35.29 (e) A facility that has received a planned closure rate 35.30 adjustment may reassign it to another facility that is under the 35.31 same ownership at any time within three years of its effective 35.32 date. The amount of the adjustment shall be computed according 35.33 to paragraph (a). 35.34 Sec. 15. [CASE MANAGEMENT STUDY.] 35.35 The commissioner of human services shall study case 35.36 management services for persons with disabilities, in 36.1 consultation with consumers, consumer advocates, and local 36.2 social service agencies. The commissioner shall report to the 36.3 chairs and ranking minority members of the house and senate 36.4 committees having jurisdiction over health and human services 36.5 policy and funding, by January 15, 2003, on strategies that: 36.6 (1) streamline administration; 36.7 (2) improve case management service availability across the 36.8 state; 36.9 (3) enhance consumer access to needed services and 36.10 supports; 36.11 (4) improve accountability and the use of performance 36.12 measures; 36.13 (5) provide for consumer choice of vendor; and 36.14 (6) improve the financing of case management services. 36.15 [EFFECTIVE DATE.] This section is effective the day 36.16 following final enactment. 36.17 ARTICLE 2 36.18 LICENSING 36.19 Section 1. Minnesota Statutes 2001 Supplement, section 36.20 245A.04, subdivision 3b, is amended to read: 36.21 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 36.22 individual who is the subject of the disqualification may 36.23 request a reconsideration of the disqualification. 36.24 The individual must submit the request for reconsideration 36.25 to the commissioner in writing. A request for reconsideration 36.26 for an individual who has been sent a notice of disqualification 36.27 under subdivision 3a, paragraph (b), clause (1) or (2), must be 36.28 submitted within 30 calendar days of the disqualified 36.29 individual's receipt of the notice of disqualification. Upon 36.30 showing that the information in clause (1) or (2) cannot be 36.31 obtained within 30 days, the disqualified individual may request 36.32 additional time, not to exceed 30 days, to obtain that 36.33 information. A request for reconsideration for an individual 36.34 who has been sent a notice of disqualification under subdivision 36.35 3a, paragraph (b), clause (3), must be submitted within 15 36.36 calendar days of the disqualified individual's receipt of the 37.1 notice of disqualification. An individual who was determined to 37.2 have maltreated a child under section 626.556 or a vulnerable 37.3 adult under section 626.557, and who was disqualified under this 37.4 section on the basis of serious or recurring maltreatment, may 37.5 request reconsideration of both the maltreatment and the 37.6 disqualification determinations. The request for 37.7 reconsideration of the maltreatment determination and the 37.8 disqualification must be submitted within 30 calendar days of 37.9 the individual's receipt of the notice of disqualification. 37.10 Removal of a disqualified individual from direct contact shall 37.11 be ordered if the individual does not request reconsideration 37.12 within the prescribed time, and for an individual who submits a 37.13 timely request for reconsideration, if the disqualification is 37.14 not set aside. The individual must present information showing 37.15 that: 37.16 (1) the information the commissioner relied upon is 37.17 incorrect or inaccurate. If the basis of a reconsideration 37.18 request is that a maltreatment determination or disposition 37.19 under section 626.556 or 626.557 is incorrect, and the 37.20 commissioner has issued a final order in an appeal of that 37.21 determination or disposition under section 256.045 or 245A.08, 37.22 subdivision 5, the commissioner's order is conclusive on the 37.23 issue of maltreatment. If the individual did not request 37.24 reconsideration of the maltreatment determination, the 37.25 maltreatment determination is deemed conclusive; or 37.26 (2) the subject of the study does not pose a risk of harm 37.27 to any person served by the applicant, license holder, or 37.28 registrant under section 144A.71, subdivision 1. 37.29 (b) The commissioner shall rescind the disqualification if 37.30 the commissioner finds that the information relied on to 37.31 disqualify the subject is incorrect. The commissioner may set 37.32 aside the disqualification under this section if the 37.33 commissioner finds that the individual does not pose a risk of 37.34 harm to any person served by the applicant, license holder, or 37.35 registrant under section 144A.71, subdivision 1. In determining 37.36 that an individual does not pose a risk of harm, the 38.1 commissioner shall consider the nature, severity, and 38.2 consequences of the event or events that lead to 38.3 disqualification, whether there is more than one disqualifying 38.4 event, the age and vulnerability of the victim at the time of 38.5 the event, the harm suffered by the victim, the similarity 38.6 between the victim and persons served by the program, the time 38.7 elapsed without a repeat of the same or similar event, 38.8 documentation of successful completion by the individual studied 38.9 of training or rehabilitation pertinent to the event, and any 38.10 other information relevant to reconsideration. In reviewing a 38.11 disqualification under this section, the commissioner shall give 38.12 preeminent weight to the safety of each person to be served by 38.13 the license holder, applicant, or registrant under section 38.14 144A.71, subdivision 1, over the interests of the license 38.15 holder, applicant, or registrant under section 144A.71, 38.16 subdivision 1. 38.17 (c) Unless the information the commissioner relied on in 38.18 disqualifying an individual is incorrect, the commissioner may 38.19 not set aside the disqualification of an individualin38.20connection with a license to provide family day care for38.21children, foster care for children in the provider's own home,38.22or foster care or day care services for adults in the provider's38.23own homeif: 38.24 (1) less than ten years have passed since the discharge of 38.25 the sentence imposed for the offense; and the individual has 38.26 been convicted of a violation of any offense listed in sections 38.27609.20 (manslaughter in the first degree), 609.205 (manslaughter38.28in the second degree), criminal vehicular homicide under 609.2138.29(criminal vehicular homicide and injury),609.215 (aiding 38.30 suicide or aiding attempted suicide), felony violations under 38.31609.221 to609.2231 (assault in thefirst, second, third, or38.32 fourth degree), 609.713 (terroristic threats),609.235 (use of38.33drugs to injure or to facilitate crime), 609.24 (simple38.34robbery), 609.245 (aggravated robbery), 609.25 (kidnapping),38.35609.255 (false imprisonment), 609.561 or 609.562 (arson in the38.36first or second degree),609.71 (riot), burglary in thefirst or39.1 second degree under 609.582 (burglary), 609.66 (dangerous 39.2 weapon), 609.665 (spring guns), 609.67 (machine guns and 39.3 short-barreled shotguns),609.749 (harassment; stalking),39.4152.021 or 152.022 (controlled substance crime in the first or39.5second degree), 152.023, subdivision 1, clause (3) or (4), or39.6subdivision 2, clause (4) (controlled substance crime in the39.7third degree), 152.024, subdivision 1, clause (2), (3), or (4)39.8(controlled substance crime in the fourth degree),152.024 or 39.9 152.025 (controlled substance crime in the fourth or fifth 39.10 degree), 609.224, subdivision 2, paragraph (c) (fifth-degree 39.11 assault by a caregiver against a vulnerable adult),609.22839.12(great bodily harm caused by distribution of drugs),609.23 39.13 (mistreatment of persons confined), 609.231 (mistreatment of 39.14 residents or patients), 609.2325 (criminal abuse of a vulnerable 39.15 adult), 609.233 (criminal neglect of a vulnerable adult), 39.16 609.2335 (financial exploitation of a vulnerable adult), 609.234 39.17 (failure to report), 609.265 (abduction),609.2664 to 609.266539.18(manslaughter of an unborn child in the first or second degree),39.19609.267 to609.2672 (assault of an unborn child in thefirst,39.20second, orthird degree),609.268 (injury or death of an unborn39.21child in the commission of a crime),617.293 (disseminating or 39.22 displaying harmful material to minors), a felony level 39.23 conviction involving alcohol or drug use, a gross misdemeanor 39.24 offense under 609.324, subdivision 1 (other prohibited acts),a39.25gross misdemeanor offense under 609.378 (neglect or endangerment39.26of a child), a gross misdemeanor offense under 609.37739.27(malicious punishment of a child),609.72, subdivision 3 39.28 (disorderly conduct against a vulnerable adult); or an attempt 39.29 or conspiracy to commit any of these offenses, as each of these 39.30 offenses is defined in Minnesota Statutes; or an offense in any 39.31 other state, the elements of which are substantially similar to 39.32 the elements of any of the foregoing offenses; 39.33 (2) regardless of how much time has passed since the 39.34 involuntary termination of parental rights under section 39.35 260C.301 or the discharge of the sentence imposed for the 39.36 offense, the individual was convicted of a violation of any 40.1 offense listed in sections 609.185 to 609.195 (murder in the 40.2 first, second, or third degree), 609.20 (manslaughter in the 40.3 first degree), 609.205 (manslaughter in the second degree), 40.4 criminal vehicular homicide under 609.21 (criminal vehicular 40.5 homicide and injury), 609.235 (use of drugs to injure or to 40.6 facilitate crime), 609.24 (simple robbery), 609.245 (aggravated 40.7 robbery), 609.25 (kidnapping), 609.255 (false imprisonment), 40.8 609.561 or 609.562 (arson in the first or second degree), 40.9 609.749 (harassment; stalking), 609.228 (great bodily harm 40.10 caused by distribution of drugs), 609.2664 to 609.2665 40.11 (manslaughter of an unborn child in the first or second degree), 40.12 609.267 or 609.2671 (assault of an unborn child in the first or 40.13 second degree), 609.268 (injury or death of an unborn child in 40.14 the commission of a crime), 609.221 to 609.223 (assault in the 40.15 first, second, or third degree), 609.582 (burglary in the first 40.16 degree), 609.66, subdivision 1e (drive-by shooting), 609.165 40.17 (felon ineligible to possess firearm), 609.498, subdivision 1 40.18 (tampering with a witness), 609.687 (adulteration), 609.855, 40.19 subdivision 5 (shooting in or at a public transit vehicle or 40.20 facility), 609.229 (crime committed for benefit of a gang), 40.21 609.2661 to 609.2663 (murder of an unborn child in the first, 40.22 second, or third degree),a felony offense under609.377 40.23 (malicious punishment of a child), a felony offense under 40.24 609.324, subdivision 1 (other prohibited acts),a felony offense40.25under609.378 (neglect or endangerment of a child), 609.322 40.26 (solicitation, inducement, and promotion of prostitution), 40.27 609.342 to 609.345 (criminal sexual conduct in the first, 40.28 second, third, or fourth degree), 609.352 (solicitation of 40.29 children to engage in sexual conduct), 617.246 (use of minors in 40.30 a sexual performance), 617.247 (possession of pictorial 40.31 representations of a minor), 609.365 (incest), a felony offense 40.32 under sections 609.2242 and 609.2243 (domestic assault), a 40.33 felony offense under 624.713 (certain persons not to possess 40.34 pistols), 152.021, 152.022, or 152.023 (controlled substance 40.35 crime in the first, second, or third degree), a felony offense 40.36 of spousal abuse, a felony offense of child abuse or neglect, a 41.1 felony offense of a crime against children, or an attempt or 41.2 conspiracy to commit any of these offenses as defined in 41.3 Minnesota Statutes, or an offense in any other state, the 41.4 elements of which are substantially similar to any of the 41.5 foregoing offenses; 41.6 (3) within the seven years preceding the study, the 41.7 individual committed an act that constitutes maltreatment of a 41.8 child under section 626.556, subdivision 10e, and that resulted 41.9 in substantial bodily harm as defined in section 609.02, 41.10 subdivision 7a, or substantial mental or emotional harm as 41.11 supported by competent psychological or psychiatric evidence; or 41.12 (4) within the seven years preceding the study, the 41.13 individual was determined under section 626.557 to be the 41.14 perpetrator of a substantiated incident of maltreatment of a 41.15 vulnerable adult that resulted in substantial bodily harm as 41.16 defined in section 609.02, subdivision 7a, or substantial mental 41.17 or emotional harm as supported by competent psychological or 41.18 psychiatric evidence. 41.19 In the case of any ground for disqualification under 41.20 clauses (1) to (4), if the act was committed by an individual 41.21 other than the applicant, license holder, or registrant under 41.22 section 144A.71, subdivision 1, residing in the applicant's or 41.23 license holder's home, or the home of a registrant under section 41.24 144A.71, subdivision 1, the applicant, license holder, or 41.25 registrant under section 144A.71, subdivision 1, may seek 41.26 reconsideration when the individual who committed the act no 41.27 longer resides in the home. 41.28 The disqualification periods provided under clauses (1), 41.29 (3), and (4) are the minimum applicable disqualification 41.30 periods. The commissioner may determine that an individual 41.31 should continue to be disqualified from licensure or 41.32 registration under section 144A.71, subdivision 1, because the 41.33 license holder, applicant, or registrant under section 144A.71, 41.34 subdivision 1, poses a risk of harm to a person served by that 41.35 individual after the minimum disqualification period has passed. 41.36 (d) The commissioner shall respond in writing or by 42.1 electronic transmission to all reconsideration requests for 42.2 which the basis for the request is that the information relied 42.3 upon by the commissioner to disqualify is incorrect or 42.4 inaccurate within 30 working days of receipt of a request and 42.5 all relevant information. If the basis for the request is that 42.6 the individual does not pose a risk of harm, the commissioner 42.7 shall respond to the request within 15 working days after 42.8 receiving the request for reconsideration and all relevant 42.9 information. If the request is based on both the correctness or 42.10 accuracy of the information relied on to disqualify the 42.11 individual and the risk of harm, the commissioner shall respond 42.12 to the request within 45 working days after receiving the 42.13 request for reconsideration and all relevant information. If 42.14 the disqualification is set aside, the commissioner shall notify 42.15 the applicant or license holder in writing or by electronic 42.16 transmission of the decision. 42.17 (e) Except as provided in subdivision 3c, if a 42.18 disqualification is not set aside or is not rescinded, an 42.19 individual who was disqualified on the basis of a preponderance 42.20 of evidence that the individual committed an act or acts that 42.21 meet the definition of any of the crimes lists in subdivision 42.22 3d, paragraph (a), clauses (1) to (4); or for failure to make 42.23 required reports under section 626.556, subdivision 3, or 42.24 626.557, subdivision 3, pursuant to subdivision 3d, paragraph 42.25 (a), clause (4), may request a fair hearing under section 42.26 256.045. Except as provided under subdivision 3c, the 42.27 commissioner's final order for an individual under this 42.28 paragraph is conclusive on the issue of maltreatment and 42.29 disqualification, including for purposes of subsequent studies 42.30 conducted under subdivision 3, and is the only administrative 42.31 appeal of the final agency determination, specifically, 42.32 including a challenge to the accuracy and completeness of data 42.33 under section 13.04. 42.34 (f) Except as provided under subdivision 3c, if an 42.35 individual was disqualified on the basis of a determination of 42.36 maltreatment under section 626.556 or 626.557, which was serious 43.1 or recurring, and the individual has requested reconsideration 43.2 of the maltreatment determination under section 626.556, 43.3 subdivision 10i, or 626.557, subdivision 9d, and also requested 43.4 reconsideration of the disqualification under this subdivision, 43.5 reconsideration of the maltreatment determination and 43.6 reconsideration of the disqualification shall be consolidated 43.7 into a single reconsideration. For maltreatment and 43.8 disqualification determinations made by county agencies, the 43.9 consolidated reconsideration shall be conducted by the county 43.10 agency. Except as provided under subdivision 3c, if an 43.11 individual who was disqualified on the basis of serious or 43.12 recurring maltreatment requests a fair hearing on the 43.13 maltreatment determination under section 626.556, subdivision 43.14 10i, or 626.557, subdivision 9d, the scope of the fair hearing 43.15 under section 256.045 shall include the maltreatment 43.16 determination and the disqualification. Except as provided 43.17 under subdivision 3c, the commissioner's final order for an 43.18 individual under this paragraph is conclusive on the issue of 43.19 maltreatment and disqualification, including for purposes of 43.20 subsequent studies conducted under subdivision 3, and is the 43.21 only administrative appeal of the final agency determination, 43.22 specifically, including a challenge to the accuracy and 43.23 completeness of data under section 13.04. 43.24 Sec. 2. Minnesota Statutes 2001 Supplement, section 43.25 245A.04, subdivision 3d, is amended to read: 43.26 Subd. 3d. [DISQUALIFICATION.] (a) Upon receipt of 43.27 information showing, or when a background study completed under 43.28 subdivision 3 shows any of the following: a conviction of one 43.29 or more crimes listed in clauses (1) to (4); the individual has 43.30 admitted to or a preponderance of the evidence indicates the 43.31 individual has committed an act or acts that meet the definition 43.32 of any of the crimes listed in clauses (1) to (4); or an 43.33 investigation results in an administrative determination listed 43.34 under clause (4), the individual shall be disqualified from any 43.35 position allowing direct contact with persons receiving services 43.36 from the license holder, entity identified in subdivision 3, 44.1 paragraph (a), or registrant under section 144A.71, subdivision 44.2 1, and for individuals studied under section 245A.04, 44.3 subdivision 3, paragraph (c), clauses (2), (6), and (7), the 44.4 individual shall also be disqualified from access to a person 44.5 receiving services from the license holder: 44.6 (1) regardless of how much time has passed since the 44.7 involuntary termination of parental rights under section 44.8 260C.301 or the discharge of the sentence imposed for the 44.9 offense, and unless otherwise specified, regardless of the level 44.10 of the conviction, the individual was convicted of any of the 44.11 following offenses: sections 609.185 (murder in the first 44.12 degree); 609.19 (murder in the second degree); 609.195 (murder 44.13 in the third degree); 609.2661 (murder of an unborn child in the 44.14 first degree); 609.2662 (murder of an unborn child in the second 44.15 degree); 609.2663 (murder of an unborn child in the third 44.16 degree); 609.20 (manslaughter in the first degree); 609.205 44.17 (manslaughter in the second degree); 609.21 (criminal vehicular 44.18 homicide and injury); 609.221 to 609.223 (assault in the first, 44.19 second, or third degree); 609.228 (great bodily harm caused by 44.20 distribution of drugs); 609.235 (use of drugs to injure or 44.21 facilitate crime); 609.24 (simple robbery); 609.245 (aggravated 44.22 robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 44.23 609.267 (assault of an unborn child in the first degree); 44.24 609.2671 (assault of an unborn child in the second degree); 44.25 609.268 (injury or death of an unborn child in the commission of 44.26 a crime); 609.561 (arson in the first degree); 609.562 (arson in 44.27 the second degree); 609.582 (burglary); 609.749 (harassment; 44.28 stalking; penalties); 609.165 (felon ineligible to possess 44.29 firearm); 609.66, subdivision 1e (drive-by shooting); 609.687 44.30 (adulteration); 609.855, subdivision 5 (shooting at or in a 44.31 public transit vehicle or facility); felony offense under 44.32 624.713 (certain persons not to possess pistols); 609.229 (crime 44.33 committed for benefit of a gang); 609.498, subdivision 1 44.34 (tampering with a witness); 609.2664 (manslaughter of an unborn 44.35 child in the first degree); 609.2665 (manslaughter of an unborn 44.36 child in the second degree); 152.021, 152.022, or 152.023 45.1 (controlled substance crime in the first, second, or third 45.2 degree); 609.322 (solicitation, inducement, and promotion of 45.3 prostitution); 609.342 (criminal sexual conduct in the first 45.4 degree); 609.343 (criminal sexual conduct in the second degree); 45.5 609.344 (criminal sexual conduct in the third degree); 609.345 45.6 (criminal sexual conduct in the fourth degree); 609.352 45.7 (solicitation of children to engage in sexual conduct); 609.365 45.8 (incest);felony offense under609.377 (malicious punishment of 45.9 a child);a felony offense under609.378 (neglect or 45.10 endangerment of a child); a felony offense under 609.324, 45.11 subdivision 1 (other prohibited acts); 617.246 (use of minors in 45.12 sexual performance prohibited); 617.247 (possession of pictorial 45.13 representations of minors); a felony offense under sections 45.14 609.2242 and 609.2243 (domestic assault), a felony offense of 45.15 spousal abuse, a felony offense of child abuse or neglect, a 45.16 felony offense of a crime against children; or attempt or 45.17 conspiracy to commit any of these offenses as defined in 45.18 Minnesota Statutes, or an offense in any other state or country, 45.19 where the elements are substantially similar to any of the 45.20 offenses listed in this clause; 45.21 (2) if less than 15 years have passed since the discharge 45.22 of the sentence imposed for the offense; and the individual has 45.23 received a felony conviction for a violation of any of these 45.24 offenses: sections609.20 (manslaughter in the first degree);45.25609.205 (manslaughter in the second degree); 609.21 (criminal45.26vehicular homicide and injury);609.215 (suicide);609.221 to45.27 609.2231 (assault in thefirst, second, third, orfourth 45.28 degree); repeat offenses under 609.224 (assault in the fifth 45.29 degree); repeat offenses under 609.3451 (criminal sexual conduct 45.30 in the fifth degree); 609.713 (terroristic threats);609.23545.31(use of drugs to injure or facilitate crime); 609.24 (simple45.32robbery); 609.245 (aggravated robbery); 609.25 (kidnapping);45.33609.255 (false imprisonment); 609.561 (arson in the first45.34degree); 609.562 (arson in the second degree);609.563 (arson in 45.35 the third degree); repeat offenses under 617.23 (indecent 45.36 exposure; penalties); repeat offenses under 617.241 (obscene 46.1 materials and performances; distribution and exhibition 46.2 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 46.3 609.67 (machine guns and short-barreled shotguns);609.74946.4(harassment; stalking; penalties); 609.228 (great bodily harm46.5caused by distribution of drugs);609.2325 (criminal abuse of a 46.6 vulnerable adult);609.2664 (manslaughter of an unborn child in46.7the first degree); 609.2665 (manslaughter of an unborn child in46.8the second degree); 609.267 (assault of an unborn child in the46.9first degree); 609.2671 (assault of an unborn child in the46.10second degree); 609.268 (injury or death of an unborn child in46.11the commission of a crime);609.52 (theft); 609.2335 (financial 46.12 exploitation of a vulnerable adult); 609.521 (possession of 46.13 shoplifting gear);609.582 (burglary);609.625 (aggravated 46.14 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 46.15 forged check); 609.635 (obtaining signature by false pretense); 46.16 609.27 (coercion); 609.275 (attempt to coerce); 609.687 46.17 (adulteration); 260C.301 (grounds for termination of parental 46.18 rights);chapter 152 (drugs; controlled substance);152.024 or 46.19 152.025 (controlled substance crime in the fourth or fifth 46.20 degree); and a felony level conviction involving alcohol or drug 46.21 use. An attempt or conspiracy to commit any of these offenses, 46.22 as each of these offenses is defined in Minnesota Statutes; or 46.23 an offense in any other state or country, the elements of which 46.24 are substantially similar to the elements of the offenses in 46.25 this clause. If the individual studied is convicted of one of 46.26 the felonies listed in this clause, but the sentence is a gross 46.27 misdemeanor or misdemeanor disposition, the lookback period for 46.28 the conviction is the period applicable to the disposition, that 46.29 is the period for gross misdemeanors or misdemeanors; 46.30 (3) if less than ten years have passed since the discharge 46.31 of the sentence imposed for the offense; and the individual has 46.32 received a gross misdemeanor conviction for a violation of any 46.33 of the following offenses: sections 609.224 (assault in the 46.34 fifth degree); 609.2242 and 609.2243 (domestic assault); 46.35 violation of an order for protection under 518B.01, subdivision 46.36 14; 609.3451 (criminal sexual conduct in the fifth degree); 47.1 repeat offenses under 609.746 (interference with privacy); 47.2 repeat offenses under 617.23 (indecent exposure); 617.241 47.3 (obscene materials and performances); 617.243 (indecent 47.4 literature, distribution); 617.293 (harmful materials; 47.5 dissemination and display to minors prohibited); 609.71 (riot); 47.6 609.66 (dangerous weapons);609.749 (harassment; stalking;47.7penalties);609.224, subdivision 2, paragraph (c) (assault in 47.8 the fifth degree by a caregiver against a vulnerable adult); 47.9 609.23 (mistreatment of persons confined); 609.231 (mistreatment 47.10 of residents or patients); 609.2325 (criminal abuse of a 47.11 vulnerable adult); 609.233 (criminal neglect of a vulnerable 47.12 adult); 609.2335 (financial exploitation of a vulnerable adult); 47.13 609.234 (failure to report maltreatment of a vulnerable adult); 47.14 609.72, subdivision 3 (disorderly conduct against a vulnerable 47.15 adult); 609.265 (abduction);609.378 (neglect or endangerment of47.16a child); 609.377 (malicious punishment of a child);609.324, 47.17 subdivision 1a (other prohibited acts; minor engaged in 47.18 prostitution); 609.33 (disorderly house); 609.52 (theft); 47.19609.582 (burglary);609.631 (check forgery; offering a forged 47.20 check); 609.275 (attempt to coerce); or an attempt or conspiracy 47.21 to commit any of these offenses, as each of these offenses is 47.22 defined in Minnesota Statutes; or an offense in any other state 47.23 or country, the elements of which are substantially similar to 47.24 the elements of any of the offenses listed in this clause. If 47.25 the defendant is convicted of one of the gross misdemeanors 47.26 listed in this clause, but the sentence is a misdemeanor 47.27 disposition, the lookback period for the conviction is the 47.28 period applicable to misdemeanors; or 47.29 (4) if less than seven years have passed since the 47.30 discharge of the sentence imposed for the offense; and the 47.31 individual has received a misdemeanor conviction for a violation 47.32 of any of the following offenses: sections 609.224 (assault in 47.33 the fifth degree); 609.2242 (domestic assault); violation of an 47.34 order for protection under 518B.01 (Domestic Abuse Act); 47.35 violation of an order for protection under 609.3232 (protective 47.36 order authorized; procedures; penalties); 609.746 (interference 48.1 with privacy); 609.79 (obscene or harassing phone calls); 48.2 609.795 (letter, telegram, or package; opening; harassment); 48.3 617.23 (indecent exposure; penalties); 609.2672 (assault of an 48.4 unborn child in the third degree); 617.293 (harmful materials; 48.5 dissemination and display to minors prohibited); 609.66 48.6 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 48.7 exploitation of a vulnerable adult); 609.234 (failure to report 48.8 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 48.9 (coercion); or an attempt or conspiracy to commit any of these 48.10 offenses, as each of these offenses is defined in Minnesota 48.11 Statutes; or an offense in any other state or country, the 48.12 elements of which are substantially similar to the elements of 48.13 any of the offenses listed in this clause; a determination or 48.14 disposition of failure to make required reports under section 48.15 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 48.16 in which: (i) the final disposition under section 626.556 or 48.17 626.557 was substantiated maltreatment, and (ii) the 48.18 maltreatment was recurring or serious; or a determination or 48.19 disposition of substantiated serious or recurring maltreatment 48.20 of a minor under section 626.556 or of a vulnerable adult under 48.21 section 626.557 for which there is a preponderance of evidence 48.22 that the maltreatment occurred, and that the subject was 48.23 responsible for the maltreatment. 48.24 For the purposes of this section, "serious maltreatment" 48.25 means sexual abuse; maltreatment resulting in death; or 48.26 maltreatment resulting in serious injury which reasonably 48.27 requires the care of a physician whether or not the care of a 48.28 physician was sought; or abuse resulting in serious injury. For 48.29 purposes of this section, "abuse resulting in serious injury" 48.30 means: bruises, bites, skin laceration or tissue damage; 48.31 fractures; dislocations; evidence of internal injuries; head 48.32 injuries with loss of consciousness; extensive second-degree or 48.33 third-degree burns and other burns for which complications are 48.34 present; extensive second-degree or third-degree frostbite, and 48.35 others for which complications are present; irreversible 48.36 mobility or avulsion of teeth; injuries to the eyeball; 49.1 ingestion of foreign substances and objects that are harmful; 49.2 near drowning; and heat exhaustion or sunstroke. For purposes 49.3 of this section, "care of a physician" is treatment received or 49.4 ordered by a physician, but does not include diagnostic testing, 49.5 assessment, or observation. For the purposes of this section, 49.6 "recurring maltreatment" means more than one incident of 49.7 maltreatment for which there is a preponderance of evidence that 49.8 the maltreatment occurred, and that the subject was responsible 49.9 for the maltreatment. For purposes of this section, "access" 49.10 means physical access to an individual receiving services or the 49.11 individual's personal property without continuous, direct 49.12 supervision as defined in section 245A.04, subdivision 3. 49.13 (b) Except for background studies related to child foster 49.14 care, adult foster care, or family child care licensure, when 49.15 the subject of a background study is regulated by a 49.16 health-related licensing board as defined in chapter 214, and 49.17 the regulated person has been determined to have been 49.18 responsible for substantiated maltreatment under section 626.556 49.19 or 626.557, instead of the commissioner making a decision 49.20 regarding disqualification, the board shall make a determination 49.21 whether to impose disciplinary or corrective action under 49.22 chapter 214. 49.23 (1) The commissioner shall notify the health-related 49.24 licensing board: 49.25 (i) upon completion of a background study that produces a 49.26 record showing that the individual was determined to have been 49.27 responsible for substantiated maltreatment; 49.28 (ii) upon the commissioner's completion of an investigation 49.29 that determined the individual was responsible for substantiated 49.30 maltreatment; or 49.31 (iii) upon receipt from another agency of a finding of 49.32 substantiated maltreatment for which the individual was 49.33 responsible. 49.34 (2) The commissioner's notice shall indicate whether the 49.35 individual would have been disqualified by the commissioner for 49.36 the substantiated maltreatment if the individual were not 50.1 regulated by the board. The commissioner shall concurrently 50.2 send this notice to the individual. 50.3 (3) Notwithstanding the exclusion from this subdivision for 50.4 individuals who provide child foster care, adult foster care, or 50.5 family child care, when the commissioner or a local agency has 50.6 reason to believe that the direct contact services provided by 50.7 the individual may fall within the jurisdiction of a 50.8 health-related licensing board, a referral shall be made to the 50.9 board as provided in this section. 50.10 (4) If, upon review of the information provided by the 50.11 commissioner, a health-related licensing board informs the 50.12 commissioner that the board does not have jurisdiction to take 50.13 disciplinary or corrective action, the commissioner shall make 50.14 the appropriate disqualification decision regarding the 50.15 individual as otherwise provided in this chapter. 50.16 (5) The commissioner has the authority to monitor the 50.17 facility's compliance with any requirements that the 50.18 health-related licensing board places on regulated persons 50.19 practicing in a facility either during the period pending a 50.20 final decision on a disciplinary or corrective action or as a 50.21 result of a disciplinary or corrective action. The commissioner 50.22 has the authority to order the immediate removal of a regulated 50.23 person from direct contact or access when a board issues an 50.24 order of temporary suspension based on a determination that the 50.25 regulated person poses an immediate risk of harm to persons 50.26 receiving services in a licensed facility. 50.27 (6) A facility that allows a regulated person to provide 50.28 direct contact services while not complying with the 50.29 requirements imposed by the health-related licensing board is 50.30 subject to action by the commissioner as specified under 50.31 sections 245A.06 and 245A.07. 50.32 (7) The commissioner shall notify a health-related 50.33 licensing board immediately upon receipt of knowledge of 50.34 noncompliance with requirements placed on a facility or upon a 50.35 person regulated by the board. 50.36 Sec. 3. Minnesota Statutes 2000, section 245B.02, 51.1 subdivision 10, is amended to read: 51.2 Subd. 10. [INCIDENT.] "Incident" means any of the 51.3 following: 51.4 (1) serious injury as determined by section 245.91, 51.5 subdivision 6;accident; reports of a child or vulnerable adult51.6maltreatment; circumstances that involve a law enforcement51.7agency; or51.8 (2) a consumer's death; 51.9 (3) any medical emergencies, unexpected serious illnesses, 51.10 or accidents that require physician treatment or 51.11 hospitalization; 51.12 (4) a consumer's unauthorized absence; 51.13 (5) any fires or other circumstances involving a law 51.14 enforcement agency; 51.15 (6) physical aggression by a consumer against another 51.16 consumer that causes physical pain, injury, or persistent 51.17 emotional distress, including, but not limited to, hitting, 51.18 slapping, kicking, scratching, pinching, biting, pushing, and 51.19 spitting; 51.20 (7) any sexual activity between consumers involving force 51.21 or coercion as defined under section 609.341, subdivisions 3 and 51.22 14; or 51.23 (8) a report of child or vulnerable adult maltreatment 51.24 under section 626.556 or 626.557. 51.25 Sec. 4. Minnesota Statutes 2000, section 245B.05, 51.26 subdivision 7, is amended to read: 51.27 Subd. 7. [REPORTING INCIDENTSAND EMERGENCIES.] (a) The 51.28 license holder must maintain information about and reportthe51.29followingincidents under section 245B.02, subdivision 10, 51.30 clauses (1) to (7), to the consumer's legal representative, 51.31 other licensed caregiver, if any, and case manager within 24 51.32 hours of the occurrence, or within 24 hours of receipt of the 51.33 information:51.34(1) the death of a consumer;51.35(2) any medical emergencies, unexpected serious illnesses,51.36or accidents that require physician treatment or52.1hospitalization;52.2(3) a consumer's unauthorized absence; or52.3(4) any fires and incidents involving a law enforcement52.4agencyunless the incident has been reported by another license 52.5 holder. An incident under section 245B.02, subdivision 10, 52.6 clause (8), must be reported as required under paragraph (c) 52.7 unless the incident has been reported by another license holder. 52.8 (b) When the incident involves more than one consumer, the 52.9 license holder must not disclose personally identifiable 52.10 information about any other consumer when making the report to 52.11 each consumer's legal representative, other licensed caregiver, 52.12 if any, and case manager unless the license holder has the 52.13 consent of a consumer or a consumer's legal representative. 52.14 (c) Within 24 hours of reporting maltreatment as required 52.15 under section 626.556 or 626.557, the license holder must inform 52.16 the consumer's legal representative and case manager of the 52.17 report unless there is reason to believe that the legal 52.18 representative or case manager is involved in the suspected 52.19 maltreatment. The information the license holder must disclose 52.20 is the nature of the activity or occurrence reported, the agency 52.21 that receives the report, and the telephone number of the 52.22 department of human services licensing division. 52.23 (d) Death or serious injury of the consumer must also be 52.24 reported to the department of human services licensing division 52.25 and the ombudsman, as required under sections 245.91 and 245.94, 52.26 subdivision 2a. 52.27 Sec. 5. Minnesota Statutes 2000, section 245B.07, 52.28 subdivision 1, is amended to read: 52.29 Subdivision 1. [CONSUMER DATA FILE.] The license holder 52.30 must maintain the following information for each consumer: 52.31 (1) identifying information that includes date of birth, 52.32 medications, legal representative, history, medical, and other 52.33 individual-specific information, and names and telephone numbers 52.34 of contacts; 52.35 (2) consumer health information, including individual 52.36 medication administration and monitoring information; 53.1 (3) the consumer's individual service plan. When a 53.2 consumer's case manager does not provide a current individual 53.3 service plan, the license holder shall make a written request to 53.4 the case manager to provide a copy of the individual service 53.5 plan and inform the consumer or the consumer's legal 53.6 representative of the right to an individual service plan and 53.7 the right to appeal under section 256.045; 53.8 (4) copies of assessments, analyses, summaries, and 53.9 recommendations; 53.10 (5) progress review reports; 53.11 (6)incident and emergency reportsincidents involving the 53.12 consumer; 53.13 (7) reports required under section 245B.05, subdivision 7; 53.14 (8) discharge summary, when applicable; 53.15(8)(9) record of other license holders serving the 53.16 consumer that includes a contact person and telephone numbers, 53.17 services being provided, services that require coordination 53.18 between two license holders, and name of staff responsible for 53.19 coordination;and53.20(9) incidents involving(10) information about verbaland53.21physicalaggressionbetween consumersdirected at the consumer 53.22 by another consumer; and 53.23 (11) information about self-abuseaffecting the consumer. 53.24 Sec. 6. Minnesota Statutes 2000, section 626.557, 53.25 subdivision 14, is amended to read: 53.26 Subd. 14. [ABUSE PREVENTION PLANS.] (a) Each facility, 53.27 except home health agencies and personal care attendant services 53.28 providers, shall establish and enforce an ongoing written abuse 53.29 prevention plan. The plan shall contain an assessment of the 53.30 physical plant, its environment, and its population identifying 53.31 factors which may encourage or permit abuse, and a statement of 53.32 specific measures to be taken to minimize the risk of abuse. 53.33 The plan shall comply with any rules governing the plan 53.34 promulgated by the licensing agency. 53.35 (b) Each facility, including a home health care agency and 53.36 personal care attendant services providers, shall develop an 54.1 individual abuse prevention plan for each vulnerable adult 54.2 residing there or receiving services from them. The plan shall 54.3 contain an individualized assessment of the person's 54.4 susceptibility to abuse by other individuals, including other 54.5 vulnerable adults, and a statement of the specific measures to 54.6 be taken to minimize the risk of abuse to that person. For the 54.7 purposes of this clause, the term "abuse" includes self-abuse. 54.8 ARTICLE 3 54.9 MISCELLANEOUS 54.10 Section 1. Minnesota Statutes 2000, section 144.05, is 54.11 amended by adding a subdivision to read: 54.12 Subd. 4. [IDENTIFICATION OF DECEASED INDIVIDUALS.] Upon 54.13 receiving notice under section 149A.90, subdivision 1, of the 54.14 death of an individual who cannot be identified, the 54.15 commissioner must post on the department's Web site information 54.16 regarding the individual for purposes of obtaining information 54.17 that may aid in identifying the individual and for purposes of 54.18 notifying relatives who may be seeking the individual. The 54.19 information must remain on the Web site continuously until the 54.20 person's identity is determined. 54.21 Sec. 2. Minnesota Statutes 2001 Supplement, section 54.22 149A.90, subdivision 1, is amended to read: 54.23 Subdivision 1. [DEATH RECORD.] (a) Except as provided in 54.24 this section, a death record must be completed and filed for 54.25 every known death by the mortician, funeral director, or other 54.26 person lawfully in charge of the disposition of the body. 54.27 (b) If the body is that of an individual whose identity is 54.28 unknown, the person in charge of the disposition of the body 54.29 must notify the commissioner for purposes of compliance with 54.30 section 144.05, subdivision 4. 54.31 Sec. 3. Minnesota Statutes 2000, section 150A.06, is 54.32 amended by adding a subdivision to read: 54.33 Subd. 2c. [GUEST LICENSE OR REGISTRATION.] (a) The board 54.34 shall grant a guest license to practice as a dentist or dental 54.35 hygienist or a guest registration to practice as a dental 54.36 assistant if the following conditions are met: 55.1 (1) the dentist, dental hygienist, or dental assistant is 55.2 currently licensed or registered in good standing in North 55.3 Dakota, South Dakota, Iowa, or Wisconsin; 55.4 (2) the dentist, dental hygienist, or dental assistant is 55.5 currently engaged in the practice of that person's respective 55.6 profession in North Dakota, South Dakota, Iowa, or Wisconsin; 55.7 (3) the dentist, dental hygienist, or dental assistant is 55.8 seeking to practice in a public health setting in Minnesota that 55.9 (i) is approved by the board; (ii) was established by a 55.10 nonprofit organization that is tax exempt under chapter 55.11 501(c)(3) of the Internal Revenue Code of 1986; and (iii) 55.12 provides dental care to patients who have difficulty accessing 55.13 dental care; 55.14 (4) the dentist, dental hygienist, or dental assistant 55.15 agrees to treat indigent patients who meet the eligibility 55.16 criteria established by the clinic; and 55.17 (5) the dentist, dental hygienist, or dental assistant has 55.18 applied to the board for a guest license or registration, 55.19 providing evidence of being currently licensed or registered in 55.20 good standing in North Dakota, South Dakota, Iowa, or Wisconsin, 55.21 and has paid a nonrefundable license fee to the board of $50. 55.22 (b) A dentist, dental hygienist, or dental assistant 55.23 practicing under a guest license or registration may only 55.24 practice at a single, specific location in Minnesota. A guest 55.25 license or registration must be renewed annually with the board 55.26 and an annual renewal fee of $50 must be paid to the board. If 55.27 the clinic in Minnesota at which a dentist, dental hygienist, or 55.28 dental assistant seeks to practice permanently ceases operation, 55.29 the guest license or registration issued under this subdivision 55.30 is automatically revoked. 55.31 [EFFECTIVE DATE.] This section is effective the day 55.32 following final enactment. 55.33 Sec. 4. Minnesota Statutes 2001 Supplement, section 55.34 256B.69, subdivision 5b, is amended to read: 55.35 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 55.36 prepaid medical assistance and general assistance medical care 56.1 program contract rates set by the commissioner under subdivision 56.2 5 and effective on or after January 1, 1998, capitation rates 56.3 for nonmetropolitan counties shall on a weighted average be no 56.4 less than 88 percent of the capitation rates for metropolitan 56.5 counties, excluding Hennepin county. The commissioner shall 56.6 make a pro rata adjustment in capitation rates paid to counties 56.7 other than nonmetropolitan counties in order to make this 56.8 provision budget neutral. The commissioner, in consultation 56.9 with a health care actuary, shall evaluate the regional rate 56.10 relationships based on actual health plan costs for Minnesota 56.11 health care programs. The commissioner may establish, based on 56.12 the actuary's recommendation, new rate regions that recognize 56.13 metropolitan areas outside of the seven-county metropolitan area. 56.14 (b) For prepaid medical assistance program contract rates 56.15 set by the commissioner under subdivision 5 and effective on or 56.16 after January 1, 2001, capitation rates for nonmetropolitan 56.17 counties shall, on a weighted average, be no less than 89 56.18 percent of the capitation rates for metropolitan counties, 56.19 excluding Hennepin county. 56.20 (c) This subdivision shall not affect the nongeographically 56.21 based risk adjusted rates established under section 62Q.03, 56.22 subdivision 5a. 56.23 Sec. 5. Minnesota Statutes 2000, section 261.063, is 56.24 amended to read: 56.25 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 56.26 PENALTY.] 56.27 (a) The board of county commissioners of each county shall 56.28 annually levy taxes and fix a rate sufficient to produce the 56.29 full amount required for poor relief, general assistance, 56.30 Minnesota family investment program, county share of county and 56.31 state supplemental aid to supplemental security income 56.32 applicants or recipients, and any other social security measures 56.33 wherein there is now or may hereafter be county participation, 56.34 sufficient to produce the full amount necessary for each such 56.35 item, including administrative expenses, for the ensuing year, 56.36 within the time fixed by law in addition to all other tax levies 57.1 and tax rates, however fixed or determined, and any commissioner 57.2 who shall fail to comply herewith shall be guilty of a gross 57.3 misdemeanor and shall be immediately removed from office by the 57.4 governor. For the purposes of this paragraph, "poor relief" 57.5 means county services provided under sections 261.035, 261.04, 57.6 and 261.21 to 261.231. 57.7 (b) Nothing within the provisions of this section shall be 57.8 construed as requiring a county agency to provide income support 57.9 or cash assistance to needy persons when they are no longer 57.10 eligible for assistance under general assistance, the Minnesota 57.11 family investment program, or Minnesota supplemental aid.